Postpartum period What happens to a woman after childbirth

Immediately after birth

The first two hours after birth are dangerous due to the occurrence of complications, especially bleeding. In addition, a hematoma may appear on the perineum if some rupture was not noticed or was not completely repaired (fortunately, this does not happen often). And the woman cannot get up yet, because her body is still too weak. Therefore, during these two hours, the postpartum woman is in the maternity ward, since there, if complications arise, it is easier to call someone for help, since all the medical personnel are nearby. During these 2 hours, the woman lies on the couch and rests. At this time, the baby lies swaddled on the changing table in the birth room where he was born, and most often sleeps. And only after two hours, if everything is fine, you and the baby will go to the postpartum ward together.

After giving birth, women feel differently. Some say that they suddenly felt very good (this is explained by the release of endorphins - pleasure hormones) into the blood, others are completely exhausted. Some people want to call everyone, everyone, and talk to the medical staff, while others only think about getting everyone to leave as quickly as possible. In any case, after a heavy load, you need to take a nap while you have the opportunity. It would also be a good idea for you to eat something, because you haven't eaten for many hours and you need to recuperate. You will most likely skip dinner in the maternity hospital, because most births occur in the evening or at night. Take care of yourself in advance. Take something with you to the hospital to snack on after giving birth.

When you are transferred to the ward, try to start getting up as early as possible, first with the help of the midwife, and then on your own. This helps improve blood circulation, normalize the functioning of the urinary system and intestines, and accelerate healing processes. In addition, very soon the baby will require attention.

Feeling disliked towards your own child

The feeling of hostility towards your own child is a very alarming phenomenon, but in fact, from a psychological point of view, it is not so rare. Many mothers do not want to acknowledge these socially disapproved feelings, others try to hide them, and only a few find the courage and strength to admit them openly. And this is already a good sign, it means that the woman is ready to cope with the problem, she has a desire to establish harmony in her inner world and love her baby.

There are many reasons for the occurrence of such negative emotions. Perhaps the baby was born of the wrong gender as expected, and the mother feels guilty, and the child is perceived as unnecessary, or perhaps the woman has serious problems in the family or with the child’s father, or pregnancy and childbirth caused the destruction of pre-constructed life plans. Be that as it may, many mothers, without even realizing it, blame the child for causing such changes. However, you should not reproach yourself for these thoughts; self-flagellation will only make the problem worse.

What to do? First, a young mother needs to calm down and tell herself “stop!” After all, this state is like a vicious circle: the feeling of hostility is accompanied by a feeling of guilt for one’s own emotions and thoughts, and this leads to even greater irritation and venting one’s negative state on the child. Yes, now you don’t feel love for your baby, but not because (in most cases) you don’t have a maternal instinct, but because your dissatisfaction or accumulated and unresolved life problems are preventing him from waking up. Therefore, it is very important to understand what is the true reason for the child’s aggressiveness, irritation and rejection. Perhaps you're just too tired, trying to take on too much and don't know who to share your feelings with? Entrust the baby to your husband, mother, or friend for a while and spend these hours for your own pleasure. Sometimes it is enough to be alone with yourself to understand that the most precious and beloved thing is the baby, who is not around right now. It also happens that a born child does not fit into a woman’s “life scenario,” which completely disorients her. Then it's time to build a new plan, with new goals and prospects, including the baby. After all, in fact, a child is not an obstacle to your desires and achievements; only your fears, complexes and self-doubt can serve as an obstacle.

You cannot force yourself to love your baby, but you can learn to do so: take a closer look at him, rejoice at even the smallest positive changes in your attitude towards him, remember that even love can take time. If you understand that the situation is not improving over time, and your loved ones do not provide support and understanding, do not hesitate to contact a specialist - a psychologist or psychiatrist. On the one hand, the opportunity not to keep such feelings to yourself and to be accepted without judgment will ease your condition, and on the other hand, such meetings will help you understand your own problems and outline ways to solve them, understand your emotions and learn to respond adequately to them.

Remember, everything that happens to your psyche after childbirth is not a death sentence, but temporary phenomena that will certainly recede if you make some effort. Be attentive to yourself and your emotions, be patient, it is quite possible that very soon the situation will change, and you will be able to feel like a truly happy mother.

