Postpartum Care and Seeing Your Doctor After Giving Birth

What is postpartum care?

Postpartum care refers to the care of a mother after giving birth to her baby. In the United States, the standard "postpartum visit" is typically about four to six weeks after giving birth. However, you can expect to be seen sooner if you have/had a:

• high-risk medical condition in pregnancy such as preeclampsia (high blood pressure)
• complicated delivery such as a complex laceration or complex surgery
• high risk for postpartum depression

What to expect in a postpartum visit

During a postpartum visit, your doctor or midwife will check on your overall well being, vaginal bleeding, mood, and how breastfeeding is going if you're nursing. We also discuss what your plans for preventing another pregnancy might be so that you can safely and intentionally plan your family.

Postpartum concerns – what to watch for

There are some things a new mother should keep an eye on after giving birth.

Bleeding

It is normal for a woman to have vaginal bleeding for up to six to eight weeks postpartum. Most women will bleed for about two weeks and then perhaps spot for another few weeks. This is called lochia and is the uterus shedding the lining that supported your pregnancy.  

Call your doctor if you experience any persistent heavy bleeding, meaning bleeding that is filling a large overnight maxi pad every hour for about two hours, or if you are continuously passing large clots. This could indicate that some pregnancy tissue is still inside the uterus and may need to be removed.

It's important to note that as you recover and become more active at home, or if you are nursing your baby, you may have occasional increases in your bleeding. Again, what concerns us is continuous heavy bleeding or the passage of multiple clots. Call your doctor immediately if you are experiencing bleeding like this.

Mood

Perinatal depression, meaning a depressive (or anxiety) episode that occurs during pregnancy or in the first 12 months after delivery, is one of the most common complications of pregnancy, affecting about one in seven women. Perinatal depression often goes unrecognized because sleep deprivation, a sense of overwhelm, and changes in appetite or libido are often attributed to normal pregnancy and postpartum changes.

However, unrecognized postpartum depression can have devastating effects on a woman and her family, so early recognition and treatment are critical. After you have a baby, your hormones rapidly plummet and this hormonal instability can lead to what's commonly known as "baby blues." During this time, many women will experience weepiness, feel overwhelmed, and may have mild anxiety. Typically, these mood changes are self-limited, resolving about two weeks after delivery, and don't generally affect your ability to care for yourself, your baby, or your family.

The following could be signs of postpartum depression and require immediate evaluation. You should contact your doctor immediately if your mood changes persist and

• start to affect your sleep or concentration
• you lose the ability to take pleasure in things that once brought you joy
• you have intrusive thoughts, panic episodes, or thoughts of harming yourself or your baby

Other concerns to report

Beyond the bleeding and mood precautions I listed above, your obstetrician or midwife will want to know about any of the following:

• A fever over 100.4 degrees.
• A headache that does not improve with Tylenol or ibuprofen. This could be a sign of preeclampsia, a dangerous blood pressure disorder in pregnancy.
• New onset of chest pain or shortness of breath.
• Breast pain, especially if it's associated with redness, engorgement, fever, and body aches. These are symptoms of mastitis, an infection of the lactating breast that often requires antibiotics.
• Severe abdominal pain, nausea, or vomiting.

Your own health and wellness

Most of the attention is showered on the new baby when you arrive home from the hospital.  But it's essential to remember that your body, heart, and mind just underwent an extraordinary event and you need time to recover physically and emotionally.

In many cultures, communities of women come together to care not only for the newborn but for the mother as well so that she can recover, rest, and replenish. Unfortunately, we now return to our homes where we often have limited family or friends nearby who can relieve some of the pressure to not only care for our new baby, but also maintain a household and care for other children.

Having a network of support is critical for maternal wellbeing, infant bonding, and successful breastfeeding. It's essential to engage the people in your life to help where they can. When you do get a break from your baby, enjoy it. You are still a person who has needs and dreams and those do not need to be disrupted by the arrival of a new baby.

Self-care may look different once you have a baby but finding time to do things for yourself is essential to maintaining your wellness and your wholeness.

Be sure to find time for:

• rest
• spending time outside in nature
• gentle movement
• nourishing meals
• engaging in pleasurable activities like reading a novel, watching a movie, or talking to a friend on the phone

For more information on how we can help you with your pregnancy or postpartum care, visit our website.