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Postpartum Cliff Notes

During pregnancy, your body changed a lot. It worked really hard to keep your baby safe and healthy. Now that your baby is here, your body is changing again. Some of these changes are physical. Other changes are emotional. The following are short (needing edit Im sure) cliff notes on what to expect after the baby arrives.


  • perineum soreness

The perineum is the area between your vagina and rectum. It stretches during labor and vaginal birth, and it may even tear. It often is sore after you give birth. You may be even more sore if you had an episiotomy (a cut made at the opening of the vagina to help the baby out).

What you can do

Do Kegel exercises. These strengthen the muscles in the pelvic area, which helps the perineum heal. To do them, squeeze the muscles that you use to stop yourself from passing urine. Hold the muscles tight for 10 seconds and then release.

Put a cold pack on your perineum. Use ice wrapped in a towel. Or you can buy cold packs that you freeze in your freezer.

Sit on a pillow.

Soak in a warm bath.

Wipe from front to back after going to the bathroom. This can help prevent infection as your episiotomy heals.

Use water to help rinse as you pee, urine is acidic

Ask your provider about medicine to help ease the pain.

  • afterbirth pains

These are cramps that you feel as your uterus shrinks back to its regular size. Right after you give birth, your uterus is round and hard and weighs about 2 ½ pounds. By about 6 weeks after birth, it weighs only 2 ounces. The cramps should go away in a few days.

What you can do

Ask your provider about over-the-counter medicine you can take for pain.

  • after a cesarean section

A cesarean section (c-section) is major surgery, so it may take a while for you to recover. You may be really tired for the first few days or weeks after a c-section. This is because you lost blood during the surgery. Also, your incision (the cut on your belly) may be sore. For these reasons, you’ll be encouraged to walk each day. Try to take your walks a short time after you’ve taken pain medication, when you’re likely to feel more comfortable.

It’s also important to get to the bathroom to urinate regularly. A full bladder makes it harder for the uterus to stay contracted and increases pressure on the wound.


What you can do

Ask your provider for pain medicine. Check with him before you take any over-the-counter medicine for pain.

Ask your partner, family and friends, DOULA for help with the baby and around the house.

  • vaginal discharge

This is bodily fluid that comes out of your vagina. It is also called lochia. Vaginal discharge may increase during and after pregnancy. After your baby is born, your body gets rid of the blood and tissue that was inside of the uterus. For the first few days, it’s heavy, bright red and may contain some blood clots. Over time, the flow gets less and lighter in color. You may have discharge for a few weeks, or even for a month or more

What you can do

Use sanitary pads until the vaginal discharge goes away.


  • breast engorgement

This is when you breasts swell as they fill with milk. It can be painful. Once you start breastfeeding, it should go away. If you’re not breastfeeding, it may last until your breasts stop making milk.

What you can do

Take a warm shower or lay warm towels on your breasts.

Tell your provider if your breasts stay engorged and are painful.

If you’re not planning to breastfeed, wear a supportive bra (like a sports bra).

  • nipple pain

If you are breastfeeding, you may have pain in the area in and around your nipples during the first few days, especially if your nipples crack.

What you can do

Use a special cream on the nipples. Make sure baby is latching on properly via a IBCLC

Ask your provider what kind to use.

Let your breasts air dry.

  • swelling

Lots of women have swelling in their hands, feet and face during pregnancy. It is caused by extra fluids in your body that helped you get ready for labor and birth. It may take time for the swelling to go away after you have your baby.

What you can do

Lie on your left side or put your feet up.

Try to stay cool and wear loose clothes.

  • hemorrhoids

Hemorrhoids are painful, swollen veins in and around the anus. Lots of women get them during pregnancy. They may get worse after giving birth.

What you can do

Soak in a warm bath.

Use an over-the-counter spray or cream to help relieve pain. Ask your provider which ones are OK to use.

Eat foods that are high in fiber, such as fruits, vegetables and whole-grain breads and cereals.

Drink lots of water.

Try not to strain when you’re having a bowel movement.


  • constipation

This is when you have painful gas or trouble having a bowel movement. It may happen after you give birth.

What you can do

Eat foods that are high in fiber.

Drink lots of water.

Ask your provider about medicine to take.

  • urinary problems

You may feel pain or burning when you urinate. Or you may try to urinate but find that you can’t. Sometimes you may not be able to stop urinating. This is called incontinence. You may even pee when you laugh, sneeze or cough.

What you can do for pain, burning or if you have trouble urinating

Drink lots of water.

Run water in the sink when you go to the bathroom.

Soak in a warm bath.

If the pain continues, tell your provider.

What you can do for incontinence

Do Kegel exercises to strengthen your pelvic muscles. In late pregnancy, your pelvic floor was put under great strain. The weight of your uterus, your baby, and the placenta and amniotic fluid, all bore down on your muscles. As you gave birth, your pelvic floor muscles relaxed and stretched, to allow your baby out into the world.