Let's get acquainted, baby!

When you have finally recovered from the stress you have suffered, you want to get to know your little miracle, which now lies nearby, as closely as possible. You start to look at him. And who does he look like? Is everything okay? Some women begin to worry when they notice a tumor on their head. However, in most cases this is not a cause for concern. It will go away on its own within 1-2 days.

To be honest, immediately after birth, the baby may seem “scary” to even the most loving mother: a small, wrinkled creature with a large head, closed eyes, thin arms and legs. All this was due to the fact that he had to squeeze through a fairly narrow space and experience quite a lot of stress. But in a few days he will fully recover and become even more beautiful than the children in diaper advertisements.

The baby holds his arms and legs close to himself. This is due to physiological hypertonicity of the muscles, and it is not worth fixing the legs in an unnatural position (straightening them). Swaddling in the “log” style is no longer in fashion. In the first day, you can swaddle the baby’s arms quite tightly, because when the baby waves them in front of his eyes, he gets scared, because he doesn’t understand what it is dangling in front of him. In addition, while the baby was in the uterus, his mobility was limited, he got used to it, and felt more protected when swaddled. At home, you can gradually switch to vests and rompers.

The question often arises about how warmly a baby should be swaddled, whether a blanket is needed or whether there are enough diapers. To check if the baby is not freezing, you need to feel the nose and hands (they should be warm). The baby should be “dressed” warmer than the mother, because his thermoregulation is still imperfect and he is very sensitive to the ambient temperature. But you don’t need to wrap your baby up so that he sweats.

From the very first day, the baby needs your care. It's not just about feeding him. You also need to change his clothes at least once every three hours, wash him several times a day so that he is clean, and calm him down after examinations by the medical staff. These troubles will be enough for the whole day.

In the first day, the baby can sleep almost all the time, waking up only to eat, if nothing bothers him. But it happens that the baby is restless, falls asleep only for a short time, and cries a lot. You need to tell the doctor about this so that he can assess the baby’s condition and check if he has any pain. If the doctor says that everything is fine, it means the baby has simply not fully adapted to the new environment. You need to be patient, maybe the next day he will become calmer.

Don't be afraid to do something wrong! No one can take care of your child better than you. He needs your warmth, which he is used to while in his tummy. You may take it slow at first and don't swaddle as carefully as a nurse, but you'll definitely learn!

State of deep despair

Many mothers experience a state of deep despair during the postpartum period. This is a very common mood, especially if the child is the firstborn. A woman may give up, she may become indifferent even to her own child, and a feeling of depression and oppression appears. This condition is accompanied by constant fatigue from sleepless nights and the cycle of household chores. And although this is a completely natural and sometimes necessary stage of adaptation to motherhood, it is most difficult for women who have not had time to psychologically prepare for a new role during pregnancy. Mood instability, irritability, and confusion can last from several weeks to months, so it is better not to wait until this temporary condition goes away on its own, but to take action and help yourself cope with the onset of depression.

What to do? First of all, to avoid such a situation, try from the very first days after the birth of the baby to be close to him and take care of the baby yourself, otherwise, after returning from the maternity hospital, household problems, misunderstanding of your child, and complete lack of understanding may roll over you like a snowball. skill to care for it. Of course, this does not mean that you need to be left alone with the baby and all the troubles. On the contrary, accepting and realizing your duties and responsibilities, attract helpers. There is nothing wrong if dad or grandma walk with the child for a couple of hours while you read a book, lie in the bath or get a manicure. Don't forget that many things can wait, while others can be simplified. It is absolutely not necessary to iron all children's things on both sides; it is always useful to have a supply of frozen vegetables and pre-cooked and frozen cutlets in the refrigerator in case you do not have enough time to make dinner. Allow yourself to be an “imperfect mother” and motherhood will begin to bring joy. Don’t keep your emotions to yourself: if you understand that tears are choking you, allow yourself to cry for a few minutes, kick the pillow, tear plain paper into many small pieces. This way you will give vent to negative emotions and will not “break” at your husband or child. Get enough sleep with your child (while the baby is small and often sleeps) to feel rested, go for a walk even on sunny days (vitamin D and fresh air will improve your mood), do not neglect your hobby, especially if it is related to creativity. Perhaps this way you won’t be able to clean the apartment and wash the dishes, but you will transform irritation and apathy into the desire to live and enjoy the present moment.

