Recovering from C-Section

Recovering from C-Section

If you have had a C-section, first let me say that you are probably feeling pretty overwhelmed right now. That’s perfectly normal. You have just gone through the drama of delivery and (possibly) an unexpected c-section. You had major surgery, delivered your baby after months of waiting, and your body is now going through major recovery. Your emotions will probably be uncontrollable and your body will feel like a train wreck. Take it one moment at a time and you can do this. Whatever you feel, it’s normal. Here’s what to expect the first few days:

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COMING OUT OF SURGERY
Coming out of surgery, you will feel groggy and nauseated. You may also feel itchy from the meds. You will still have your epidural or spinal block to receive pain medication through.

PAIN MANAGEMENT
You will be given IV pain medication for up to 24 hours. You will probably have a button on your IV that you can push any time you need pain relief. This is not the time to be sparing, the less pain you have, the better you will be able to take care of your baby and recover. After that, your pain management will be in pill-form and you will receive stool softeners and simethicone for gas. These are all safe for your baby if you are breastfeeding. You should be able to breastfeed right away.

BREASTFEEDING
If you decided to breastfeed during your pregnancy, you probably studied up to know what to expect. Breastfeeding after surgery is different and difficult and you will need help. Finding a position that does not aggravate your incision and that your baby will take to, can be frustrating. Don’t give up. Listen to the lactation consultant. They can help.

TAKING CARE OF THE INCISION
The typical incision is 4-6 inches long horizontally below your belly button. You will need to place a pillow over your incision when you cough, sneeze, or laugh. It will be sore and will have staples that will be removed before you leave the hospital.

MOBILITY
The women I have helped weren’t able to move around much at first. Getting out of bed was difficult and they needed help but moving is important to prevent blood clots. By the time you leave the hospital, you will be able to walk to the bathroom with help. Empty your bladder often as a full bladder crowds the healing uterus and slows recovery.

WHAT TO EXPECT RECOVERING AT HOME
You will need help at home so accept any that you can get. You will be given a prescription for painkillers for a week and then you can use over-the-counter meds. You will be recovering from major surgery and taking care of a baby so use this time to rest and take care of yourself.

WHEN TO BE CONCERNED
Call your doctor if your incision oozes or gets worse, painful, or red. If you have a fever, increasing pain, or any other puzzling symptoms, don’t ignore them.

WHAT TO EXPECT LONG-TERM
Expect your recovery to take several weeks to a month. Don’t rush it. Go through the emotional process and deal with the physical limitations and know that you will be back to normal soon. Try to focus on your baby and enjoy this time with your family and take care of yourself; you just did something awesome. Celebrate you!

 

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The Postpartum Period: What No One Wants to Talk About

The Postpartum Period: What No One Wants to Talk About

When I was pregnant, I couldn’t wait to get rid of my heavy belly, back-ache, and maternity clothes and to be able to enjoy countless lattes and a glass of full-bodied wine on a Friday night. The only part of pregnancy that I didn’t mind was not having my period every month. Nine months without one were wonderful. But when it did return, things were a little different than before.

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WHEN DOES THE PERIOD RETURN?

The period returns at different times largely dependent on breastfeeding. Breastfeeding produces a hormone that suppresses ovulation and delays periods. Since I was breastfeeding, my period returned a month after I stopped, which seems to be pretty common. Breastfeeding moms tend to get their period back six months after birth or when the baby begins weaning. Non-breastfeeding moms usually get their period 6-8 weeks after birth.

WILL IT BE THE SAME AS BEFORE?

Though I started having my period after I stopped breastfeeding, it wasn’t particularly regular after that. I would have one cycle at 28 days, then one at 35, and then another at 45 days. Though I worried about it at the time, I soon learned that this was not uncommon. My partner and I struggled to conceive and I finally became pregnant through IVF after taking many hormone shots. This treatment made it more difficult for my body to adjust after birth. Taking oral contraceptives before pregnancy can have a similar effect. Breastfeeding also affects the hormones and can make the periods irregular to begin with.

THE FIRST “PERIOD” AFTER BIRTH

I was also bleeding heavily in the first few weeks after childbirth. This bleeding was accompanied with heavy cramping. This was not a regular period, but the process of my uterus returning to its normal size after pregnancy. I found that thin overnight pads worked well for this bleeding given that I was instructed not to use tampons while my vaginal tears were healing and I found other pads to be too bulky and painful against the tears. I was told not to worry about this bleeding as long as I didn’t need to change my pad more often than every hour and I wasn’t passing large clots.

WHEN TO BE CONCERNED

While there is no such thing as a “normal” post-pregnancy period, I learned that there were certain things to watch for:

  • If you have periods lasting longer than seven days or contain clots larger than a quarter.
  • If you miss a period once your periods have become routine.
  • If you experience spotting between periods.
  • If your period has not returned within three months after childbirth (when not breastfeeding) or three months after you stop breastfeeding.

