Pregnancy is a beautiful experience, but many women face postpartum issues. From cramping and bleeding to pooping after pregnancy, Thalia, along with obstetrician Andrew R. Kramer, provides a guide to help you deal with your body after the baby is born. An excerpt.
Two weeks before my due date, one of my closest friends came to visit, and in her hand was a mysterious little bag. Curious, I asked her what it was. “Open it later and call me,” she replied. Inside the bag I found small, peculiar-looking squirt bottles, witch hazel pads, maxi pads large enough for the crotch of Godzilla, and a few sets of disposable hospital underwear.
When I looked inside this little bag I almost fainted, because up to that moment, all I had heard from everyone were light-hearted pep talks and pink balloons. No one talks about the real tribulations of postpartum care to a first-time mom who’s already on edge about everything else that a pregnancy entails. Our loved ones and even our closest friends protect us from the not-so-pleasantries, sparing us the details and allowing us to get there on our own. My aforementioned friend was the one who gave it to me straight; let me be the one to give it to you straight right here.
Let’s not kid ourselves: The postpartum period can be as challenging as those first few months when you were vomiting your way through the day, your body adjusting to its new cocktail of hormones and your belly slowly taking charge of your life. But the aftermath of birth brings with it an entirely new slew of physical challenges, as your organs shift back into place and the body recovers from the process of labor. Your breasts will become the two great planets around which all of life will seem to orbit, and you may feel more tired and physically drained than you could have ever imagined possible.
The truth is that it will be different for every woman, depending on what kind of birth took place: Mothers who had C-sections and episiotomies, for example, have essentially endured delicate surgeries, which require time and plenty of rest until the healing is complete. Though each mother’s process of restoration will be unique, given how complicated or straightforward her own delivery may have been, or what kind of personality your baby has, the key to getting through the postpartum time is to honor this final frontier of your pregnancy. Acknowledge that the fourth trimester is a natural and necessary part of the healing experience for both mother and baby, because the two of you went through a shock in birth. Whatever comes up, do not be afraid; you’ve been through the worst of it, and by now you are a seasoned pro in the art of endurance.
Tips Familiarize yourself with this general list of symptoms and conditions that may arise as your body heals. This way, you’ll have fewer surprises and more time to recover.
• Abdominal pain or cramping: Not unlike mild contractions or menstrual discomfort, these pains occur as the uterus contracts back to its original size during a process known as involution, which can take anywhere from four to six weeks. Ways to avoid and sometimes treat abdominal pain include not sitting or standing with your legs crossed, drinking plenty of water, stretching your muscles regularly, and talking little walks.
• Baby blues: Not to be confused with postpartum depression (see “Gentle on the Mental,” page 178), which is a lot more serious, baby blues can kick in, lasting for a few days or a few weeks, during which you experience moodiness or even some sadness. Book yourself a day at the spa and get yourself nice and pampered, which is something that always cheers me up. Talking about your feelings with your partner, friends, or family is also therapeutic and healthy for the psyche.
• Bleeding: Heavy, bloody vaginal discharge will occur for about a month after the birth, as all of the remaining tissues and fluids are released from the uterus. The blood is bright red and typically appears as thick clots or mucus in the beginning, lightening up to brownish or yellow spotting as it subsides. Use supersize sanitary napkins or disposable underwear for the first few weeks, but do not use tampons for at least six weeks after delivery. But perhaps worse than the sight of all that raw blood is the smell it brings with it. It is a rancid, gag-worthy stench that essentially trails you for weeks after your delivery. I made sure to keep aromatic candles and oils like lavender and eucalyptus in my bathroom and in the common areas where I’d host visitors. (Note: These scents may be too strong for the baby’s room.) If you feel that bleeding has gone on too long (past a month), consult your doctor.
• Bloodshot eyes: Red eyes and/or dark circles around the eyes can result from pushing during delivery. Chilled slices of cucumber on the eyes are refreshing and help to brighten the eyes.
• Breast problems: Cracked nipples or engorgement due to breastfeeding may occur.
• C-section scar: Women who have undergone C-sections will also have a post-op incision to contend with; after a few days it will tighten and seal. Within seven days or so, the scar should start to fade, and vitamin E can be used to further lighten the mark. Contact your doctor if you suspect an infection in the area or if the scar feels painful beneath the surface.
