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Postpartum Period

10 October 2024

The period from birth to 6 weeks afterward is a period in which the body systems return to the state they were in before pregnancy.

In this period, called the postpartum period, you may feel changes in your mood, fatigue, difficulties in coping with your varying body structure and more. It is important to cake care to have balanced nutrition, drink enough water and rest. It is also important for you to take time in this period and be attentive to your own needs.

Physical changes that you may experience in this period:

  • Vaginal pain.
  • Vaginal bleeding and discharge.
  • Uterine contractions.
  • Urinary incontinence.
  • Hemorrhoids and related pain.

Physical examination: 6 weeks after the birth, it is recommended that you schedule an appointment with your gynecologist. In this appointment you will undergo a vaginal examination, will receive a referral for a blood count and consultation on contraception. The physician may perform a cervical screening test, if not done before. The appointment may also be a good opportunity for consultation and getting important information for a future pregnancy, if relevant to you.

The period between the end of the delivery process and 6 weeks afterward is called the postpartum period. This is the period in which the body systems revert to their normal state as they were before pregnancy. During this period, you may experience changes in your mood, fatigue, difficulty in coping with your changing body structure and more. It is important for you to ensure balanced nutrition, drink enough water and get enough rest. It is important for you to take the time in this period to be attentive to your own needs. You do not have to host guests if you aren’t interested in doing so. It is possible and desirable to ask for help from your family and friends.

Emotional state after childbirth

Sometimes, after childbirth you may feel sadness, fear, anger, failure or frustration. These feelings are natural and mean mothing about you as a woman and mother.

For further information on baby blues and postnatal depression

What to expect physically

If you had an episiotomy or experienced tearing during childbirth, you may suffer from pain that may last a few weeks. To relieve the pain, you can sit in a warm bath for a few minutes. While sitting, you can use a cushion. If the pain is strong, you can also take painkillers. Eating vegetables and fibers may prevent constipation that can intensify the pain. If you feel necessary, consult the pharmacist and medical staff caring for you on products that can relieve constipation.

After birth, the membrane lining the uterus during pregnancy must be voided from your body and this happens through discharges and bleeding. The bleeding may last several weeks, and is usually heavier in the first few days, like a strong period. Later, the bleeding will change and become more watery. The bleeding may strengthen or weaken during these weeks. If the bleeding continues to be heavy for a long time and does not weaken, it's important to discuss this with your gynecologist in your next appointment – 6 weeks after birth. If you suffer from very strong bleeding and pads are not enough to soak it up, you must seek a physician for examination, even if 6 weeks have not yet passed since birth. During these days, it’s better to use external absorption accessories or period underwear rather than a tampon or menstrual cup.

In the first few days after delivery, you may experience contractions of the uterus. These contractions will cause pain that is reminiscent of menstrual pain. The contractions may strengthen at the beginning of breastfeeding because of the secretion of the hormone oxytocin. If the pain is strong and causing you great suffering, you can take painkillers.

Vaginal delivery and pregnancy itself may weaken the pelvic floor muscles that support the uterus, the urinary bladder and anus. Weakening of these muscles may result in mild loss of urine during sneezing, laughter or coughing. Usually the condition improves within a few weeks but sometimes it may have a long-term effect.

It is recommended to perform exercises to strengthen your pelvic floor muscles: imagine that you’re sitting on a small ball and tighten your pelvic muscles as though you were lifting the ball up. Try to do this for 3 seconds each time and then relax. Repeat the exercise 10 to 15 times in succession, at least 3 times a day.

Pelvic floor strengthening workouts are recommended both for women who have had vaginal delivery and those who have had a cesarean section.

More on pelvic floor rehabilitation

If you feel pain or swelling near your anus when using the toilet, you may have developed hemorrhoids. It is possible to use anti-hemorrhoid products that you can buy from the pharmacy over the counter. If this is not enough, it’s important to see your physician (family physician or gynecologist) for obtain suitable care. In addition, you should know that fiber rich nutrition may help soften the stool and relieve pain.

Gynecologist examination

To make sure that you are recovering from childbirth properly, it is advisable to schedule an appointment for examination by your attending gynecologist approximately 6 weeks after birth, in addition to the follow-up at the family health center. Bring the maternity hospital discharge letters and any other relevant document with you. It is important for you to update the physician on any medical disorders or complications during pregnancy and birth.

The examination will include:

  • A vaginal examination.
  • Referral for a blood count.
  • Contraception consultation.
  • A screening test of the uterine cervix, if not done previously. It is worth knowing that it is advisable to have this test once every 3 years from the age of 25 to 65. This test may also be a good opportunity for consultation and getting important information for any future pregnancy, if relevant to you.

Taking nutritional supplements

In addition to maintaining a balanced, healthy diet, it is advisable to take the following nutritional supplements:

  • Folic acid

    Significantly reduces the risk of developing neural tube defects (NTD) in the embryo. The importance of taking the additive increases if you have unprotected sexual intercourse.

    • Recommended daily dose: 400 micrograms.
    • Recommended time for taking the supplement: every day, throughout fertility.
    • Consumption directions: it is desirable to take the supplement every day at the same time.

    Further information on the importance of taking folic acid

  • Iron

    Iron deficiency may cause anemia and effects such as fatigue, weakness, headaches, breathing difficulty and faster heart rate.

    • Recommended daily dose: 30 micrograms.
    • Recommended time for taking the supplement: up to 6 weeks after pregnancy.
    • Consumption directions: it is important to take the additive at least two hours after consuming foods such as milk and dairy products, coffee and tea, which interfere with iron absorption in the body. To increase iron consumption, it is recommended to eat foods rich with vitamin C, which helps iron absorption.

  • Iodine

    Iodine is a nutrient that is critical for good health in all stages of life. It is vital for normal thyroid functioning. The additive is particularly important during breastfeeding to ensure normal development of the brain of the fetus and newborn.

    • Recommended daily dose: 150-250 micrograms.
    • Recommended time for taking the supplement: throughout breastfeeding.

  • Vitamin D

    Takes part in iron absorption in the gut and maintaining a sufficient level of calcium and phosphorus in the bones. It is necessary for bone growth, ensures bone strength and prevents fractures and bending of bones.

    • Recommended daily dose: 200-400 international units (5-10 micrograms).
    • Recommended time for taking the supplement: throughout the breastfeeding period.

You can take these supplements as a combined supplement, a multivitamin for pregnant women. The combined supplement should contain at least the vitamin and mineral dosage stated here. You can consume other vitamins and minerals up to the recommended daily level for pregnant women. It is advisable to consult the pharmacist.

Genetic screening or counseling

You may be recommended to have genetic screening or counseling at the family health center staff’s discretion. For further information, you can contact the family health center nurse.

Getting the whooping cough vaccine after childbirth

If you did not get the whooping cough vaccine during pregnancy, it is recommended to get the vaccine as early as possible, up to 3 months after childbirth. The vaccine will protect you from whooping cough, and so you will protect your baby from infection.

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