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Early Post Partum is like riding a Roller Coaster
I like to think of it as a huge amusement park Roller Coaster, you will navigate it’s bends and endure the long haul of screaming to get to the end and do it all again. This ride will challenge you, force you to grow and it will leave you with memories of some beautiful moments with your little one, that one day you will wish you could go back in time and relive it all again.
While pregnant women are focused on preparing for their birth and upcoming baby it is important not to forget about what comes next. Navigating the changes that will occur within our body post-partum and adjusting to motherhood. This transition can be difficult, stressful and a huge learning curve.
At Rouse Hill Women’s Health Physio, we assist women in navigating the changes that occur within their body during pregnancy, preparing the body for birth and transitioning into the post-partum recovery stage while supporting them as they transition into being a new mum.
If you are feeling overwhelmed by all the unknowns and new responsibilities of becoming a mum, or just need some guidance on how to best approach this stage in life then join one of our upcoming courses. Whether you are eagerly awaiting your due date, have given birth already, needing assistance with breast feeding we have a course to assist you.
What to expect early post partum
For 9months your body has been changing as it continued to house, care and grow your baby.
The initial week or two post partum can be challenging as your body slowly begins to change again.
Everyone’s body responds differently, and the following is a general guide of what may occur within the first week.
Bleeding aka Lochia
The bleeding comes from inside your uterus, clearing of thickened endometrial lining and retained products of conception. Your body controls the bleeding by squeezing down or ‘contracting’ the uterus. Women have described it to feel like menstrual pain and menstrual cramping.
We recommend you wear menstrual pads within the first, it is not recommended to use tampons due to increased risk of infection.
You can expect heavier bright red bleeding for about 3-4days and then it usually slows down and lightens in colour. Typically, by day 8-10 the bleeding is changing to more of a thicker yellowy white discharge and you may experience a light flow or spot bleeding for up to 6 weeks.
You should seek medical attention if you experience:
An increase in abdominal cramping
Fever or Chills
A ‘rotten’ odour to your flow
Pain in you abdomen, back or headaches
Milk "The Let Down"
Milk supply usually takes 3-4days to come in, until then baby will be consuming about 1 teaspoon of colostrum with each feed and feeding frequently. During this time your breasts may feel fuller, firmer and uncomfortable. You may experience some discomfort around your nipples, we recommend you seek advice for any concerns from a local lactation consultant. We recommend Keryn Thompson at Itty Bitty Bub and Patricia Doyle at Nurturing Well.
Abdominal Pain and Odd Sensations
This could be for multiple reasons
Uterus contracting down, this will feel like menstrual pain or cramping. Use of a heat pack, prescribed medication and rest can ease the pain.
Bleeding ‘lochia’ as mentioned above.
Constipation and trapped wind, gentle walking, hydration, fiber rich food, stool softeners can assist. Make sure you use correct toileting technique and support any wounds when passing bowels.
Abdominal Separation and weakness will be present, we recommend plenty of rest and compression when able to tolerate around the abdomen for additional support. We recommend high waisted underwear, tubi-grip and SRC shorts for those experiencing >3-4cm finger separation. We can assist you with all these products at our Rouse Hill Women’s Health Physio clinic.
Reduced abdominal sensation may be a result of your birth and stretching of the nerves. We recommend giving it time to heal and gentle touch around the abdomen to bring awareness back to the area.
Discuss this further with your medical team to ensure personalised advice.
Baby Blues and Post Partum Depression
What a whirlwind this journey has been, it is not uncommon to experience a whirl wind of emotions from excitement, joy, fear, overwhelm, sadness, frustration, and confusion. You may find yourself happy in one moment and sad in the next, this can be a result of your rapidly changing hormones, sleep deprivation and the unknowns of being a new mum.
Baby Blues
Extremely common and usually lasts from 2days to 2weeks. Typically presents as tearfulness, rapidly changing mood swings, reactiveness, and exhaustion. Despite this you are still generally happy, the emotions are not due to stress or any previous mental health disorder.
