"Aside from new babies, new mothers must be the most beautiful creatures on earth." ~Terri Guillemets
Postpartum Instructions
Congratulations on the arrival of your baby! It’s been a long year of trying to prepare, waiting for this day you get to bring your baby home. The crib is assembled, your new baby clothes have been washed in Dreft to be ready for your precious child.
We know you are conflicted: leaving the hospital without the whole team. Don’t worry, we all felt that way, and we all got through it. We trust you. If you have any worries, do NOT hesitate to call us for reassurance and advice.
We put down on paper some of the discussions we’ve had with you in recent days, knowing you may have forgotten much of it, with the excitement of your newly created family. The following instructions are to help you in the next few weeks at home. If specific problems arise, please call our office at any time: (914.214.8616), for advice.
Follow-Up Appointments:
In the next few months, we’ll want to see you several times to check in on your transition to motherhood . After going through such an intense experience together, it is hard on all of us to say good-bye for an entire year. We will want to check on your breastfeeding, your bleeding, pain control, confirm that you are taking care of yourself, and getting through the expected post-partum blues.
When you are ready, well talk about birth control options. We’d like to see you in 2 weeks after delivery. When you catch your breath, please call and schedule an appointment for 2 weeks after you are discharged from the hospital. Call the Yorktown office to schedule an appointment in either Yorktown or Katonah: 914.214.9616.
Your baby will usually need to be seen by the pediatrician in a day or two after you are both discharged from the hospital. They will want to check your baby's weight, color, and assess feeding. Please confirm with him/her before you leave to set up baby's follow-up.
Activity Level:
Please, please, please: rest as much as possible! We cannot stress this enough, having tried to defy our own physician's orders. During your first weeks at home, restrict your activities to caring for the baby. You will heal faster and be at less risk for depression. Do not worry about the vacuuming and laundry piling up! Take frequent naps. Limit your visitors to close friends and family who are willing to cook and clean and fold your laundry.
Everyone else can wait to admire your little doll. When you are up to it, you may begin light exercise when you feel like it. Do not push yourself. Walking is better for you than running or lifting weights the first six weeks after birth. After six weeks, you may slowly build back up to begin light exercise when you feel like it. After six weeks, you may slowly build back up to your normal exercise routine.
If you had a cesarean section, walking up and down stairs will not harm you. You should not carry anything heavier than the baby for the first week or two. Use common sense – if it hurts, don’t continue with that activity.
Intercourse:
Returning to sex is fine after the vaginal discharge and bleeding stop, usually by 6 weeks post-partum. If you have had vaginal stitches, take it very gently. Be sure to use a gentle water-soluble lubricant such as Astroglide.
Driving:
You may drive when you feel comfortable and have stopped taking pain medications. Wait until your 2-week post-partum visit if you have had a cesarean section. Sitz baths, showers, and baths are safe after vaginal delivery. Do not use a Jacuzzi until the vaginal discharge stops or bathe after a C-section until the incision is healed.
Vaginal delivery:
After delivery, you will experience bleeding and a discharge for 4-6 weeks. It may last longer. The discharge is called lochia. It may be any color, and often has an odd odor (this is not an infection, don't worry.) This continues until the uterus has healed. If you had a vaginal tear, you will likely feel swollen and sore vaginally (that baby’s head is much bigger than your vagina.)
Urination may cause external stinging a bit, this should resolve after several days. Taking sitz baths or a warm tub bath 2-3 times a day will help with the discomfort and promote healing. You may use Tucks on stitches or hemorrhoids for comfort. These may be purchased without a prescription. The stitches will dissolve by themselves, and do not need to be removed. Do not worry if you see a stitch or knot fall off.
Cesarean section:
Cesarean section incisions have many layers that heal at the same time. There are strong stitches below the skin. Steri-strips should be removed one week after C-section, if they have not already fallen off. It is not necessary to keep the healing incision covered when you shower or walk around.
Diet, Bowel and Bladder Care:
Feel free to return to your regular diet at home. Drink more water than usual and eat lots of fresh fruits and vegetables. If you are breast-feeding and took prenatal vitamins during your pregnancy, continue them for the duration of breast-feeding. Increase your diet by 500 calories, (you’ll be naturally hungrier after the first 2 weeks, this is easy), and drink 8+ glasses of water each day.
