DELIVERY AND POSTPARTUM (cache list below)
The following changes may occur hours, days, or even weeks before your labor begins:
- Loss of mucous plug: a blood-tinged mucous discharge sometimes called a bloody-show
- Increased vaginal secretions
- Diarrhea or softer stools
- Spurt of energy
- Lightening, the process in which the baby moves deeper into the mother’s pelvis. It may become easier to breathe but more difficult to walk gracefully. The pressure may increase in the pelvic area. You may notice the need to urinate more frequently and urine may leak more frequently. Some women refer to this as the baby has dropped.
- Rupture of the membranes- a leaking or gush of clear odorless fluid. It is sometimes difficult to distinguish between this and urine. However, if you suspect that your membranes have ruptured, call the office immediately. You will need to be hospitalized within a few hours of leaking membranes even if you are not in good labor.
- Labor contractions. You may begin with some irregular, false labor often known as Braxton-Hicks contractions. As your contractions establish a regular pattern, coming about every 5-7 minutes apart, lasting about sixty seconds for an hour, you may be in early true labor.
Call the office day or night, if any of the following occur:
- You begin to establish a regular pattern of contractions longer than an hour.
- Your membranes rupture and you have a gush of fluid or you suspect a leaking of fluid.
- You begin to bleed bright red blood from the vagina
- You have a severe, knife-like pain in your abdomen that lasts.
A designated doctor is on call at all times. If you call the office during normal working hours, with one of the above complaints, please tell the receptionist that you are pregnant and need to speak to the nurse immediately. If you call at night, the answering service will call the nurse or doctor on duty and notify her of your call. If they do not return your call in 15 minutes, call again. Sometimes phone numbers are transmitted incorrectly, or names and numbers are misdialed, etc. If it is an emergency, do not wait for the physician or nurse to return your call; tell the answering service you are going to the hospital and have them notify the physician.
When you arrive at Labor & Delivery, a nurse will take you to a room and instruct your support person where to go to meet you. You will be asked to undress and put on a hospital gown, to get a urine specimen and then to get in the hospital bed. You will be hooked up to a monitor that will show the nurse how your baby is responding and show your contractions. After asking you questions about your general health background and this pregnancy, the nurse will do a pelvic exam to see if you are dilated. The nurse will then call the doctor with all of this information. If you are in false labor, you will be sent home. If you are in good, true labor or if your membranes have ruptured, you will remain in Labor & Delivery until after your delivery.
While you are in the hospital, the nursing staff is there to help you in your recovery from delivery. Be sure a nurse or assistant is with you when you get out of bed the first time following delivery. The following are guidelines to help you in your recovery period at home:
- Bathing – You may take showers or tub baths and wash your hair as soon as you like. You should bathe daily. If you had a C/section or tubal ligation, blot your incision dry instead of rubbing it.
- Activity level – It is important that you get adequate rest, especially the first two weeks at home. You will tire much more easily than before you delivered the baby. Take frequent rest periods; whenever you put the baby to bed, you take a nap too.You may walk up and down stairs as necessary. Do not lift anything heavier than the baby for the first three weeks if you had a vaginal delivery four weeks if you had a C/section. You may return to your normal household activities four weeks after the delivery, but take it easy. If you get tired, rest. You may take short rides in the car after the first week at home. Do not drive for two weeks. If you had a C/section, do not drive for four weeks.
- Bleeding – You may expect a bloody discharge from 2-6 weeks after delivery. It may come and go. If your bleeding seems excessive (more than a pad an hour), please call the office. Generally, your bleeding will decrease if you will decrease your physical activity. Your first menstrual period may begin from three weeks to three months after delivery. It may be longer, shorter, milder or heavier than usual for you. Do not use tampons until after your postpartum exam in the office.
- Stitches – Your episiotomy (incision made in the perineum to allow the baby to come more easily) may still be sore when you go home from the hospital. Sitting in a shallow tub of warm water 2-3 times a day will help relieve the discomfort. Using Tucks pads or Balneollotion to clean yourself after every stooling and voiding will help Neither of these products require a prescription. Your stitches should dissolve in about two weeks; however, if one of the stitches comes out, there is no problem; you will heal normally without the stitch.
- Diet/Vitamins/Constipation – It is just as important for you to eat a well-balanced meal now that your baby is here as it was while you were pregnant. To heal properly, your body needs vitamins, iron, minerals and protein. Continue to take your prenatal vitamins until your prescription runs out. If you are breast feeding, take your vitamins until you completely wean the baby. If you have problems with constipation, increase your fluids and fiber intake (eight glasses of water a day, apples, raw fruits and vegetables, bran cereals). You may take any mild laxative that you can buy without a prescription. Never go more than 48 hours without having a bowel movement.
- Breasts – You should wear a good support bra except when bathing, whether you are breast feeding or not. If you are not nursing, your milk supply will dry up in about two weeks. Do not pump or massage your breasts. Ice packs to your breasts may help. You may take aspirin or Tylenol every four hours for breast pain. If you develop redness, tenderness, or fever, please call the office. If you have problems with or questions regarding breast feeding, please call the office, the Le Leche League, or the nursery at the hospital.
- Baby – If you have questions regarding care of your baby, please contact your pediatrician.
- Sexual relations – You may resume intercourse in four weeks if your bleeding has stopped or when all soreness from your episiotomy is gone unless instructed otherwise by the physician on your discharge from the hospital. Since there may be decreased vaginal lubrication for a while, you may find it more comfortable to use Ortho Personal Lubricant during intercourse. Use condoms, foam or a diaphragm until your post-partum exam.
Please call the office if any of the following occur:
- Bleeding becomes excessive.
- Burning sensation when you urinate or a frequent urge to urinate but little urine is passed.
- Spiking fever or sudden elevation in temperature.
- Soreness, redness in breasts.
- Soreness and redness in legs.
- Persistent or prolonged postpartum blues; when the depression begins to interfere with your ability to function.
- Drainage or foul odor and tenderness or redness at CSection or tubal incision or from vagina.