Child Care - After the birth: physical changes

The mother's body will take several weeks to get back to something resembling the pre-pregnancy state. Weight gain, uterine expansion, and breastfeeding all change the body and take some time to undo.

Weight gain

Depending on how much weight the mother has gained during the course of the pregnancy, it can take several weeks to several months to get back down to her pre-pregnancy size. If you have gained the recommended 20 to 25 pounds during pregnancy, it will take about two months to lose the extra weight if you don't diet. If you are breastfeeding, dieting should only be done under strict supervision of your doctor.

The uterus will remain distended for several weeks following delivery. Breastfeeding helps reduce the size of the uterus because a hormone (oxytocin) that increases uterine contractions is released during breastfeeding.

Extra water is maintained in the mother's body during the pregnancy, and this water takes some time to eliminate. The extra fluids will be eliminated from the mother through frequent urination and heavy sweating. It is important that the new mother continue to replenish her fluids despite this apparent flood of liquids leaving her body. Increased intake may help increase the speed with which the body eliminates the un-needed fluids.

The body will also pick up extra weight in the breasts if the mother continues to breastfeed. For mothers who are bottlefeeding, it will take several days for the breasts to reduce in size.

Exercising to help tone and shape the pelvic, stomach, and thigh muscles is a good method of speeding your return to your usual size. Talk with your physician for post-partum exercises that will not tax your muscles but will help build back up and firm them.

Lochia

For several days following a delivery, whether vaginal or caesarian, the body will excrete through the vagina a discharge that will shift from dark brown to yellowish-white. This discharge is the product of the body shedding the last particles of blood and fluids from the uterus.

Warning signs that are not part of the normal discharge include: bright red blood after about the fourth day, heavy bleeding that requires pad changes of more than one an hour (at any time following delivery), foul smelling discharge, heavily clotted blood, or an absence of discharge during the first two weeks following delivery. Other symptoms to watch for include: lower abdominal pain after the second day and/or lower abdominal swelling. All of these symptoms require immediate consultation of your doctor .

Perineal pain

With or without an episiotomy, the perineal area is normally sore following vaginal deliveries. The head of the baby has pushed against the muscles and the muscles are likely to be bruised. Talk to your physician about methods of alleviating soreness if the pain moves beyond irritating. For mild pain try soaking baths, sitting on inner tubes or cushions, lying on your side instead of sitting up, and continuing with Kegel exercises to alleviate some of the discomfort.

Fever

Puerperal fever is a sign of infection following delivery. Although it is extremely uncommon now (it was once a major killer of post-partum women) any fever that lasts for more than a few hours, or which gets over 100 degrees, should be reported immediately to your doctor. It may be just a virus or from the changes taking place for breastfeeding, but your doctor should be notified of any fever during the first month you are home.