How You'll Be Feeling
During the second week postpartum, many women feel a burst of energy and may seem more like normal. Enjoy this boost, but remember that you still have healing to do and need to take it easy. Your body will probably still be showing aftereffects of the birth, so you'll have to make sure you don't do too much too quickly and undo the healing you've already accomplished.
Bleeding
Your lochia should continue to taper off over the first six weeks postpartum. However, there's no definite timetable for how long it will take for this transition to happen.
To handle bleeding during the first few weeks postpartum, you can wear menstrual pads, just like you would during your period. Some women prefer cloth menstrual pads because they're softer and more breathable and they don't chafe. You can make them yourself from cotton flannel, or purchase them through catalogs or Web sites carrying eco-friendly products. You may also be able to find them at your local health-food or natural-products store. As mentioned previously, do not use tampons during the first six weeks postpartum. They can harbor bacteria, and during this time your pelvic area is particularly vulnerable to infection.
Fact
Postpartum bleeding doesn't always follow a textbook pattern. Sometimes it can take longer for bleeding to stop with second and subsequent pregnancies, and what's typical for another woman may not be typical for you. As long as the flow is decreasing, not increasing, and isn't going back to bright red, it's probably your body's version of normal.
You should call your care provider if you pass large blood clots after the first week postpartum. If your bleeding has turned brown or white but returns to red, it's probably a sign you've been doing too much. Check with your doctor or midwife just to be on the safe side — he or she will probably tell you to slow down and rest. Still, you'll want to let them know it's happening, so that they can rule out infection or other possible causes.
Breasts
You'll probably be getting the hang of breastfeeding by now. Your engorgement will pass, and your breasts will probably leak less and begin to regulate their milk production to make only as much as your baby will need. If your nipples are still sore, there may be something going on besides run-of-the-mill tenderness. Check out Chapter 8 to troubleshoot possible problems.
Soreness and Stitches
Any stitches or tears should be well on their way to healing by this point, though you may still notice some tenderness or soreness in your perineum, particularly at the end of the day when you're tired or have been standing a lot. Rest, keep doing your Kegel exercises regularly to keep the blood circulating in this area, and continue using your peri bottle when you go to the bathroom, as long as it feels like it's helping.
Your Pelvic Floor
In Chapter 6 you read about pelvic-floor injuries like uterine and bladder prolapse. You're at most risk for developing these conditions in the first six weeks postpartum, and too-strenuous exercise and activity greatly increases your risk. Don't overdo it! Even if you get a bolt of energy and feel like you can jump right back into all your old household chores, you're still healing and need to take it easy.
Hemorrhoids
If you developed hemorrhoids during pregnancy or birth, they may still be sore or itchy a few weeks after birth. But your hemorrhoids should begin to shrink and feel less painful during this time. If they continue to bleed or remain very sore, you'll want to talk to your doctor or midwife about them.
Fact
Certain nutrients are linked with increased vein health, and consuming more of them may aid in healing hemorrhoids and preventing them from becoming an issue in the future. Vitamin C, bioflavinoids, vitamin E, and essential fatty acids are all vital to vein health. These nutrients are most effective when consumed as part of a healthy diet containing dark green leafy vegetables, citrus fruits and berries, and healthy fats like the kind found in fish, flaxseed, and olive oil.
Sometimes, hemorrhoids are a big enough problem that they have to be removed. Be vigilant about helping your hemorrhoids heal; continue to eat enough fiber and drink plenty of fluids. Caffeine, which is found in chocolate, coffee, tea, and soda, can be constipating and may make hemorrhoids worse. If you suffer from hemorrhoids, it's best to avoid or cut back on caffeine.
Also, instead of wiping with toilet paper, you can try flushable wet wipes medicated with witch hazel, available at drugstores. Or, you can continue to use your peri bottle for cleansing the area after using the bathroom, and just pat dry with soft toilet paper.
Even if you can't feel your hemorrhoids anymore, it doesn't mean they're not there. Once the vein wall is weakened, you'll be prone to developing hemorrhoids in the future. Be sure to always drink enough water and eat enough fiber to keep your stools soft and regular, and don't strain while having a bowel movement.
Essential
You may have developed varicose veins in your legs or vulva during pregnancy. Since a hemorrhoid is basically a varicose vein in the rectum, some of the same advice applies for soothing and shrinking these swollen blood vessels: consume plenty of vein-strengthening nutrients, keep your blood circulating, and elevate the affected area whenever possible.
Hemorrhoids can also be caused or worsened by too much sitting, standing, or inactivity. You shouldn't overdo it in the first six weeks postpartum, but changing positions often and going for gentle strolls around the house or block can keep your blood moving.
Also, assuming a knee-chest position — from your hands and knees, bend forward so that your rear end is sticking up and your chest is resting on the bed — every once in a while can take the pressure off the veins in your bottom. Avoid chairs that create a V in which the lowest point is your perineum, like recliners.