These symptoms can be a sign of more serious complications like anemia, fibroids, or a thyroid problem, so it’s always best to contact a doctor.

LIFE AFTER PREGNANCY

Life after pregnancy will never be the same “normal” as it was before. For the most part, this is fine. This new life will have its challenges and delights. I tried to learn to embrace them both.

Why you’re struggling to lose your post-baby tummy: diastasis recti

Why you’re struggling to lose your post-baby tummy: diastasis recti

Post pregnancy, you expect a little tummy pooch until your uterus contracts to its pre-pregnancy size. What you don’t expect, though, is a condition called diastasis recti, which causes the so-called “mummy tummy” to never go away. This is a separation of the abdominal muscles. The muscles on the left and right side of the belly become stretched by the constant pressure of the growing baby and they are unable to retain their shape. It is what makes your high waist jeans that fit great before, never fit again even though you return to your pre-pregnancy weight.

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SYMPTOMS & CAUSES

Diastasis can cause a host of problems beyond the mummy tummy such as lower back pain, constipation, and urine leakage. The muscle should return to normal after birth but most women report this ongoing condition to at least some extent. Having multiple pregnancies, surgeries, or other abdominal issues raises your chance of having it.

AVOID ABDOMINAL EXERCISE WHILE PREGNANT AND POSTPARTUM

To keep a toned stomach, I often did exercises like crunches and planks before and soon after pregnancy. These muscles are already strained during pregnancy and when done wrong, exercises like these can make matters worse. Although I was one of the few who escaped permanent damage, I have friends who weren’t so lucky. They went on to have protruding stomachs, abdominal issues, and even a hernia (a condition when organs start poking out of the thin band of connective tissue that is left when the abdominal muscles have separated).

A SIMPLE TEST CAN TELL

You can get a good idea of whether or not you have diastasis recti through a simple, at-home test. Diastasis is measured by a gap of more than 2.7 cm between the muscles. Lie on your back with your knees bent and your feet flat on the floor and place your fingers palms down on your belly button. Lift your head and neck up a little while you press down with your fingers. If there is a gap between the muscles you feel, that is the diastasis.

TREATMENT OPTIONS

There are some specific treatment options to help. If you suspect that you have this condition talk to your doctor. They can tell you whether your case is manageable through postpartum exercise or if you need surgery. If you go to a trainer, make sure they are familiar with diastasis or they could make your condition worse. Your doctor might recommend some gentle, at-home exercises or refer you to a physical therapist.

An operation called abdominoplasty or a tummy tuck may be recommended if your condition is bad enough to cause additional problems. The surgery involves stitching together the weakened central ridge. There is a device called a splint or binder that you can ask your doctor about but it’s still up in the air as to whether it is helpful or not.

There are programs online and that provide postpartum exercises that you can do at home to strengthen your core and try to close up that diastasis recti.

PREVENTION

If you know that you’re planning to get pregnant, the best thing is to start strengthening your core before getting pregnant to prevent diastasis recti. While pregnant, it’s best to avoid movements that isolate abdominal muscles like sit-ups and instead focusing on overall body strengthening.

Dealing with postpartum night sweats

Dealing with postpartum night sweats

There are a lot of crazy things that happen to your body postpartum and most of them, for some reason, no one wants to talk about. They happen to everyone and someone out there should educate women about their own bodies. Postpartum night sweats are a common occurrence for thousands of women. You wake up and suddenly find yourself soaked in sweat for no apparent reason. Why do people not warn you that this could happen to you?

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WHY DOES THIS OCCUR?

Normal night sweating can happen when you are wrapped up too much or your room gets too hot. Postpartum night sweats occur for a different reason and it is a perfectly normal symptom of post-pregnancy. Due to hormone fluctuation (yes, hormones are to blame for yet another postpartum issue) and excess body fluid from lactation, your wonderful body just finds a way to rid itself of what it simply doesn’t need.

You may notice yourself urinating more frequently; though who could tell after spending half of the last nine months in the bathroom anyway. This is also your body’s way of getting rid of all of that extra fluid previously needed to maintain a healthy pregnancy and delivery. Your body will also be producing tons of extra fluid if you are breastfeeding.

If you experience night sweats with other symptoms present, such as fever or chills, call your doctor because these can be signs of a serious infection.

WHAT TO EXPECT

Due to your body’s crazy hormonal ups and downs, these night sweats can occur nightly or sporadically. They will usually last for several weeks after you give birth. They should stop as your body returns to normal.

