CARING FOR YOURSELF
After the Baby Has Been Born
WHAT IS NORMAL PHYSICALLY
!!WARNING!! At any time, if you are having chest pain or difficulty breathing, please call 911 or get to the nearest Emergency Department.
What to Expect with Self-Care Postpartumn
Both physical and mental heatlh changes occur after the delivery of a baby. It can be helpful to have a guide for what these changes can mean for you, and get some tools in your self-care toolbox to start building a strong base to navigate through any challenges that you may experience with these changes. Click HERE for full access to our postpartum physical and mental health guide.
Vaginal and C-Section Delivery
Depending on how you delivered there can be specific things to watch for as your body changes and recovers. And, there are many things that are the same. At any time, if you are having chest pain or difficulty breathing, please call 911 or go to the nearest Emergency Department.
Call your Doctor/Midwife if you have:
- Heavy Bleeding (soaking more than a pad an hour)
- Bright red blood after the first week (it should be getting darker in color and smaller in amount)
- Fever >100.4
- Redness, swelling, or persistent painful lump in your breast
- Redness, pain, or swelling from a vaginal tear or c-section incision
- Problems urinating or having a bowel movement (after the first week)
- New or worsened pain, unexplainable
- New or worsened depression
Experiencing Grief
It is not uncommon to experience tough emotions after delivery. Having emotions like grief and loss, especially when coupled with adoption, is expected. And, is different for each of us. You are deciding to give your baby a different life, different than what you can provide at this time, and this can be triggering on many levels. Having a willingness to acknowledge emotions and allow them is an important step to navigating and processing them. There are many resources you can utilize to help you focus through this, so support yourself by reaching out and exploring what your resources are.
Acknowledge ALL of Your Feelings
You may have a lot of other feelings, sometimes opposite of each other, as you navigate through this experience. For example, you may find yourself feeling much relief while also feeling guilt and heartbreak. It is important to allow yourself to experience all of these feelings because they are your guides to navigate through this process. It is well known that we can store unexpressed feelings in our bodies, and when we don’t acknowledge them they can erupt in different (and sometimes unhealthy) ways at a later time. Be gentle with yourself, and allow grace for the feelings you are having. Reach out for support when you are struggling. Sometimes just saying out loud to someone else what you are experiencing helps you to sort it out. Click HERE for ideas and tools for dealing with hard feelings.
Lean into Your Support Team
Creating a network of support is so important throughout this process. Your support team can be in the form of family, friends, church groups, work family, or anyone with whom you feel comfortable to confide in. If you feel too vulnerable to express yourself to another person, start journaling. Just taking the time to write down your thoughts can clarify for you where to start. Use your own writing to bounce your feelings, thoughts, and concerns off of yourself while working through your experience.
When to call your Doctor/Midwife
- Heavy Bleeding (soaking more than a pad an hour)
- Fever <100.4
- Redness or persistent lump in your breast
- Problems urinating or having a bowel movement (after the first week)
- Severe pain
- New or worsened depression
What's Normal and Expected?
Breastmilk production
Supplying baby with your first breastmilk for gut health
Pumping to provide breastmilk for the adoptive family if this is an option
Freeze-drying breastmilk for powder reconstitution
Donation of pumped breastmilk for preemie babies as medicine (finding a milk bank near you)
Drying up your milk, Milk Suppression
How to stop milk production: DO NOT bind your breasts.
Avoid breast or nipple stimulation (this will cause your body to make more milk).
Wear a comfortable but not overly tight bra, even at night.
Use the following techniques to help with pain and inflammation of breasts. If you feel engorged when your milk comes in (within 48-96 hours after delivery), it’s normal to see Engorgement sometime within the first week of life.
Ice: A bag of frozen peas or corn works great for this because you can form them to your breast to combat discomfort
Apply raw cabbage leaves that are chilled (green or red cabbage works). Squeeze them gently between your hands to get the juices flowing, and place them on your breasts with a towel tied around your chest to hold them in place. Red cabbage can discolor fabric.
Use cabocream as a topical cream to help slow down production (Research)
Use ibuprofen for pain as recommended by your Dr.
