What New Parents Need to Know About Postpartum Recovery

As your body recovers from pregnancy and birth, you may go through a range of physical and emotional symptoms. Remember to care for yourself as much as you care for your little one. Just take it one step at a time. And ask for help when you need it, especially if you’re feeling anxious or depressed. 

Also, be sure to schedule your 6-week checkup with your obstetrician. Here are some common post-delivery symptoms to watch for. Learn what they might mean — and when you should let your doctor know about them.

Uterine Contractions

During the first few weeks after giving birth, you may feel occasional pain or contractions. This is especially common during nursing and if you’ve had more than 1 pregnancy. These pains are normal. They’re caused by the uterus contracting as it returns to its prebirth state. (That takes about 6 weeks.)

Post-birth pains often feel like menstrual cramps. They can range from very mild to more severe. Sometimes, they’re worse after a second or third pregnancy. Taking ibuprofen (Advil or Motrin) can be a big help for most new parents. If your pain doesn’t go away after a few days, or if it’s making it hard for you to take care of yourself or your baby, tell your doctor.

Have questions about your postpartum symptoms? Check out BlueForMe, your digital health management app. You can search the health library for information or send questions straight to your care advocate. Call 844-730-2583 to see if you’re eligible for BlueForMe today.  

Bleeding

It’s normal to have vaginal bleeding, called lochia, for about 4 to 6 weeks after giving birth. It’s part of the process of your uterus returning to its regular size. Lochia is made up of the tissue and blood cells that lined the uterus while you were pregnant.

How long you’ll bleed is different for everyone. Most people have the heaviest bleeding in the first 3 days after giving birth. As the days go on, the bleeding should slow down.

If you’re bleeding heavily enough to soak through a sanitary pad per hour, tell your doctor. The same goes if you’re passing blood clots larger than an egg. Both of these symptoms could be a sign of hemorrhaging. You should also tell your doctor if the bleeding doesn’t start to slow down after several days.

Blood Clots

As the uterus grows during pregnancy, it can put pressure on the veins that return blood from the legs. That can raise your risk of clots during and after pregnancy. Often, the clots happen in the legs. In some cases, they can travel to the lungs.

Signs of a clot include redness, swelling, or pain in the part of the leg affected by the clot. If the clot has traveled to the lungs, you might have chest pain, shortness of breath, or trouble breathing. Call your doctor right away if you have any of these symptoms. A clot can affect your blood flow. If left untreated, it could lead to a heart attack, stroke, or permanent lung damage.

Postpartum Preeclampsia or Eclampsia

Later in pregnancy (usually after week 20), some people are diagnosed with preeclampsia. A primary symptom is high blood pressure — sometimes dangerously high. It’s a sign that the kidneys or liver might not be working correctly.

Most preeclampsia symptoms go away after you give birth. But some can go on, or begin for the first time, after delivery. If so, it usually happens within the first 48 hours of having the baby. But sometimes it’s as long as 6 weeks later.

The most common postpartum preeclampsia symptoms are the same as those for preeclampsia. They include:

• High blood pressure
• Headaches
• Belly pain
• Blurry vision
• Seeing spots
• Nausea
• Swelling in your face, arms, legs, hands, and feet

Without treatment, postpartum preeclampsia can lead to postpartum eclampsia. The symptoms of eclampsia are the same, but they can also include seizures and organ damage. Treatment for postpartum preeclampsia includes medications to lower your blood pressure and prevent seizures. If you’re worried that you have any of these symptoms, call your doctor right away. 

Episiotomy or Spontaneous-Tear Healing

Giving birth vaginally can sometimes cause tearing of the skin or muscle around the vagina. Some of these tears are very minor and will heal on their own. Others require stitches.

It’s no longer recommended that doctors automatically make a cut near the vaginal opening. This is known as an episiotomy. But it is still necessary in some cases. For instance, it might be necessary when a baby needs to be delivered quickly or is stuck behind the pelvic bone.

The healing process from a tear or episiotomy usually takes 2 to 3 weeks. If you have stitches, they will dissolve in about 6 weeks. Meanwhile, your care provider will give you a list of things you can do to help with healing and to soothe discomfort. These include taking a stool softener to prevent constipation and wearing cooling pads with a sanitary pad.

Urinary Issues

For the first few days (and sometimes weeks) after birth, some new parents find it hard to control their urine. The culprit: damage to the base of the bladder, the pelvic floor muscles, and the perineum. (The perineum is the area between the opening of the vagina and the anus.)

Try Kegel exercises to improve control. To do these exercises, you lift, squeeze, and hold your pelvic floor muscles. These muscles support your pelvis, bladder, and uterus. If you’re still having problems with urine leaking out more than 6 weeks after you deliver, call your doctor. 

Infection

About 5% to 7% of women develop an infection within 6 weeks of giving birth. Be on the lookout for signs of infection, including:

• A C-section or episiotomy incision that isn’t healing, feels warm, is red or leaking, or has a foul odor
• Increasing pain at the incision site
• Breast pain and swelling that’s not relieved by feeding or pumping. This swelling is called mastitis. It’s usually caused by a blocked milk duct or bacteria that has gotten into the milk duct.
• Fever higher than 100.4° F 

Always Err on the Side of Caution

Many people have a trouble-free pregnancy and delivery. But giving birth also comes with risks. Knowing the warning signs of more serious issues and when to seek medical care is important. Telling your doctor about a problem early on could possibly save your life.

If you’re having a symptom that doesn’t seem normal or that your doctor didn’t warn you about, let them know right away. If you feel like your life or that of your baby may be in danger, call 911 right away. It’s always better to be more cautious than to put off getting help.

[SOURCES]

[1] Deussen Ar, Ashwood P, Martis R, et al. “Relief of Pain Caused by Uterine Cramping or Involution After Giving Birth.” Cochrane, October 20, 2020.

[2] Moldenhauer JS. “Postpartum Blood Clots.” Merck Manual Consumer Version, May 2020, https://www.merckmanuals.com/home/women-s-health-issues/postdelivery-period/postpartum-blood-clots. Accessed November 1, 2021.

[3] “Preeclampsia.” March of Dimes, October 2020, https://www.marchofdimes.org/complications/preeclampsia.aspx. Accessed November 1, 2021.

[4] “Postpartum Preeclampsia.” Cleveland Clinic, August 17,2021, https://www.mayoclinic.org/diseases-conditions/postpartum-preeclampsia/symptoms-causes/syc-20376646. Accessed November 1, 2021.

[5] “Vaginal Tears in Childbirth.” Mayo Clinic, October 11, 2019, https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/multimedia/vaginal-tears/sls-20077129?s=4. Accessed November 1, 2021.

[6] “Mastitis.” Mayo Clinic, July 22, 2020, https://www.mayoclinic.org/diseases-conditions/mastitis/symptoms-causes/syc-20374829#:~:text=Mastitis%20is%20an%20inflammation%20of,%2Dfeeding%20(lactation%20mastitis). Accessed November 1, 2021.

DISCLAIMER: Florida Blue has entered into an arrangement with Wellframe to provide members with care decision support services, information and other services. This article is provided by Linkwell Health through their arrangement with Wellframe. Please remember that all decisions that require or pertain to independent professional medical/clinical judgment or training, or the need for medical services, are solely your responsibility and the responsibility of your physicians and other healthcare providers. Wellframe is an independent company that provides online services to Florida Blue members through the Blue for Me app.