postpartum healing

Your Six-Week Postpartum Visit - What to Expect

Midwife Postpartum Visit

Whether you give birth at a birth center with midwives or at the hospital with your OBGYN, you will likely have a postpartum follow up appointment about six weeks after you deliver. The purpose of the visit is to check on your physical and emotional well-being as you recover and adjust to your new life post childbirth. Here’s what you can expect to happen at your six-week postpartum check-up. 

NOTE: Health Foundations also provides a postpartum visit at 2 weeks for our families

A thorough assessment of how your body is recovering from childbirth: 

Your midwife or doctor will likely check the size of your uterus to see if it has returned to its pre-pregnancy size. She or he will also want to ensure that any vaginal tearing or C-section incisions are healing well, and assess for any post-birth physical problems like hemorrhoids, incontinence or constipation. Now’s the time to mention any other aches and pains you are experiencing. Your care provider will likely also clear you for sex and exercise at this visit should everything check out okay.

A check-in on your mental health: 

Your care provider may give you a written assessment for postpartum depression or she may just evaluate how you are feeling in discussion. Postpartum mood disorders affect approximately 10-15 percent of all new moms though many feel ashamed or afraid to seek the necessary help. If you are experiencing symptoms of depression such as hopelessness, sadness, anger or thoughts of harming yourself or your baby, please tell your care provider right away so they can support you in finding the appropriate help. There are many options for moms experiencing postpartum depression or anxiety including counseling, support groups and even medication. Your postpartum visit is a great opportunity to share any concerns about your mental well-being with your care provider.

A discussion about birth control:

Since you’ll most likely be cleared to resume having sexual intercourse with your partner at this visit, your care provider will probably want to discuss options for birth control. While exclusive breastfeeding can provide effective protection for the first six months postpartum and sometimes beyond, you may want to consider a back-up plan such as the mini-pill or an IUD if you don’t want to risk your kids being too close in age. Your midwife or OBGYN can discuss the various options for birth control with you and help you come up with a plan that works for you.

Your annual gynecological exam:

Many practitioners will go ahead and perform your annual exam at your six-week postpartum visit. She may conduct a pelvic exam, Pap smear and breast exam in addition to the usual physical exam measures such as weight and blood pressure. It’s a good time to discuss any other health concerns you have so be sure to bring a list of questions with you to the appointment. 

A breastfeeding consultation:

Your midwife or OBGYN will check in with you to see how breastfeeding is going with your new babe. They can help you troubleshoot any difficulties, address issues with engorgement or clogged ducts and refer you to a lactation consultant if you need additional guidance or support. 

Your postpartum visit is a great time to address any questions or concerns that you are having about your recovery, physical or mental health or adjustment to caring for a newborn. Be sure to come prepared with your questions written down so that you can make the most of the time with your care provider. At Health Foundations, our care doesn’t end in the birthing room. We are here for you during your postpartum period and beyond to support you and your new family as you adjust to motherhood. For questions about natural birth or postpartum care, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

Postpartum Care: What Happens After Giving Birth?

As your due date approaches, you may be wondering what to expect for your own recovery after giving birth. There is often so much focus on the excitement of having a new baby that women give little forethought to postpartum recovery. Preparing for postpartum is the key to having a smooth transition. You can expect your body to undergo a series of physical and hormonal changes following birth. These changes come in addition to the competing feelings of sheer joy and utter exhaustion as you adjust to your new life as a parent. Below is a list of physical and emotional side effects that you may experience following the birth of your child.

Vaginal Pain, Soreness and Bleeding:

Whether you have perennial tearing, require an episiotomy, or simply have normal vaginal stretching to allow the baby through the birth canal, you will likely have some pain and soreness for several weeks. It is also normal to have postpartum bleeding and discharge, called lochia, for up to a month following childbirth. The bleeding and discharge will initially be red and heavy in the early days but should eventually become lighter in color and volume. To alleviate vaginal pain, consider sitting on a pillow, utilizing cold witch hazel soaked sanitary pads and cleansing the area after urinating with warm water in a peri bottle.

