Postpartum Care and Recovery

Just as your body—and mind—took some time to adjust to the idea of being pregnant, you'll need some time to recover after giving birth. Your recovery period will be determined by how you delivered; cesarean moms have undergone major surgery and will need more time to heal, although a vaginal delivery also takes a toll on a woman's body.

After Vaginal Delivery

After delivery, your uterus will begin to shrink back to its prepregnancy size. You may feel some mild cramping during this process, but you should not experience extreme discomfort. If you do, notify your doctor. You'll have some bleeding, which may be heavy at first. For the first few days you may find that you soak a sanitary napkin in a couple of hours. If you've had a previous pregnancy, you won't find this surprising, but it may be heavier than you experienced in the past. That's because your uterus stretched and expanded further to accommodate the extra babies. You may want to be prepared with some supersize sanitary napkins from home; they'll work better than those provided by the hospital.

Drinking plenty of fluids is vital after delivery, especially if you intend to nurse your babies. An increased fluid intake will speed your recovery and keep you healthy as you begin to care for your newborns.

The bloody discharge, called lochia, can last for several weeks after delivery. It should taper off, however, and should not include any large clumps or clots. If it increases, or is accompanied by pain, fever, or a foul odor, notify your doctor right away.

You will need to wear sanitary napkins to accommodate this discharge for up to six weeks after you deliver. Tampons are not recommended. If you experienced anemia during your pregnancy, it's important to continue supplementing your iron intake, either by eating iron-rich foods or by taking pills prescribed by your doctor.

If you had an episiotomy or any tearing of the perineum during your delivery, you may be somewhat sore. Ice packs, sitz baths, and witch hazel pads can relieve the discomfort. You may also be plagued by hemorrhoids as your distended veins return to normal capacity. Discuss their treatment with your caregiver.

Although you'll probably be ready to leave the hospital soon after your delivery, it will take a couple of weeks for your body to return to full strength. After the strain of pregnancy, the process of labor is intense—your body worked hard!—and you need to give yourself time to recuperate. It's not realistic to expect that you will get plenty of rest and relaxation; the weeks following the delivery of multiples are hectic, to say the least. But you should definitely consider lining up plenty of help so that you can minimize your responsibilities and focus your energy exclusively on caring for yourself and the babies.

After C-Section

A cesarean section is major surgery and necessitates more intensive recovery. You'll probably have to remain in bed for at least twelve hours, after which time you'll be encouraged to move around or at least get out of bed. It may be unpleasant; the effects of the surgery and the anesthesia may leave you feeling like you've been hit by a truck. Rely on the nurses and caregivers to assist you. You may have a great deal of pain or discomfort, but relief is available. Discuss your options for pain medication with your doctor.

Will pain medications affect my breastfeeding plans?

You can still initiate breastfeeding, even if you are taking pain medication. Your doctor will advise you if the medication will impact the babies. Even if it prevents you from feeding the babies, you can still begin the nursing process using a pump.

A cesarean section does not exempt you from the other aftereffects of delivering a baby. You will still have some cramping as your uterus returns to its normal size, and you will have a vaginal delivery of lochia as your body expels blood and tissue. As with a vaginal delivery, you'll have to wear sanitary napkins for several weeks after your babies are born.

As you recover from a C-section, you'll have to avoid strenuous activity for a period of time. That may include driving, stair climbing, and heavy lifting. Depending on your circumstances, it may be difficult to obey some of these restrictions. However, it is important to follow your doctor's recommendations during your recovery. You cannot effectively care for your newborns if you are unwell. Arrange for extra help and give your body the time and nurturing it needs to heal.

Emotional Impact

No matter how much you read, study, and prepare for the arrival of your babies, their birth will be nothing like you expected. You may feel overwhelmed by emotions: relief, anxiety, elation, despair, fear, and love. Your conflicting feelings may stir up some unusual reactions. Remember that this is a time of transition. You're not pregnant with multiples anymore; rather, you are the mother of two, three, or more infants. You are all settling into your new roles as a family and will require some time to adjust.

Postpartum depression (PPD) is characterized by feelings of hopelessness that last most of the day and don't diminish after several weeks. It's normal to feel overwhelmed or out of control, but you need to seek medical attention if your feelings are preventing you from properly caring for your babies or yourself.

Fifteen percent of women experience postpartum depression after giving birth, and mothers of twins are particularly at risk. A 2004 study by the National Organization of Mothers of Twins Clubs found that nearly 40 percent of moms of multiples experienced depression.

Have some strategies in place for coping with the stress of multiples. Line up plenty of help to see you through the rough times. Maintain a sense of humor. Find the joy in your amazing babies. Establish priorities and give yourself permission to temporarily release any nonessential responsibilities.

Communication is key. Talk to your spouse or partner about your feelings. Share your experience with fellow parents of multiples; they will understand what you are going through. Down the road, you will recall the rush of emotion that followed the birth of your babies with amazing tenderness.

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