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Postpartum Instructions

Congratulations on Your New Little Bundle of Joy

Congratulations!!

After many weeks of anticipation your new baby has arrived! We are thrilled to have been a part of this amazing life changing event. Here are a few suggestions to help you get through the healing process as easily as possible.

Rest!

You have probably heard this before “Sleep when the baby sleeps.” It is the key to surviving the first few weeks with a newborn. If others offer to help, let them help. They will sleep soundly through the night while you are up taking care of the baby.

Care of Stitches

If you had an episiotomy or vaginal tear, these stitches will dissolve on their own with very little care on your part. Keep the area as clean as possible. Using the peri-bottle provided in the hospital will help with cleanliness. Warm sitz baths or tub soaks will ease the soreness. Cesarean section stitches also dissolve over time. These wounds should be kept clean and dry. After a shower pat the wound dry. No dressing or bandage is needed.

Vaginal Bleeding

Postpartum vaginal bleeding can last up to 6 weeks but will vary from day to day. While breastfeeding however you may notice intermittent and unpredictable bleeding. This is normal and should not cause you to worry. Vaginal rest, which means nothing should be placed into the vagina, is recommended until your postpartum visit. Douching is never recommended. The use of tampons may be resumed after your postpartum visit. The return of a regular period is unpredictable but please remember you will ovulate before your first period. So you could get pregnant even before your first period. Your provider can prescribe birth control at your postpartum visit. If you are breastfeeding your period may be delayed until you wean your baby. But please know breastfeeding is not 100% effective in preventing pregnancy.

Constipation

This is very common in the postpartum period and should not be ignored. Breastfeeding, pain medications, lack of exercise and episiotomy pain can make constipation worse. Drink a lot of fluids, eat fruits, vegetables and bran cereals. If needed you can use an over the counter stool softener such as Colase. If a laxative is needed over the counter Miralax or Milk of Magnesia are good options.

Exercise

You may begin exercise gradually after your delivery. Start with walking and light exercise when it is comfortable to do so. Aggressive exercise programs, sit-ups and other abdominal exercise should wait until after your postpartum visit. After you are cleared we encourage you to resume your pre-pregnancy exercise or initiate an exercise program. Exercise not only helps in weight loss but also aids in stress reduction and better overall heath.

Breastfeeding

If you are breastfeeding be sure to drink plenty of fluids throughout the day to replenish what is used for breast milk. Dehydration can reduce the quantity of your milk. Continue to take prenatal vitamins while nursing and eat a well-balanced diet that includes plenty of calcium and protein.

Bottle Feeding

If you have chosen to bottle feed, wear a supportive bra day and night for the first week or until breast swelling has decreased. If painful engorgement has occurred ice packs can be helpful. Do not stimulate the breasts by expressing or pumping milk or allowing the shower to hit them while bathing.

Mastitis

Mastitis is an infection in the breasts that can occur during breastfeeding. Engorgement, plugged milk ducts and incomplete breast emptying can contribute to the problem and make symptoms worse. Mastitis may appear as red, sore, hard to the touch or unusually warm areas of the breast. To treat these symptoms continue to breast feed frequently on the affected side, if your breast does not feel empty after feeding use a breast pump to empty the breast. Moist heat applied a few times a day may also help. If your symptoms don’t improve within 24 hours or if you develop chills, fever of 101 degrees or higher call for an appointment right away.

Driving

Please refrain from driving for at least 2-3 weeks or until you are off pain medication. It is difficulty to drive safely when you are still sore and your stitches are uncomfortable. We are concerned about you and your new baby’s safety as well as everyone else on the road.

Contraception

You should wait until after your postpartum visit to resume intercourse. This will allow for proper healing without the risk of infection. Condoms should be used with intercourse every time until you start contraception. Breastfeeding reduces your chance of pregnancy but it is not 100% effective so condoms should still be used. At your postpartum visit you can discuss long term contraception with your provider.

Pain Relief

Regular and extra strength Tylenol may be used according to the package instructions. Ibuprofen (Motrin) is recommended over Tylenol and will be prescribed by your physician before discharge from the hospital. If you have had a C-section you will also be sent home with a narcotic pain medication. You may use those in addition to the Motrin.

Baby Blues

Baby blues are very common after delivery affecting 80-90% of mothers. Some new mothers feel overwhelmed by their new duties and when combined with lack of sleep and hormone changes baby blues can occur. Baby blues symptoms may include moodiness, sadness, difficulty sleeping, irritability, appetite changes, or concentration problems. Symptoms may appear within a few days of giving birth and last from several days to several weeks

Postpartum depression is a more serious problem but may be hard to distinguish from the baby blues. The symptoms may appear gradually or suddenly and may not appear until many months after delivery.

Signs and symptoms of Postpartum Depression:
  • Lack of interest in your baby
  • Negative feelings towards your baby
  • Worrying about hurting your baby
  • Lack of concern for yourself
  • Loss of pleasure
  • Lack of energy and motivation
  • Feelings of worthlessness and guilt
  • Changes in appetite or weight
  • Sleeping more or less than usual
  • Recurrent thoughts of death or suicide

If you have any of these symptoms or think you may have postpartum depression call your provider for an immediate appointment at 210-858-1101.

Coping tips for Baby Blues and Postpartum depression

  • Find people who can help you with child care, housework, and errands so you can get some much needed rest.
  • Make time for yourself every day, even if it’s only 15 minutes. Do something relaxing or that makes you feel good about yourself.
  • Keep a daily diary of your emotions and thoughts. Let everything out and keep track of your progress as you begin to feel better.
  • Give yourself credit for the things you are able to accomplish, even if you only get one thing done in a day. If you aren’t able to get anything done don’t be hard on yourself.
  • Give yourself permission to feel overwhelmed.
  • Remember no one expects you to be supermom.
  • Be honest about how much you can do and ask others for help.

Source: American Academy of Family Physicians


Once again, CONGRATULATIONS! Parenthood is a challenge but a rewarding one. With a good helping of common sense and the above suggestions, things should go well.

Don’t forget to schedule your postpartum check-up appointment: vaginal deliveries at around 6 weeks and C-sections at around 2 weeks.

From Our Patients

“She is a great doctor, and brings with her a sense of comfort hard to find in other professionals. I’d recommend her to everyone! Thank you, Dr. Akonye, for your dedication.” – Priscilla Terrazas