And most importantly, remember that the cure for any sadness is your baby. Look at him differently, because a child is not only an object of constant care and concern, he is also a little person with his own character, emotions, and constant desire for communication and development. It grows and changes every day, and watching this amazing process can bring joy and pleasure.

Isn't it time for us to refresh ourselves?

One of the most important things for a baby is proper feeding!

Breastfeeding immediately after birth is very good for both of you. Moreover, it is necessary that it is not formal, for recording in the medical history, but so that the baby sucks and eats. This first portion is a gift for the baby and plays a big role in the formation of lactation and in establishing emotional contact.

Colostrum is released on the first day. It is a thick yellowish liquid. Although it is not much, it is enough for the baby for the first time. The calorie content of colostrum is 150 kcal/100 ml (milk has only 70 kcal/100 ml), it is rich in immunoglobulins, enzymes, and vitamins. You need to feed your baby on demand. On the first day, the baby can eat from 2 to 20 times. Feeding is usually frequent, but if this is not the case, there is no need to specifically wake up your baby to feed him. Again, there is no need to panic and demand additional feeding if the baby requires the breast almost all the time and does not let go of it for several hours. Gradually he will adjust his diet. Milk usually arrives on the third day, after which the baby asks to eat less often and fills up much faster.

The nipples, especially in first-time mothers, rub and hurt; it hurts most at the moment of application, but after a few seconds the pain subsides. Gradually the nipples harden and the pain disappears. Bepanten cream helps a lot. Its great advantage is that it does not need to be washed off before feeding.

Maternal and child hygiene

About mom

If the birth went without complications, then soon after its completion you may be asked to take a shower. And, most likely, you will want to do this. However, listen carefully to yourself, try to carefully stand up and take a couple of steps. If you feel weak, don't take the risk: fainting in the shower is not in our plans. Use wet wipes, and then, when you are confident, take a shower, put on a fresh shirt and feel the joy of life.

Often childbirth ends with stitches. In order for the unpleasant sensations to stop faster, doctors recommend washing yourself after each trip to the toilet and arranging - no matter how strange it may sound - air baths in your intimate area. By the way, ordinary laundry soap relieves inflammation surprisingly well. And if on the first day washing with soap is very scary, try doing it a little later.

Monitor your discharge after giving birth. Of course, you will use pads: special postpartum ones or regular large ones. They need to be changed frequently, and at this point pay attention to the clots that are in the discharge. Large clots in large quantities are a reason to consult a doctor.

Some time after giving birth, on the second or third day, you will need to go to the toilet a lot. If the thought of having to push again fills you with dread, or if you can’t go to the toilet a few days after giving birth, you can do a microenema or use glycerin suppositories.

Remember that while you are in the maternity hospital, every day you can ask your doctor any questions, do not be shy.

About the baby

Every morning your baby is examined by pediatricians and, of course, they give advice on how to care for a newborn and whether the umbilical wound needs to be washed and treated. Interestingly, doctors' opinions may differ from each other. In one maternity hospital, the umbilical wound can be treated with peroxide and brilliant green, in another it is forbidden to touch it. Several years ago, in the maternity hospital they ordered to wash the baby with liquid baby soap, today they only require the use of wet wipes.

You should listen not only to the opinion of pediatricians, but also to your own intuition. It may happen that the child gets very dirty, and it will be difficult to cope with wet wipes alone. If you already feel good and are confident on your feet, just wash your baby with warm water.

Of course, use diapers. This great invention saves the nerves of both: mother and baby. If you were planning to do without them, leave the experiments until you get home. There you will have more strength and helpers.

How should mom eat?

If during pregnancy a woman could eat almost whatever she wanted, now the situation has changed, because not everything that the mother likes is good for the baby. Therefore, there are some dietary restrictions.

Foods that should not be consumed can be divided into three groups:

1. Allergens. Most often, allergies are caused by citrus fruits, chocolate and alcohol. It is also worth limiting cow's milk, eggs, and sweet juices.