Antihistamines can be used at sleep time to help to dry up your system.
Sage tea, as well as peppermint oil, has been shown to have an impact (research)
Ask your Dr about cabergoline (Dostinex) (EBP)
What to expect on days 1-7 and beyond
1-4
4-7
1-14
Uterus:
Involution: after birth contractions, the uterus shrinks with contractions to get back to it’s pre-pregnancy size.
Bladder:
Incontinence: can’t control your muscles that keep you from peeing.
Hemorrhoids
Varicose veins
Hair Loss
Returning menstrual cycle
Pelvic “rest”
Vaginal vs C-Section: Recovery
What's Normal and Expected?
Vaginal
Stitches: If you had tearing during the delivery, your provider may have used stitches to help the tissue heal properly. These stitches are most commonly dissolvable, so you don’t have to go back in and have them removed.
Pain with bowel movements, smooth movements. And speaking of bowel movements, when stitches are present, you mustn’t be straining or pushing too hard in case you dislodge the stitches.
Healthy perineum
No tampons, only pads, for six weeks
Wash your hands well before and after changing your pads.
No wiping, only patting with a peri-care bottle flush. The perineum is a very tender tissue that must be patted gently after peeing or having a bowel movement instead of wiping. Use a peri bottle to spray with clean water and then pat dry.
Vaginal discharge, Lochia
First 1-3 days
Days 3-10
Days 10-14, maybe longer
!!WARNING!! SIGNS
Soaking more than a pad an hour is too much.
Baths and showers
Cesarean
Incision Pain: There will be stitches that will dissolve or medical-grade staples that will be removed before you are discharged from the hospital or shortly after at a follow-up appt.
Sharp
Burning
Itchy
!!WARNING SIGNS!!
Gas Pain
It can feel like heart pain or difficulty breathing. Walking and gentle movements can help ease this.
Scar tissue
Massage treatments to break up adhesions
Lifting restrictions
Support the belly
Activity restrictions
Limit stairs and driving for the first few weeks.
Use a pillow to brace pressure with coughing or getting up out of bed, or from sitting for the first week or so
Baths and showers
What is NOT Expected/Abnormal
HIGH BLOOD PRESSURE (also known as pregnancy-induced hypertension (PIH), postpartum preeclampsia)
!!WARNING!!
What do high blood pressure symptoms from pregnancy look like? They can be life-threatening. Please notify your Dr or midwife immediately if you have more than 1 of these symptoms.
If you find that you are having:
Blurry vision
A headache that does not go away even after taking Tylenol (acetaminophen),
Pain under your right rib cage where your liver sits
A sudden increase in swelling of your body, notably in your extremities (fingers feel puffy when you bend them, and your face feels puffy)
Seizures could be one of the last signs that your blood pressure is higher than what your system can handle.
If you had issues with your blood pressure being too high during pregnancy, there is still a chance it can cause problems after delivery. Your healthcare provider should be working with you to monitor your BP’s even after you have delivered. But sometimes your pressures don’t go up during pregnancy and then do after the baby is born.
HEMORRHAGE OR BLEEDING (Losing too much blood)
!!WARNING!!
Hemorrhage, bleeding too much. If you are soaking more than a pad an hour, you need to report this to your Doctor or Midwife. And to note, you will need to use pads and not tampons as there is not to be ANYTHING in the vagina for six weeks after delivery.
Blood clots: We are at the highest risk for blood clots while pregnant and after delivery for six weeks
Signs of a Thromboembolism
Bleeding: Within the first few weeks, you will have continued vaginal bleeding regardless of how you delivered. This happens because where the placenta was attached to your uterus, there is now an open wound that allows blood to be expelled. As this wound heals, you will see less bleeding. So, It is normal for this bleeding to slow down and become a darker red to brown as the days go forward. If it starts to increase and is bright red instead of dark, your body is telling you to slow down because you are doing too much.
