The postpartum period, also known as the puerperium or "fourth trimester”, refers to the time after birth when maternal physiologic changes related to pregnancy return to the nonpregnant state. Postpartum recovery takes time. Many women feel recovered after six to eight weeks. But some women don't feel like their pre-pregnancy selves for a few months. 

After your baby is born, your body gets rid of the blood and tissue that was inside your uterus. This is called vaginal discharge or lochia. For the first few days, it's heavy, bright red and may contain blood clots. Over time, the flow gets less and lighter in color.

During the first week after a vaginal or c-section delivery, take it easy. You will still be bleeding vaginally, be sore, and likely have small contractions. Contractions will continue well after delivery, helping to shrink the uterus. If you’ve had a vaginal delivery, light walks are okay. Limit them to fifteen/twenty minutes. A C-section is major surgery, so it is important you listen to your body. After clearance from your medical practitioner, and when you are feeling up to it, walk for fifteen/twenty minutes. You can walk with the stroller for assistance. 

Gentle movement is important during the first six weeks postpartum. It will increase blood flow to your muscles. Once you are cleared by your doctor to return to exercise, we highly recommend visiting a Pelvic Floor Physical Therapist to be checked from a muscular and strength perspective to design an individualized plan for whatever form of exercise and movement you wish to do!

If you would like to manage postpartum symptoms, here are a few things that are important to know and understand: 

1. Use a Peri bottle. The hospital will likely give you one but you can also buy one if you want an extra (Peribottle). Use lukewarm water with the peri bottle and squeeze it onto the perineum, the area between the anus and vulva, while you are urinating and when finished urinating. This makes it more comfortable to pee, reduces the stinging sensation, increases blood flow to the incision and cleans the area to reduce the chance of infection. 

2. Use Perineal ice packs after a vaginal delivery. The hospital will also provide. Based on your delivery experience, the OB may recommend using an ice pack during the first 48-72 hours. After 72 hours, the ice may impede healing. Why? Ice is a vasoconstrictor and can decrease blood flow to the area. Make sure to ask your medical provider the extent and duration that you should use the ice packs.

3. Use maxi pads or adult diapers. Regardless of type of delivery, you will bleed vaginally afterwards. Remember that Lochia is a mixture of blood, mucus and uterine tissue. For the first three to four days, Lochia is dark/ bright red. The flow is heavy and may contain clots. After a week the lochia will become waterier and turn pinkish brown. The flow will be lighter. At day ten, lochia should be a lot lighter and contain less blood. Some people may continue with discharge for up to six weeks. You should only use pads during this time - do not use a tampon! In addition, it’s helpful to wear lightweight mesh underwear. The hospital may provide these. If not, many women are fans of Frida underwear. 

4. A sitz bath is often provided by the hospital. It is a small tub that you fill with warm water. It is placed over the toilet. You can sit in a sitz bath for ten to twenty minutes to relieve pain and promote healing to the perineum. 

5. Tucks Wipes are witch hazel pads that relieve burning and itching caused by hemorrhoids or perineal pain. It is very common to get hemorrhoids during pregnancy and as a result of pushing during delivery.

At Solstice Physiotherapy, we see women during pregnancy, preparing them for postpartum. And during postpartum, we see women to design individualized exercise and movement programs. If you have questions and want to speak with one of our physical therapists, email us at info@solsticept.com or call (929) 269-2505 to schedule a free, 15-minute consultation.