2. Products that increase gas formation, which can cause the baby to have a tummy ache. These are cabbage, black bread and legumes.

3. Products that worsen the taste of milk. These are onions, garlic, spicy dishes.

You definitely need to eat meat; boiled meat and meat puree for baby food are best digested. You can also eat yogurt without additives, cheese, cottage cheese, green apples, simple cookies (like “Maria”), some walnuts, and porridge. You can eat pasta and boiled potatoes. You should drink a lot so that milk is released better.

Most women think that everything they give in the maternity hospital can be eaten. Unfortunately, it is not. In all departments the menu is the same; they do not prepare special food for nursing mothers. Therefore, you need to be critical of everything that they bring.

The food they provide in the maternity hospital is not enough, besides, the last meal is no later than 18:00, and you also want to eat in the evening. Therefore, it is necessary to prepare relatives in advance for the fact that they will have to wear bags, so that the nursing mother has a nutritious diet and recovers faster after childbirth.

Newborn in the first hours of life

After birth, the baby’s airways are cleared to make breathing easier, placed on the mother’s stomach, the umbilical cord is cut off, and a special bracket is put on the stump. Then the eyes are treated once with an antiseptic (2 drops of silver nitrate 1%) to prevent infection of the conjunctiva with gonococci during passage through the birth canal. Next, the blood type and Rh factor are determined and the baby is transferred to the children's department or to a ward with the mother. This is how the first day after giving birth in the maternity hospital goes.

Before the appointment, the nurse checks the text of the bracelets, notes the exact time of the appointment and the following parameters: scream activity, breathing, skin color, weight, body temperature. Then she treats the skin and swaddles the baby.

The neonatologist examines the baby daily, paying attention to the color of the skin, mucous membranes, motor activity, muscle tone, and the degree of expression of unconditioned reflexes. In addition, the child’s hearing is checked and the functionality of all body systems (cardiovascular, respiratory, digestive, etc.) is assessed. If there are problems, the doctor invites specialists of a narrower profile (ophthalmologist, surgeon, neurologist). If a central nervous system disease is suspected, the newborn undergoes an ultrasound scan of the brain through the large fontanel.

The pediatrician treats the umbilical remnant daily with ethyl alcohol (95%), and then with a solution of potassium permanganate (5%). At the same time, touching the skin is prohibited. If it dries out slowly, then at first the nurse bandages it, and during each swaddling, wipes it with a solution of potassium permanganate. The remainder of the navel can be removed 2 to 3 days after birth. If it falls off on its own, then the wound is wiped every day with hydrogen peroxide (3%), ethanol (95%), and a solution of potassium permanganate (1%), without touching the skin around the navel.

The baby is weighed every day, as this indicator is very important for him. High weight indicates the health of the baby, and low weight indicates various diseases. However, doctors say that the normal weight of the baby is in the range from 2.5 to 4 kg. And after 2 - 3 days, children lose from 100 to 300 g, but this is normal. This is due to the fact that the hydrophilicity of tissues (the ability to accumulate water) changes and the child is not able to absorb food normally. Closer to discharge, the baby’s weight normalizes and begins to increase.

The maternity hospital also conducts tests for serious diseases: phenylketonuria (amino acid metabolism disorder) and hypothyroidism (lack of thyroid hormones). They need to be diagnosed as early as possible, otherwise the likelihood of impaired mental and mental development increases.

This is what's happening to me

You are undoubtedly worried about what you will become after giving birth. Don’t be upset if, looking in the mirror, you don’t seem as beautiful as before pregnancy: a flabby belly, bruises under your eyes, some kind of rash on your face... Everything will return to normal, only this will not happen on the very first day, but gradually !

After childbirth, the uterus is located at the level of the navel. When feeding, it contracts, as irritation of the nipples causes the release of oxytocin, which has a contractile effect. Therefore, breastfeeding, among other things, is the prevention of postpartum hemorrhage. There may be nagging pain in the lower abdomen. It is better to sleep and lie on your stomach, this way the uterus contracts faster.

The discharge on the first day is bloody and quite copious (about 300 ml in the first three days). Increased discharge when moving is normal. You will have to walk with a diaper between your legs. This is not very convenient, so stock up on disposable panties and pads in advance. They must be changed at least every 2 hours.

