Use your common sense and follow your body signals as energy resumes and fatigue gradually subsides. Rest whenever you can, doing only the essentials of caring for yourself and your baby. The house can wait and chores can be done by others. Limit visitors and phone calls to promote rest. Plan ahead and anticipate the need for help. Also, limit climbing steps and be sure to have both feet on the same step before moving on to the next. Vigorous exercise should wait until four to six weeks.

You may resume exercising as soon as you feel you can. Those who had a cesarean section should avoid heavy lifting (more than 20 lbs) and specific abdominal exercises for six weeks.

All patients are encouraged to gradually work up to an exercise program. Walking and Kegel exercises are an excellent place to start.

You should avoid intercourse for six weeks to allow time for vaginal tissues to heal. Using a water-based lubricants such as KY Jelly®, slight position changes, and extra gentleness will help with discomfort during intercourse. If you are breastfeeding, your vaginal tissue may be drier and more sensitive due to the decreased amount of estrogen in your body. Again, a lubricant can help.

CAUTION: Remember to use adequate means of contraception even if you are breast feeding. Talk with your provider about when your chosen birth control will be effective. This will make sure that you are protected from pregnancy when you become sexually active again. When unsure, use condoms to help prevent pregnancy.

Patients who had a vaginal delivery may drive whenever they feel comfortable. Patients who had a cesarean section should wait two weeks. Remember, do not drive while you are still using narcotic pain medication.

It is important to continue the good nutritional habits practiced during your pregnancy. Drink plenty of fluid and continue your vitamin and iron supplements until your six-week postpartum check or until you stop nursing.

If you are nursing, you will still need approximately 400 to 500 extra calories a day (2,500 -3,000 total) concentrating on a high protein and calcium intake to provide adequate nutrition for your baby.

We do not recommend diets while nursing unless you are given specific instructions to do so.

Breast feeding can be a wonderful experience for you and your baby, but it often takes patience and diligence. Breastmilk is the perfect food for your new baby and we recommend it exclusively for the first six months of life.

You should wear a supportive nursing bra at all times and keep your nipples clean and dry. Warm water is all you need to clean your nipples and they do not need to be cleaned before or after each feeding. Never use soap or alcohol on your nipples. Also, allow nipples to air dry and make sure they are completely dry before replacing your bra. Change nursing pads when wet and do not use pads with a plastic liner as they may promote infection. If you develop dry or cracked nipples, you may use lanolin.

If you experience painful engorgement (full, hard, and tender), you may use Motrin® and warm compresses or showers to promote milk let-down prior to nursing. Feeding more frequently or hand-expressing or pumping a small amount of milk prior to nursing may be helpful.

If you have fever > 100.4⁰F, severe pain in your breast, redness in your breast, body aches, and/or chills; please call our office to be evaluated by a provider as soon as possible.

If you choose not to breast feed, you can still promote love and trust with your baby through bottle feeding.

Your breasts may become engorged as they fill with mature milk but using ice will help limit this process. Minimize nipple stimulation by using a snug fitting bra. Do not use a breast pump or manually express milk unless you choose to bottlefeed your breast milk to your baby (this is a great option!). Avoid letting the shower hit the breast directly.

Caution: If you develop redness, tenderness, or fever greater than 100.4⁰F, please contact our office immediately.

Preventive measures are best. Drink at least 12 ounces of water 5 times each day. A diet high in fiber is also important: fresh fruits and vegetables, whole grains, beans, and nuts are great choices. Stool softeners such as Colace® may be used. Limiting your use of narcotic medications will help as well. A mild laxative such as Milk of Magnesia® may be used with hemorrhoids, follow the above suggestions to avoid constipation. Warm soaks or over-the-counter hemorrhoid medications such as Tucks® or Preparation H® can provide relief from hemorrhoids. If your hemorrhoid becomes firm and extremely painful, or if you experience significant rectal bleeding, please contact the office for further instruction.

If you had a 3rd or 4th degree laceration with your delivery, we do not want you to insert anything into your rectum for 6 weeks and it is very important to not have constipation and strain with bowel movements. If you have questions or concerns if this pertains to you, please contact our office.

You may shower and wash your hair at any time. For those who had a vaginal delivery, you may continue to use your peribottle for perineal hygiene or try sitting in several inches of warm water (sitz bath) 3 times a day and after a bowel movement. For those who had a cesarean delivery, let warm soapy water run over your incision, but do not scrub. Pat the area of your incision dry with a clean soft towel.

We do not recommend you taking a tub bath with soaps, bubbles, oils, or perfumes until at least 6 weeks postpartum if you have had a vaginal delivery. If you have had a cesarean delivery you may take a tub bath after your incision is well healed.

All sutures used to repair the vagina will dissolve in time. Sitz baths can be used as described above. Frequent pad changes and cleanliness will promote healing. If you have increased pain or bleeding, contact our office.

This normal cleansing process of the uterus may last four to six weeks. It is normal for there to be a gradual change from dark red to yellowish-white to clear before stopping. Remember to use a soft pre-moistened cloth wipe and to wipe from front to back. Never use a douche and do not use tampons until after your six week check. The timing of your next period will vary, but may take weeks or months.

CAUTION Heavy, bright red bleeding, especially associated with clotting, should be reported. If you have heavy vaginal bleeding that soaks a pad in an hour with or without clots that is continuing, you should go to the hospital for evaluation.

In addition to guidelines outlined above, please call our office if you notice any redness or increased tenderness around the incision. A small amount of drainage may be normal, but if you have a heavy amount or any that is bloody or foul smelling, please contact our office.

There are many physical and emotional adjustments during the initial weeks after childbirth which contribute to various moods as one copes with the reality of parenthood. Stress and fatigue can aggravate your mood. Share your feelings with family and friends who may be able to help make sure you get the rest you need. If you feel like you are excessively tearful, unable to feel happy, or have any thoughts of hurting yourself or your baby, please contact our office immediately. For those with postpartum depression, support groups and/or medication may be beneficial.

Postpartum depression can occur up to 1 year postpartum. Postpartum depression is different from postpartum blues because it will impact your day-to-day activities, thoughts of harming yourself or your baby, or you may find the inability to be motivated to take care of yourself or your baby. Postpartum depression should be evaluated as soon as you or your partner find that you are having trouble. We encourage you to call our office for an appointment ASAP.

This is usually done about six weeks following your delivery. A breast and pelvic exam is performed as well as any necessary lab work or pap smear obtained. Write down any questions pertaining to your personal care and birth experience that you might have to review with us. This visit is a great time to discuss breastfeeding, contraception, and any emotional concerns that you have. Your postpartum visit date and time will be mailed, emailed, or texted to you.