Post partum Concerns

Vaginal tears, episiotomy or swelling

If you had an episiotomy or vaginal tear during delivery, the wound might hurt for a few weeks. Extensive tears might take longer to heal. In the meantime, you can help promote healing:

  • Soothe the wound. Cool the wound with an ice pack, or place a chilled witch hazel pad available in most pharmacies — between a sanitary napkin and the wound.
  • Keep the wound clean. Use a squirt bottle filled with water to rinse the tissue between the vaginal opening and anus (perineum) after using the toilet.
  • Baths. Use sitz baths to alleviate the swelling and discomfort. Sitz baths are 8-10 inches of warm water with ½ cup of Epson salt dissolved in them.

While you're healing, expect the discomfort to progressively improve. Contact your health care provider if the pain intensifies, the wound becomes hot, swollen and painful, or you notice a pus-like discharge.

Vaginal bleeding/discharge (lochia)

You'll have a vaginal bleeding/discharge (lochia) for 6-8 weeks after delivery. Expect a bright red, heavy flow of blood for the first few days. If you've been sitting or lying down, you might notice a small gush when you stand up or go to the bathroom. You may also notice a gush when you nurse. The lochia will gradually taper off, changing from red/pink to yellow or white and then clear. To reduce the risk of infection, use pads or liners rather than tampons.

It is normal to occasionally pass small blood clots. Contact us if:

  • You soak a sanitary pad within an hour while lying down
  • The discharge has a foul odor
  • You pass clots larger than a golf ball
  • You have a fever of 100.4 F or higher


You might feel contractions, sometimes called afterpains, during the first few days to a week after delivery. These pains which often resemble menstrual cramps help prevent excessive bleeding by compressing the blood vessels in the uterus. These contractions tend to become stronger with each delivery. Ibuprofen or Naprosyn are a good medication to help with these pains and don’t affect your baby if taken while breastfeeding.

Let us know if you have a fever or if your abdomen is tender to the touch. These signs and symptoms could indicate a uterine infection.

Bladder problems

Pregnancy and birth stretch the connective tissue at the base of the bladder and can cause nerve and muscle damage to the bladder or urethra. You might leak urine when you cough, strain or laugh. Fortunately, this problem usually improves within three months. In the meantime, wear sanitary pads and do Kegel exercises to help tone your pelvic floor muscles.

To do Kegels, tighten your pelvic muscles as if you're stopping your stream of urine. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions. Aim for at least three sets of 10 repetitions a day.

Let us know if you have any symptoms of a urinary tract infection. For example:

  • It hurts to urinate
  • You don't think you're emptying your bladder fully
  • You have an unusually frequent urge to urinate

Bowel movements and hemorrhoids

If you notice pain during bowel movements and feel swelling near your anus, you might have hemorrhoids, which are stretched and swollen veins in the anus or lower rectum. To ease any discomfort while the hemorrhoids heal, soak in a warm tub (sitz bath) and apply chilled witch hazel pads to the affected area after. You can also use the over the counter hemorrhoid creams.

It is important to also keep your stools soft and regular. Eat foods high in fiber, such as whole or dried fruits, vegetables and whole grains. It is very important to drink plenty of water, especially when taking stool softeners. It's also helpful to remain as physically active as possible.

Another problem is the inability to hold your bowel movements after delivery (fecal incontinence). Most of the time it will resolve within 3-4 weeks, but it is very important to do your Kegal exercises to aid in the healing and retention of stool.

Sore breasts and leaking milk

Several days after delivery, your breasts might become heavy, swollen and tender. This is known as engorgement. To ease the discomfort, nurse your baby or use a breast pump to express milk. Another aid is standing in a warm shower with the warm water running over your breasts. This will allow milk let down. Ibuprofen and Naprosyn are good pain medications for this. Be sure to eat when taking these medications to protect your stomach. To help prevent nipple pain, make sure that your baby latches on to your breast correctly (see video on latching). If you need further help contact the Feeding Expert or contact a lactation nurse.

If your breasts leak between feedings, wear nursing pads inside your bra to help keep your shirt dry. Change pads after each feeding and whenever they get wet.

If you're not breast-feeding your baby, wear a firm, supportive bra. Compressing your breasts will help stop milk production. Try to decrease stimulation to your breasts, and apply ice packs (frozen bag of peas are a very good ice pack)

Hair loss and skin changes

During pregnancy, elevated hormone levels put normal hair loss on hold giving you thick hair. After delivery, you may shed the excess hair all at once. Within six months, your hair will most likely be back to normal. It is possible to lose all of your hair, but it will grow back.

Stretch marks won't disappear after delivery, but eventually they'll fade from reddish purple to silver or white. Areas of skin that have darkened during pregnancy, such as nipples and the middle of your stomach will typically fade.

Mood changes

Mood swings, irritability, sadness and anxiety are common after delivery, due to changes in hormones. Many new moms experience a mild depression, sometimes called the baby blues. The baby blues typically subside within a week or two. In the meantime, take good care of yourself. Share your feelings, and ask your partner, loved ones or friends for help. If your depression worsens or persists past 2 weeks contact us.

Weight loss

After you give birth, you'll probably feel flabby and out of shape. You might even look like you're still pregnant. This is perfectly normal. A healthy diet and regular exercise can help you gradually return to your pre-pregnancy weight and fitness.