Healing of uterus

Uterus would maintain at umbilicus height first day after delivery, descending one finger body width daily. Approximately 10 days after delivery, you would not be able to palpate uterus. The uterus will return to previous size and shape 6 weeks after the delivery.

• Self-care : Circular massage of your belly can stimulate uterus contraction, at the same time and facilitate residual membrane to slough off from the uterine cavity. Do not exert yourself excessively because overly stimulating uterus may decrease its contractility.

Lochia

One of uterus function is capable of removing all piece and leftovers by itself after giving birth to a baby. These residual pieces flow out through vagina is what we know as lochia. They can be classified into :

• Red lochia : 1 ~3 days after delivery, lochia is dark reddish in color which is attributed to bed rest or decreased activity, resulting small bloody clots.
• Mucinous lochia : 4~10 days after delivery. Lochia is dark reddish to brownish in color.
• White lochia : 1~2 weeks after delivery. Lochia is creamy yellowish in color. Breasting feeding women may have lochia up to 30~40 days because of the uterine contraction. Lochia may appear from bloody reddish to dark reddish. As long as the amount and the blood are decreased or fresh, the condition is still within normal range.
• Self-care : Every time after your urinating or defecation, wash the perineum area with warm water and dry it thoroughly. If lochia amount increases rapidly, you may try uterine massage first and then return to the hospital for examination.

Vagina change

Postpartum vagina edema ( or hematoma ) and folds disappear. The folds may recover 3 weeks later but it will not be the same before your delivering the baby.

• Self-care : you may utilize vagina exercise ( Kegel exercises ) and postpartum exercise to regain vagina tension and strength.

Menstruation and sexual life

60 - 70 % of women will regain menstrual cycle 3 - 6 months after the delivery. However, breastfeeding women will not have menstruation during breastfeeding period.Sex life can return to normal 6 weeks after delivery.

• Self-care : Mothers who do not have their babies take anything else other than breast milk, menstruation period would not return which will incur 98% of contraception. Once your menstruation period returns, you might want to check to see if you have gotten pregnant again.

Striae Gravidarum

During the pregnancy, the bulging of the belly would break the elastic fiber of the skin, causing a crimson to the purple line.  The lines will gradually fade away into silvery white after the delivery, but it will not go away completely.

Gastric and intestinal system

After the delivery, progesterone would relax your intestine and abdomen which might delay your first stool.

• Self-care : It is recommended for the patients to get out of the bed and walk around to facilitate the return of the normal bowel movement. Adequate fresh fruit and fiber-rich diet could promote defecation. Constipation and discomfort can be caused by delay of or fear for defecation.

Urinary system

12 ~ 24 hours after the delivery, urine output would increase due to postpartum diuretic effect.

• Self-care : It is critical to empty your bladder because it could incur urinary tract infection if urine retention occurs. Inflated bladders could hinder uterine contraction and cause postpartum hemorrhage.

Post-natal perspiration

During the postpartum period, skin will remove excessive body fluid and metabolic waste by sweating.

• Self-care : When sweating, stay dry to prevent cold or fever.

Postpartum pain

Pain often results from intermittent uterine contraction. Mothers often sense greater pain for the repeated delivery compared to the 1^st delivery. The severity will also increase if the uterus was overly distended during pregnancy ( for examples：polyhydramnions, multiple gestation )

• Self-care : Baby’s suckling will stimulate maternal body to secrete oxytocin causing the uterine contraction pain. The pain will gradually improve in approximately 2~3 days. It can be alleviated by lying on your belly or applying pressure upon your belly with a pillow.

Post-natal examination

Return to obstetric OPD 42 days later for a post-natal exam. Please return to the hospital for further examination if you have the following symptoms or signs :

• Oral temperature exceeds 38.5 degree
•  Redness or pus or burning sensation of the wound
• Massive vaginal blooding
• No lochia 2 weeks after the delivery
• Swelling, painful, and nodular breast