Caring for Yourself after Birth

The first few weeks after birth can be both wonderful and chaotic. Whether this is your first baby or not, it is a time of adjustment for everyone.

Having a baby affects the whole family physically, emotionally and mentally but will affect you who have given birth the most.

Your body

Here are some changes you can expect in the early days and weeks after birth and info on when to seek help.

Breasts

Your breasts will produce colostrum (early milk) until your mature milk comes in. It’s normal for your breasts to feel large, heavy and tender for a few days after birth as they become full with milk. Your mature milk will come in about 2-5 days after birth.

If you experienced a stillbirth or newborn loss, see lactation after loss for more information.

How you can help yourself

Breastfeed whenever your baby shows signs of hunger
Place a warm pad (e.g. a warm wash cloth) on your breasts before feeding to help them release milk
Place a cold pad on your breasts after feeding to ease discomfort

When to speak to a healthcare provider

Call your health care provider if you have signs of mastitis (a breast infection):

fever greater than 38 C
very swollen, sore or red areas on your breasts
general flu-like aches and chills

For more information

Breastfeeding questions and challenges: info on common issues with breastfeeding and what to do
BC Women’s Breastfeeding Clinic: Specially educated lactation consultants provide support for breastfeeding families and provide information and support to health care providers in BC
Vancouver Breastfeeding Clinic: Advice and support for breastfeeding mothers provided by family physicians with specialized training in breastfeeding medicine. Information for physicians and health care providers also offered. Patients wishing to participate in this program must be referred by their health care provider

Bowels

Constipation: You may feel blocked or constipated the first few days after having a baby

How you can help yourself

Drink lots of water and eat high-fibre foods
Take stool softeners (only use these for 5 days)

Fecal incontinence: inability to control your bowel movements

How you can help yourself

Talk with your care provider immediately about possible causes
Speak with a BC Women's physiotherapist about pelvic floor retraining

Hemorrhoids: swollen veins near your rectum/anus.

How you can help yourself

Use a hemorrhoid cream
Avoid straining with a bowel movement
Rest lying down to relieve the pressure

Call your health care provider if you have:

Not had a bowel movement for more than 3 days
Blood in your stool (poo)
Inability to control your stool
Painful haemorrhoids

For more information:

Healthy Families BC: Managing Bowel Movements After Pregnancy

Bladder

Having a baby can stretch and weaken the pelvic floor muscles and occasionally affect the nerves controlling the bladder. Leaking urine is common for the first 6 weeks following delivery.

Urinary incontinence: involuntary loss of urine

How you can help yourself:

Frequently empty your bladder in the first few days after birth
Attend the Postpartum Physiotherapy Class at BC Women's and learn how to find your pelvic floor muscles and do muscle strengthening exercises correctly

Call your health care provider if you have:

Severe pain when urinating
Constant leaking
Inability to pee
A strong need to pee but very little comes out
Leaking for more than 6 weeks after delivery

For more information

Belly

Cramping (after-pains) is common after birth as your uterus returns to its regular size. Cramps are often more intense when breastfeeding. It takes about 6 weeks for your uterus to return to normal size.

Take ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) to manage pain.

If you had a C-section, you may have stitches or staples in your lower abdomen. The stitches will go away (dissolve) within 2 weeks; the staples will be taken out before you leave the hospital. It is common to feel tender and numb around the incision (cut).

If you had a C-section help yourself by

Keeping the incision clean and dry
Showering using mild soap and warm water
Giving yourself time to heal by resting and not doing too much
Trying not to lift anything heavier than your baby
Not driving until you are pain-free and moving well

Call your health care provider if you had a C-section and notice any of the following:

Redness
Leaking from the incision
Bleeding
Worsening pain
Fever greater than 38 C or chills
Opening of the incision

For more information:

HealthLink BC - What to Expect after a C-Section

Vagina

During delivery you may have had vaginal tearing, or you may have had an episiotomy (cut) requiring stitches. Your vaginal area will take time to heal and the stitches will dissolve on their own. It's common to feel tender and sore for a few days or longer.

How you can help yourself

Place a cold compress or frozen sanitary pad wrapped in a thin cloth on the sore area for 10 minutes at a time for relief
Have warm sitz baths (sitting in water up to the hips) for 10 minutes, 3 times a day after the first 24 hours to ease pain
Rest lying down to relieve the pressure and improve swelling or pain
Take ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) for pain

Call your health care provider if you have:

Vaginal pain that is getting worse
Increasing swelling between your vagina and anus
Stitches coming out

For more information

Bleeding

How you can help yourself

Use sanitary pads for bleeding, not tampons, to prevent infection
Change your pad every 4 hours if you had a vaginal tear to reduce your chance of infection
Bleeding may increase with activity, and is normal

Bleeding after birth (PDF)

Call your health care provider if you have:

Bright red, heavy bleeding even when resting
Passing blood clots larger than a loonie over several hours
Bleeding that soaks more than 1 large pad an hour for more than 2 hours
Bleeding that lasts beyond 6 weeks

For more information:

HealthLink BC - Vaginal Bleeding After Delivery

Physical activity

Start moving right away but increase your activity gradually. It takes time to heal.

How you can help yourself

Balance rest with activity
Attend a postpartum physiotherapy class at BC Women’s

Postpartum physiotherapy class

Learn to recognize the signs of healthy recovery in the days, weeks and months after birth
Find out how to take care of yourself while taking care of your newborn
Get the right information about how to begin early, safe exercise (following a vaginal or C-section birth)
Learn how and when to progress your exercise
Learn more about ongoing back or pelvic pain, leaking urine, gas or stool, bulging abdominal muscles and/or pain or numbness in your hands

When to speak to a health care provider

Call your healthcare provider if you have increased bleeding that won’t stop.

For more information

Healthy Families BC - Physical Activity and Breastfeeding

Your mood

You may feel down, or have moments of crying or feeling anxious about three to five days after having a baby. The ‘baby blues’ affects 8 in 10 new mothers and is due to hormonal changes. The feelings usually go away within 2 weeks without treatment.

How you can help yourself

Try these self-care tips to help you feel better:

eat nutritious food (fruit, vegetables, lean protein, grains);
move your body every day (walking, stretching);
sleep and rest when you can;
find a few moments each day to do something you find important;
ask family, friends and healthcare providers for help.

When to speak to a healthcare provider

If your mood doesn’t improve after two weeks you may have postpartum depression or anxiety. Get help. Call your healthcare provider if you:

feel down, sad or anxious most days for more than two weeks;
feel irritable or angry;
feel guilty or worthless;
feel hopeless or overwhelmed;
have difficulty managing daily activities or caring for your baby;
have thoughts about harming yourself or your baby.

For more information

Support for postpartum/perinatal distress, depression and anxiety

Sex + birth control

You may feel like having sex days after delivering or much later - weeks or months after delivering. However, it is best if you wait until stitches or tears have healed and vaginal bleeding has lessened before having any sex involving the vagina.

If you are not planning on getting pregnant, it is important to use birth control if you are having vaginal sex with a male partner. You can still get pregnant after giving birth, even if you are breastfeeding or before your period starts again.

How you can help yourself

use a lubricant during vaginal sex to help relieve vaginal dryness, which is common;
breastfeed your baby before sex if you want to lower the chance of your breasts leaking;
explore other ways to be sexual or intimate with your partner if you do not want to have intercourse.

Call your healthcare provider if you have

severe, ongoing pain during sex more than six weeks after birth.

For more information

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