My dear mother, in her infinite wisdom, only ever told me how she heard the “angels singing” when her babies were born. Little did I realise that, besides the initial euphoria as the baby comes into the world, hours of labour and the enormous physical effort of pushing a baby out would leave me exhausted, shaking and sore from head to toe. Of course, I’ve learned this is perfectly normal.
As a midwife and a mother of four, and having been through both natural and C-section births, I’ve compiled a post-birth recovery plan, based on my experience, which you may find useful.
The recovery room
Women from the labour wards and theatre all stay in the recovery room for about an hour or two to be closely monitored for signs of after-birth complications before they are sent to the postnatal ward. Called the “magic hour”, mother and baby snuggle skin-to-skin. This helps with recovery, breastfeeding and bonding.
Midwives check vaginal bleeding, control pain and change or remove drips (depending on the doctor’s orders). Once the midwife is happy your blood pressure is normal, bleeding is under control and your baby is coping with the change, you’ll be taken to the postnatal ward.
After a vaginal birth
- When you feel ready, and with the help of your partner or midwife, take a walk to the toilet, and have a warm (not hot) bath.
- Tell your midwife if you are passing clots and using more than one pad every hour.
- You may not be hungry, but eat a light meal to prevent nausea.
- Take paracetemol for painful stitches, sore muscles and period-like cramps after breastfeeding.
- Your baby will only suckle a few mouthfuls of rich colostrum at a time, but this is enough to last two to three hours.
If you had an epidural
- It’s best to lie flat on your back for the first few hours.
- Don’t get up until you have the full use of your legs. The “ice-test” can be done to make sure the epidural is wearing off.
- Tell the midwife if you have a headache, or feel dizzy or nauseous when you get up.
- Ask your partner or midwife for help when you do this for the first time.
If you had a C-section
- While you’re in the recovery room, you’ll be given pain injections to avoid the shock of returning pain when the epidural or spinal block wears off.
- Make sure you get pain injections regularly for the first 12 hours after the op, and take pain tablets as often as needed after that.
- As soon as you can move your legs, turn over, bend and straighten your knees and rotate your ankles. Do this as often as possible.
- You’ll only be able to do this once the catheter and drip have been taken out.
- You can bath or shower when your doctor has checked the incision and given you the OK.
- Firm (not tight) support panties are helpful.
Post-birth warning signs
There’s a difference between bleeding after birth and haemorrhaging. Heavy bleeding (like a heavy period) is to be expected, but if you need to change your pad every half hour, and you’re passing big clots, there’s a problem.
Call the midwife if you’re feeling:
- Dizzy and nauseous with blurred vision
- Anxious while looking pale with cold clammy hands in spite of feeling hot
- Weak, faint and lethargic.
High or low blood pressure
If you had high or low blood pressure during your pregnancy, this will usually resolve on its own after birth, but your midwife will need to keep a close eye on this. Women with eclampsia will be taken to high-care, because there is also a risk of haemorrhaging. High blood pressure with other causes will need to be treated with medication.
Signs of high blood pressure include:
- Severe headache
- Feeling sleepy and listless
- Seeing spots, or other visual disturbances
- Feeling nauseous or vomiting.
Low blood pressure can happen during or after a C-section, when pain injections are given or when you have an epidural. A drip is put up to prevent this. Low blood pressure also risks haemorrhaging and is a sign of shock.
Signs of low blood pressure include:
- Looking pale
- Feeling weak and dizzy
- Feeling confused and faint.
Infections can seriously delay recovery and cause complications if ignored and women are especially vulnerable after giving birth. Infections can be caused by a C-section, vaginal tearing, episiotomy (cut) or invading organisms through the vagina.
Signs of infection include:
- Fever – temperature of, or above, 38°C 24 hours after birth
- Heart palpitations (fast pulse) nausea and feeling faint
- Flu-like body aches and pains
- Tenderness and inflammation around the incision.
Other infections to consider:
- Breast infections can begin at the nipple and spread to the ducts.
- Bladder and UTI (urinary-tract) infections can be caused by the catheter.
- Phlebitis can be caused by the drip.
Blood clots (thrombosis)
These are a biggie, and fortunately very rare. They’re also unpredictable and can cause multiple complications.
There are some things you can do to help:
- Make sure you don’t become dehydrated during labour and after birth.
- Keep moving your legs and rotate your feet while you’re in bed.
- Never cross your legs.
- Get up and about as soon as possible.
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