Sister Lilian, leading pregnancy and parenting advisor and author, writes about what a woman can expect in terms of bleeding after birth and gives some special tips for care of the perineum to ensure rapid healing...
Recovery from birth differs from woman to woman, depending on her general physical state before delivery and the ease of labour and birth. A new mom faces many challenges, not least of all a few intimate physical changes. After pregnancy, with no menstruation to contend with, she suddenly needs to think of this aspect again.
Bleeding from the womb after birth is called ‘lochia’ and will last for anything up to 6 weeks. A new mom will experience ‘after-pains’ in the first few days after birth. These are contractions to ensure that the womb becomes progressively smaller and that one does not bleed abnormally after birth.
After-pains are more pronounced while one nurses one’s baby but after the first minute or two of suckling, they ease off in intensity! In the first few days after giving birth, bleeding is as heavy or heavier as the strongest menstrual flow. Bleeding should then become progressively less.
From about two or three weeks until no more than six weeks after birth, there should not be more than a little spotting or a brownish discharge. Sudden passing of blood clots followed by free bleeding at about Day Ten should be reported to one’s clinic, midwife or doctor incase a section of placenta has been retained. Lochia flow is generally a little less after a Caesarean birth, as the inner lining of the womb is scraped during the operation.
One should never use tampons for bleeding in the first six weeks after birth, whether one had a normal vaginal delivery or Caesarean section, as this increases the chances of infection in the womb because blood is a good medium for bacterial growth. From the first normal menstrual period, one can again revert to tampon use, but sanitary towels are essential until then. Use special maternity pads while lochia flow is heavy and thereafter choose sanitary towels according to your needs.
One should also consult one’s doctor or midwife immediately if one notices any symptoms of infection of the birth canal in the early days and weeks after delivery. These include a purulent vaginal discharge, dull aching pain over the pubic region, burning pain in vagina or perineum, a bad odour from the lochia or vaginal area, excessive localized redness or swelling and fever.
Top Tips for Post Birth Perineal Care
Apply an ice poultice to the perineum to treat swelling on Day One and Two. Wrap ice blocks in a cloth or freeze water in a condom – do not insert into the vagina but apply externally. This will also help ease pain. Use a bidet or spray your perineum after each visit to the toilet to prevent infection and promote healing. Add a handful of coarse salt to your daily bath to help prevent infection.
From about the third day, warmth is more suited to soothing the perineal area, and both infra-red lamp therapy and direct sunlight for about 10 minutes at a time, twice a day, is beneficial.
Sit on a semi-inflated and covered swimming ring to ease pressure on the area. This is especially good when feeding baby or when you have visitors. Face the cistern/toilet for the first few days when using the toilet to pass urine, and pour lukewarm water from a jug over the pelvic floor area. This prevents burning & discomfort.
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