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Postpartum instructions

Take care of your well-being after giving birth with these guidelines for managing pain, handling side effects and getting the proper rest and nutrition.

Thank you for choosing Midtown OBGYN for your pregnancy care.

At My Midtown OBGYN in Denver, CO, we know your baby is your main priority, but we want to ensure you continue to take care of yourself too. Please call (303) 321-2166 to make an appointment for your six-week postpartum visit.


Postpartum instructions

Taking care of yourself is just as important post-pregnancy as it is during your pregnancy. Below are general guidelines you should follow as you recover from labor and delivery.


Pain control after delivery

You may take Ibuprofen (600mg every six hours or 800mg every eight hours) as needed for discomfort. Ibuprofen is preferable to stronger narcotic medications because it does not cause sleepiness or constipation, and it is non-addictive. Do not take Ibuprofen on an empty stomach.

If you need additional pain relief, continue taking Ibuprofen, and add a prescribed narcotic. You may take one to two by mouth every three to four hours as needed for moderate to severe pain. Do not take on an empty stomach as it may cause sedation and constipation. Both drugs are safe while breastfeeding.


Prenatal vitamins, supplements, and birth control

If you are not breastfeeding, continue taking your prenatal vitamin for six weeks. If you are breastfeeding, keep taking your prenatal vitamin for as long as you are breastfeeding.

If you take iron supplements during pregnancy, continue until your six-week postpartum visit. If you have postpartum anemia, your doctor will recommend starting iron supplements. You may take iron sulfate 325mg one to two times per day for six weeks. Alternatively, you may take elemental iron 60mg once daily for six weeks. Both are available over the counter.

You and your doctor will discuss birth control options at your postpartum visit.


Constipation

Drink at least 64 ounces of fluids per day and eat a fiber-rich diet (whole grains, fruits and vegetables). You can also use medication (like Milk of Magnesia) to prevent or treat constipation. Your doctor will inform you which over-the-counter medicines are safe to use while breastfeeding.


Emotional changes

You may feel tired, anxious or sad, and you may notice you cry very easily. This is normal and is called postpartum depression or "baby blues." These feelings can begin a few days after delivery and usually disappear in about a week or two.

Prolonged sadness may indicate postpartum depression. Please call the office to speak with us if you are experiencing extended periods of severe sadness.


Breastfeeding

Wash your breasts for cleanliness daily with water, as soap can be very drying and unnecessary. Air dry nipples after each feeding. If nipples are sore, apply a bit of nipple cream or ointment after feeding and let air dry. Cooled, wet tea bags over your nipples can also be soothing. If your breasts are engorged, apply warm packs and gently squeeze out the milk.

If you are not breastfeeding, wear a well-fitting bra for support. Use ice packs to relieve discomfort from engorgement (a bag of frozen peas for each breast works well). Avoid nipple stimulation and do not press out milk, which encourages more milk production. Non-breastfeeding engorgement will subside in 24 to 72 hours. You may use pain medication as directed above.


Activity after delivery

Rest is extremely important. Do not do heavy housework or strenuous exercise for two weeks. Walking is the activity of choice during this period.

If you had a vaginal delivery and are not taking narcotics, it is acceptable to drive. If you had a Cesarean section (C-section), do not drive for one to two weeks (or longer if still taking narcotics). If you had a C-Section, you should avoid heavy lifting for six weeks. You may carry your baby in a car seat, but nothing heavier, and you may go up and down stairs.


Pelvic rest

Avoid tampons until your postpartum visit. Do not douche.

Generally, we recommend abstaining from intercourse until you are six weeks postpartum. However, if you are between four and six weeks postpartum, have completely stopped bleeding, and your episiotomy is well-healed and non-tender, it is okay to have intercourse.


Uterine cramping

Uterine cramping is normal, especially while breastfeeding. This cramping is how the uterus stops bleeding and returns to its pre-pregnant size. The uterus takes four to eight weeks to return to its pre-pregnant size.


Vaginal bleeding and discharge

Postpartum vaginal discharge, also called lochia, usually lasts about two to six weeks, yet even eight weeks is standard. The color will change from bright red to brownish to tan and decrease each week. It is normal to occasionally have a heavier discharge of blood, especially after breastfeeding or with increased activity. Your bleeding should then return to the amount of flow you had beforehand.

Normal bleeding is less than a pad per half hour. If you are soaking a large maxi pad more than every half hour, more than once, please call your doctor. Do not use tampons until after your six-week postpartum visit. If you are not breastfeeding, your period will resume in approximately six to eight weeks. If you are breastfeeding, it is common not to have your period.


Episiotomy and laceration care

A Sitz bath (sitting in a tub of warm water for 15 minutes, two to three times per day) can help to relieve discomfort resulting from lacerations. Additionally, cooling pads, witch hazel and lidocaine, may be applied to the external vaginal area as needed. You may also use oral pain medications as described above. Stitches will dissolve in one to three weeks.

If you are not constipated, you will be more comfortable; please follow the directions above to prevent/treat constipation.


Hemorrhoids

Sitz baths, as described above, can also help alleviate hemorrhoid pain. You can also use topical agents such as cooling pads, witch hazel pads or medication that prevents constipation.


Reasons to call your physician

Sometimes, we may disregard certain feelings or symptoms because they don't seem severe or we think they will pass. However, you should call your doctor if you experience the following:

  • C-section incision that is red, draining or increasingly painful
  • Excessive vaginal bleeding
  • Fever greater than 101 degrees
  • Foul-smelling vaginal discharge
  • Signs of a breast infection, including red and painful areas on your breast, especially when associated with flu-like symptoms and fevers greater than 101 degrees
  • Chest pain
  • Crying and periods of sadness lasting longer than two weeks
  • Persistently painful urination or inability to urinate
  • Swollen, red, painful areas on your leg
  • Worsening vaginal or rectal pain

If you have questions about your infant, please call your pediatrician.