You can strengthen your pelvic floor muscles by doing pelvic floor exercises. You may not feel much when you first do the exercises, or be able to do much more than twitch your muscles.


Keep trying, even if you can’t feel an awful lot. Soon after your baby’s birth your midwife should explain why it’s important to do your exercises. So ask her for help if you think you haven’t got the technique right. Also, see our video about how to understand your pelvic floor.


Doing pelvic floor exercises three times a day, every day, should strengthen your pelvic floor muscles, and remedy the problem within a few weeks. But if doing the exercises doesn’t help, or if you are having any difficulty with passing wee, speak to your doctor or midwife. You may need to see a women’s health physiotherapist, or a continence nurse.



  • Peeing so much now I’ve had my baby

While you were pregnant, your body stored fluid. Now that your body is returning to normal, this fluid has to go somewhere. The extra fluid, tissues and blood needed during pregnancy have to be dissolved, and will leave your body, via your kidneys, when you wee.

Even though your body is trying to shed fluid, you still need to drink plenty to keep your bladder and kidneys healthy. Staying hydrated will also help to prevent constipation. If you’re breastfeeding, you’ll be thirsty often, so have a drink handy while you’re feeding your baby.



  • sweat after giving birth

This happens a lot to new moms, especially at night. It’s caused by all the hormones in your body after pregnancy.

What you can do

Sleep on a towel to help keep your sheets and pillow dry.

Don’t use too many blankets or wear warm clothes to bed.

  • you feel tired after giving birth

You may have lost blood during labor and birth. This can make your body tired. And your baby probably doesn’t let you sleep all night. Emotionally and physically stressful time and that drains you!

What you can do

Sleep when your baby sleeps, even when he naps during the day.

Eat healthy foods, like fruits, vegetables, whole-grain breads and pasta, and lean meat and chicken. Limit sweets and foods with a lot of fat.

Ask your partner, family and friends for help with the baby and around the house. DOULA!

  • you get your period again?

If you are not breastfeeding, your period may start again in 6 to 8 weeks after giving birth. If you are breastfeeding, you may not start again for months. Some women don’t have a period again until they stop breastfeeding. Be careful – if you have sex, you can get pregnant even before your period starts again, breastfeeding or not.

  • lose weight after giving birth

Now’s a great time to get to a healthy weight, no matter how much you weighed before you got pregnant. You feel better and are less likely to have health conditions, like diabetes and high blood pressure, if you’re at a healthy weight. And just in case you get pregnant again, or if you plan to have another baby sometime in the future, it’s best to be at a healthy weight before your next pregnancy.

What you can do

Talk to your provider about your healthy weight. If you were overweight before pregnancy, you may want to lose more weight than you gained during pregnancy.

Eat healthy foods. Limit sweets and foods with a lot of fat.

Drink lots of water.

Do something active every day. Walking and swimming are great activities for new moms.

Breastfeed your baby. Breastfeeding helps you burn calories. This can help you lose the weight you gained during pregnancy faster than if you weren’t breastfeeding.

Don’t feel badly if you don’t lose the weight as quickly as you’d like. It takes some for your body (and your belly) to get back into shape.

  • skin changes can happen after giving birth

You may have stretch marks on your belly, thighs, breasts and bottom where your skin stretched during pregnancy.

What you can do

Use creams or lotions on your skin.

  • hair changes can happen after giving birth?

Your hair may have seemed thicker and fuller during pregnancy. After your baby is born, your hair may thin out. You may even lose hair. Hair loss usually stops about 3 to 4 months after your baby’s birth.

What you can do

Eat lots of fruits and vegetables. These may help protect your hair and help it grow.

Be gentle with your hair. Don’t wear tight ponytails, braids or rollers. These can pull and stress your hair.

Use the cool setting on your hair dryer.

  • When can you get pregnant again

It’s possible that you may ovulate (release an egg) before you get your period again. This means you could get pregnant.

What you can do

Use birth control to help make sure you don’t get pregnant again until you’re ready. If you’re breastfeeding, ask your provider about which birth control to use. Not all kinds of birth control are safe to use when breastfeeding.


  • Why do I still look pregnant even though I’m not?

Your tummy muscles have been stretched and weakened, and your uterus needs time to shrink down. After a vaginal birth, it’s recommended that you start exercising your tummy muscles as soon as possible. This will help you get back into shape, and lowers your chances of getting a bad back.

Start off gently with any exercise programme, and always listen to your body. Seek advice from a midwife or physiotherapist before exercising if you had back or pelvic pain when you were pregnant.


  • Will I have enough milk to feed my baby?

