Healing After Childbirth - The First 6 Weeks
REST
In between feeding, changing, settling, dressing, bathing, cuddling and staring at your newborn baby - you must squeeze in some rest. We have all heard the saying “sleep when the baby sleeps” and I have to admit that was hard for me. When the girls slept, I was changing my surfboard pads, filling up my drink bottle or getting something to eat, and then the baby is awake again.
So instead, what I would suggest is rest whenever you can and ask for help! Be horizontal as much as possible. Lie down on the floor and gaze at your baby. Lie down in bed and feed in this position - ask your lactation consultant for tips on this. Get your partner, family or visitors to do the nappy changes, food and drink runs. And finally, understand WHY you need the rest. Yes, to recover after a massive effort of pregnancy and childbirth but also to allow your body to heal and recover. Particularly your pelvic floor!
P.S. Rest doesn’t have to mean sleep. Just closing your eyes will help the ‘my eyes are falling out of my head’ feeling.
Baby Adele….1 Hour Old
2. CONNECT WITH YOUR BABY
I know this one kind of goes without saying but when all is said and done, this really is your only job right now. The first 6 weeks after having a baby are life changing and a huge adjustment for you, your baby and your family. Stare at her (I am saying her because I have two girls) touch her, kiss her, sing to her, cuddle her, feed her and love her. That’s your job now, your priority.
The rest of the world can wait and believe me, it will all be there when you come out of your bubble! On a side note, the happy hormones that will be released by just loving your baby will help you heal, repair and rebuild after pregnancy and birth!
3. AVOID CONSTIPATION
There is lots of talk about “the first postpartum poo” but let me tell you, constipation is much more of a pain in the arse than the first bowel movement. It doesn’t matter if you have a caesarean section or a vaginal delivery, straining or pushing on the toilet will put A LOT of unwanted pressure on your pelvic floor.
Keep up your water intake, talk to your doctor about a stool softener and relax on the toilet. A glass of prune or pear juice a day can be a godsend! Please remember, using your bowels WILL NOT affect your stitches.
Tip #1: When you need to go, roll up some toilet paper (if you are a scruncher maybe now is the time to convert to the folder side, like seriously who scrunches). Anyway, fold your toilet paper and gently place it on your perineum or stitches to support the area. You may feel like you are going to have another baby and yes, it is scary but trust me, it’s not that bad!
Image curtesy of https://www.rcog.org.uk
TIP #2: Toilet positions - Knees higher than hips, lean forward and put your elbows on your knees. Breath into your belly and keep your spine straight. Relax your pelvic floor and all will be well.
4. WOUND CARE
After a vaginal delivery, your perineum will be swollen and sore (hence the importance of rest). Ice packs and ice cubes in your pads are great. Get a heap of the massive surfboard pads and rip the side so you can insert a few ice blocks into the cotton. You don’t want the ice right on your perineum! A tip I was told was to fill up condoms half-way with water and freeze them, perfect size and they give you a giggle when your partner or mum gets them out of the freezer. Remember to change your pad regularly.
Take care of the stitches (caesarean incision or perineal stitches) – your nurse will help you with this after birth and should give you some tips for home care. Keep the area clean and dry. After a caesarean birth, try to roll onto your side when getting out of bed. The same way you did when you were pregnant. This will reduce the pressure on your abdominal muscles and the incision. For perineal stitches, it can sting when you do a wee so pouring warm water over the area when you go can reduce the sting.
Support garments can be worn straight away after a vaginal delivery or a few days after your caesarean section. Some women find support shorts or bands really comfortable and others don't like them. It is really up to you whether you wear them or not. If you have abdominal separation after the birth it may be worth investing in a compression garment. That can be specific shorts designed for postpartum or just cheap tubi grip that you can get from the hospital or your Physiotherapist.
But please remember – don’t be too hard on yourself to get back “into shape”. Your body has been through so much and there is a reason they call it the fourth trimester!
(If you are concerned there is a problem with your stitches you should see a healthcare professional)
5. START PELVIC FLOOR EXERCISES
Your body produces hormones during pregnancy and particularly through birth to relax your muscles and ligaments ready for birth. There can be a hangover effect of these hormones so don’t be worried if your pelvic floor doesn’t feel strong. Pregnancy and birth, no matter how the baby comes out, puts a lot of pressure on your pelvic floor so it takes time to rebuild strength.
I recommend starting gentle pelvic floor contractions as soon as you feel comfortable. This will help to boost circulation and aid healing. If you have an episiotomy or perineal tear it is safe to begin gentle pelvic floor contractions, if not more important.
6. GENTLE EXERCISE
When you feel up to it you can start slow, easy walking. Start with around the block or to the park and rest along the way if you need. Aim for 10-15 minutes and then build up from there. If you feel sore or achy afterwards, then rest and try again a few days later. Remember there is NO pressure to get out and about after having a baby. If you want to, that is ok, but if you want to stay home in your newborn bubble, that’s ok too!
I recommend seeing a Pelvic Floor Physiotherapist after your 6-week check with your doctor, or earlier if you are concerned. A postnatal assessment will include assessment and treatment of any birth injuries, abdominal muscles for separation, pelvic floor check if needed and assessing any other aches or pains. I usually set my new mums up with a gentle pelvic floor training program for home and then discuss a return to exercise plan depending on her goals.