POSTPARTUM CHANGES: TAKING CARE OF YOURSELF

The moment you’ve waited and planned for—your child’s birth—has arrived. The first days and weeks with your newborn will be a very busy time. One of your greatest challenges will probably be to find time to take care of yourself. Fortunately, there’s much you can do to help yourself to heal and to adjust more easily to the changes in your life.

During the first few hours or even days after giving birth, you can expect to feel both very excited and very tired. You may feel very happy or you may feel sad immediately after birth; you may want to gather friends and relatives around you to celebrate the birth, or you may want private time to start breastfeeding as soon as your baby is ready. It can be helpful to talk about how the labour and birth went with your nurse or doctor. Just don’t forget that both you and your baby need and deserve a good, long rest after the exercise of childbirth!

The period during which your uterus repairs itself and returns to normal size and during which most of your physical recovery takes place—the first three months or so after childbirth—is called postpartum(don’t be confused-the word postpartum has many definitions; this is just one of the many). Understanding the changes that affect your body during this time will help you know that you are recovering well.

Let’s take a look at a few body changes you may encounter.

	THE FIRST HOURS AFTER BIRTH	THE FIRST WEEK AFTER BIRTH	THE SECOND WEEK AFTER BIRTH	THE THIRD WEEK TO THE THIRD MONTH AFTER BIRTH
Lochia	The placenta separates from the uterus and is pushed out over the first 30 minutes after birth. If you breastfeed immediately after birth, that separation will often happen more quickly.	You will experience a vaginal discharge called lochia over the next few weeks, as your uterus heals. For the first one to three days after giving birth, your lochial flow will look much like your period. It should be dark-red or brownish. It may contain clots that should not be larger than quarters, and it should smell like blood. From days 3 to 10, this flow turns pink.	Lochial flow at this time is made up of a small amount of blood, mucus, and white blood cells. The colour is pink or brown-tinged. It usually continues until about day 10. Call your caregiver if you notice a fishy odour, or if you notice a bright red colour or clots after your lochia has turned pink. After day 10, your flow should become white or pale yellow.	White or pale yellow lochial flow lasts from two to eight weeks. It should not contain any blood or clots and should not have an odour. If you are breastfeeding, your period will usually start again one to three months after weaning. If you are not breastfeeding, your period can return anywhere from one to four months after the birth.
Uterus	Your uterus stretched to hold your infant and now needs to shrink back into a tight ball of muscle. Your nurse or doctor may gently massage the area over your uterus to feel for this tightness. Right after birth, you will be able to feel the top of your uterus just below your bellybutton.	Your uterus shrinks a little every day. By the end of the first week, you should be able to tell that it has grown smaller. Your nurse or doctor may want to teach you how to locate your uterus and feel for firmness to make sure it shrinks about one finger-width a day. Some women will notice “afterbirth pains” that feel like menstrual cramps. These cramps are the result of the muscle of the uterus contracting back to its pre-pregnant size. These pains are usually felt more strongly by women when they start to breastfeed or by those who have given birth to other children.	By the end of the second week, you should no longer be able to feel the top of your uterus through your belly. The “afterbirth pains” you may have felt should be over.	Your uterus should return close to its pre-pregnant size by the sixth week.
Perineum	The area between your vagina and rectum is called the perineum. After giving birth, this area is often swollen and may have torn. Your health care provider may have made a surgical incision here called an episiotomy.	Your perineum will probably still be swollen, and it may be uncomfortable for the first week.	Swelling should be mostly gone by the end of the second week. If you had an episiotomy, the area may still be uncomfortable.	If you have an episiotomy wound, it should heal by the end of the third week.