The abdomen is flabby, and there may be separation of the rectus abdominis muscles. It comes into tone only after 6 weeks. But you can start wearing a bandage immediately after giving birth. In addition, from the first day you can do breathing exercises: inflate your stomach as you inhale, deflate it as you exhale. Repeat 10-20 times, 4-5 times a day.

After childbirth, a woman may also experience muscle pain in different parts of the body. Which muscles hurt the most depends on which muscle group you strained the most during childbirth.

The “rash” on the face is pinpoint hemorrhages. They appeared because small capillaries burst due to stress during childbirth. There may also be bleeding in the eyes.

Blood pressure may be low on the first day, so dizziness may occur. To avoid this, you do not need to make sudden movements; you should stand up smoothly and carefully. If you constantly feel very weak, tell your doctor.

You may feel pain in the perineum, even if there were no tears and no incision was made in the perineum. They appear because the perineum has in any case been subjected to severe stretching, and, consequently, traumatization. If there are stitches in the perineum, you will not be able to sit for at least the first 2 weeks.

Hemorrhoids sometimes appear during pregnancy and after childbirth and also cause pain. Careful hygiene (showering after each act of urination and defecation) and applying ice to the perineum helps reduce pain.

There may be problems with urination, which is associated with a decrease in the tone of the bladder muscles and swelling of its wall due to the fact that during childbirth it was compressed between the baby’s head and the pelvic bones. Even if you don't feel the urge, you need to empty your bladder at least every three hours. There is usually no stool on the first day.

Other changes

The changes affect not only the mother’s genitourinary system, the appearance of the body changes, the condition of hair, nails, and general well-being worsens. Therefore, gynecologists recommend taking vitamins in the form of complex preparations immediately after childbirth and monitoring your diet.

Perestroika:

1. the cardiovascular system;
2. genitourinary system;
3. mammary gland;
4. figure (stomach);
5. leather;
6. hair.

The cardiovascular system. In the first 2 weeks, the level of hemoglobin, hematocrit, and pulse are restored. Blood pressure will remain within the limits that were during pregnancy for at least another 3 months. The size of the heart ventricles changes, and the amount of blood pumped decreases. But doctors say that the heart does not return to its original size after childbirth.

Genitourinary system. In addition to the genitals, pregnancy affected the kidneys and bladder. They do not have the ability to move, so the uterus squeezes them. At the same time, the volumes and structure of the walls are disrupted, and the nerve endings atrophy. After childbirth, a woman in labor may not feel when her bladder is full; this is fraught with an inflamed uterus, since under pressure, inflammation can intensify. You need to urinate every 2 hours, even if you don’t feel like it.

Mammary gland. The glandular tissue of the breast is very susceptible to hormonal changes; even during pregnancy, it grows and prepares for lactation. If a woman receives breast milk, this affects the appearance of the breasts and the internal tissue ratio changes.

What happens to the breasts after childbirth:

• the size and circumference of the areolas increases;
• blood flows to the glands, they become coarser;
• the load on muscles and ligaments increases;
• a pulling sensation appears if you do not attach the baby to the breast.

Due to the volume of milk, muscle tissue and skin are stretched, so among the body changes after childbirth, stretch marks appear on the chest. To avoid the consequences, you need shapewear, massage, position your baby correctly, and use moisturizer.

You are not alone

On the first day, and generally while you are in the maternity hospital, you will be under the control of medical personnel.

Soon after you are transferred to the postpartum ward, regardless of the time of day, the midwife will come. She will tell you about the daily routine and help you wash. Then the children's nurse will come. She will treat the child (clean the nose, eyes, ears, remove the remaining cheese-like lubricant, disinfect the umbilical wound). She will teach you how to swaddle your baby, explain how to care for him, and show you how to properly apply to the breast.

In the morning you will be woken up at six o'clock to measure your blood pressure and both of your temperatures. These measurements are taken twice a day. Also, twice a day, in the morning and in the evening, the pediatric nurse performs toileting for the baby.

