'Babies are such a nice way to start people'
- Don Herold
Many women get sidetracked with the arrival of their
baby. They tend to ignore the fundamentals of postnatal
care and shift the entire focus on the newborn. Without
a doubt caring for a new baby is a demanding task.
But equally important is postnatal care or taking
care of yourself after you have had your baby. Adequate
rest, eating well and doing gentle exercises to regain
and maintain your strength are all a vital part of
staying healthy. In order to do it right you must
protect your own health by attending to postnatal
care with some amount of dedication.
Changes in you in the first
week
• Your tummy will feel soft and round; you
won't look pregnant but your tummy won't resemble
the pre-pregnancy state either. Within minutes of
delivery, the uterus (womb) changes from a sac with
a capacity to hold four-and-a-half liters of liquid
to a grapefruit-sized pouch of muscle. The uterus
will downsize in weight from 1000g to 50g within
six weeks.
• You will feel some 'afterpains' in your
uterus when breastfeeding because it is shrinking
in size.
• The vaginal muscles will slowly regain its
former tone and the pelvic floor will return to
its previous position. Tears to the neck of the
womb, vagina and perineum should also heal quickly.
• Your breasts grow bigger from day 2 or 3
as 'milk comes in'. Slight feeling of discomfort
is normal but this is temporary.
• After childbirth progesterone levels fall
rapidly causing discomforts such as heartburn, constipation
and varicose veins to subside, although hemorrhoids
(piles) take longer to resolve
• In the first few weeks, there will be a
lot of vaginal discharge. The uterus is shedding
the rest of its lining. This discharge, or lochia,
is red in the start. It changes to pinkish brown
and then cream. Use sanitary towels and avoid tampons,
as there's a risk of infection. Heart, lungs and
circulation, relieved of the burden of pregnancy,
assume normalcy.
• Joints of the pelvis and spine, softened
by the hormones during pregnancy take time to go
back to normal. Back discomfort may continue for
months to come, so be cautious with lifting and
carrying. Best to avoid weighty stuffs. The abdominal
muscles, stretched to twice their normal length
during pregnancy, regain their tone within a couple
of months. Getting back to your pre-pregnancy weight
and appearance takes time.
• Weight loss is most rapid and obvious in
the first few days after delivery as the extra two
to eight liters of water carried during late pregnancy
are passed out as urine. After this, weight loss
slows down. Exercising and eating right will help
in the later months.
• Some leg and ankle swelling may begin during
the first two days after delivery that can persist
for several weeks. This is not unusual. When resting,
reading or watching TV, elevate your legs using
pillows or cushions above the level of your hips.
If your legs remain painful and swollen call your
caregiver.
• Occasionally you will feel tired and weepy
- it is normal to go through this. Don't confuse
this with postnatal depression.
Your
first check-up post delivery
This is your last visit to your
obstetrician (the 6th week check up) where you will
receive a thorough check. Basically your doctor will
want to make sure your body is healing well after
the delivery of your baby.
• Your weight will be taken and your blood pressure
will be measured.
• A pelvic exam to assess if your uterus is
getting back to its pre-pregnancy size, your cervix
is closed and the episiotomy has healed well Stitches
• Checks stitches, if any
• A check on your emotional and overall well
being
• Advice on minor problems such as constipation
and birth control
Now is the time to make
life easier!
• Accept any offers of help. Hire a temporary
help if you must since it is easily available anywhere.
You may need all the help you can get in the initial
phase with the basics around the house i.e. cooking,
cleaning up, shopping etc.
• Visitors will come pouring in to visit you
and your baby. Since this is especially customary
in any culture, it becomes all the more necessary
to make it clear you don't expect to entertain them.
• Don't forget your pelvic floor exercises -
you can start these as soon as you like, even from
one day after the birth. If you have concerns on exercising,
address them with your doctor.
• You may lose up to twelve pounds when the
baby is born and maybe another one or two the following
week. If you continue to follow the healthy eating
habits suggested during pregnancy, the weight should
come off naturally. Crash diet is not the solution,
especially if you are breastfeeding. Talk to your
caregiver about healthy weight loss. Breastfeeding
moms should aim for four servings of milk and milk
products each day. To make sure you get all of the
nutrients you need when you first get home, let someone
else cook for you.
• Ignore the need to get back to normalcy just
after coming home from the hospital. If you feel like
staying in your night clothes all day, do it. Everything
takes time; don't pressurize yourself. The key issue
is REST. The more you rest and take care of yourself
in the first few weeks, the quicker you will return
to your normal self.
When your GP has assured you on your full recovery,
join a postnatal exercise class. This is a really
good way of making friends and keeping fit. Alternatively
you can engage in more strenuous abdominal exercises
like sit-ups and curl-ups at home. These exercises
may help you flatten your stomach and lose weight.
Bear in mind it takes up to three months for your
body to recover from the birth.
Postnatal Care includes
some Exercises Pelvic floor exercises
• Pull up around the vagina as if to stop wetting
yourself. Hold for a count of four and release. You
should feel the difference when you let go.
• Repeat the exercise in batches of six or eight
as often as you can during the day.
• As well as holding for a count of four, try
doing some where you squeeze, release, squeeze, release
quite quickly.
• Breathe normally throughout the exercise.
As soon as possible after delivery, start doing pelvic
floor exercises. If you have stitches you will be
sore, but the exercise will improve your circulation
and help your perineum heal. If you have had a Caesarean,
you will still need to do your pelvic floor exercises.
Pelvic rock
Lie on your back with knees bent and feet flat on
the floor. As you breathe out, rock your pelvis so
that the small of your back flattens onto the floor.
Then rock your pelvis again so that your back is lifted
away from the floor.
Leg slide
Lie on your back, knees bent and feet flat on the
floor. Put your hand in the small of your back, flat
against the floor. As you breathe out, let your legs
slide forward slowly, bringing your knees closer to
the ground. Then gently slide your legs up again.
Some to observe:
• Start with GENTLE exercising in the first
few weeks after the birth. Follow the cues your body
gives you.
• DO NOT lie flat on your back and lift both
legs in the air.
• DO NOT lie flat on your back and do sit-ups
with your feet held down.
• If in doubt, wait till you go for
your check up and consult your doctor on the dos and
don'ts of exercise
