The postpartum period begins immediately following childbirth and lasts for six weeks.  During this time, a mother's body changes significantly including hormone levels.  The World Health Organization (WHO) describes this period of time as the most critical, yet most neglected phase in the lives of mothers and babies.  

The postpartum period is a time for healing and recovery.  Many women feel fully recovered within 4 to 6 weeks following delivery, but the healing process can be longer for some.  After delivery, it is perfectly normal to experience things such as vaginal bleeding and soreness, uterine cramping, breast and nipple soreness, hemorrhoids,  fatigue, and changes in mood, to name a few. 

Postpartum visits are an essential part of your care as they allow us to assess both your physical and mental well-being after the birth of your baby.  At Alliance Obstetrics & Gynecology Group, we will address many different topics including normal/abnormal postpartum changes, incision checks for those who had a cesarean section, assessment for postpartum depression/anxiety, and overall emotional support.  Patients will have a 2 week visit and a routine follow up visit at 6 weeks postpartum.  If you had a vaginal delivery, we typically will perform a gentle pelvic examination to ensure that everything has healed.  It is critical not to have intercourse before this visit!

Most symptoms which occur postpartum are common and will resolve spontaneously.  There are, however, some concerning symptoms which require a call to your provider or a visit to the hospital.  These include:

• fever greater than 100.4°F 
• heavy vaginal bleeding (soaking a pad in less than 30 minutes)
• excessive pain not relieved by medication
• signs of breast infection (pain/redness)
• swelling, redness, increased pain, or foul odor from the vaginal tear or c-section incision
• persistent headache nor relieved by Tylenol
• chest pain, shortness of breath, fainting
• extreme sadness, withdrawal from family/baby, thoughts of hurting yourself or someone else

It is normal to have bleeding similar to your period for about two weeks, but vaginal bleeding can persist up to 6 weeks after delivery.  You may notice increased bleeding with activity or after breastfeeding the baby. This is normal and can be your body's way of reminding you to slow down.  We recommend avoiding tampons and only using pads during this time.

If you have stitches in place from a vaginal tear, the sutures will dissolve on their own and do not need to be removed.  Wash as you normally would in the shower and pat the area dry.  You can use the squirt bottle you received at the hospital as well to keep the area clean -- especially after using the bathroom.  Tylenol and ibuprofen are the preferred medications to treat vaginal soreness. You should avoid soaking in water until your tear has completely healed to prevent infection.

Hemorrhoids are common during and after pregnancy.  We recommend using over the counter Tucks pads, Preparation H, or Anusol suppositories for hemorrhoids.  If you are constipated, increase your water and fiber intake and consider stool softeners such as docusate sodium (Colace) or Miralax which are available over the counter.  If you have severe pain or hemorrhoids which will not improve, please let your provider know, as a referral to a specialist may be needed for banding or surgery.

Most OBGYNs recommend pelvic rest (nothing in the vagina) for 6 weeks after delivery.  That means no douching, no tampons, and no intercourse until you have received your postpartum checkup to confirm everything has healed appropriately.  

Lactation support is an important part of postpartum follow up visits for breastfeeding patients.  Research supports numerous health benefits for both you and your baby.  Breastfeeding is a very personal choice and something we wholeheartedly support if it is your goal.  At Alliance Obstetrics & Gynecology Group we have a Certified Breastfeeding Specialist who is an excellent resource for breastfeeding patients.  From helping you and your baby achieve a good latch to discussing ways to help increase your milk supply and everything in between, we are here to help guide you through your breastfeeding journey.  We provide both office and home visits to help accommodate the busy schedule new moms have!

One of the most important aspects of healing after a c-section is to keep your incision clean and dry!  Shower daily and pat the incision site with a dry, clean towel.  Do not soak in a bathtub until the incision has completely closed. Avoid lifting anything more than 15 pounds. We recommend alternating ibuprofen and Tylenol around the clock for pain control. As needed, take your prescription pain medication in addition to this regimen. You can typically start driving within 1-2 weeks as long as you are no longer taking narcotic pain medication. 

Alliance Obstetrics & Gynecology Group supports the March of Dimes recommendations on baby spacing (the time between babies) and offers counseling on birth control options to all mothers postpartum.  Certain birth control methods are safe to start immediately postpartum while others are avoiding until 6 weeks postpartum due to the increased risk for blood clots before your hormones return to their normal state.   Estrogen-containing birth control is ideally avoided in breastfeeding patients due to its tendency to decrease milk supply early on.  Every woman’s needs are different and our team will work with you to determine the best option for you and your family planning needs.  

At both your postpartum visits, screening for symptoms of postpartum depression is a priority.  Postpartum depression is nothing to be ashamed of, and it is important that you receive adequate treatment in order to get better.  At Alliance Obstetrics & Gynecology Group, we are here to treat your depression and offer you the support you need, without judgement.  Please do not be afraid to let us know if you have feelings of worry or sadness – we are here to help!   

Treatment for postpartum depression varies from person to person and is tailored to address the specific needs of each individual patient.  Methods that are frequently used for treatment include medications (to help stabilize hormone levels) and referrals to outside counseling resources if needed.   Providing emotional support is something we take very seriously at Alliance Obstetrics & Gynecology Group.  Your mental health is just as important as your physical health.

Feeling stressed, tired, or overwhelmed (especially in the first few of weeks after having a baby) is very common and a normal part of the postpartum process.  These feelings are due to the physical, mental, and hormonal changes that follow delivery.  An estimated 50-80% of mothers experience “baby blues” in the first 2 weeks after birth. These feelings often begin when your baby is just 2 or 3 days old and typically resolve within 2 weeks postpartum.  Postpartum depression, however, affects up to 10-20% of mothers and lasts longer than 2 weeks. Symptoms are more severe and can involve feelings of sadness and hopelessness.  Sometimes mothers experience difficulties bonding with their baby or are unable to properly care for themselves.   Postpartum depression is more common than many people realize.  Even if you don’t have any previous history of depression, you are still at risk for postpartum depression.