Saturday, October 18, 2014

the first week after birth {31 Days of Postpartum Health and Healing}





The nursery is ready, baby clothes are sorted and washed, meals are stocked in the freezer and your birth bag is waiting by the door. So much of the last nine months has been spent wondering over this little human growing inside of you - what they'll be like, what sort of mother you'll be, how your life will change. There's a blank spot, though - what of the moments right after the birth? The days to come? Those blurry nights and hazy days that are spent in joy but that can also be really tough. Sometimes we skip over the logistics of those first days (I'm guilty of it!) and it can come as an overwhelming surprise if not prepared for the reality of body after birth.

Here's a brief timeline of what you can reasonably expect the first week or so after a vaginal birth. Of course, every mother and baby are different, so don't hold yourself too strictly to this, okay? For a more in-depth timeline that includes Cesarean info, check out Alpha Parent's Timeline of Postpartum Recovery. And more importantly, check with your doctor or midwife if anything feels amiss or you have questions. This is not medical advice! Your healthcare provider will give you things to be on the look out for to signal problems and please take those recommendations seriously.

Day 1

Did you just run a marathon or climb a mountain? No, you've only just given birth to your baby! You're completely elated yet sore and probably very tired. You're lighter, and probably look about 6 months pregnant as you're now missing the baby, placenta...and amniotic fluid, blood, and all that was keeping your baby alive. You will feel cramping as your uterus begins the slow process of shrinking down to its normal size, and breastfeeding stimulates this action so you may feel cramps come on when the baby suckles. If this is not your first child, the cramping may also be painful, sometimes just as painful as birth contractions. This is where the crampbark tincture comes in very handy! Your breasts are producing colostrum which is all your baby needs right now, so don't worry that they're not getting enough. They are. It takes a few days for your milk to come in.

Vaginal bleeding - lochia - is like a heavy period at this point and the whole area is probably pretty damn sore. Padsicles to the rescue! It's important to remember that you have an open internal wound inside of you after giving birth at the site where the placenta was attached to the uterine wall and requires delicate care. It's also very important to empty your bladder regularly right after birth to avoid a UTI (speaking from experience!).  Use your peri bottle to gently cleanse the area after peeing. A nice warm sitz bath with some healing herbs will be soothing to the area, too.

Rest, rest, rest and more rest. Take a warm shower and get into a clean, fresh pair of jammies. Have someone bring you a hot meal, and take a nap or two in between nursing this new little one.

Day 2-4

Continue the regimen of rest, shower, fresh jammies, hot meal and naps. Arrange childcare for your other children and do not even THINK about starting a load of laundry. Move AWAY from the dishwasher!

You have a lot of excess fluids from pregnancy so you're probably peeing quite a bit. Keep it up. You may have to go poop, which can be a little traumatic. I mean, everything - the bowels, bladder - is just so close down there so yeah, it's scary. And hemorrhoids. Have some natural cream on hand. Avoid straining, try using a squatty potty or propping your legs up on a wastebasket or stool to get to a squatting position. Taking some magnesium powder will help the elimination process go much more smoothly, this is something I will not be without after any subsequent births! (check with your doc/midwife though, I'm not a doctor!). Your uterus is continuing to shrink and will continue to cramp during this process.  Some warm sitz baths will be soothing and can be done every day.

You're producing the liquid gold colostrum during this time, but at any point your milk will be coming in. Make sure you stay well hydrated and well nourished to support this process. After it comes, you'll most likely be heavily engorged for the first few days. Honestly, it is not an altogether pleasant experience. Standing in a warm shower and allowing a little milk to self-express can be soothing. Do not express too much milk, as your body works on supply and demand and will take that as a message to make more. Breast pads are helpful to soak up excess leaky milk. And you may leak a lot of not at all - it's no indication of milk supply. The best way to reduce engorgement is to feed when the baby is hungry. Avoid schedules or anything of the sort - it will lead to misery for all.

Check to make sure baby's latch is deep and correct to avoid any excess pain. Your nipples may be a bit sore, and some coconut oil or nipple cream can help. This is now a time to watch for tongue or lip tie too, as that can dramatically and negatively affect your breastfeeding relationship. If you suspect a tie, find a lactation consultant who is qualified to confirm the diagnosis.

You're also probably more sore today than yesterday! The adrenaline rush is decreasing and yep, you can feel it. Padsicles, Crampbark tincture, Arnica every few hours for soreness and Tylenol as needed.

Your hormone levels are fluctuating and can make you feel weepy, anxious, and tired. Basically, you'll be feeling ALL THE FEELINGS. This is normal! Make sure you have a good support network around you or a friend you can call. And nothing is EVER wrong with a good cry.

Day 5-7

You're still in recovery so I repeat: rest, rest, rest. The more you can give yourself the space to rest and heal in the early days means a swifter recovery time overall. The majority of your day should still be spent on your comfy couch or bed, and hopefully you still have some help around the house.

You're still bleeding and your lochia may be changing colors to a darker red or a light brown. A good indication of slowing down or overdoing it is your bleeding level. If you notice an increase in bleeding or it turning red after it has been brown, you've probably overdone it and need to take that as a cue to rest. Bleeding may subside entirely in the next week or continue for a bit longer.

You should also be getting less sore in that lower area and find it easier to move about and get comfortable. If you've had stitches, they'll start to get itchy as the tissue heals. Your peri bottle for gentle cleansing after going to the bathroom should still be used. Pelvic floor exercises will be helpful in bringing everything back together and will help you avoid incontinence and any risk of uterine prolapse.

The uterus now weighs half of what it did right after birth but you still look pregnant and your belly is jiggly, because there is no baby in there any more! Binding with a postpartum binder or a wrap can help your abdominal muscles to not only heal but to help you feel more self-confident, too. Afterpains should be subsiding at this point.

Your breast engorgement should be subsiding as your body learns to produce just the right amount for your baby, although you'll still get engorged if baby sleeps longer than normal without feeding. Milk leakage is just a part of breastfeeding (although some leak more than others and is no indication of milk supply!) so your breast pads will be used often.

Now is a good time to go for a gentle walk. My midwife told me to walk around the block for my first outing and see how I felt. Besides gentle stretching, walking, and some deep breathing and pelvic floor routines, this is ALL the exercise you should be doing for the next 4-6 weeks.

Slowly from here you'll return to your normal self. A good thing to remember is that it took your body nine months to grow this precious baby, so it WILL TAKE TIME to return to normal, in all aspects. Be so, so gentle with yourself. Rest and enjoy these days. They can be stressful and uncomfortable but they really are golden!

Resources:

The Alpha Parent Timeline of Postpartum Recovery (She also included C-Section in her timeline!)
Postpartum Timeline from Pregnancy & Newborn magazine
After the Baby's Birth...A Woman's Way to Wellness by Robin Lim

What would you add to this timeline - anything that caught you off guard in those first few days that you wish you could share with another expecting mother? Let us know in the comments! 



And one more time: I'm not a doctor and this is not medical advice. Please be in constant communication with your healthcare provider to know the signs of infection or other problems. 

{disclosure} This post also contains affiliate links to the death star (amazon) which means I get a small commission from anything your purchase through the links above. I really appreciate your support! 












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