When I packedmy hospital bag before giving birth, I threw in a tunic and a pair of pre-pregnancy capris for heading home. But despite delivering a 7-pound bundle of joy, I still couldn't squeeze myself into those capris when it was time to go. I left the hospital wearing the same sundress I had arrived in. Many new moms don't realize how big they'll still be after giving birth (surprisingly, it can take up to nine months for your abdomen to return to its pre-pregnancy size)—or know about the other changes that occur in the hours and days afterward. While you can't prepare for everything, there are some common postpartum experiences you should be aware of before your baby arrives.
You'll get a "massage." After you deliver your baby and the placenta, your doctor or midwife will press gently on your belly to ensure your uterus is contracting. Called a "fundal massage," this practice helps decrease the bleeding that occurs after childbirth. But "massage" is a misleading term. For some, it can be uncomfortable. "After my C-section with baby # 1, it was the most painful thing ever," says Leslie Goldman, a mom of two in Chicago. "After my second child was born, I dreaded that moment when they would come in and press."
Shaking is normal. Your body knows childbirth is a monumental event—which may be why it's common for your whole body to shake toward the end of delivery or right afterward. "It's caused by a combination of the adrenaline from pushing as well as from hormonal shifts," says Shannon Clark, M.D., associate professor of obstetrics and gynecology at the University of Texas Medical Branch at Galveston. Shaking generally lasts for several minutes after giving birth and subsides within an hour, says Dr. Clark. If you experience shivers or shakes in the days following your delivery, this could be a sign of infection and you should notify your doctor.
Stitches may be needed. You might have an episiotomy (a surgical incision in the perineum, the area between the vagina and the anus, to assist in the delivery of the baby's head), or you may have a natural tear that requires stitches. If you received an epidural, no other medications will be needed during repair. If you didn't, you'll be given local anesthesia for pain control. Any stitches in that area will dissolve on their own over time. For the soreness that follows, witch-hazel pads, cold packs, or a sitz bath (sitting in a shallow basin of warm water) can be soothing. You can also ask your doctor about a topical numbing cream or ibuprofen to ease the pain. Of course, if you have a C-section, your doctor will use either stitches or staples to close up the incision in your abdomen. Stitches will dissolve on their own over time, but staples will need to be removed by your doctor in five to seven days.
Expect a lot of blood. You probably assume you'll bleed during childbirth, but you'll continue bleeding after delivery, says Samuel Bender, M.D., assistant clinical professor of obstetrics, gynecology and reproductive science at Mount Sinai Hospital, in New York City. This discharge, or lochia, is the uterine lining that's been building up during pregnancy. While lochia is bright red in the first few days (and blood clots that are golf-ball size or smaller are normal), it should decrease and become lighter in color in the weeks after delivery. Alert your provider if you have larger-size blood clots or you're soaking through two or more maxi pads in an hour, as this may be a sign of a hemorrhage and will require a prompt evaluation.
There's swelling. During pregnancy, your blood volume increases by as much as 50 percent. And while you do lose blood during childbirth, this extra blood, as well as the IV fluids you received during labor or a C-section, need to go somewhere, says Dr. Clark. As a result, you may notice swelling in your lower legs and even in the vaginal and labial areas. However, this should resolve within ten days to two weeks after you have your baby.
You'll still pee a lot. As your body tries to get rid of the extra fluid, you'll need to urinate frequently—much as when you were pregnant. Alas, birth can take a toll on your urinary tract: You may have trouble going or sensing when you need to, or leak when you cough or sneeze. "It's normal to have a little incontinence the first few days," says Dr. Clark. But tell your doctor if it persists for more than a few weeks.