The postpartum period is a dynamic adjustment stage for your body, your baby, and your family. Most people stay in the hospital 1 to 2 days after a vaginal birth and 2 to 3 days after a C-section.   Six weeks after delivery you will have a full physical exam at our office and birth control will be discussed.  If you have had a high-risk condition, you may be seen more frequently. You may feel overwhelmed at times—this is normal. We hope these instructions serve as a guide, but they are not an exhaustive list. We are here to help, to answer questions, and to guide you through your recovery. 

At Home 

• Don’t drive until you are no longer taking opiate pain medications. If you had a cesarean section, you can drive when you can slam on the brakes in a car without your abdomen hurting.

• Walking at a slow to moderate pace is encouraged. Take it slow when doing simple housework or when climbing the stairs. 

• You may need others to help you with chores, cooking, and errands. You may add activities as you feel able, but if you feel overly tired or uncomfortable, you should decrease activity again.

• Sleep when the baby sleeps. Naps throughout the day are encouraged since consistent sleep overnight will be difficult with a newborn. 

• Vaginal bleeding will continue on and off for 4-6 weeks. Use pads or panty liners as needed, but tampons should be avoided. 

• Avoid constipation:

• Eat a diet with fiber including fruits, vegetables, and whole grains.

• Drink 6 to 8 glasses of water a day, unless directed otherwise.

• Over the counter medications (May use both if needed)

• Docusate sodium (Colace®) 1- 3 times/ day as needed

• Polyethylene glycol (MiraLAX®) 1 capful 1-2 times/ day as needed

• Do not put anything in the vagina until instructed by your provider. No tampons, douching or sex for at least 6 weeks, but may vary depending on healing. 

• Continue your prenatal vitamin for at least 4 weeks after delivery. If your prenatal vitamin contains iron, please keep in mind this can be constipating. You may benefit from a prenatal vitamin without iron depending on your health history. Please discuss this with your doctor. 

Breastfeeding Moms

• Discomfort from engorgement will decrease in 2-3 days. Use ibuprofen and warm packs as needed, as well as warm showers. Supportive, but not overly tight bras will help. 

• If a milk duct becomes clogged, gentle massage can help relieve the blockage.

• Nipple pain and soreness will improve with time. Lanolin and Vit A and D ointment will help with sore or cracked nipples. A large crack or fissure may require vitamin E oil to heal but wash it off thoroughly prior to nursing. 

• Lactation consultants are available after discharge from the hospital if needed. 

• You may notice increased cramping after nursing; this is normal.

• You should consume a total of about 500 calories/day over the pre-pregnancy diet

• Ensure you are getting enough liquids, calcium (about 2000 mg/day), protein, and rest, as all of these will affect you and the quantity/quality of the breast milk. 

• Each time the baby nurses, you should drink 8–12 ounces of fluid.

• Signs of breast infection (mastitis) include flu-like symptoms, fever, and a red, tender, warm spot on usually one, but sometimes both breasts. Please call our office if you experience these symptoms. 

Non-breastfeeding Moms

• Your milk supply may come in 2-4 days after delivery and is associated with breast swelling and tightness as well as low-grade fevers. 

• Wrapping your breasts will decrease engorgement and can be done with 1-2 tight fitting sports bras or an ace bandage wrap for 2-3 days. Emptying your breasts will lead to further production and should be avoided. 

• Ice packs and ibuprofen can be used as needed.

Cesarean delivery

• Wash incisions with mild soap and water and pat dry. Do not scrub your incisions. Do not use oils, powders, or lotions on your incision.

• Keep incisions clean and dry; do not cover your incisions with tight clothing. If you have steri-strips, you may remove them when the edges start to peel up (usually 5-7 days). If you have surgical glue on your incisions, you may remove it when the edges start to peel. 

• Don’t lift anything heavier than 15 pounds for 6 weeks. This includes heavy housework such as vacuuming, heavy gardening or yardwork, and laundry. No swimming in the pool, hot tub, or lake.

Vaginal tears or episiotomy

• Keep stitches clean with generous washing with a squirt bottle filled with warm water after each trip to the restroom. Then, pat the area dry. Try to avoid rubbing. You may also use a blow dryer on a low setting

• Stitches dissolve in 3-4 weeks. 

• Sitz baths can be done 2-3 times per day as needed for pain relief and cleansing.

Contraception

• In general, intercourse should be avoided until your postpartum visit at 6 weeks.

• Pregnancy is possible as soon as 2-4 weeks after a delivery. 

• We will discuss family planning and contraception with you at your postpartum visit. The best choice for contraception is determined by your medical history, and how long you plan to wait to conceive again. Sterilization is an option (male or female) if you are certain you have completed childbearing. We have information on all birth control options and will be happy to help you with your decision.

When to call your doctor

• Headache unrelieved by Tylenol accompanied by blurred or spotty vision, increased swelling of face, hands or feet

• Temperature of 100.5 or greater unrelieved by Tylenol

• Vaginal bleeding that soaks more than 1 pad per hour or large clots (larger than a baseball)

• A smelly discharge from the vagina

• Pain, burning, or trouble with emptying your bladder

• Severe pain in your abdomen that is not improved by pain medications

• Your incision becomes red, warm, and oozes pus. Mild swelling and clear drainage at the incision is normal.

• Nausea and vomiting where you can’t keep any food/fluids down or is becoming dehydrated

• Feelings of sadness, hopelessness or severe anxiety

Follow-up

• You will have a postpartum visit around 6 weeks after delivery.

• You may be seen more frequently if you had elevated blood pressures during pregnancy or delivery or if you had other high-risk conditions.