All you need to know about postpartum uterine cramps

All you need to know about postpartum uterine 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.

xavier-sotomayor-192007

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.

ben-hartley-293931_0a2e460a824945c53b9769c1b5f056d5

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.

5 tips for healing vaginal tearing

5 tips for healing vaginal tearing

The birthing process comes with many unexpected realities. We expect pain, joy, and even the unknown. One less known fact of delivery is vaginal tearing. Vaginal tearing occurs most commonly because the baby’s head is too large for the opening. Other factors can also raise your risks, such as being a first-time mother, having a larger baby, longer delivery, or the use of birthing assistance like forceps or the vacuum.

Vaginal tearing is often a natural part of the birthing process and should not be feared. In many cases, it heals back quickly, usually within ten days. The healing process for natural vaginal tearing also tends to be quicker than that of an episiotomy. Episiotomy is a surgical cut to the vaginal opening to prevent uncontrolled tearing during birth.

Birthing Process, Vaginal Tearing Healing and Treatment

FOUR DEGREES OF VAGINAL TEARING

There are four different degrees of vaginal tears. Depending on the severity of the tear, you may require stitches. For a higher degree tear, your recovery time could be a bit longer and you might experience more pain or discomfort. With some of my children’s births, I hardly noticed the vaginal tearing. With others, it was significant and took patience.

VAGINAL TEARING TREATMENT

There were some vaginal tearing treatment methods that my doctor recommended that really did work well.

1. REST

Your body cannot heal unless you rest. You have your hands full trying to take care of your baby so rest as often as you can and allow your body to naturally go through the process of healing. There are certain activities that I found aggravated the stitches or just prolonged healing. Walking too much, sitting too long, and lifting anything heavier than my baby were a bad idea. My doctor recommended no exercise or sexual activity until after the six-week checkup to ensure that everything did heal properly. In the meantime, take naps often, even short ones. Try to eat healthy and drink lots of fluids to prevent constipation.

2. STOOL SOFTENER

I got stool softeners after the delivery to prevent strain during a bowel movement as constipation is common during postpartum recovery. My doctor recommended using them for a couple of weeks, which I think is a great idea.

3. SQUATTY POTTY

Another great way to avoid putting pressure on the perineum while recovering from a vaginal tearing delivery is to use a squatty potty to empty your bowels. It keeps you in a squatting position that doesn’t compress the rectal canal. This shortens the time you spend on the toilet and minimizes the pressure on the perineum.

4. APPLYING COLD PACKS

The best way I found to relieve the discomfort was by using cold packs. In the hospital, the nurses used ice cubes in a sealed plastic bag and wrapped in a cloth or a baby diaper. The sharp corners on the ice cubes can be really painful against the tear, even through a diaper. Luckily, there are softer perineal cold packs filled with gel that can be applied without any discomfort. In the days following the delivery, I applied cold packs for 20 minutes at a time every few hours and it really helped with the swelling, bruising, and pain. Don’t apply too long as it can do damage.

5. SITZ BATH

My nurse at the hospital recommended soaking the perineum in a warm sitz bath at least twice a day. There are many different sitz bath devices that can be placed in the toilet to help with this. You can also just sit in a tub with water up to your hips. In fact, sitz bath got its name from the German “Sitzbad”, which just means sitting in a bath.

For me, taking a sitz bath never really worked in the stressful first weeks of taking care of my newborn and I think my perineum recovery suffered as a result. I’ve heard from a couple of friends who tried it that this is an effective technique and I regret not taking the time to make it work.

6. PERINEAL MASSAGE 

Keeping muscles healthy and strong can help avoid complications. Perineal massage can be beneficial both in preparation for and recovery from delivery. Make sure to consult with a pelvic floor physical therapist before doing perineal massage. My physical therapist didn’t recommend perineal massage until my vaginal tear stitches had properly healed.

7.  KEGELS

Kegel exercises is another way to prepare the pelvic muscles for delivery and recover the muscles after birth. But it’s actually really hard to do kegels correctly. Some 25% of women do them wrong! A physical therapist can help you learn how to do kegels right and determine whether it’s the right fit for you. Some women have an overly tense pelvic floor and so should not do kegels.

CONTACT YOUR DOCTOR

A few months after my delivery, I discovered a painful pink spot in the stitched part of my perineum. I showed it to a number of doctors, before one of them figured out that it was granulation tissue and burned it off with silver nitrate. She explained that I was essentially “healing too well.” And eventually, the pink spot disappeared. But the road there was painful and frustrating. One of the doctors that I saw speculated that the area was too moist to heal and gave me the completely impractical advice to go commando!

But that’s not to say that you shouldn’t see a doctor if you’re not healing well. If you see any larger blood clots on your pad, any foul-smelling discharge, or your symptoms get worse, call your doctor as you could have an infection or other complications.