A doctor will examine you both. An obstetrician-gynecologist will look at how your uterus contracts, whether colostrum is released, and assess the condition of the sutures and the amount of discharge. The pediatrician will examine your baby, check his innate reflexes and tell you about his condition. Don't hesitate to ask all the questions that interest you. If you forgot to ask something, don’t worry, the doctor on duty will come in the evening.

On the very first day, your child will be vaccinated against hepatitis B with your consent.

If you have stitches, you will need to go for treatment three times a day.

Most maternity hospitals have a lactation specialist who advises new mothers and helps them express milk when necessary. Don't hesitate to contact him!!!

In general, one of the medical staff will always be nearby. They won't leave you alone. They will help, advise, tell. Postpartum wards are most often two- or three-bed. This has its advantages: you still need to go out from time to time, and it is calmer if the child is not left completely alone. Women who gave birth on the same day are placed in the same room, so you will have something to talk about.

Visits are usually not allowed (unless you are staying in the service ward). You can wave to your relatives from the window. And so communication mostly takes place over the phone. If you are not superstitious, you can take a photo of the baby and send the photo to dad. Although, to be honest, you won’t be able to chat much on the first day.

Psychology of the postpartum period

Could anyone be happier than a woman who gives birth, feeds and kisses her baby? Why do we so often see tears of despair on the faces of young mothers who have been waiting for their baby for so long? During pregnancy, the level of female sex hormones reaches its maximum values ​​in a woman's entire life. Immediately after the birth of the placenta, the level of these substances decreases significantly. In this regard, some young mothers report irritability, devastation, anxiety for any reason, and sleep disorders. These phenomena occur on the 3-4th day after birth; more often they disappear without any medical intervention within two weeks. In 10% of women, these phenomena drag on and become painful, resulting in postpartum depression.

If symptoms of postpartum depression persist for longer than two weeks, it may be a sign of a medical condition for which it is best to seek professional help. Signs that postpartum depression is getting out of control include:

• acute feeling of fear, fear of the next day;
• apathy, refusal to eat, desire for complete loneliness;
• constant hostility towards the newborn;
• insomnia, recurring nightmares;
• constant feeling of inferiority, guilt towards the child.

Deja Vu

It’s a little easier for multiparous women, because they already know a lot. But nevertheless, if questions arise, do not hesitate to ask them. Repeated births may differ from the first, as well as the postpartum period. For example, in multiparous women, cramping pain in the lower abdomen during feeding is more pronounced, as the uterus contracts more intensely. The amount of milk may also vary.

You should also not expect that the second baby will be exactly the same as the first, he has his own character, and he can behave completely differently.

If you gave birth several years ago, recommendations for caring for the child may have changed, for example, they began to swaddle differently, use new hygiene products and medications.

Therefore, even if you have become a mother for the second or third time, be sure to seek help from the medical staff, ask all the questions that interest you, because this is why you and your baby are in the maternity hospital.

Complications

The body may require medical attention after childbirth. Fever and pain in the abdomen are reasons for an early visit to the doctor. This is how endometritis can begin - an inflammatory process in the uterus. The doctor will do an ultrasound and prescribe an antibiotic.

Lactostasis is a lump in the mammary glands that can result from stagnation of milk in the breast or improper attachment of the baby to the breast. If your temperature rises, do not delay calling a doctor. After the examination, he will prescribe physiotherapeutic procedures and... possibly an antibiotic. Purulent mastitis will require surgical intervention.

Possible complications of the postpartum period:

• endometritis – inflammation of the uterine epithelium, endometrium;
• chorioamnionitis - inflammation of the uterus or amniotic tissue;
• inflammation of the urinary canal, bladder, kidneys (pyelonephritis).

These diseases are associated with low immunity of the mother, the remains of placental tissue in the uterus, and the presence of chronic infections. The main symptoms of the inflammatory process are high fever, poor health, pain in the lower abdomen or back (with inflammation of the kidneys). Lochia acquires an unpleasant putrid odor and contains pus. If you notice any of the listed symptoms, you should seek medical help.

Breastfeeding women need to closely monitor the condition of the mammary glands and prevent stagnation of milk. If harmful bacteria enters the breasts through cracks in the nipples, mastitis begins. The disease is accompanied by fever, weakness, chest pain, and discharge of pus from the nipples.