CARE AFTER DELIVERY

DR.SHELLU KARNAWAT

CHANGES IN THE UTERUS

Your uterus was stretched toaccommodate your babyduring the pregnancy Now ithas to contract and reach itsnormal sizeIn the first few days afterdelivery you might feel a hardround lump in the lower partof your abdomen This is theuterus which has contractedto half the size it was justbefore your delivery Theuterus will shrink rapidly inthe next few weeks

AFTERPAINS is the term used to describe the pains that you experience as the uterus shrinks The cramps can be relieved by a painkiller. A hot water bag can also be used

BLEEDING

It is normal to have vaginal bleeding for 2-6 weeks

after the delivery. The discharge from the vagina

after a delivery is called lochia. The amount of

bleeding may vary from day to day. The colour will

change from bright red to watery red to pink.

After a few weeks it will change to a clear white

colour.

BLADDER FUNCTION For months the uterus waspushing the bladder. During delivery too there wouldhave been pressure on the bladder .This can cause thebladder to lose sensation or to become NUMB. Youmight not always have the sensation that the bladder isfulleven though it is. It is important for you to passurine every 2-3 hours ,Drink plenty of fluids.

ATONIC BLADDER Sometimes the bladder becomes sonumb after the delivery that it might keep filling up withoutyour realizing it.After a few hours your bladder migh beoverdistended. You might have to have a catheterinserted.The best way to avoid an overdistended bladder isto make sure that you pass urine within 6 hours after yourdelivery and then at least every 2-3 hours after that.

KEGEL S EXERCISES It is a specific type of exercise for themuscles that support the vagina rectum and urethra.Strengthening these muscles can help bladder control after avaginal delivery and decrease the risk of getting a prolapse.You can start doing these exercises anytime anywhere.Squeeze the pelvic muscles for 10 seconds and repeat 20-30times .You can do this three times daily.

BOWEL FUNCTION You might have your first bowelfunction 2-3 days after your delivery. You might be scaredthat it might be painful because of the episiotomy. Thereis nothing to be worried about,Take foods high in fibreDrink plenty of water

HAEMORROIDS OR PILESIn pregnancy it is common to develop haemorroids Due to the pushing during delivery they may become bigger or painfulHOT SITZ Bath will help Take stool softeners Use a local an anesthetic ointment

EATING HEALTHY AFTER A DELIVERY In INDIA there are a lot of misconceptions about the food that can be eaten after a delivery .It is important to remember that there are no dietary restrictions after a delivery.Eat from food groups that contain plenty of iron calcium and proteins Drink enough fluidsContinue your prenatal vitamins and iron supplements

RESUMING NORMAL ACTIVITY You can start moving around as soon as you feel upto it. You can walk upto the bathroom and have a bath the very next day after a deliveryYou might feel tired and exhausted . Rest whenever the baby rests Once you are at home you can resume normal activity gradually

FLUID RETENTION It is normal to see an increasein the swelling in your legs during the first one or twoweeks after delivery,Remember that the body can retainupto 6 litres of water during a pregnancy.After deliverythis might tend to collect in your legs .In a few weeksthis swelling will come down by itself.

SEXUAL INTERCOURSE It is usually safeto resume intercourse 6 weeks after birth.

CONTRACEPTION

AFTER A CAESAREAN SECTION:

WHILE YOU ARE IN HOSPITAL You will be encouraged to get up

and and do deep breathingexercises after 24 hours

Urinating after the catheter isremoved can sometimes beuncomfortable

You might feel pain at the incisionsite

Soon you will be able to stroll nyour room Walking helps inrelieving the gas pain that youmight experience

AFTER YOU GET HOME Your activity level should begradually increased In the first week after you get home youcan walk around the room and take care of your baby .Overthe net week you can start walking around the house .In thethird week you can resume small domestic chores likecutting vegetables and making coffee and tea.A month afteryou are home you can resume your normal work includingcooking and washing .It is important not to lift heavy objectstill 6 weeks after the surgery.

CARE OF THE INCISION The incision should be kept cleanand dry.You may wash the incision with soap and water after thedressing is removed.Wear a cotton underwear and no tight fitting clothing.The incision will heal in a few days but it takes 6-8 weeksfor the complete healing of all the layers of the abdomenand uterus that were cut.

BATHINGYou can bathe every day. Gently apply soap and waterover the wound. There is no need to apply any lotion orcream over the wound.

EXERCISE After 4-6 weeks you may begin to exercise

POST PARTUM PERIOD: An excellent opportunity for HPV Vaccination

REASONS *You should not have a fever after you get home . If you have fever of more than 100 F for more than 24 hours. *Sudden onset of pain in the abdominal area accompanied by pain or tenderness

*Foul smelling vaginal discharge*Sudden onset of pain over the incision area along with redness or discharge Burning urination or *blood in the urine which may indicate a urinary infection

Extremely heavy bleeding or passage of clots.A Sore red painful area over the breast that may beaccompanied by fever

A swollen red painful area in the leg.Severe headache that begins right after birth notlessening in intensity

THANK YOU