It was our first full day at home with our 3-day-old son, Noah. By 7 p.m., he was sleeping in his bassinet and I was resting when our pediatrician called. Blood test results revealed Noah had jaundice and needed treatment. At the hospital. Right now.
We spent that night and most of the next day in the hospital -- me on a cot, my husband in a creaky chair, and Noah in an isolette, a tiny blocker over his eyes, basking in the UV light that would help his body fight the toxins of this common newborn illness. I wish that I'd had the perspective then to see that jaundice would be a passing problem -- it's highly curable -- but even once we were home, the experience left me an emotional wreck. I struggled to settle into a routine.
Feeling out of sorts is just part of the postbirth experience. "Those first days are a complex mix of physical, psychological, and social changes," says Leena Mittal, M.D., director of the Reproductive Psychiatry Consultation Service at Brigham and Women's Hospital, in Boston. Here's how to gracefully clear the hurdles ahead.
Your Body Is in Shock From Delivery. Most first-time moms-to-be spend so much time obsessing about childbirth that the struggles of recovery aren't on their radar. "I didn't realize it would be so traumatic," says Sarah Camacho, a mom of two in Denver, recalling a lot of "down there" discomfort from her vaginal delivery. "I had to use a squirt bottle every time I went to the bathroom to soothe the pain of my stitches, and I felt bruised. I couldn't sit down without a donut pillow. Even walking was exhausting."
If you deliver vaginally, you are going to be extremely sore -- a baby the size of a Virginia ham did just come out of a very small spot. Ice the area for the first 24 hours and then take frequent warm baths to soften stitches and to keep them from feeling tight, says Laura Riley, M.D., an American Baby advisory board member and author of You and Your Baby: Pregnancy. The good news? "Because a lot of blood flows to your vagina, the area heals quickly -- in a matter of days," she says.
For cesarean births, pain medication (OTC or prescription) can relieve the soreness and pulling at your incision site. "It's important that you take enough medication during the first week so you feel good enough to move around, which is what encourages recovery," explains Dr. Riley. Your C-section incision will take four to six weeks to fully heal, so keep an eye out for infection. If it leaks, smells, burns, or looks red, or if you develop a fever of more than 100.4 degrees F, call your doctor.
No matter how you delivered, you can expect a lot of cramping during this time as your uterus shrinks to its pre-pregnancy size. If you're nursing, the pain will be strongest when your baby latches on, which signals your body to start releasing oxytocin, the contraction-triggering hormone. And all postpartum women experience a few weeks of lochia, vaginal discharge that includes blood, mucus, and bits of placental tissue. Have plenty of sanitary napkins on hand; don't use tampons for at least six weeks, because they can introduce bacteria.
Shall we go on? Incontinence, hemorrhoids, and urinary tract infections (UTIs) may enter into the picture. To help prevent incontinence, perform frequent Kegels (tightening vaginal muscles as if you're attempting to stop the flow of urine), and for hemorrhoids, move around, guzzle water, and take a stool softener. Tell your doctor about any pain when urinating or if you develop a fever, since either symptom could signal a UTI.