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Post Partum Instructions
We hope this handout will
help you with answers to some of the questions that may arise in the
early days and weeks after having a baby. You can expect a call from
your doctor’s nurse soon after you come home from the hospital. She will
ask a few questions about how things are going at home, and will also be
happy to discuss any concerns you may have.
ACTIVITY
We recommend that you begin to gradually resume a regular exercise
program once you have recovered from your delivery. If you had a
Cesarean section, you should wait 2-3 weeks before beginning any
significant exercise and then slowly progress toward a normal level of
activity. Do not do exercises that are uncomfortable. At your 6-week
check-up appointment, we will discuss more strenuous activity. If you
have had a vaginal delivery, we suggest that you begin a program of
walking and light post natal exercises as tolerated, and then after 3-4
weeks, progress to your normal activity when your bleeding has ceased.
In the first few days home from the hospital, it is a good idea to lie
down and rest when your baby is sleeping.
PERSONAL CARE
The major bleeding after delivery will stop within 2 to 3 days. The
discharge/bleeding you can expect after that will be lighter in color
and flow, and will last for up to 3-5 weeks. If your flow increases
after it has begun to lessen, you should consider this a reminder to
slow down your activity for a while, and get off your feet. If you
should pass large bright red clots or have bleeding that is
significantly heavier than a period, you should call your doctor. If you
are not breast-feeding, you may have a period before your six-week
appointment.
Caring for your C-Section incision will be very simple. “Steri-strips”
of surgical tape were placed across the incision during surgery. These
may begin to fall off on their own, but should be gently peeled off
after 7 days. If your incision was sutured, the stitches will slowly
dissolve on their own. If your incision was stapled, these were mostly
likely removed before you came home (if not, please call the office to
schedule an appointment to have your staples removed). Keeping your
incision clean and dry is usually all that is needed. You may find that
a blow dryer works best for drying the incision after bathing.
If you had your tubes tied after a vaginal delivery, you probably came
home with a large Band-Aid over your umbilical incision. This Band-Aid
can be removed as soon as you wish to shower at home. You may find it is
easiest to dry these stitches with a blow dryer. If you notice redness
or drainage from your incision, you should call your doctor.
We recommend that you restrict sexual activity, douching, tampons,
swimming and tub baths until your bleeding has completely stopped. You
may shower or take sitz baths at any time (3-4 times a day is helpful if
you have stitches). You can gently cleanse your perineum and stitches
with soap and water. If you were given a prescription medication to put
on your stitches, you may do this 3 times a day or as directed. You may
resume driving when you can move quickly without hesitation. If you have
had a Cesarean section, this will take at least 3 weeks. Travel with a
new baby is difficult, and we suggest that you plan to stay close to
home for at least a month.
Hemorrhoids may cause pain or discomfort after delivery. You may use
Witch Hazel compresses, Preparation H, Anusol cream or suppositories, or
the prescription medication given to you. You may find that sitz baths
will help with the swelling, but staying off your feet as much as
possible for the first week or so after delivery will be the most
helpful. Please call your doctor if you have severe pain not relieved by
the above. It is important to have a thermometer on hand for both you
and your baby, and to be familiar with how to use it. You do not need to
check your temperature unless you feel that you are sick (having chills
or increasing pain). If your temperature is >101, please notify your
doctor. We will need to know if you are having other signs of infection
such as redness or pain in one or both breasts, foul smelling vaginal
discharge, or bladder infection symptoms (burning, frequency, blood in
the urine). Pain or redness in the legs should also be reported.
BREAST CARE
A good support bra is essential whether or not you are breastfeeding.
If you are nursing, a good nursing bra should be worn around the clock.
The most likely part of post partum recovery and adjustment to
motherhood that can be difficult is breastfeeding. However, the special
nature of the bond between a mother and her baby is such that most
problems are overcome. The two principal ingredients for successful
breastfeeding are patience and confidence. You and your baby must learn
to know each other and work together to accomplish the task of infant
nutrition. The hospital’s lactation specialist will have visited you
before you left the hospital, and she continues to be available to you
both by phone and by appointments to come in and work with her. She can
be reached at 352-333-5315. Your Pediatrician’s office can also offer
assistance. We recommend that new nursing mothers nurse in a very
private environment and allow themselves the luxury of total emotional
involvement in the baby during feeding. This helps to stimulate the let
down reflex. Do not allow yourself to be overly scrutinized while
nursing, as this can be confusing and detrimental. Your milk will
probably come in on the third day after delivery. We recommend that you
nurse your baby on both breasts at each feeding. Start feeding on the
breast you finished with last time. Your breasts will become less sore
and provide more milk if you nurse on both breasts each time. Please
consult either our office or your Pediatrician’s before taking any
medications, since many drugs do pass through breast milk into the baby.
Remember to increase your fluid intake while nursing. We recommend that
you continue your prenatal vitamins while nursing.
If you are bottle feeding, you should continue to wear a good support
bra around the clock for the first week after delivery. Your breasts
will reach a peak of engorgement about 72 hours after delivery. Avoid
all stimulation to the breasts (hot showers directly on your breasts,
nuzzling your baby against your breasts, or pumping to relieve
engorgement) as this will stimulate more milk production. Tylenol or
Ibuprofen is usually sufficient to relieve discomfort. Ice packs applied
to the breasts also will decrease swelling. Cabbage leaves applied
inside the bra against the breasts act as an astringent and can be very
helpful too.
BIRTH CONTROL
In general, this will be discussed at the six-week check up appointment.
If you are sexually active before that time, it is best to use foam and
condoms. Other forms of birth control are not recommended until later.
Remember that it is possible to conceive soon after delivery, and that
if you are breast-feeding you may not have periods but can still ovulate
and get pregnant.
CONGRATULATIONS!
All of us at North Florida
Women's Physicians look forward to seeing you in our office again soon.
If we can assist you in any way, please don’t hesitate to call.
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