How You May Be Feeling
The process of labor and birth creates endorphins, nature's pain relief, and the elation of seeing your baby for the first time may have taken your mind off any aching areas. But now that the rush has worn off a little, you may find that you're tender and sore. Even something as simple as using the bathroom can be a real chore. This section covers some helpful tips for caring for your sore spots and making your first week after birth as comfortable as possible.
If you had a tear or episiotomy, you may find that your perineum is most sore the first to the third day after your baby is born. Even if you didn't tear and weren't cut, it's normal to feel some achiness in your bottom, particularly in the evening or when you're tired.
Between excess of breastmilk, the lochia that continues to flow for weeks after giving birth, and the extra sweat the body might still be producing to get rid of excess fluid from pregnancy, many mothers report feeling “leaky” for the first several weeks postpartum.
For a sore perineum, you'll want to alternate heat and cold therapy. Heat increases circulation, promoting healing, while cold decreases swelling and relieves pain. A nurse or other care provider may give you an ice pack for your perineum soon after delivery. When you get home, you can freeze wet maxi pads or fill rubber gloves or condoms with water and freeze them. A mix of one part alcohol to 4 parts water works well. It freezes into a slush, and adjusts to your shape better than plain frozen water. Wrap any frozen item in flannel or a wash cloth — don't put ice directly onto your skin!
Take a Bath
A warm bath can be soothing and healing for tender tissues. Your doctor or midwife may recommend holding off on a full submersion if you've had an especially deep tear or extensive episiotomy, since it can be more difficult to get in and out of the tub easily and safely. In these situations, you may be able to take a sitz bath, a shallow bath that just covers your bottom, instead. You can also use your peri bottle to squirt warm or cool water over your bottom area every time you use the bathroom.
Herbal baths are also a great way to achieve postpartum comfort. Try this recipe, hailed by midwives and herbalists for its healing and soothing properties:
2 parts comfrey leaf
1 part calendula flowers
1 part lavender flowers
1 part sea salt
Bring pot of water to boil. Turn off heat, put a large handful of herbal mix in the water, and steep for 20 to 30 minutes. Strain the herb “tea” into your bath using a fine strainer or cheesecloth (to keep the leaves out of your drain). Immerse mom and baby in a comfortably warm bath for about 20 minutes.
Is it safe to bathe after I've just had a baby?
A generation ago, doctors feared that water from the bath could enter the vagina and birth canal, causing infection in the postpartum woman. But since then, research has shown that bath water does not enter the vagina, and it's generally considered safe for new mothers to soak in the tub.
You can obtain these herbs in bulk at a food co-op or natural-foods store, or by mail order. Put some of the “tea” into your peri bottle as well for a healing squirt each time you use the bathroom.
Using the Bathroom
When you use the bathroom, urine may come into contact with tears, abrasions, or stitches in your perineum. It may really sting for a few days. Concentrated urine stings more than regular-strength urine when it comes into contact with traumatized tissue, so be sure to drink enough fluids. Keep using your peri bottle to squirt warm water or the herbal recipe on your vaginal area each time you use the bathroom. Pat yourself dry when you're done using the toilet, always moving the toilet tissue from front to back.
You will probably notice that you have to pee a lot in the first days after giving birth. Your body is ridding itself of excess fluids it no longer needs. Be sure to keep your bladder empty, as a full bladder will make afterpains (uterine contractions) worse, make it more difficult for your uterus to contract, and can lead to a bladder infection. If you are still finding it difficult, you can try urinating in the shower or even while in the bath. Your urine is sterile when it comes out, so you don't have to worry about your urine “infecting” your healing body. You may find it hard to tell when your bladder is full in the first days, so try to urinate every hour or so while you are awake, whether you feel like it or not, until the sensation is all back. If you aren't able to urinate, feel pain or burning during or after urination (except for the stinging you may feel when your urine touches abrasions, tears, or your episiotomy site), or if you feel like you have to urinate even when your bladder is empty, call your care provider.
In the first few days after giving birth, you may find that you leak urine when you sneeze or cough. This condition is called stress incontinence, and should improve after your bladder and other internal organs have gotten back into their prepregnancy condition. Sometimes, though, incontinence lasts past the postpartum period.
Sometime in the first few days after giving birth, you will probably need to have a bowel movement. This can be scary the first time. A lot of mothers would rather not push anything out of their bodies so soon after birth, and you may also fear that you will reopen a wound. But you'll find that it's not nearly as bad as you're afraid it will be. You can try applying a little pressure to your perineum with a piece of gauze, toilet paper, or Tucks pad. This might make it a little easier to empty your bowels and will also help you feel as though you're protecting any healing tears or stitches, though you really don't have to worry that having a bowel movement will reopen stitches. Give yourself some time, don't strain, and try some deep breathing exercises if you are having a hard time relaxing on the toilet. Eating a diet high in fiber and making sure you drink enough fluids can help your stools stay soft and help you pass them easily. If you haven't had a bowel movement within a few days of having your baby, call your health-care provider.
Hemorrhoids are varicose veins, or swollen blood vessels, in the rectal area. Pregnant women are prone to varicosities of all sorts due to sluggish circulation, and hemorrhoids are often caused or exacerbated by the weight of the baby on the pelvic region during the last weeks of pregnancy. They can also be caused or worsened by the pressure of your baby's head as he is pushed out past the perineum.
Hemorrhoids can itch, burn, or hurt, and they may bleed, particularly during a bowel movement. They may be just under the skin or protrude through the anus and get as large as the size of a grape.
Be sure to give your rectal area a squirt with the peri bottle each time you use the bathroom, then pat — don't rub or wipe — the area dry, always moving from front to back. Medicated, premoistened wipes made for hemorrhoids might be more comfortable for wiping after using the bathroom. Use Tucks pads or cotton balls dipped in witch hazel to help hemorrhoids shrink, and to soothe the area. Be sure to check with your care provider before using any medicated suppositories or other hemorrhoid creams.
Many women rave about Dermoplast, an over-the-counter analgesic spray that can help numb tissue and soothe hemorrhoids. Some experts say you shouldn't spray Dermoplast directly on the site of a tear or episiotomy, so ask your doctor or midwife before you use it for that purpose.
If you have hemorrhoids, it might make you especially reluctant to have a bowel movement. If you're really afraid, using hemorrhoid cream that contains topical anesthetic can soothe and lubricate the area and make it more comfortable to move your bowels. If you have hemorrhoids, it is especially important that you don't get constipated. Be vigilant with your diet, avoiding constipating foods like processed cereals and bread. If a hemorrhoid is bleeding all the time, or getting bigger, or the pain is intolerable, call your doctor or midwife.
As mentioned previously, your bleeding will continue during this first week. Sometimes lochia turns from red to pink to brown and lightens, only to become red and heavier again. This usually means you are doing too much too soon.
During pregnancy, your internal organs gradually shift around to make room for your growing baby. Then, when your baby is suddenly gone from your uterus, your organs have to make their way back to their prepregnancy position. This can make you feel like your organs are just hanging in space. This feeling will pass over the next week or so, as your abdominal muscles regain some of their tone and your organs shift back into place. A support garment made especially for supporting your pelvis and abdomen during the postpartum weeks may help.