Mothercare After Birth

UTERUS (fundus) - It should feel hard like a grapefruit, well below the level of the umbilicus (navel) shortly after birth. Within about 12 hours it rises up to just below the umbilicus and from there it starts shrinking back to a non pregnant size (the shrinking is called "involution"). It takes about 7-10 days for the uterus to shrink to where you can't feel it any longer. Massage the fundus frequently for the first couple of days after birth and occasionally thereafter. VAGINAL BLEEDING (lochia) - You should saturate no more than two pads in an hour. It will be bright red at first, fading to pink, brown, and then yellow over the first few weeks. It should smell like a normal period. Don't use tampons. If you soak more than two pads in an hour, call your midwife. Also, if you soak through one pad an hour for two hours, call and tell your midwife.

Student midwives promote the art by helping each other in birth.

TEMPERATURE - Check it twice daily the first few days. It should stay below 100.4 F. It may rise slightly when your breastmilk comes in, but should go down within 12 hours. Call your midwife if your temp goes above 100.4 F.

URINATING - Be sure you do! A full bladder prevents your uterus from contracting and makes you bleed. Rinse with warm water and and don't wipe. If it stings, sit in warm water to pee, or pour water over yourself as you pee. If you have stitches, pat yourself dry. Later, always remember to wipe front to back to help avoid bladder infections.

BOWEL MOVEMENT- Avoid constipation by drinking lots of liquids and eating fruits and vegetables. You need 8-12 glasses of water a day when nursing.

SORE BOTTOM - Use ice at first for swelling, later heat and warm water sitz baths. Compresses of comfrey tea or aloe vera gel will help you heal. Start your kegels as soon as you can.

REST- Get plenty of rest at first, even if you feel great. Just take care of your baby. Increase in amount of bleeding can be a sign of too much activity. Your breasts are also your barometer. Sore breasts tell you to slow down and rest more.

EXERCISE - Begin a gradual exercise program. Start with your kegels and begin a daily increasing program to help tone your muscles. At your two week visit your practitioner should be checking your abdominal muscles to see if they are tight enough to start doing sit-ups and more strenuous activities.

BATHING - You may shower at anytime. Bathing after birth is fine if the tub is clean. Try taking your baby in the bath with you, having someone stand by to assist. See the herbal bath instuctions at this site. The herbal bath is highly recommended postpartum.

INTERCOURSE - Vaginal intercourse is best delayed until bleeding is no longer red or pink, and it does not hurt. Choose a birth control method to use by 4 weeks postpartum. You can get pregnant while nursing.

BREASTFEEDING - You need good nutrition and more calories when breastfeeding than during your pregnancy, and at least 8-12 glasses of clear liquid a day. Keep your nipples clean, but don't use soap. Expose them to air as much as possible. Aloe vera gel or Lansinoh cream work well for cracked nipples. Or massage your own breastmilk onto the nipple and areola after each nursing. Let the baby nurse as much as s/he wants. Alternate breasts, using both for each feeding at first. Most important, be relaxed while nursing. Call your midwife or La Leche League if you have any problems or questions.

MASTITIS (sore breasts) - If lumps, redness or swelling appear, go to bed with your baby and continue to nurse on both breasts. Drink even more clear liquid, preferably water. Drinking a gallon of water a day helps some women prevent chronic mastitis. You may try hot ginger packs made by dipping a wash cloth in hot ginger tea (simmer grated ginger 10 minutes) and apply to sore area. Plantain compresses are ideal for breast infections. Wrap the steeped plantain and wet the compress with the liquid infusion. Apply as warm as tolerated three times a day. If you have a fever >100.4, call your midwife.