Breastfeeding

POSTPARTUM RECOVERY

By Dana Sullivan

No one knows better than you that pregnancy is an amazing journey. But after you give birth, your body goes through another round of dramatic emotional and physical changes. You probably feel alternately sheer joy and utter exhaustion, and you may be experiencing physical pain that you didn't expect. Here, some of the most common postpartum complaints, and advice from the American College of Gynecologists on the best ways to treat them:

• Afterbirth contractions After you give birth, your uterus must continue contracting in order to get back to its original size. These contractions aren't as painful as labor contractions, but they can be intense and uncomfortable. They may intensify during breastfeeding, since suckling stimulates the release of the hormone oxytocin, which contracts the uterus. The good news is that the contractions will decrease over the next few weeks. Try to keep your bladder empty, and when the pain is severe, lie on your stomach with a pillow under your abdomen. If you've had a C-section and can't lie on your tummy, practice the same relaxation techniques you used during labor, such as deep breathing and visualization.
  
  
• Breast engorgement When your milk comes in, two to five days after delivery, your breasts may become painfully full and hard. If you're not breastfeeding, the engorgement should subside within a few days. If you are breastfeeding, it may take a week or more for your baby and your breasts to work out a demand-and-supply relationship. Until then, here are a few things you can do: Apply bags of crushed ice to your breasts several times a day; stand under a warm shower, which should trigger "letdown" and release some milk; express a little breast milk with a breast pump or by hand; massage your breasts, stroking gently but firmly toward the nipple.
  
  
• Difficulty urinating The bladder and urethra are right next to the birth canal, and can become stretched and bruised during delivery. (If you had an epidural or a C-section, the effects of the anesthesia may also make it difficult to urinate for the first postpartum day or so.) To get your bladder working again, drink water immediately after delivery; run water in the bathroom sink (hearing running water may increase the urge to empty your bladder); stand or walk-- gravity may help; and soak your bottom in a tub of warm water.
  
  
• Episiotomy Good hygiene is essential while the wound heals. Take warm sitz baths to keep your bottom clean and to soothe soreness. Use a warm-water rinse on your bottom while you urinate to reduce the stinging caused by the acidic urine running over the wound. You might also place ice packs on your bottom and try using a witch-hazel-soaked pad between your perineum and sanitary pad. If the pain is unmanageable, ask your physician to prescribe pain medication.
  
  
• Hemorrhoids The best way to prevent hemorrhoids is to avoid constipation. But if it's too late for that, take a hot sitz bath two or three times a day for 20 minutes each time; applying cold witch-hazel compresses several times a day may also bring comfort. Try sleeping on your side, which takes pressure off the rectal veins; avoid standing or sitting for hours at a time; and don't strain during bowel movements (elevating your feet on a footstool may make it easier to avoid straining). If none of these home remedies relieves the discomfort, ask your physician to recommend a stool softener and a medicated topical cream.
  
  
• Gas pains Your bowels are "traumatized" by childbirth, just as your bladder is. The muscles may be sluggish, which can cause constipation and a gassy, bloated feeling. If you've had a cesarean, the pain may be very intense. Drink and eat small amounts, slowly and often; avoid foods such as beans, onions, cabbage, broccoli, and fried and sugary foods, which are known to cause gas. And ask your physician to suggest a gas-relieving medication.
  
  
• Cesarean-section incision pain You'll be given pain medication to take for at least the first few days following your C-section. It may make you feel woozy, but it will help you sleep, something the pain would likely prevent. If your stitches aren't the type that dissolve, you'll need to have them removed by your health-care provider, probably within four or five days after delivery. She'll tell you how the incision should look and feel while it heals, but if you notice any of the following symptoms, call her immediately: fever over 100.4 degrees; nausea and vomiting; painful urination; bleeding that is heavier than your normal period; pain, swelling, or signs of infection.

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