Postpartum, also known as the puerperium, defines the time following childbirth during which pregnancy-induced maternal anatomical and physiological changes return to the nonpregnant state. Its duration is inexact but is considered to last between 4 and 6 weeks. However, the symptoms and the changes that can occur may last way beyond the time frame.⁽¹⁾

During this period, several changes can be noted, including breast engorgement related to breastfeeding and vaginal bleeding. Your hormones will also fluctuate, which may lead to emotional instability and unclear thinking.⁽³⁾

What to expect during this period?

1. Baby blues

Often seen in the first few weeks as women struggle due to sadness that is caused by hormonal withdrawal.⁽³⁾

Management: Don't be afraid to share your feelings or ask for help, Share your feelings with your partner to help you feel better.

If feelings of sadness persist beyond a few weeks, it may be postpartum depression. Reach out to your healthcare provider if you experience severe symptoms like hopelessness or thoughts of self-harm.⁽⁵⁾

2. Abdominal pain

Commonly noted due to the shrinkage of the uterus to its normal size.⁽⁵⁾

This can also be noted due to breastfeeding as a release of chemicals is stimulated that causes of contraction uterine muscles.

Management: you can use heating pads to relieve the pain.⁽³⁾

3.Constipation

This can be seen due to the pain medications given during labor that slow down your bowel movements. fear of stitches getting undone may also be one of the causes women may experience difficulties or hesitation passing stools.

Management: Drinking plenty of water and staying hydrated along with a diet rich in fiber can help relieve constipation.

4. Hemorrhoids

Painful swelling of a vein at the rectum is called hemorrhoid and it may develop during pregnancy or during the strain caused during labor, this may lead to experiencing pain or bleeding during bowel movements.

Management: they should shrink overtime but if persistent you can contact your doctor,

5. Hormonal shifts

Apart from baby blues, hormonal shifts can cause other symptoms like excessive sweating and hair loss.

If sweating is accompanied by fever, let your doctor know as it could be a sign of infection.

6. Sore nipples and breasts

Common in the first few days of breastfeeding. Prolonged soreness may indicate difficulties with the baby's latch.

Management: Try repositioning your baby while breastfeeding to avoid cracks and soreness.

7. Vaginal Bleeding and Discharge

This is a Normal postpartum symptom, even with a C-section, as your body eliminates extra blood and tissue known as Lochia.

Management: Light bleeding and spotting can last up to six weeks. Report clots larger than a quarter to your doctor.

8. Perineal Soreness:

Pain in the area between your vagina and anus, especially after a vaginal delivery is common.⁽³⁾

Taking Care of Yourself and the Baby

This period of time can be very challenging for you. It is important to allow yourself to heal and rest to ensure a proper and smooth recovery. Make sure you have help during this time, as having a helpful hand can lower the burden and also provide you with emotional support.⁽²⁾

Nutrition

• Have a proper diet

• Make sure to drink plenty of water

• Include foods like lean protein, fruit, vegetables, and whole grains in your diet.

Physical Care

• Perineal Care: You can be sore for a few weeks after a vaginal delivery, so the perineal area must be taken care of with a peri bottle with warm water to rinse after using the bathroom.

• Limited Activity :

  • Limit your physical activity and don’t rush to exercise. Follow your doctor's advice on when it will be safe to start.

  • Most people can begin walking or doing gentle movements a few days after giving birth. People who had a C-section birth may need to wait longer.

Mental Health

Due to the hormonal changes, make sure to feel comfortable asking for help if you experience a low mental state.⁽²⁾

When should you Report to Your Doctor?

Any unusual symptoms or prolonged discomfort should be reported to your healthcare provider to ensure timely care.

• Heavy Vaginal Bleeding which is Soaking more than one pad per hour or increasing bleeding which increases day by day instead of decreasing.

• Yellow or green discharge with a foul smell.

• Passing Large Clots bigger than a quarter.

• Chills and/or Fever, a fever over 100.4°F

• Dizziness

• Severe Headache, Vision changes.

• Painful or Difficult Urination.

• Cardiac Symptoms like chest pain, or difficulty breathing.

• Vomiting.

• C-Section or Episiotomy Incision Issues with Red, weepy (with pus), or swollen.

• Worsening Abdominal Pain

• Sore Breasts that are red or hot to the touch.^(3,5)

References

1. Cunningham FG, Leveno K, Dashe J, Hoffman B, Spong C, Casey B. Williams obstetrics 26e. 26th ed. Columbus, OH, USA: McGraw-Hill Education; 2022. (cited on 24/07/2024)

2. https://my.clevelandclinic.org/health/articles/postpartum (cited on 24/07/2024)

3. https://familydoctor.org/recovering-from-delivery/ (cited on 25/07/2024)

4. https://www.marchofdimes.org/find-support/topics/postpartum/postpartum-depression#:~:text=Postpartum%20depression%20(also%20called%20PPD)%20is%20a%20medical%20condition%20that,of%20yourself%20and%20your%20baby. (cited on 25/07/2024)

5. https://health.clevelandclinic.org/postpartum-recovery(cited on 25/07/2024)

By Dr. Ruchika Brahmmadandi

_MSM