First of all, congratulations on the birth of your baby – or perhaps even babies! Of course, what we want most of all is for you to enjoy the period after giving birth. To ensure that things go smoothly, we provide some nursing advice below that is important for a good recovery.
Medication
Paracetamol tablets: a maximum of eight tablets per 24-hour period in the first week. Any other medication should only be taken in consultation with your doctor or midwife.
Afterpains
Afterpains occur mainly during breastfeeding and only in the first week after giving birth. Having a full bladder causes afterpains, so you should pee regularly. You may take two 500-milligram paracetamol tablets if necessary.
Hygiene
Take a shower every day. While doing so, rinse your vulva (pubic area between the labia) under a gently running shower. Do not use soap. As long as you are losing bright red blood through the vagina, you should not take a bath. Always wash your hands after going to the toilet and before caring for your baby. Rinse your vulva with a little water after each toilet visit. Change your maternity towels or sanitary pads several times a day. Do not use tampons during the period after giving birth.
Blood flow
On the first day, it is normal to have a full sanitary pad every two to three hours. It is normal to lose a blood clot sometimes in the first few days. The blood you lose will change from bright red to brownish, then brownish yellow, until it eventually turns a yellowish-white or sometimes a pinkish colour. It takes four to six weeks after giving birth for the bleeding to stop and the wall of the uterus to heal.
Enlarged breasts
On the third or fourth day, you may experience swollen, tight or painful breasts. Wearing a well-fitting bra will help reduce discomfort. Hot or cold showers or compresses may also give relief. If you are breastfeeding, let your baby drink every two hours or express milk in one session until both breasts are empty. If you are not breastfeeding, the breast enlargement will go away on its own. Your doctor or midwife may give you medication against enlarged breasts.
Going to the toilet
It takes about three to four days before your stool becomes normal again. Do not strain too hard. After using the toilet, wipe from front to back (from your vagina to your anus), so that you do not wipe intestinal bacteria from the anus towards the vulva and/or wound. Peeing may be difficult during the first few days. If necessary, leave the tap running, pee in the shower or rinse your vulva with lukewarm water while peeing. Take care to pee regularly, for example before each time you feed your baby.
Movement and exercise
Try to get back to your daily activities as soon as possible, but listen to your own body when doing so! When getting out of bed, roll onto your side with your knees together. Stick your feet out of the bed, push yourself up with your arms until you are seated, and then stand up. Exercise your pelvic floor muscles: squeeze the muscles as if you are holding in urine, while counting to five or 10. Repeat this exercise several times a day. Abdominal muscles take some time to contract again after pregnancy. Briefly tightening the abdominal muscles is enough exercise to start with. After a caesarean section, you should wait six weeks before starting abdominal exercises.
Lifting
Apart from your baby, do not lift any heavy items (like a full shopping bag, rubbish bag or a baby bath filled with water) for the first two to three weeks. After a caesarean section, you should not do any heavy lifting for the first six weeks.
Haemorrhoids
Straining while on the toilet may sometimes cause haemorrhoids (bulges around the anus). Keep your stool soft by drinking plenty of fluids and eating a high-fibre diet. Usually, haemorrhoids shrink on their own or disappear altogether. If necessary, ask your GP for a laxative drink, suppositories or ointment.
Eating and drinking
Eat a high-fibre diet to keep your stool soft. Eat a varied and nutritious diet. You can eat anything in moderation, even if you are breastfeeding. Drink at least two litres of fluids a day. Do not drink alcohol (or only a very small amount) if you are breastfeeding.
Wound (cut/tear)
In case of swelling/pain due to the stitches, you can use cold compresses for 24 hours. Sitting may be painful as a result of giving birth. Try to sit on the stitches to prevent fluid from building up. By sitting on a hard chair, you push fluid out of the wound area and the wound hurts less. After about one week, the stitches will dissolve on their own, which produces a slightly slimy discharge. The midwife or GP will remove any material that does not dissolve one week after delivery. In some cases, the stitches may be very tight. Your midwife will remove the stitches as soon as possible. You should contact your midwife if you have a dirty or inflamed wound or discharge that smells very strong.
Caesarean section
After 24 hours, the wound is essentially closed. After about one week, the stitches will dissolve on their own, which produces a slightly slimy discharge. If staples have been used to close the wound, the GP or midwife will remove them after seven days. As long as you are losing bright red blood, you should not take a bath, but you can take a shower. No dressing or plaster is needed on the abdominal wound, unless some fluid or blood is still leaking out. The edges of the scar may feel taut at first. This is not harmful. Because nerves in the abdominal wall have been cut, you will feel numb around the scar for some time. This numbness can last from six to 12 months. After a caesarean section, we recommend that you do not get pregnant again for the first six to 12 months after giving birth. This is to minimise any risks in a subsequent pregnancy. As soon as your concentration and fitness are good enough, you may go back to gentle cycling, driving, climbing stairs and bending over. After one week, you may do light household chores again. After six weeks, you may go back to your normal activities.
Fever
In case of fever (a temperature higher than 38 °C measured with a rectal thermometer), you should contact your midwife or make an appointment with your gynaecologist the same day.
Rest
It is important to listen to your body and make sure you get enough rest. Visits are very enjoyable, but make sure to spread them out.
Maternal feelings
Not every woman experiences maternal feelings immediately after giving birth. Sometimes it takes a while for you to bond with your baby. Take time to get to know your baby.
Sexual intercourse
From a medical point of view, you can have intercourse again once the bright red bleeding has stopped and the wounds have healed. Before this time, there is a risk of infection. The first menstruation may start after three weeks. Bear this in mind, because it means you can become pregnant again. Breastfeeding does not give 100% protection against pregnancy.
Baby blues
This term refers to the mood swings and sudden tearfulness that many women experience in the first week after giving birth. Our advice is to get plenty of rest, talk about your feelings, be patient and accept what is happening to you. These symptoms usually disappear after one week. If they last longer than two weeks, we recommend that you talk to a doctor.
Contact
If you still have questions or concerns after reading this leaflet, please contact:
- Your midwife: 24 hours a day, seven days a week.
- Your GP
- Gynaecology outpatients clinic: +31 (0)43 387 48 00 (during office hours)
- Inpatient ward D2 (Obstetrics): +31 (0)43 387 62 40 (24 hours a day, seven days a week)
Website
- MUMC+ (www.mumc.nl/)
- Gezond Idee (gezondidee.mumc.nl/)