Postpartum Instructions


 

Appointments

Please call to schedule a visit for 2 weeks after Cesarean Section with another visit at 6 weeks. We should see you 6 weeks after a normal vaginal delivery. We may ask you to come in sooner if you had a complicated pregnancy or delivery. If you think there is something wrong, we will bring you in as needed. At the post partum visit we will do an internal exam, discuss activity, intercourse and contraception.  We will see you again at 3 months to follow up, do a pap smear and discuss any further concerns you have.

Activity

For a normal vaginal delivery you will be limited by fatigue and the hours with a new baby. You should not engage in vigorous exercise or swimming until after your 6-week visit. Walking or stretching exercises are fine if they are comfortable and not done to excess. Getting out for a walk will actually make you feel better. Driving short distances is fine if you feel clearheaded and are not on narcotics. Tub baths and showers are safe. You should not have intercourse until after your 6-week visit. Between the delivery and new baby fatigue it will take a full 6 weeks to recover. If you do too much, it will actually prolong your recovery.

For a Cesarean section the recovery is longer. You have had major surgery and need to be patient with your body. For the first 2 weeks, limit stairs to a couple of times a day and do not carry the baby up and down stairs. You will not feel like exercising at this point and will still probably need narcotic pain medication. No driving, no intercourse and no tub baths. Showers are fine. At the 2-week visit we will discuss increasing your activities. After the 6-week visit you should be able to return to normal work and exercise, but expect that you may still have fatigue and occasionally some discomfort for a few more weeks.

Breast infections

It is not unusual to develop mastitis or a breast infection while nursing. Call if you have fever over 101 degrees, especially if associated with a red, hot, tender area of the breast.  Mastitis is treated by a combination of nursing, hygiene and antibiotics.

Diet

You should be able to return to a normal diet after delivery. If you gained excessive weight, do not start a weight loss diet until we have seen you for your 6-week visit. You should also discuss calorie intake with your pediatrician if you are nursing. Adequate fluid intake is important to nursing moms, so fluid should be increased to about 12  glasses a day. You may find certain foods upset your baby’s stomach.  Discuss any limitations on food types with your pediatrician. Continue your prenatal vitamins as long as you are nursing.

Emotional changes

It takes about 3-4 weeks for your hormone levels to return to pre-pregnancy levels.  It is not unusual during this time to have some tearfulness, anxiety, and a bit of a short fuse.  This is what we call Post Partum Blues. It is self-limiting and should not be severe. Often joining a new mother’s group will help.  Getting out of the house alone or with your husband is also helpful and the baby will be fine for a short time with a sitter.

If you or your loved ones feel that you are having significant depression, crying, difficulty sleeping or getting out of bed, call the office so we may help. If you feel you are not coping as you should, please call us. Sometimes new moms just need to talk. Sometimes they need short term counseling or medication to transition this period.

More information

Healthy New Moms is a site with information for new mothers on emotional and physical health.

The Mayo Clinic and has current and accurate information on a multitude of subjects including postpartum depression.

Laceration/episiotomy care

You will have some tenderness in the area of any stitches that were needed. Ice packs help for the first 24-48 hours. After that soaking in a warm tub will help with the discomfort. Tucks and Epifoam are over the counter and will also help with discomfort.

Hemorrhoids

You may use Tucks or Preparation H. Try not to get constipated. Percocet and Codeine will increase constipation so avoid them unless needed to manage Cesarean Section pain. If these suggestions do not help, call the office so we may see you for an appointment.

Menstruation

Return of your period after delivery is highly variable, especially if you are nursing. The first cycle is often heavy with clots, but by the second has become more normal. While you are less likely to conceive when nursing, it may still occur. You should consider contraception before engaging in intercourse.

Intercourse

You should not engage in sexual relations until after your 6-week visit. Your body needs time to heal and you are at increased risk of infection. At your 6-week visit we will discuss contraception. It is not unusual when breast feeding to experience vaginal dryness and pain with intercourse. It generally improves when your menses returns. You may use a lubricant such as Astroglide or Replens. If you are still having discomfort, we will discuss other treatment options with you.

Remember with a new baby, changes in your body and fatigue, it is not unusual to have little interest in intercourse. Discuss openly how you are feeling and that you still love and are attracted to your partner. If you are having significant issues, please schedule a visit.

Travel

After a normal vaginal delivery, moms are ok to travel after 2 weeks. We recommend 4 weeks after a Cesarean Section. You should discuss with your pediatrician when the baby is ready to go traveling.

Location
Capital Women's Care
9711 Medical Center Drive, Suite 109
Rockville, MD 20850
Phone: 301-762-5501
Fax: (301) 309-8727
Office Hours

Get in touch

301-762-5501