Sore & Engorged Breasts:

As your body works to adjust its milk production to your infant’s needs, many women experience engorgement and leaking milk. Your breasts may feel swollen, hard and sensitive. You may be more likely to experience painful symptoms such as clogged ducts and nipple soreness during these early days. To reduce pain and continue to encourage milk production, nurse often and pump when needed. Alternate between placing a warm wash cloth on the breasts and using ice packs to alleviate soreness between feeding sessions. Taking hot showers to encourage milk letdown can also help with engorgement and breast pain. Thankfully, most insurance companies now cover the costs of breastfeeding support and services.

Contractions:

You may experience contractions or ‘after pains’ that feel similar to menstrual cramps in the days following your delivery. This is caused by the uterus beginning to shrink and compress to prevent excess bleeding. Consider using an over-the-counter pain killer if these or any postpartum symptoms are causing you considerable discomfort.

Urination Difficulty:

Problems with urination following childbirth are not uncommon due to pain, bruising and swelling surrounding the perinneal area. While this will typically resolve on its own as the area heals, stretching of the tissue surrounding the bladder can often result in leaking of urine and unintended elimination when sneezing, laughing or straining. To minimize the effects of damaged muscles and nerves of the bladder and urethra, do your Kegel exercises often during pregnancy and after.

Weight Loss:

Finally, a good postpartum symptom! Most women will lose more than ten pounds immediately following childbirth that is the result of the loss of the weight of baby, the placenta and the amniotic fluids. You may still look six months pregnant as your stomach has stretched to accommodate your growing babe, but with a healthy diet and exercise, you should continue to lose your remaining weight over the coming months.

Skin and Hair Changes:

While pregnancy can often come with the added benefits of glowing skin and healthy thick hair, the postpartum period may be a rude awakening for your voluminous locks. The extra hair growth experienced and retained during pregnancy is typically lost over the six months following childbirth and often leaves you pulling clumps from your brush. Although skin problems such as dryness and itchiness may present themselves due to hormonal changes, you are also likely to see a lightening of both stretch marks and linea nigra during the postpartum period.

Constipation, Hemorrhoids and Bowels:

Whether you have a vaginal birth or a Cesarean section delivery, many women experience symptoms of constipation and difficulty passing bowel movements after giving birth. While pain killers and the residual effects of an epidural can make you constipated, you may also have pain, bruising or tearing surrounding the perineum from a natural birth. This may leave you wanting to avoid the added pressure of bowel movements all together. Unfortunately, another common problem experienced during pregnancy and post birth are hemorrhoids. Hemorrhoids occur when pressure causes the veins surrounding the rectum to become swollen and the skin to become irritated. To reduce the pain caused by the pressure of bowel movements, consider using a stool softener or laxative in the days following your delivery. As always, be sure to eat a healthy diet that is rich in fiber and to drink lots of water. Probiotics also have many benefits during postpartum, for mom and for baby that can help relieve constipation.

Emotional Changes:

The birth of your child will likely be accompanied by some of the most powerful emotions that you and your partner have ever experienced. The excitement and joy of new life, the trepidation of being new parents and the exhaustion from sleep deprivation are all common things to feel in the days following your baby’s arrival. It is not uncommon to experience what’s known as the ‘baby blues’ or a mild period of depression in the first two weeks. While the ‘baby blues’ are usually nothing to be concerned about, if you find yourself slipping into a more concerning depression, feeling hopeless and despondent or having thoughts of harming yourself or your baby, contact your health care provider immediately to seek support for postpartum depression. 

Also See: Ten Homeopathic Remedies for the Postpartum Period

Cesarean delivery:

Despite the best laid plans for a vaginal or natural delivery, many births each year necessitate a Cesarean section due to complications with the mother or baby. The recovery from a C-section can be different from a vaginal birth, and may require that you allow a couple extra weeks for rest and recuperation. Common discomforts that can occur during your recovery include pain in the abdomen and area surrounding the incision site, difficulty walking and standing, pain in the abdomen when sneezing, coughing or laughing and numbness and swelling around the incision. Take care to ensure that you are getting enough rest, drinking plenty of water and limiting lifting and physical activity until your doctor clears you at your postpartum checkup.