After delivery, you may become constipated. Fiber supplements and stool softeners (Colace) may be purchased without a prescription. Citrucel, Metamucil, and Fibercon are all equally effective. Drinking water is very important for the stool softeners or fiber supplements to work. If you become constipated, with no bowel movement for a few days, you may use a laxative such as Dulcolax or Senakot. If still no bowel movement, you might try a Fleets enema.
To prevent a bladder infection, drink plenty of water, and urinate frequently. If you develop burning or pain with urination, call the office.
Prenatal/Postnatal Medications:
Continue using the same medications and vitamins used during your pregnancy. If you have any questions about medication, call the office to confirm.
Pain meds
Non-Prescription:
• NSAIDs: (non-steroidal anti-inflammatory drug) such as Ibuprofen or Naprosyn. These are nonprescription pain relievers that reduce cramping, bleeding and discomfort. The usual dose of Ibuprofen (Advil, Nuprin, Motrin) is 600 mg every 6 hours, not to exceed 2400 mg in 24 hours and Naprosyn (Aleve) is 220 mg, 2 initially, then 1 every 6-8 hours, not to exceed 1100 mg in 24 hours. The anti-inflammatory helps decrease swelling, as well as mild cramps.
• Tylenol is also useful for pain relief and headaches.
Prescription Meds:
If you had a cesarean section, we will prescribe a narcotic like Vicodin or Percocet. Narcotics used in the immediate postpartum period are safe for you and baby, even in breast feeding, but may cause drowsiness, fatigue, nausea and constipation for you.
Ibuprofen and Naprosyn can make the narcotic work better so that you need less of it. When you are feeling less pain, wean yourself from the narcotic first before the anti-inflammatory medication (Motrin, etc...) If you run out of percocet before your pain is well-controlled with ibuprofen, call the office with your pharmacy number and we will call in more.
Post-partum hormonal changes:
It is common after delivery to experience hot flashes, night sweats, mood swings, memory loss and vaginal dryness similar to what women experience in early menopause. (Yikes!) Your estrogen level drops with delivery and is reduced until you finish nursing and your regular menses returns.
If vaginal dryness is a problem (mainly in breastfeeding moms), vaginal estrogen (cream or tiny pills) can be prescribed to make sex more comfortable, once you’ve had enough sleep to even consider this option.
Post-partum depression:
After delivery, your hormones and lack of sleep will leave you confused and exhausted, and wondering about the wisdom of parenting after all. Nothing can prepare you for this, both the workload and the wonderful returns. You will undergo many changes.
The demands of a new baby, and the implausibility of getting enough sleep can lead to feelings of depression. This is generally considered “post-partum blues” in the first two weeks. For most women, these feelings will only last 4-7 days.
Rest as much as you can. This advice is critical to your healing in the first few weeks: do NOT vacuum the house, put together baby furniture, do the laundry, go grocery shopping or cook dinner those first 2 weeks - that's why they invented take-out!
Please lie down as soon as the baby falls asleep after feeding, every few hours the first 2 weeks. Try to maintain a healthy diet, and plan a future time for you away from baby to catch your breath (hair or nail appointment?) If your blues/depression lasts longer than the first 2 weeks, or seems more severe, we hope you trust us to ask for help.
If you aren't sure: call us:914.214.8616, and let our nurse Laurie or Kathy know that you don't feel yourself, and need to come in to chat with us. We have many ways we can help. This includes everything from consistent reassurance to medication to referral to a wonderful therapist.
Good luck!
Becoming a parent is one of the richest and most memorable chapters in your life, (although this may be hard tobelieve when you haven’t slept three days in a row.)
We wish you all the best, and thank you for the privilege of standing with you during this experience as your physician and practice. Even when you are working closely with your pediatrician, we are still here for you, and hope you will check in if you need advice or wisdom.
Please send us a photo of the baby for our Yorktown office, so that we all may enjoy your blessing. It also helps the newly pregnant moms to see the gift waiting for them on the other side of this challenging year!
"The moment a child is born,
the mother is also born.
She never existed before.
The woman existed, but the mother, never.
A mother is something absolutely new." ~Rajneesh