Post Partum Depression
This appears very similar to baby blues but usually symptoms onset during pregnancy or after delivery of baby. Symptoms are usually more severe and last beyond two weeks. Symptoms may include, depression for majority of the day, lose of interest in things, significant changes in weight, difficulty concentrating, feeling of guilt and more. It can be hard to determine sometimes if depression is causing fatigue or lack of sleep, other signs may include, not feeling connected to baby, struggling to care for yourself and family, withdrawing, physical symptoms such as a headache or back pain.
If you are experiencing either baby blues or postpartum depression help is available, and we encourage you to:
Talk to your OB-GYN or midwives
Talk to your partner or family/friends
Talk to a health professional such as a post-partum psychologist
Use free resources available, we recommend PANDA (Perinatal Anxiety & Depression Australia) to our clients. They are a free National helpline that provides a safe and confidential space for any new or expecting parent struggling with the challenges. Phone Number: 1300 726 306.
Help there is Heaviness and Swelling at my Vulva
This may be a result of numerous things, a few key ones include:
Perineal Swelling can be a result of trauma during child birth and can be treated like a swollen ankle with ice and compression. We recommend:
SRC Femme-Eze and heat packs or ice
Recommend sitting on folded towels with just enough pressure on the perineum to provide compression but not too much that it hurts significantly.
Do not spend too long in one position, find a balance between sitting and standing
Mobility of Organs, you may experience early symptoms of pelvic organ prolapse, feeling a bulge sensation near your vagina opening, heaviness and notice symptoms worsen with long periods of standing or at the end of the day. We recommend you reach out to us (or a women’s health physio) immediately and when you feel these symptoms take a break and lay with a pillow under your hips to elevate your bottom and take pressure off your pelvic floor.
How to Care for Caesarean, Episiotomy and Tear Wounds
Protecting your abdominal or caesarean wounds can ensure optimal healing, we recommend
Supporting your wound when you cough or sneeze
Episiotomy or Tear: Holding toilet paper over wound when urinating or using cardboard toilet roll as a funnel over urethra. Dabbing dry or using a squirt bottle with water to clean post void.
Caesarean: Continue to roll in and out of bed, support wound upon standing or sitting, get assistance with lifting and carrying baby if able.
I am Leaking, HELP!
Urinary or Faecal incontinence can be common in the first week post-partum as the muscles and organs responsible for bladder and bowel control have become stretched and potentially weakened.
This should not be an ongoing thing if you are leaking urine or faecal matter help is available. Our Women’s Health Physiotherapist’s at Rouse Hill are trained and specialise in incontinence. We recommend you turn on your pelvic floor quickly aka ‘the knack’ when you cough, sneeze or laugh, support your perineum or sit in the first 1-2weeks.
Everyone Wants to Visit the New Baby
While family and friends are eager to meet your newest member of the family it can add to additional stress for some and welcomed help by others. It is important to set boundaries, who you would like, when you would like them, if they can do anything to help. Do not feel guilty asking your friend to stop and grab a loaf of bread and milk.
Rest, The Most Important Thing to Remember
Allow yourself the first 4 weeks to rest and recover. This period is different for everyone, some will do some light walking and gentle movements and others will sleep when able. Put your recovery first and when you see us for your 4-6week post partum check-up we can guide you to return to your daily activities and provide you with suitable advice and exercises to your body (including abdominal separation assessment and pelvic floor assessment).
The Post Partum Journey is a Rollercoaster, Don't Forget to Enjoy the Ride!
Our first time mum’s often report that they wish they would have known more about the early post partum recovery period. We hope with this article that you are feeling more confident about what is to come, what to expect and how to care for yourself. Remember every women’s experience is different so be kind to yourself and your body and enjoy the ride!
Don't forget to book your Post Partum Women's Health Physio appointment.
We thank you for taking the time to read the article and if you have any helpful advice or tips for mums please leave a comment below.
Written by Doctor Catherine McKelvey of Physiotherapy
Women's Health Physiothreapist at Rouse Hill Women's Health Physio
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