As soon as you’ve given birth, your body gets to work again. Your baby’s suckling and two hormones called prolactin and oxytocin stimulate milk production. If those first breastfeeding sessions cause some tummy cramps, it’s because oxytocin also triggers uterine contractions (afterpains).

Each time you breastfeed your baby, your body sends signals to your brain to make more hormones to produce more milk. It’s a supply-and-demand process. If you decide not to breastfeed, your body will produce milk to start with, perhaps making your breasts feel very full. But without the demand to make more, your milk will dry up.


The first, rich milk is called colostrum, and is only produced in small quantities. After two to five days, your milk should come in. Nearly all mums are able to produce plenty of milk. If you’re worried that your baby’s not getting enough milk, talk to your midwife or a breastfeeding specialist. You’ll probably find it’s to do with your baby not latching on properly to your breast.

  • How active should I expect to be?

While it’s essential to get plenty of rest once you’re home, you also need to get up and walk around regularly. Walking promotes healing and helps prevent complications such as blood clots.

Of course, you shouldn’t overdo it. Start slowly and increase your activity gradually




1. What do postpartum doulas do?

What a postpartum doula does changes from day to day, as the needs of the family change. Postpartum doulas do whatever a mother needs to best enjoy and care for her new baby. A large part of their role is education. They share information about baby care with parents, as well as teach siblings and partners to “mother the mother.” They assist with breastfeeding education. Postpartum doulas also make sure the mother is fed, well hydrated and comfortable.


2. How long does a postpartum doula spend with a family?

Doula support can last anywhere from one or two visits to more than three months.


3. What hours can I expect a doula to work with my family?

Some doulas work fulltime, with 9 to 5 shifts. Others work three to five hour shifts during the day, or after school shifts until Dad gets home. Some doulas work evenings from around 6 pm until bedtime, 9 or 10 pm., and some work overnight. Some doulas work every day, some work one or more shifts per week. (Our doulas are willing to work 24 hour shifts if needed by the family. Contact us for more information)


4. What is the difference between a postpartum doula and a baby nurse?

The role of a postpartum doula is to help a woman through her postpartum period and to nurture the family. Most baby nurses are more focused on the baby specifically ( but some will care for mom and family too), and actually should carry an RN to wear the title baby nurse.


5. What is a postpartum doula’s goal?

The goal of a doula is to nurture the parents into their new roles. As they experience success and their knowledge and self-confidence grow, their needs for professional support should diminish.


6. How does a doula nurture the parents into their roles?

Self-confidence has a tremendous impact on a person’s ability to approach any task, and parenting is no different. We always consider parents’ feelings and always build confidence whenever possible. Doulas accomplish this through praise, acceptance and a non-judgmental approach. In addition, the doula will teach parents strategies and skills that will improve their ability to bond with their babies. A calm baby who is growing well will help parents to feel more confident in their skills.


7. Do doulas help mothers to deal with postpartum depression?

Unlike therapists or psychiatrists, doulas do not treat postpartum depression. However, they will help by creating a safe place for the mother emotionally. The doula will provide a cushioning effect by accepting the mother within each stage that she passes through. They relieve some of the pressure on the new mother by helping her move into her new responsibilities gradually. By mothering the mother, doulas maks sure that the mother feels nurtured and cared for, as well as making sure she is eating well and getting enough sleep. In addition, We help clients prepare themselves for parenthood, maximizing support and rest. These doulas will help their clients to screen themselves for PPMDs and will make referrals to appropriate clinicians or support groups as needed.


8. Do doulas teach a particular parenting approach?

No. We support a mothers’ parenting approach. Doulas are good listeners and encourage mothers to develop their own philosophies.


9. How do postpartum doulas work with a mother’s partner?

A doula respects the partner’s role and input, and teaches concrete skills that will help the partner nurture the baby and mother. The doula will share evidence-based information with the partner that shows how his or her role in the early weeks will have a dramatic positive effect on the family. Adapted from: Nurturing the Family: The Guide for Postpartum Doulas by Jacqueline Kelleher (Xlibris Corporation, 2002)


10. Im so tired! Can you help me?

Need more sleep? Postpartum doulas support families in getting rest in many ways. We can set up a safe sleep environment that helps newborns and their parents get the most sleep possible. Your doula will focus on the practical tasks around the house so you can rest when the baby sleeps (and still ‘magically’ get the chores done!). Doulas can also care for babies while parents nap or take care of personal needs or provide overnight care for those families who are just too exhausted to function well.


11. Can you get us on a schedule that works for us?

Yes! We are pro’s at doing this exactly! We sit down with you and discuss your family needs and wants with regards to the general scheduling of your day and then discuss your time line goals. Once we have established your plan, we help you achieve the goals you have in getting everyone on a smooth running system so that everyones needs are met.


12. Are you background checked?

Absolutely! We are not only cleared but have documentation we can provide to you for the proof you need to feel secure.


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