If you have had a vaginal delivery, a nurse will check your blood pressure and bleeding closely for the first few hours after the birth. You will be offered medication for pain relief, and you will be encouraged to nurse your baby. If you have had a Cesarean delivery, you will be in a recovery area where a nurse will monitor you. You will be offered pain medication. After about an hour, you will be moved to your room. A nurse will measure your urine output after delivery to make sure your kidneys and bladder are working.
Episiotomy
After childbirth, you may experience two main areas of pain—your abdomen and yourepisiotomy (if you have one). You can ask for pain medication for both.
It is unusual for an episiotomy to become infected. Usually an infection doesn't appear for a few days. Antibiotic treatment will take care of an infection.
Tubal Ligation
Some women choose to have a tubal ligation done while they are in the hospital after the birth of their baby. However, this is not the time to make a decision about a tubal ligation if you haven't thought seriously about it before.
There are advantages to having a tubal ligation after delivery. You are already in the hospital; if you have an epidural, you already have the anesthesia necessary for a tubal ligation. If you didn't have an epidural for delivery, this procedure requires general anesthesia.
There are also disadvantages. Consider tubal ligation permanent and irreversible. If you have your tubes tied within a few hours or a day after having your baby, then change your mind, you will regret it.
Not Breastfeeding
Women who decide not to breastfeed sometimes ask if they can take a pill or have a shot to dry up their milk. We do not give medication to stop your milk from coming in at this time. (It was done in the past, but those medications are no longer available.) Bind or wrap your breasts to stop the milk flow. Keep in mind this decision should be considered final. If you stop your milk from coming in, you won't be able to start it later.
Getting Enough Rest
Many women are surprised by how tired they are emotionally and physically for the first few months after the birth of the baby. Be sure to take time for yourself—you'll have a period of adjustment.
Sleep and rest are essential after the baby is born to help you get back in shape. To get the rest you need, go to bed early when possible. Take a nap or rest when the baby naps.
You may feel exhausted having to deal with your baby. Parenthood is easier and more enjoyable when both partners share the responsibilities and chores. Couples should form a parenthood partnership. It will take a cooperative effort from both of you, but it can be done.
To form this partnership, sit down together before the baby is born and discuss what changes you will face. You may be able to avoid problems before they occur. Sharing tasks, such as bathing and diaper changing, seems to work out the best.
Problems to Watch For
You should not feel ill after birth. Call your doctor immediately if you have any of the following problems:
 | unusually heavy or sudden increase in vaginal bleeding (more than your normal menstrual flow or soaking more than two sanitary pads in 30 minutes) •vaginal discharge with strong, unpleasant odor |
| a temperature of 101F (38.3C) or more, except in the first 24 hours after birth |
| breasts that are painful or red |
| loss of appetite for an extended period of time |
| pain, tenderness, redness or swelling in your legs |
| pain in the lower abdomen or in the back |
Baby Blues
After your baby is born, you may feel sad and cranky. This feeling is called postpartum distress; up to 80% of all women have the "baby blues." It usually appears between 2 days and 2 weeks after the baby is born. The situation is temporary and tends to leave as quickly as it comes.
Symptoms of the baby blues include:
| anxiety |
| crying for no reason |
| exhaustion |
| impatience |
| irritability |
| lack of confidence |
| lack of feeling for the baby |
| low self-esteem |
| oversensitivity |
| restlessness |
Postpartum reactions, whether mild or severe, are temporary and treatable. One of the most important ways you can help yourself is to set up support before the birth. Ask family members and friends to help. Have your mother or mother-in-law stay for a while. Ask your husband to take some leave from his job, or hire someone to come in and help each day. Do some form of moderate exercise every day. Eat nutritiously, and drink plenty of fluids. Go out every day.
Postpartum depression.
Postpartum depression is a more severe problem than baby blues. Medication may be necessary. Medications of choice include antidepressants and tranquilizers; often they are used together. In most cases, a course of antidepressants that lasts from 6 months to 1 year successfully treats the problem.
Your partner can be affected if you suffer from the baby blues or postpartum depression. It's important to prepare him for this situation. Explain to him that if it happens to you, it is only temporary.
Physical Changes
Abdominal skin.
For some women, skin returns to normal naturally. For others, it never returns to its prepregnancy state.
Abdominal skin is not muscle, so it can't be strengthened by exercise. One of the main factors that affects your skin's ability to return to its prepregnancy tightness is connective tissue, which provides suppleness and elasticity. As you get older, your skin loses connective tissue and elasticity. Other factors include your state of fitness before pregnancy, heredity and how greatly your skin was stretched during pregnancy.
Breasts.
Most women find their breasts return to their prepregnancy size or decrease a little in size. This is a result of the change in the connective tissue that forms the support system in a woman's breasts. Exercise will not make breasts firmer, but it can improve the underlying muscle so breasts have better support.
Weight.
It's normal to lose 10 to 15 pounds (4.5 to 6.75kg) immediately after your baby is born. Extra weight may be harder to lose. Your body stored about 7 to 10 pounds (3.15 to 4.5kg) of fat to provide you with energy for the first few months after birth. If you eat properly and get enough exercise, these pounds will slowly come off.
Exercise.
It's generally OK to exercise after you have a baby, but be careful about beginning an exercise program too soon. Before you start any postpartum exercise program, be sure to check with your doctor. He or she may have some particular advice for you. Don't overtire yourself. Get adequate rest.
Do something you enjoy, and do it on a regular basis. Walking and swimming are excellent exercises to help you get back in shape. Take it slowly. Ask your doctor when and how you can increase your exercise program.
