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III. Postpartum Instructions for Mothers

This information is to be used as a guideline for mothers and families, to assist in caring for themselves and their newborns. Follow these instructions unless otherwise instructed by your primary care provider:

A. Rest

1. Get plenty of rest for a couple of weeks after birth.

2. Focus on care for self and baby; do not expect much of yourself.

3. Obtain help for general household duties (cleaning, cooking, laundry, shopping, and caring for older children).

4. Try to rest when the baby is sleeping.

5. Limit visitors to relatives and close friends. Make sure everyone washes hands before touching the baby to prevent the spread of infection.

6. Remember, fatigue decreases your milk supply and your ability to cope with new and added responsibilities.

B. Activity

1. Limit stair climbing for the first week.

2. Resume your normal activity and exercise very gradually over 6 weeks.

3. You may go out to dinner or for a ride but do not drive for 1 to 2 weeks unless otherwise instructed by physician. If you delivered your baby by cesarean section, verify with your OB care provider about when driving is permitted.

C. Diet

1. Drink 8 to 10 glasses of water per day.

2. Eat plenty of proteins, fruits, and vegetables, and drink plenty of milk.

3. A small bowl of bran daily will prevent constipation.

4. Ask your primary care provider if you should continue taking prenatal vitamins daily.

5. An adequate diet as shown above is important especially if you are breastfeeding. It takes about 800 calories a day to produce the milk the baby needs.

6. Remember, if you do not eat, you will become fatigued, and milk volume will decrease.

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D. Vaginal Discharge

1. At first the discharge is red, like a heavy period, for about 1 to 3 days.

2. By the 3rd day, the discharge should have thinned and lightened in color.

3. By the 10th day, the discharge is often a pale pink, watery fluid, but still heavy enough to wear a light pad.

4. If after the 3rd day bleeding becomes bright red and heavy again, it is often a sign that you have done too much and you should slow down and rest.

E. Intercourse

1. For most women, intercourse may be resumed when the vaginal area feels comfortable and your episiotomy has healed. You should check any doubts you have with your physician.

2. Gentleness and added lubrication may be needed for comfort when you first resume sexual activity.

3. Breastfeeding mothers may ovulate before their first menstrual period; therefore, it is possible to get pregnant even before menstruation has resumed.

4. Foam and condoms will provide contraception if sexual activity is resumed before 6 weeks postpartum.

5. Birth control should be discussed at the 6-week postpartum visit.

F. Baths and Showers

1. You may shower as necessary but DO NOT take a tub bath for at least 3 days unless otherwise instructed by OB care provider. DO NOT use bubble bath or oils in bath water.

2. Warm showers may help to relieve the discomfort of breast engorgement.

3. DO NOT USE DOUCHES. They can cause trauma; possible infection.

G. Stitches and Hemorrhoids

1. Warm tub baths or sitz bath are recommended several times a day.

2. For discomfort of hemorrhoids, Nupercainol cream, Dermoplast, or Tucks pads may be helpful. Consult your OB care provider.

3. Do not become alarmed if a week or two postpartum, loose stitches are found on a pad or in the toilet.

4. Stitches are normally absorbed or loosen when they are no longer needed.

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H. Postpartum Blues

1. You may experience "postpartum blues" during the first 10 days postpartum. The most common symptom is unexpected and  unexplainable crying. You also may feel irritable.

2. Postpartum blues usually go away in about 72 hours, but may continue for as long as 10 days.

3. You may be experiencing postpartum depression if the postpartum blues symptoms persist or increase in severity after 10 days.

4. Postpartum depression is experienced by 10% of all women and may occur anywhere within the time 6 months after delivery.

5. Signs and symptoms of postpartum depression may include any or all of the following:

a. Sleep disturbance
b. Loss of appetite
c. Fear and anxiety
d Hopelessness
e. Hostility or self-blame
f. Difficulty concentrating or making decisions
6. You should seek professional help if signs and symptoms of postpartum depression are experienced.

I. Postpartum Problems:

CALL YOUR HEALTH CARE PROVIDER IF ANY OF THE FOLLOWING PROBLEMS OCCUR:

1. A flu-like feeling, fever, or chills

2. Foul-smelling discharge or unusual abdominal tenderness

3. Redness or tenderness of breasts

4. Extreme tenderness of episiotomy area

5. Tenderness of pubic bone, accompanied by frequency, urgency, and burning with urination.

These symptoms may indicate an infection of some type, which requires immediate professional attention and treatment.

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