Healing After Childbirth

Following your baby's birth, it's entirely natural that your body must go through a period of healing. How long this takes will depend on your general health, but it can be up to a year before your body completely returns to its pre-pregnancy state. You are likely to experience a number of postnatal discomforts in the weeks after birth and its important to seek medical advice if you are concerned.

After-pains and Involution

Soon after the baby is born, the placenta is expelled and the uterus contracts tightly to seal off the open blood vessels on the uterine wall. The area where the placenta was attached is very much like an open wound that needs to be healed. The uterine contractions, sometimes called 'after-pains,' may be felt as strong cramping sensations for the first couple of days. You'll also feel these sensations if you are breastfeeding as nipple stimulation promotes uterine contractions. Although painful, know that they are helping you to heal faster and that they will disappear. Pain relief medication can help if these cramps are too uncomfortable, consult with your health expert.

Discharge

It can take up to six weeks for the placental site to heal totally. During that time you'll notice a bloody vaginal discharge called lochia. It will be bright red for a day or two after birth, very much like a heavy menstrual period. It then decreases in amount and becomes a dark brown colour, then a pinkish discharge and sometimes by 10 days a slight white discharge. This signals that the placental site is completely healed. If you notice the discharge getting heavier rather than lighter, you develop tummy pains or it becomes smelly or you start to feel feverish and unwell, contact your midwife or GP immediately.

Incision site healing

Occasionally, a doctor or midwife may need to make a cut in the area between the vagina and anus (perineum) during a vaginal delivery. This is called an episiotomy which makes the opening of the vagina a bit wider, allowing the baby to come through it more easily. Sometimes a woman's perineum may tear as their baby comes out and, in some births, an episiotomy can help to prevent a severe tear or speed up delivery if the baby needs to be born quickly.

In England, episiotomies are not done routinely, and your doctor or midwife will discuss it with you if they feel that you need an episiotomy when you're in labour.

The National Institute for Health and Care Excellence (NICE) recommends that an episiotomy might be done if:

• the baby is in distress and needs to be born quickly, or

• there is a need for forceps or vacuum delivery (ventouse), or

• there is a risk of a tear to the anus.

• If you have a tear or an episiotomy, you'll probably need stitches to repair it. Dissolvable stitches are used, so you will not need to return to hospital to have them removed.

For more information regarding episiotomies and perineal tears, please visit: https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/episiotomy-and-perineal-tears/

Some babies are also delivered by caesarean section, or C-section. This is an operation to deliver a baby through a cut, usually just below the bikini line, made in the tummy and womb.

According to the NHS, around 1 in 4 pregnant women in the UK has a caesarean birth. A caesarean is a major operation that carries a number of risks, so it's usually only done if it's the safest option for you and your baby.

Recovering from a caesarean may take longer than recovering from a vaginal delivery and providing there are no complications, most women can go home 1 to 2 days after having a caesarean. You may experience some discomfort in your tummy for the first few days and when you go home, you'll need to take things easy at first. You may need to avoid some activities, such as driving, until you have had your postnatal check-up with the doctor at 6 weeks. The wound in your tummy will eventually form a scar which may be obvious at first but should fade with time.

For more information regarding caesarean sections and recovery, please visit: https://www.nhs.uk/conditions/caesarean-section/.

Home healing tips:

There are many other ways you can help with the healing process at home:

• To prevent infection of the episiotomy incision, change your sanitary pad often – at least every four to six hours. Cleanse the perineum after urinating or a bowel movement by pouring warm water over the area and patting dry with gauze pads. Remember to always wipe from front to back as well. Sit in a warm bath or use warm compresses to promote incision healing.

• Do pelvic floor contract/release exercises – that will bring circulation to the area and promote healing.

• Keep the Caesarean incision dressings clean and dry – and follow hospital care tips.

• Eat a healthy diet – to support the healing process. Be sure you're getting protein, vitamins and lots of water.

• Rest! – Don't do too much too quickly, even though you may feel good. Plan ahead so help with all your regular activities are available.

• Sleep when the baby sleeps. – You can expect many nights of interrupted sleep and you'll need to make up for that by taking naps during the day. Aim to get as many hours of sleep in a 24-hour period of time (although broken into more segments) as you did before the baby was born, which is often easier said than done!.

When to call the healthcare provider

Contact your provider if you observe any of these signs, as they could indicate that healing is not progressing as it should, or that you're developing an infection:

• A temperature above 37.8 °C or 100 °F that lasts for more than one day.

• Bright red or heavy bleeding (lochia) after the fourth day post-partum, or very large blood clots in the lochia

• Lochia that has a foul odour.

• Pain in the lower abdominal area after the first few days after birth.

• Signs of infection (redness, heat, swelling, an oozing discharge) at the site of the episiotomy or Caesarean incision.

Because having a baby is a normal process, not an illness, your body is programmed to heal quickly. If you follow these recommendations, you'll be amazed at how quickly you'll bounce back after your baby's delivery.

If you’re still in your third trimester, reading ahead about what to expect after giving birth, then don’t forget to take time to relax amid all of that research and preparation. That’s because taking some time-out is good for both you and your baby, and soon you’ll bring your little of bundle of joy home and you won’t have much time to rest then.