If at any time during your recovery period you experience concerning symptoms such as a fever above 100.4 degrees, abnormally heavy vaginal bleeding, foul smelling discharge or pain, redness and discharge around the incision site of a C-section, contact your health care provider to be seen. Although you may be swept up in the excitement and responsibility of caring for your newborn, it is also imperative that you care for yourself during this recovery period. Nap when your baby naps, ask friends and family for help with household chores and be sure to nourish yourself with a healthy diet and plenty of water. Remember that your body just went through a major physical accomplishment and will need some TLC of its own in order to be at your best while you care for your new little one.

Further Reading:

For all questions about postpartum care, pregnancy and childbirth, contact Health Foundations to schedule a consultation with a midwife or take a tour of the Birth Center.

Ten homeopathic remedies for the postpartum period

homeopathic-remedyHomeopathy is safe and gentle energetic medicine used to support our bodies, minds and spirits from the inside out. Homeopathic remedies are available at local health food stores including Whole Foods and local co-ops. Over the counter dosages of the following remedies (at 10x to 30x) can be used to treat issues that may arise after birth (follow directions on the bottle or given by a care provider). Dr. Amy and Monica at Health Foundations are both trained in naturopathic medicine and can also advice on appropriate remedies for you or your family. Here are ten homeopathic remedies that may help women after birth, as they heal physically and adjust to the intense transformation they’re undergoing. Many of these are great for mood disturbances that can come after birth.

Arnica

Arnica is commonly used for bruising and can aid in healing the perineum and other tissues after birth. It can also be used for afterpains and uterine cramping that can occur with nursing.

Bellis Perennis

This homeopathic remedy can be used in the postpartum to treat abdominal symptoms. It too can be helpful for bruising and injury related to birth, as well as afterpains. It can also support healing after a tear. It may help women who have had a C-section.

Sepia

Sepia is one of the best remedies for assisting women experiencing hormonal changes, making it great for the postpartum period. It can be especially helpful in women experiencing the baby blues or even postpartum depression—those who may feel irritably, apathetic, resentful, or burdened. Women who benefit from this remedy may also feel indifferent to the birth experience and have trouble bonding with the baby. This remedy can also help with pelvic weakness or uterine prolapse.

Phytolacca

This homeopathic remedy can be helpful for issues arising with breastfeeding, including engorgement, painful nipples, and plugged ducts.

Natrum muriaticum (Nat Mur)

This remedy can be helpful when a woman is experiencing feelings of disappointment about the birth experience or overall outcome. It can help when one feels irritation at other’s attempts to console them even though they are sad. Women needing this remedy may also get headaches or heart palpitations when depressed.

Pulsatilla

This remedy can aid women who are feeling emotionally sensitive and prone to tears in the postpartum. These women may feel needy and insecure, wanting constant affection, reassurance, and nurturing. Getting fresh air and avoiding warm stuffy rooms can help. Finding a way to express/release the emotions in some way also greatly assists women experiencing this heightened sensitivity in the postpartum.

Phosphorus

This remedy is good for women who are experiencing anxiety and fear that something bad will happen to themselves, the baby, or others. This woman may have a hard time being alone. Many women who experience these fears and anxieties in the postpartum also experience heightened sensitivity to stimuli and exhaustion.

Calms Forte

This is a wonderful and very gentle sleep aid, helpful for women who are exhausted but having trouble sleeping and adjusting to their drastically altered sleeping rhythms.

Calcarea carbonica

This remedy can help women overwhelmed in the postpartum. For thes women, weakness and fatigue may lead to depression, anxiety, insomnia, and nightmares. A person who needs this remedy often feels sluggish, cold, and easily tired by exercise.

Cimicifuga

This remedy is for emotionally and hormonally based depression. A woman needing this remedy may feel “a dark cloud” has crept over her life and that nothing is right. Anxious and low-spirited, she may begin to believe she is incapable of caring for the baby. Alternatively, she may become excitable and talkative, saying and doing irrational things.

If you are dealing with challenging emotional or physical symptoms after birth, please reach out and connect with your care providers and your personal support team of friends and family, who can all help you.