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Postnatal Care

'Babies are such a nice way to start people' - Don Herold

Many women get sidetracked with the arrival of their baby. They tend to ignore the fundamentals of postnatal care and shift the entire focus on the newborn. Without a doubt caring for a new baby is a demanding task. But equally important is postnatal care or taking care of yourself after you have had your baby. Adequate rest, eating well and doing gentle exercises to regain and maintain your strength are all a vital part of staying healthy. In order to do it right you must protect your own health by attending to postnatal care with some amount of dedication.

Changes in you in the first week

• Your tummy will feel soft and round; you won't look pregnant but your tummy won't resemble the pre-pregnancy state either. Within minutes of delivery, the uterus (womb) changes from a sac with a capacity to hold four-and-a-half liters of liquid to a grapefruit-sized pouch of muscle. The uterus will downsize in weight from 1000g to 50g within six weeks.

• You will feel some 'afterpains' in your uterus when breastfeeding because it is shrinking in size.

• The vaginal muscles will slowly regain its former tone and the pelvic floor will return to its previous position. Tears to the neck of the womb, vagina and perineum should also heal quickly.

• Your breasts grow bigger from day 2 or 3 as 'milk comes in'. Slight feeling of discomfort is normal but this is temporary.

• After childbirth progesterone levels fall rapidly causing discomforts such as heartburn, constipation and varicose veins to subside, although hemorrhoids (piles) take longer to resolve

• In the first few weeks, there will be a lot of vaginal discharge. The uterus is shedding the rest of its lining. This discharge, or lochia, is red in the start. It changes to pinkish brown and then cream. Use sanitary towels and avoid tampons, as there's a risk of infection. Heart, lungs and circulation, relieved of the burden of pregnancy, assume normalcy.

• Joints of the pelvis and spine, softened by the hormones during pregnancy take time to go back to normal. Back discomfort may continue for months to come, so be cautious with lifting and carrying. Best to avoid weighty stuffs. The abdominal muscles, stretched to twice their normal length during pregnancy, regain their tone within a couple of months. Getting back to your pre-pregnancy weight and appearance takes time.

• Weight loss is most rapid and obvious in the first few days after delivery as the extra two to eight liters of water carried during late pregnancy are passed out as urine. After this, weight loss slows down. Exercising and eating right will help in the later months.

• Some leg and ankle swelling may begin during the first two days after delivery that can persist for several weeks. This is not unusual. When resting, reading or watching TV, elevate your legs using pillows or cushions above the level of your hips. If your legs remain painful and swollen call your caregiver.

• Occasionally you will feel tired and weepy - it is normal to go through this. Don't confuse this with postnatal depression.

Your first check-up post delivery

This is your last visit to your obstetrician (the 6th week check up) where you will receive a thorough check. Basically your doctor will want to make sure your body is healing well after the delivery of your baby.

• Your weight will be taken and your blood pressure will be measured.

• A pelvic exam to assess if your uterus is getting back to its pre-pregnancy size, your cervix is closed and the episiotomy has healed well Stitches

• Checks stitches, if any

• A check on your emotional and overall well being

• Advice on minor problems such as constipation and birth control

Now is the time to make life easier!

• Accept any offers of help. Hire a temporary help if you must since it is easily available anywhere. You may need all the help you can get in the initial phase with the basics around the house i.e. cooking, cleaning up, shopping etc.

• Visitors will come pouring in to visit you and your baby. Since this is especially customary in any culture, it becomes all the more necessary to make it clear you don't expect to entertain them.

• Don't forget your pelvic floor exercises - you can start these as soon as you like, even from one day after the birth. If you have concerns on exercising, address them with your doctor.

• You may lose up to twelve pounds when the baby is born and maybe another one or two the following week. If you continue to follow the healthy eating habits suggested during pregnancy, the weight should come off naturally. Crash diet is not the solution, especially if you are breastfeeding. Talk to your caregiver about healthy weight loss. Breastfeeding moms should aim for four servings of milk and milk products each day. To make sure you get all of the nutrients you need when you first get home, let someone else cook for you.

• Ignore the need to get back to normalcy just after coming home from the hospital. If you feel like staying in your night clothes all day, do it. Everything takes time; don't pressurize yourself. The key issue is REST. The more you rest and take care of yourself in the first few weeks, the quicker you will return to your normal self.

When your GP has assured you on your full recovery, join a postnatal exercise class. This is a really good way of making friends and keeping fit. Alternatively you can engage in more strenuous abdominal exercises like sit-ups and curl-ups at home. These exercises may help you flatten your stomach and lose weight. Bear in mind it takes up to three months for your body to recover from the birth.

Postnatal Care includes some Exercises Pelvic floor exercises

• Pull up around the vagina as if to stop wetting yourself. Hold for a count of four and release. You should feel the difference when you let go.

• Repeat the exercise in batches of six or eight as often as you can during the day.

• As well as holding for a count of four, try doing some where you squeeze, release, squeeze, release quite quickly.

• Breathe normally throughout the exercise. As soon as possible after delivery, start doing pelvic floor exercises. If you have stitches you will be sore, but the exercise will improve your circulation and help your perineum heal. If you have had a Caesarean, you will still need to do your pelvic floor exercises.

Pelvic rock

Lie on your back with knees bent and feet flat on the floor. As you breathe out, rock your pelvis so that the small of your back flattens onto the floor. Then rock your pelvis again so that your back is lifted away from the floor.

Leg slide

Lie on your back, knees bent and feet flat on the floor. Put your hand in the small of your back, flat against the floor. As you breathe out, let your legs slide forward slowly, bringing your knees closer to the ground. Then gently slide your legs up again.

Some to observe:

• Start with GENTLE exercising in the first few weeks after the birth. Follow the cues your body gives you.

• DO NOT lie flat on your back and lift both legs in the air.

• DO NOT lie flat on your back and do sit-ups with your feet held down.

• If in doubt, wait till you go for your check up and consult your doctor on the dos and don'ts of exercise

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Disclaimer: Information contained on this Web site is intended solely to make available general summarized information to the public. It should not be substituted for medical advice. It is your responsibility to consult with your pediatrician and/or health care provider before acting on any advice on this web site. While OEM endeavors to provide up-to-date and accurate information, it is not liable for any advice whatsoever rendered nor is it liable for the completeness or timeliness of any information on this site.
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