PROBLEMS WITH BREAST MILK PRODUCTION
!!WARNING!! What to do when your milk comes in
BREAST INFECTION with the onset of milk production
Contact Your Healthcare Provider if You Have the Following:
A fever, which temperature is >100.4 degrees Fahrenheit or above
You feel like you are coming down with the flu and have shooting pain throughout the breast
Red, warm & tight to the touch area of the breast
Low-grade fever over 99 degrees Fahrenheit may happen for days before spiking a true fever
It may be necessary to remove some milk from the breasts to help combat an infection
Remember that any unnecessary milk removal can encourage your body to make more milk instead of less
When your milk comes in, Engorgement
It is normal anytime within the first week of life. Most of us transition to a vast volume of breast milk production. It can last 48 hours or two weeks, depending on our body’s response to lactation hormones after the placenta is delivered at birth.
Mental Health Care
What's Normal and Expected?
Body Image: When to Expect Your Body to Return to "Normal"
Finding a new normal
Weight loss
Healthy Eating: Eating for your microbiome helps our gut-brain access through the Vegas nerve to be a healthier connection when the biome is balanced.
Exercise: Make this part of your morning routine to have it be easy and regular. Exercise helps your body release feel-good hormones and keeps your body strong and healthy.
Prenatal vitamins
Your body has just spent the last ten months or so drawing nutrients from away from your bones and muscles to the baby. Continue to take prenatal vitamins as advised by your healthcare provider and manage nutrition and hydration in a healthy manner.
Depression: Baby Blues vs Postpartum
Baby Blues
Can start anytime after delivery within the first 2-3 days to 2 weeks.
Can last no longer than the first two weeks.
Postpartum Depression
More long-term depression continues within the first 2-3 weeks and can last weeks or months
Depression anytime within the first year after delivery
Signs and symptoms of Depression that are immediate red flags for advanced depression going into unhealthy psychosis
Hormonal Changes
The most significant change of hormones our body ever experiences. Depression can be chemically driven.
Psychological Changes
Big life event
Birth trauma
EMOTIONAL RESPONSE TO BABY BEING BORN
Expected Emotions
Guilt
Relief
Anxiety
Great love
Fear
Sadness
Strength
Overwhelmed
Exhilaration/New Freedom
Aloneness
Separation
Anticipation
Hopefulness
Empowerment
Regret
Denial of Emotions
Allowing yourself to feel whatever comes up
Understanding emotions
It’s okay to have two opposing emotions at the same time
It’s vital to your self-healing to be able to identify what emotion you’re having as it happens
Emotion wheel
Social Health
Facing social/societal/cultural stigmas and stereotypes
What do these look like
Beliefs
Giving away children, unwanted children.
Adoption: Parenting choice
Facing YOUR stigmas and stereotypes
Stigma
Stereotypes
What other people think
Does it matter what others think?
Can you know what they are thinking?
!!TOOLS!! Getting some good tools in the toolbox helps you respond in a way that supports you and your journey.
Role-playing to practice what to say to people first with someone who you love and trust! Have a script that you have practiced.
Personal Self-Care: Self Healing Space
Physical Health:
Mental Health:
Personal Health (intuition and self-health)
Allowing a healing space for yourself through this experience
Creating a community
Connecting with other birth mothers or others who are also going through the adoption process now.
Seeing other’s processes helps you frame yours for self-supportive measures to come into play.
Having a trusted person you can confide in and feel safe with to discuss emotional responses and process any trauma.
Therapist
Family member
Friend
Taking the opportunity to create change in you, to make you the best version of yourself.
Create a Morning Routine: If you want something to happen, having a plan often makes it more probable that it will happen.
Pre-paving your day (Manifestation)
Meditation (Dan Siegal)
Journaling
Exercise
Learning
10-10-10-10 Journaling Meditation Exercise Learning
Showing up for yourself with the commitments that you make in your morning routines
Self-betrayal
Addiction to negative emotions
Chemical responders in your bloodstream (EBP)
Light in your eyes (Andrew Huberman)
Breathing
Nasal Breathing with a closed mouth (Dr Siegal Reaset button)
Slow-regulated breath can slow heart rate and regulate the nervous system (research links)
Relaxation
Nervous system overstimulation can disrupt our body.
NSDR (Non-sleep Deep Rest) with Dr. Andrew Huberman