After the birth of your baby, you will be entering Stage 3 of your birthing experience; the delivery of your placenta. The placenta is a vascular organ, about the size of a dinner plate. It is through the placenta and umbilical cord that your baby receives oxygen and nutrients during your pregnancy. After the birth of your baby, your body no longer needs the placenta and will release it from your body. Your uterus will then start to shrink, pushing the placenta out as it makes its way back to it's original size. At this point your Midwife, Doctor or Nurse will implement 'Active Management' care. The process of administering synthetic oxytocin to help the uterus contract thus expelling any retained placenta. In order for this to happen successfully there can not be any retained placenta or blood clots. While pregnant, the placenta pumped approximately 700ml of blood a minute. After the birth, it is normal to loose some blood as your body expels the placenta. Any blood loss over 500ml after the baby is born is considered a hemorrhage, blood loss of 1000ml can make you dizzy and/or anemic and needs to be dealt with by your caregiver.
As I mentioned above, during 'Active Management', synthetic oxytocin is administered within a few minutes of baby being born and after the umbilical cord has stopped pulsating. The umbilical cord will go from a purple blue colour to white, which means your baby has now received the remaining blood. Your Nurse, Midwife or Doctor will mention the importance of your uterus constricting and will help it by doing uterine massages. By gently pushing on your stomach in a downward motion, it will help the uterus clamp down on the placenta, expelling any retained placenta. The nurses in the 'Mother and Babe' unit will continue to check on your uterus to make sure it continues to shrink. Over the course of approximately 10 days, your uterus will continue to return to it's pre-pregnancy size (uterine involution), causing you some discomfort and pain. Your caregiver will suggest that you take pain medications and
an anti-inflammatory to help lesson the afterpains (period like cramping).
For the first 3-4 days you can expect to have bright red bleeding called lochia and is about as heavy as a menstrual period. Your Caregiver may suggest using postpartum "Padsicles" right after birth. Padsicles are sanitary pads that are covered in liquids, prepared approximately 1 month prior to baby's due date. They are frozen and help give some relief to the perineum and can help soothe hemorrhoids. Instructions for making Padsicles can be found here.
By day 3-4, bleeding will become more watery and change to a pinkish hue. If the bleeding becomes bright red again, you are probably over doing it. Try resting and see if it changes, bleeding that stays for over 16 days is unusual and as a precaution, should be discussed with your care provider. Between days 8-10 after birth, the pinkish flow should change to a thicker yellowy discharge. A little bit of flow or spotty bleeding may occur for 6 weeks after baby's birth but for some women it may disappear sooner. It is common to pass a few small blood clots after birth. Blood clots are usually maroon or dark red in colour. Blood can jell and pool inside the vagina when lying down or sitting and changing your position can cause clots to pass. If you feel a gush that fills your pad, please go straight to the emergency. There is a chance of hemorrhaging within the first 3 weeks after baby's birth so please take it easy. If you notice a piece of placenta or blood clot or have a fever, please let your caregiver know. Any placenta left inside may lead to infection and/or heavy bleeding. Always consult with your care provider if you are worried or have any questions. Things to be aware of:
Tampon Use - It is not recommended to wear tampons for the first 8 - 10 weeks after your baby's birth as it can lead to infection.
Stitches - If you received stitches due to tearing, use a peri-bottle with warm water as you pee to clean the area and lesson stinging. If it's painful to sit on your stitches you can purchase a donut ring or make one yourself using a rolled up towel. Dissolvable stitches usually take 3 weeks to heal and dissolve on their own. Continue to keep the area clean and dry to help the healing process. Contact your care provider right away if you notice any oozing, redness, increased pain or foul odor.
Afterpains - These labour like cramps are strongest during the first 2 - 3 days after the birth of your baby. The hormones that release your breast milk cause your uterus to contract bringing on afterpains. Taking pain medication regularly can help lesson any discomfort or pain. Don't wait until you start to feel it as by the time the medication sets in the pain may have already subsided.
Hemorrhoids - Hemorrhoids can be noticeable during pregnancy or after the birth of your baby. Ask your care provider if you can use a cream or ointment to help relieve any pain and shrink the hemorrhoid. You will need a prescription cream if the hemorrhoids are severe. Please contact your care provider right away if there is any bleeding or if there is any foul odor.
Bowel Movements - Drinking plenty of water and eating high fiber foods (lots of fruit and vegetables) can help you pass stool much easier. Ask your care provider for a stool softener if you are finding yourself constipated.
Sex - Check with your care provider and wait until he/she gives you the go ahead, usually between 6 - 12 weeks. There is a large risk of infection and if you've had any tearing and/or stitches they will need time to fully heal. When you do resume, take things very slow and if you feel any pain stop and check in with your care provider. Once you feel you are fully healed and ready, make sure to go pee after as 90% of UTI's are from having sex. Urinating right after can help clean out the urethra and lower the risk of getting a UTI.
Exercising - If exercising was something you did on a regular basis before getting pregnant or during your pregnancy and your care provider has given you the go ahead, then you can start slow with walking and increase from there. If you did not exercise before pregnancy or during, check in with your care provider, he/she can suggest a routine suitable for you. If you notice an increase in bleeding or have any discomfort or pain, then you are doing too much.
** Go directly to emergency if you soak an entire large maxi pad in less then an hour or feel faint.
** Notify your care provider right away if you:
- Experience bright red blood for a week or more after birth.
- Pass a clot bigger then a Canadian loonie.
- Have any fever and/or chills.
- Have increased pain in your back or lower abdomen.
- Notice a foul odor with your flow.
- Have any pain when you go pee, have to pee frequently or have an urgency to pee, as it could be a sign of a possible bladder infection.
No matter which way you gave birth, vaginally or by caesarean section, your body needs time to heal, so please don't try to rush it.
Congratulations on the birth of your baby, I wish you and your family all the best!