While there is no treatment, there are some things you can do to help alleviate your symptoms:

  • Keep your room cool.
  • Drink plenty of fluids. With all of that sweating, you can become dehydrated easily.
  • Sleep on a towel and keep a pile of them near to change if you need to.
  • There are great waterproof mattress covers that you just lay under you, too.
  • If your skin gets irritated from all of that moisture, you can consider using powder to ease the chafing and irritation.

WHEN TO BE CONCERNED

One study showed that women who experienced postpartum night sweats and hot flashes were more likely to become depressed. Breastfeeding raises the risk, even more, due to the tremendous hormone fluctuations. If you experience any of these symptoms, talk to someone and tell your doctor. There is help and you don’t need to face it alone.

Don’t worry about the night sweats but if you experience other symptoms such as fever over 100.4 º, foul-smelling vaginal discharge, large clots or bright red bleeding for more than three days after delivery, infected looking stitches, severe cramps, or red, swollen breasts, call your doctor. These can be signs of serious complications.

Also if you feel depressed, or just anxious, talk to someone you trust and keep your six-week checkup and discuss any concerns with your doctor.

Dealing with night sweats may not be pleasant, but you can take heart in knowing that your body is doing exactly what it is supposed to be doing. Isn’t that a wonder!

Easy steps to handle sore nipples

Easy steps to handle sore nipples

Breastfeeding can be a wonderful and almost magical experience for some mamas. When it works, it can be something that you look forward to. But even then, it is often accompanied by challenges like sore nipples. Sore nipples can also plague exclusive pumping mamas. The skin around the nipples can become cracked and sore and even bleed. While in most cases, this is one of those normal things that goes with the territory, there are some simple things that you can do to help get through the process.

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PINPOINT THE PROBLEM

First, pinpoint the cause of the problem. If your baby isn’t latching properly it will cause soreness. I absolutely recommend having a postpartum talk with a La Leche League member or a lactation consultant. They can help with proper latching and feeding as each child is different. The tip of your baby’s nose should touch your breast and they should latch onto a large portion of your breast. If this is painful, gently insert your finger between the breast and their mouth to break suction and try again.

Some babies have a hard time latching properly due to tongue tie or other special situations. In some cases, a nipple shield can help. A lactation consultant can help you spot issues and refer you to an appropriate medical practitioner if needed.

There are also other types of discomfort with breastfeeding that should be addressed differently than sore nipples. For example, when my baby had thrush, a yeast infection of the mouth, it was passed on to me and my doctor prescribed a cream to apply and liquid oral drops for the baby. Look for itchy, red bumps or white patches in your baby’s mouth and tell your doctor. Engorgement is another common problem and expressing milk before feeding can help. You can also apply warm cloths to ease the discomfort. None of these conditions will affect your baby and you need not worry about continuing nursing through it all.

Sore nipples can also result from pumping milk. If your nipples are sore from pumping, you may need a different size breast shields. You can also try to decrease the frequency of pumping, if you’re able to do it without getting clogged ducts.

BEFORE FEEDING

Before feeding from the sore side, I would take a warm shower and hand-express milk until some of the discomfort subsided. If you use a breast pump instead, set it on the lowest suction that is effective. I always fed from the unaffected side first, if there was one. Babies feed eagerly at first and then slow down on the second side. Try different positions and if you need to, pump and feed from a bottle for a few days.

AFTER FEEDING

Mix 1/2 teaspoon of salt in one cup of warm water and place it in a squeeze bottle or small bowl. Soak the affected area in this natural saline solution for just a few minutes. Rinse with warm water, pat dry and apply pure lanolin cream (ask your doctor for a specific brand) to the area. This tremendously speeds up recovery. Wipe away any excess cream before feeding again.

Take acetaminophen or ibuprofen as needed and apply anti-fungal cream prescribed by your doctor if you are dealing with thrush.

Between feedings, you can put a soothing gel pad in your bra. Ideally, you would leave nipples exposed to air, but many mamas don’t have time to sit around topless. You can get nipple shells that create space between your bra and your nipples. I found those to be painful once my breast filled up with milk again. If you wear nursing pads, make sure to change them anytime they get damp to aid in a faster recovery. For me, most nursing pads would scratch my nipples when they were sore, so I would usually try to avoid them if possible.

CONTINUE NURSING AS USUAL

You can continue nursing your baby as long as it is not too painful. Your little one likely won’t notice any problems and, unless they are having latching-on issues, they should feed steadily.

All you need to know about postpartum uterus cramps

All you need to know about postpartum uterus cramps

With my first child, I was totally unprepared for the afterbirth pains. I went through the pregnancy with all of its ups and downs and then the pain of delivery. I’d heard that postpartum recovery could be trying but I had no idea what to expect.

Soon after the birth, I began having very uncomfortable cramps. They would come and go. They were similar to menstrual cramps but more intense. I just wanted to enjoy my baby. Thankfully, my doctor explained what was going on and what to do about it.

