Postpartum Problems

Your Body After Baby

What to Expect and What to Do about Postpartum Problems

By Lynsey Caldwell Owen, MD, FACOG

Congratulations! You have made it through 40 weeks of pregnancy and the birth of your little one – now it’s time for the home stretch. The postpartum period is filled with lots of joy, but many women also experience their share of discomforts. While your doctor or midwife is a great resource, these tips may help you prepare or cope with some of the most common postpartum troubles.

After a vaginal delivery, many women can have vaginal or perineal pain and irritation. Often this is related to tears and the stitches required to repair them, but even without tearing, a feeling of pressure or discomfort is not uncommon. Oral medications like ibuprofen (Motrin, Advil) and acetaminophen (Tylenol) can be helpful, but sitz baths (soaking your bottom in a few inches of warm water two to three times per day) can relieve pain and help promote more rapid healing. For the first few days after delivery, ice can also provide some relief. Try putting some water or witch hazel onto maxi pads and freezing them for easy perineal “ice packs”.

Straining to have a bowel movement can be uncomfortable whether you’ve had a vaginal or cesarean delivery. Constipation can also cause or worsen hemorrhoids. Staying well hydrated and eating a diet rich in fiber will help to ease the passage of bowel movements. For the first few weeks after delivery, a stool softener or gentle laxative can also be helpful. If you do have hemorrhoids, ice packs, witch hazel pads (like Tucks), sitz baths, and over-the-counter hemorrhoid creams can provide relief. Most women will notice a significant decrease in the size of hemorrhoids, as well as the associated discomfort, within a few weeks of delivery.

For breastfeeding moms, nipple concerns may top the list of postpartum pains. Lanolin ointments can help soothe and protect nipples as the newborn perfects his or her latch. Hydrogel pads may also help with healing nipples that are sore and cracked. Wearing loose shirts, or going topless entirely, will minimize irritation secondary to friction. If nipple pain does not improve or seems to be getting worse, talk to your doctor or seek help from a lactation consultant.

Another common complaint shortly after delivery is swelling of legs and feet. Many women assume the puffy feet will disappear as soon as the baby is out, but often the swelling gets worse before it gets better. As long as it is equal on both sides and not associated with pain, redness, chest pain, or shortness of breath (which can be signs of a blood clot), the swelling will usually start to improve within a week of delivery. Hydration and elevation of the lower legs while resting can help speed the process along.

Arguably the most difficult part of the postpartum period is the inevitable fatigue. Before baby, illness or injury was a ticket to resting in bed or on the couch. Unfortunately, consistent sleep is not so easy after delivery. The age-old wisdom holds true here — “Sleep when the baby sleeps”. The postpartum mom should have two primary jobs: to care for the newborn and to heal. So when baby is sleeping, that’s the time to focus on your own resting and healing. Enlist others to help with cooking, cleaning, laundry, shopping, caring for older children, or any other tasks that are important to the family. Dedication to rest will aid your recovery and pay off in the long run.

Sleep deprivation, frustrating aches and pains, and the responsibility for a tiny human can be an overwhelming combination. Feeling stressed, tearful, and even sad is not uncommon in the first few weeks after delivery. Having a good support network can help to alleviate some of these negative emotions, but it is important to seek help if these emotions persist, outweigh the happiness of having a new baby, and/or inhibit your ability to care for yourself or your newborn. Your doctor may be able to connect you with a postpartum support group and provide other resources to help you get through this difficult time. Don’t be afraid to ask for assistance.

As always, if you are concerned about any symptoms that you may be experiencing, or if you have tried these suggestions without any relief, please contact your obstetric provider for further evaluation and advice.

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