What about Mum’s health?
While pregnant mothers often get plenty of attention, after the birth, most of this attention can be focused on the baby. Mothers can often neglect their own health, perhaps because they don’t wish to bother others with their own problems. It takes a while for your body to adjust following childbirth. If you had a caesarean section you will also need time to recover from the effects of the operation.
Your health professionals are concerned about your well being as well as your baby’s, so do not hesitate to discuss your own health concerns. Caring for children can be fun and rewarding, however babies need a lot of attention during the early weeks and this can make life tiring. Some of the following ideas may help:
- trying not to expect too much from yourself. It may help to do what is essential and catch up later if or when you have more time and energy.
- asking your partner, family and friends to help with housework and child care. They often enjoy being needed and accepting offers of help may make life easier for you.
- making time to relax, cuddle and play with your children.
- resting and relaxing while your baby is sleeping.
- trying not to over-tire yourself with visitors. Visitors may like to help you by making a drink, a meal or helping around the house.
- planning time out with your partner, family and friends, leaving your baby with someone you trust.
- talking about your feelings, with your partner, family, friends, or health professionals particularly if you are stressed or feeling depressed.
- joining a local Plunket or parent group, which will give you the opportunity to meet, talk, share experiences and advice with others in your situation.
Out and About
You may feel isolated and lonely during the first few weeks at home with a baby, it may help to talk to others about how you are feeling. If you have made friends at antenatal classes or in the maternity unit, you may like to keep in touch. You could also meet other mothers at the Plunket clinic, or there may be a local mother-and-baby group you can join.
Early postnatal care
If your baby is born in a hospital, the length of time you spend there following the birth will vary depending on where you live and the type of birth you experienced.
Once you are at home, your midwife and later your Plunket nurse or other Well Child Health Provider, will visit you to provide support and answer any questions or concerns.
Now, more than any time, is when you will need all the energy you can find. Eating well will be essential to help you through the busy days and sleep-interrupted nights with your new baby. While you are focusing on your baby’s needs, don’t overlook your own.
Be guided by your own appetite. You may find you are hungrier during the first few weeks or months of breastfeeding. There is good reason for this – you are feeding you and your baby. You may also feel thirstier; partly having lost a good deal of the fluid accumulated during pregnancy, but also when breastfeeding. Drink according to your thirst.
As you are adapting to your new daily routine, try to include three meals and some nutritious snacks throughout the day to meet the nutritional needs of both your and your baby. Breakfast is often missed but vitally important to kick start the day. Nourishing snacks include:
- fruit smoothies
If you are concerned about weight gained during pregnancy, don’t try to lose it all at once. Crash dieting is never a good approach; it will drain you of energy and can leave you short on essential vitamins and minerals. Extra weight often reduces naturally, particularly with breastfeeding. Keeping active will certainly help. Not only can it burn off any extra calories/kilojoules, but makes you feel good too. A brisk walk in the fresh air with friends or family is ideal, as well as a chance for them to meet your new baby.
Supplements - Folic Acid
You will almost certainly have been advised to take a folic acid supplement before and during pregnancy, to help prevent neural tube defects. If you are planning on becoming pregnant again or could become pregnant, you will need to start taking a folic acid supplement. Apart from folic acid, try to avoid reaching for the supplements as an alternative to eating well; they can’t provide the building blocks of a good eating pattern. Foods high in folic acid include fruit, vegetables, bread, cereals and cooked dried beans. Only food can provide the energy and protein needed to fuel your new lifestyle.
If you are on a special diet, including a vegetarian diet, discuss your eating pattern with your midwife, or visit a dietitian, to ensure your diet is adequate. Omitting whole foods, such as meat and fish can leave you short on iron and zinc; avoiding dairy foods will reduce calcium and vitamin D; and going ‘wheat-free’, i.e. breads and cereals, can leave you low on fibre and many B vitamins.
Skin and hair
Any reddish ‘stretch marks’ on your breasts, thighs and abdomen will shrink and become paler with time. Stomach muscle tone can improve with time and exercise.
You may also find that your skin is not as clear as it was, but this problem will improve.
You may find that your hair is dry and falling out more freely than usual; this is caused by temporary hormone changes and will stop in time.
After the birth of a baby it is normal to have a discharge from the uterus, which is called lochia. This usually starts bloodstained and gradually becomes lighter and brownish. You may find that bleeding increases temporarily when you become more active. It may continue for over 6 weeks after baby’s birth. If you are breastfeeding your baby, it is likely to stop earlier as the uterus returns to normal more quickly.
Pads are best used for at least two weeks after the birth, after that time you may prefer using tampons once you feel comfortable.
See your doctor if you have a sudden heavy loss of blood, there are clots, or if the bleeding is smelly.
If you are breastfeeding your periods may return in the first few months or may not return for the time you are breastfeeding. If you are formula feeding, your period is likely to return in the first 1-3 months. The first periods are often irregular and may be heavier or lighter than your usual period as your hormone levels settle to their pre-pregnant state.
It is important for early detection of cervical cancer to have regular smears. Talk to your midwife or doctor about smears and when your next one is due.
You may feel bruised and sore around the perineum (the area between the vagina and rectum) even if you experienced a normal birth.
Your midwife can advise on treatment to relieve perineal pain and on the best position to adopt when lying or sitting.
Having sex again
Many women do not enjoy sex for some months after the birth of a child. You may feel tired and be sore from the birth. Caring for your baby places demands on your time and energy.
It is important to talk to your partner about your feelings and help him understand that he is not being rejected if you do not feel like sex.
You may decide as a couple to find other ways of sharing your love, cuddling or a massage can be relaxing and loving. Sex may be uncomfortable at first, especially if you have had stitches. Lubricating jelly or a different position may help. If sex continues to be painful, talk to your doctor.
Some breastfeeding women find that milk leaks when having sex. This is quite normal, it may help to have a towel handy.
It is possible before your periods begin again to ovulate. Breastfeeding can delay fertility, but is not a reliable method of avoiding pregnancy. Remember, that once you start having sex after the baby’s birth, you may become pregnant before you have had a period. You can discuss contraceptives with your midwife, doctor, or family planning clinic 0800 372 5463 www.fpanz.org.nz
Postnatal exercises may feel like the last thing you want to do. After childbirth the pelvic floor is very often weakened. The pelvic floor is a “hammock” shape of muscles that sits between your coccyxbone (tail bone) and your pubic bone. These muscles are there to support your bladder and bowel. If, during childbirth your pelvic floor is weakened there could be tendency to leak urine especially when you jump, cough or sneeze. With regular pelvic floor exercises most women manage to correct the problem. They will feel weak initially, but the more you do, the stronger the muscles will become. These exercises will help to prevent leaking urine.
The pelvic floor muscles are easily located-imagine you are desperate to pass urine, or pass wind, the muscles you use to stop from leaking are the pelvic floor muscles.
- Imagine you are stopping yourself from passing urine, you pull the pelvic floor muscles up and in.
- Hold this position for the count of five, then release.
- Repeat that as many times as you can throughout the day-aim for 50 times a day.
- Try and remember to do them whenever you are on the phone
To help strengthen your abdominal muscles kneel on all fours and, keeping your back flat, pull your tummy button in towards your spine. You should feel the muscles at the side of your abdomen tightening but your back should not move. Keep breathing normally. Repeat this eight to 10 times.
Care of your back
Take care with lifting, lift bending your knees rather than your back. Be careful doing exercises after the birth e.g. ‘cycling’ with both legs in the air, sit-ups or lifting both legs together while lying down are best avoided at present. These can damage your back.