Around 80 per cent of women (4 out of 5) will experience the “baby blues.” During the baby blues, you may feel sad and tearful, irritable, exhausted, overwhelmed, and have changes in your eating or sleeping pattern. This is normal. It happens in the first few days or weeks after baby is born, and lasts a few days to, at most, two weeks.
If “the blues” don’t go away, or happen during your pregnancy or further into the baby’s first year of life, it may be Postpartum Depression/Postpartum Mood Disorder. About 20 per cent (1 in 5) of mothers experience a Postpartum Mood Disorder. If you have a Postpartum Mood Disorder, you may:
- Not feel yourself
- Be sad and tearful
- Feel exhausted, but can’t sleep
- Have changes in eating or sleeping patterns
- Feel overwhelmed and can’t concentrate
- Have no interest or pleasure in activities you used to enjoy
- Feel hopeless or frustrated
- Feel restless, irritable or angry
- Feel extremely high and full of energy
- Feel anxious – you might feel this as aches, chest pain, shortness of breath, numbness, tingling, or a ‘lump’ in your throat
- Feel guilty and ashamed, thinking you are not a good mother
- Not be bonding with the baby, or be afraid to be alone with the baby
- Have repeated scary thoughts about the baby
- Have thought about harming yourself or the baby
If you’ve had any of these symptoms for more than two weeks, don’t wait! There is help for you and your family.
- Your health care provider (family physician, midwife, OB/GYN, psychiatrist)
- Southwestern Public Health: 519-631-9900
- Telehealth Ontario: 1-866-797-0000
- REACHOUT: 519-433-2023 (available 24 hours a day) or http://reachout247.ca/
If you are thinking of harming yourself or your baby, call your health care provider immediately. If you are unable to see your health care provider immediately, please come to the Emergency Room.
Care of Perineum following Episiotomy or Tear
If you have an episiotomy or tear at the time of delivery, you may experience swelling of the tissues of the perineum. Please follow these instructions:
- Use pads, NOT TAMPONS. Change pads frequently.
- Fill your perineal bottle with warm water, and rinse your perineal area well after urinating and every bowel movement.
Vaginal Discharge (Lochia)
Following your delivery, you can expect a bloody vaginal discharge called lochia. This flow may last four to six weeks. The colour of your lochia should change from the bright red seen just after delivery to a darker brown and finally to a creamy tone. Increased activity may result in heavier bleeding or a return to a redder colour. You should limit your activity until the bleeding decreases. Please call your doctor if you experience excessive bleeding, foul smelling discharge, acute abdominal pain, or a sudden fever.
A caesarean birth includes all the normal body changes that happen after a vaginal birth as well as healing of an abdominal surgical incision. Six weeks is a realistic time to expect this healing to occur. During your hospital stay, you will be encouraged to move around as frequently as possible. Once home, walking is an excellent form of exercise until your postpartum visit. Delay any strenuous exercise for at least six weeks. Be sure to keep your incision clean and dry, pat do not rub.
Return of your Period
Your menstrual cycle usually reappears between the 4th and 12th week after delivery, if not breastfeeding. It may take several months to re-establish a regular cycle. The first menstrual period may be heavier than usual.
Breast Care for Promoting Milk Production
Your breasts may feel heavier and firmer sometime between three to five days after delivery. This is the increase in milk production you and your baby have been anticipating. Continue feeding your baby eight to twelve times each day to promote milk flow from the breast. Breasts should feel softer and lighter after a feeding. Wearing a supportive, properly-fitting bra may help during this time. You may find it comfortable to wear a soft, light support bra at night. Do not sleep in an underwire bra.
Please contact your doctor's office if you have any of the following signs of breast infection (please continue to breast feed unless otherwise instructed by your physician):
- elevated temperature above 100.2
- localized redness and swelling of breast
- localized tenderness and a painful breast
Breast Care for Discouraging Milk Production
Your breasts may respond to the hormonal changes of birth and begin milk production even though your plans are to feed your baby formula. To minimize the stimulation of milk production, we suggest wearing a bra that provides firm comfortable support for breasts that are swollen or fuller than usual. Ice packs applied for 20 minutes every two to three hours will relieve swelling a well. Some women use a loosely-applied ace wrap to hold the ice packs in place. Tylenol, ibuprofen may be used for pain relief. This period of discomfort usually resolves itself within 48 to 72 hours, by may last up to two weeks.
Please don't put anything in your vagina prior to your follow-up visit with your doctor. Try to abstain form sexual intercourse for four to six weeks or until after your postpartum examination and discussion about contraception. This helps avoid infection and allows the vaginal wall and uterus time to heal and regain strength.
When your physician indicates it is safe to resume sexual intercourse, you may initially find it uncomfortable because the vaginal tissues may still tender. Vaginal lubrication is lower than usual because of decreased estrogen level. Using a lubricating agent may help minimize your discomfort.
Please remember that you can become pregnant soon after the birth of your baby.
Birth Control Options
There are several forms of birth control that you may use. These include birth control pills, the Norplant system, Depo-Provera, and IUD, a diaphragm, condoms, and spermicide. Each has its own advantages and disadvantages, and your doctor can discuss your options before you leave hospital or during your first office visit.
If breastfeeding, use a barrier method of contraception, such as spermide, condoms, or diaphragm.
During the first and second week, be sure to rest during the day. Focus your energy on your baby. Leave the housework to other family members. It is important to note that light activity is important for the prevention of DVT's (deep vein thrombosis i.e. blood clots).
During the third week you may increase your physical activity.
If you had a caesarean birth, DO NOT LIFT anything heavier than your baby . Your incision requires four to six weeks to completely heal. If you have other children who want to be held, encourage them to climb up in your lap rather that your lifting them.
Listen to your body. When you feel tired, try to rest. Remember that you are recovering from a physical and emotional event that has had an enormous effect on your body.
You will need to see your Obstetrician, Midwife or Family Physician, six weeks after your delivery. Please, schedule your appointment soon after your discharge so that the best dates and times are available.
*If your doctor's instructions differ from this information, please follow your doctor's instruction.