• Epidural side effects: Epidurals can sometimes leave some residual symptoms that include nausea, headaches, itching, leg numbness, and soreness at the site of the injection. Anesthesia can also cause constipation, which you can relieve with a stool softener, enema, or suppository. For the itching, try applying some chamomile lotion, and if the nausea gets really bad, consult with your doctor about other possible treatments.
• Exhaustion: No getting around this one, it just comes with the territory. You can try get ahead of the exhaustion by making sure you are getting seven to eight hours of sleep nightly, which I know is easier said than done. See “Counting Sheep, Yearn to Sleep,” page 180, for tips on catching your Zs.
• Gas and bloating: Slow digestion and trapped air in the belly can cause severe gas and bloating, easily treatable with enemas and suppositories.
• Hair loss: Some women experience extreme hair loss after giving birth, a condition known as postpartum alopecia. Generally, hair will start to grow back within the next year and a half, and depending on how noticeable it is on you, experimenting with new styles can help to ease the transition.
• Hemorrhoids and fissures: It’s possible to get these grapes of wrath from pushing during labor and delivery, as well as fissures, which are tiny tears in the skin around the anus. Sometimes the hemorrhoids are minor — but other times these little monsters explode from within the anus like some sort of unruly, purposefully destructive force, leaving one’s bottom unmercifully raw. There are excellent hemorrhoid-relieving creams, such as the old faithful Preparation H, to relieve the irritation and quell the burn, and stool softener also helps things along so that you don’t have to work so hard. There is also a fabulous little invention that might just be as relieving to an overly irritated bum as it is embarrassing to lug around — the notorious donut. The donut is a pillow-like tube-shaped mobile seat you can take anywhere, making the prospect of sitting viable.
• Incontinence and difficulty going to the bathroom: The first poop is another subject no one is dying to discuss. Women are scared to push, and everything stings. Thankfully one of my sisters filled me in on how to prepare for this dilemma by instructing me to eat lots of fiber and drink tons of prune juice as I got close to delivery; she also insisted I start taking a stool softener immediately after the birth .... Never mind the notion of wiping afterward, especially if you have stitches on your perineal area like a bridge from Manhattan to New Jersey. I quickly learned what the squirt bottles and witch hazel pads from my friend’s goodie bag were for!
Some women also experience postpartum incontinence (leaking urine), because the pelvic floor is weakened after the birth, and most women find themselves urinating more often than normal as the body gradually releases all of the water that accumulated during the pregnancy. If incontinence is a problem, don’t be afraid to wear adult undergarments like Depends, and know that this too shall pass.
• Night sweats: The hormonal changes that occur after you give birth can cause any number of different problems, one being night sweats. I had to sleep with three to four sets of pajamas and underwear next to my bed, because I would wake up soaked in my own sweat, leaving puddles of perspiration on every square inch of my sheets. To aid your body in eliminating the hormones you no longer need, drink plenty of water throughout the day, and at night put a towel under your sheets to soak up excess sweat.
• Sleep issues: For so many reasons, both logistical and physiological, women will suffer from sleep deprivation during their pregnancy, and certainly after they give birth. If it is a case of restlessness or insomnia, a bit of exercise each day can help that, as can a soak in a warm tub before bed. Unfortunately, getting up in the middle of the night to tend to a crying or hungry baby is simply unavoidable.
• Soreness of the perineum: General soreness and stinging of the vagina and/or perineum is common. If your nether-petals hadn’t swollen during pregnancy, they will swell and very likely hurt like hell for several weeks after the delivery. The vagina, tough as she is to be able to endure the miracle of birth, also happens to be one of the most delicate parts of your body. The poor thing will sting, burn, itch, and irritate. To tame the flame, try sitting on an ice pack; not only does it cool your business, but it’s also generally invigorating when you’re not feeling tip-top. You can also dab the area with witch hazel pads, or consider sitting in a cool sitz bath, which is a traditional European method of soaking just the hips and buttocks, typically to relieve any discomforts related to the pelvic area. You can find plastic sitz baths at most drug stores and pharmacies.
Need to relax? Here's Thalia's recipe for her pomegranate mimosa:
1 glass sparkling cider
1/2 ounce pomegranate juice
Lemon peel for garnish
Pour the sparkling cider into a champagne flute. Add the pomegranate juice. Garnish with the lemon peel or drop it right into the drink.
Excerpted from “Thalia: !Radiante!” Copyright (c) 2009, reprinted with permission from Chronicle Books.