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WHAT’S HAPPENING?

After birth, the uterus begins to shrink back to its normal size by contracting. It is also shifting and moving back to its original pre-pregnancy position. This could feel like cramps and should only last a 10-14 days after birth. These cramps are also known as the afterbirth pains or afterpains.

My afterbirth pains were the worst each time I began breastfeeding. Breastfeeding releases a hormone called oxytocin. This is the hormone responsible for the contractions I breathed (or yelled!) through during delivery. It makes sense that it could cause some pain after the delivery, too.

I tried to think of the cramps as one step in the direction of going back to my pre-pregnancy self.  The cramps were helping my uterus return to its normal size. During pregnancy, the body produced lots of fluids to maintain the life of the baby and now, they were all being flushed out because they were no longer needed.

THINGS TO HELPS EASE THE DISCOMFORT OF POSTPARTUM UTERUS CONTRACTIONS

There were two things that the doctor recommended that helped tremendously. The first was massage. Massaging the uterus gently every half hour or so helps to stimulate it and continue the natural cycle or shrinking back to normal size. Although this can be slightly uncomfortable, it should not be painful. Apply gentle pressure and work in a circular motion.

The other thing was a heating pad or warm cloths. The heat relaxes the muscles between these cramps and just feels good.

There are other things you can try, as well.

  • I always took acetaminophen or ibuprofen postpartum until all of the pain subsided.
  • Empty your bladder often, as a full bladder interrupts these uterus contractions.
  • I know it’s been ages since you were able to lie on your stomach and, for some women, this is the perfect time. Lying on your stomach with a pillow under your lower abdomen can help relieve the discomfort.

WHEN TO BE CONCERNED

These cramps shouldn’t last long and they shouldn’t be unbearable, only uncomfortable. Call your doctor if your pain gets worse or if the cramps last longer than two weeks. These symptoms can be a sign of infection or other postpartum complications.

THE NORMAL HEALING PROCESS

These cramps were mild with my first child but did get less tolerable with consecutive deliveries. Even so, they still weren’t bad. Your body knows how to heal itself and return to normal. Just sit back and watch in wonder of it all as you hold that precious baby that you just brought into the world.

How to deal with swollen hands & feet after birth

How to deal with swollen hands & feet after birth

Towards the end of my pregnancy, I couldn’t wait for my swollen hands and feet to get back to normal. I was longing to wear regular shoes, not to mention my wedding ring. Nothing could prepare me for what would happen to my hands, feet, and face(!) after I had my baby.

I had a really difficult labor, pushing for over 30 hours, and finally having to resort to a forceps delivery. All that time, I was given IV fluids. So when my son finally made an appearance, I had turned into a Shrek with massive sausage fingers, ankle-less feet, and puffy cheeks. Once I had recovered enough to get up on my feet, I could only wobble around in massive slippers. It took over a week for the swelling to go down. I was miserable.

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WHAT CAUSES THIS FLUID RETENTION?

Postpartum edema is a common condition. It affects many women after delivery to various degrees. During pregnancy, the body produces lots of extra fluids and 50% more blood to maintain a healthy pregnancy. This fluid doesn’t just go away immediately after birth. The body has to work for several days to rid itself of it.

That extra dose of hormones that brought my baby into the world was also responsible for some of the fluid retention. During the delivery, the pressure in the uterus forced all the fluid I received via IV to the extremities.

WHAT ARE THE SYMPTOMS OF POSTPARTUM EDMEA?

You may find yourself with extremely swollen hands, feet, legs, and face. Even your stomach can swell. The skin can be tight and itchy. There is a simple test you can do to check for fluid retention. Press on your skin for a few seconds and then after you remove your finger, there should not be an indention. The longer the indention lasts, the worse your condition is.

WHAT ARE MY TREATMENT OPTIONS?

Your body will naturally rid itself of these extra fluids. Even in my extreme case, it went away on its own. You may notice that you sweat a lot or urinate often. These are just other ways your body is getting rid of fluids.

I found a few things that made the swelling feel better:

  • Keeping my hands and feet elevated.
  • Avoid crossing my legs.
  • Drinking a lot of fluids to keep things moving and avoiding salty foods.
  • Getting up and moving around to get my circulation moving properly again. This can be difficult after a c-section and you should go slowly.
  • Soaking my feet in warm water with a few drops of essential oils.
  • Massage can improve circulation and help against fluid retention. I scheduled a massage right after we got back from the hospital and my husband watched the baby. It was magical!

WHEN TO BE CONCERNED

Be watchful that your condition improves daily. If you have any other symptoms like chest pain, trouble breathing, pain in your legs, headaches, changes in vision, or nausea, or if your condition worsens, call your doctor as these can be signs of other complications.