Postpartum Instructions After Vaginal Birth

GENERAL ACTIVITY

Your amount of activity can gradually increase, but try to avoid getting overly tired. Household activities should be resumed gradually, beginning with the easiest, and later adding the more difficult tasks. You should expect to be able to do almost all of your activities within 3-4 weeks. Try to rest as much as possible, for example take a daily nap the first few days. Try to sleep when the baby sleeps.

*Avoid driving for about 1-2 weeks, and do not drive if you are still taking pain medication. Being a passenger is okay. Do not begin driving until you feel that your reflexes are normal, and you can make fast or sudden movements without hesitation.

IN THE HOSPITAL

You will generally spend 1-2 nights in the hospital. We urge you to have someone who can sleep over in your room with you. This person can be very helpful in case the nurses are too busy. Just having someone close by to hand you something, get you some water, help you up to the restroom, or to call the nurse for you can make a big difference in your recovery.

DIET AND VITAMINS

In general, you may eat whatever you wish. Breastfeeding mothers tend to avoid spicy or odorous food such as garlic, onion, pepper, etc. You still need 3-4 servings per day of dairy or calcium supplementation. High fiber is helpful to maintain bowel regularity. Prenatal vitamins should still be taken once daily.

PAIN RELIEF

A prescription for pain medication will be written for you at the time of discharge home. Pain in the episiotomy area gets better quickly, usually within one week. Warm sitz baths (shallow warm bath), Tucks pads and Dermoplast spray (topical anesthetic available non-prescription) and Tylenol or Motrin may help.

A wonderful home care product called Hygenique Plus converts the toilet into a whirlpool sitz bath. It is available from Andermac, Inc. In some cases, it may be covered by insurance.
For more information, call 1-888-824-0214, or log on to www.hygenique.com.

HYGIENE

You may wash your hair, shower, or take warm hot sitz baths as you wish. Full tub bathing is okay as long as the tub has been carefully cleaned in advance. Continue perineal care as you have been instructed in the hospital, but do not douche, use tampons or resume intercourse before your SIX-WEEK postpartum visit.

VAGINAL BLEEDING/DISCHARGE

Some vaginal discharge or bleeding (“lochia”-initially red, later on pink to brown) will usually last for 3-5 weeks after giving birth, and occasionally longer. Use pads only, not tampons. With excessive activity the lochia may return to a redder color for a few days. The return of menses is variable. If you are nursing, you may not have any menses throughout the nursing period, or you may have random spotting. The 1st period may be from 6-8 weeks after cessation of nursing. On the other hand, you can have regular menses even while still breast-feeding.

If you are not nursing, the first period may be from 6-8 weeks after delivery. The first period can be unusually heavy with clots, and it may take a few months for regular menses to resume.

HEMORRHOIDS AND CONSTIPATION

Constipation is common postpartum, particularly while nursing (due to fluid losses). Please follow the same advice given during pregnancy. Prevention is the key. Drink plenty of water throughout the day. Have a good daily intake of fiber (fruits, vegetables and bran). For constipation, you can try prune juice, Metamucil or Citrucel (adds bulk), Colace (a mild laxative), or MOM (Milk of Magnesia). For hemorrhoids, we recommend fiber and bulk supplements to help produce soft stools (bran, bran and more bran), sitz baths at home, Preparation H or Anusol (with or without hydrocortisone), or Tucks pads.

EXERCISE

We recommend taking it easy the first week or two. Walking is good exercise initially. By 3-4 weeks you may be able to begin some stretching and mild exercises.

CARE AFTER CIRCUMCISION

The penis will be wrapped with Vaseline gauze. There will be a small amount of dark blood on the gauze – this is normal and expected. You should remove the gauze in about 48 hours. Apply a little Vaseline or A&D ointment first, and the gauze will easily slide off. It is okay if the gauze falls off before 48 hours. After the gauze is removed, the tip of the penis usually looks a bit red and swollen with some white or yellow secretions on it. For the next 2 weeks, apply Vaseline or A&D ointment liberally to the tip whenever you change the diaper. When the tip looks pink like normal skin, the area is fully healed, usually about 2 weeks after the procedure is done.

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