Problems After Delivery of Your Baby

Topic Overview

During the days and weeks after the delivery of your baby (postpartum period), you can expect that your body will change as it returns to its nonpregnant condition. The postpartum period lasts for 3 months after delivery. As with pregnancy changes, postpartum changes are different for every woman. For example, if you had heartburn while you were pregnant, it may go away after delivery. But other symptoms, such as hemorrhoids, could continue to cause problems after your baby is born.

Many minor postpartum problems can be managed at home. For example, home treatment measures are usually all that is needed to relieve mild discomfort from hemorrhoids or constipation. If you develop a problem and your doctor has given you specific instructions to follow, be sure to follow those instructions.

Most women need 6 to 8 weeks after delivery to return to their normal activities, such as driving and exercise. It is important to start slowly and increase your activity level as you feel stronger. Your doctor will tell you when you can have sex again, but for most women, 6 to 8 weeks after delivery is the average time.

Although most women do not have serious health problems during the postpartum period, you should see your doctor if you develop heavy vaginal bleeding, calf pain, pain with breathing (pulmonary embolism), or postpartum depression.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

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	Managing postpartum depression

Emergencies

Do you have any of the following symptoms that require emergency treatment? Call 911 or other emergency services immediately.

• Any of the following after delivery:
  • Signs of shock
  • Fainting (syncope) or loss of consciousness
  • Severe vaginal bleeding
  • Seizures. Note: For information about how to help a seizure victim, see protecting a victim from harm during a seizure.
  • Severe belly pain
  • Signs of a pulmonary embolus, such as sudden, sharp chest pain; shortness of breath; chest pain that gets worse with deep breathing or coughing; coughing up blood; fast heart rate; sweating; feeling anxious

Check Your Symptoms

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

Yes

Do you have vaginal bleeding?

See significance of vaginal bleeding if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If your doctor has given you specific instructions to follow after your delivery, be sure to follow those instructions.

Call your health professional immediately if you answer "Yes" to the following question.

Yes

Do you have severe vaginal bleeding or are you passing large clots?

Call your health professional today if you answer "Yes" to any of the following questions.

Yes

Do you have moderate vaginal bleeding or are you passing small clots?

Yes

Have you had mild vaginal bleeding for longer than your doctor told you to expect?

Yes

Do you have bleeding after sexual intercourse?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have belly, pelvic, or back (flank) pain?

See significance of belly, pelvic, or back (flank) pain if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer "Yes" to any of the following questions.

Yes

Do you have moderate belly pain?

Yes

Do you have moderate to severe back (flank) pain?

Yes

Do you have moderate to severe pelvic pain?

Call your health professional today if you answer "Yes" to any of the following questions.

Yes

Do you have mild pelvic pain?

Yes

Do you have mild back (flank) pain without other signs of a kidney infection?

Yes

Do you have mild belly pain that is different from what your doctor told you to expect?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have pain when you breathe or pain deep in your leg or calf?

See significance of pain with breathing if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer "Yes" to any of the following questions.

Yes

Does your pain become severe when you take a deep breath?

Yes

Are you coughing up blood or sputum mixed with blood?

Yes

Do you have swelling or pain deep in your leg or calf that is not from a leg injury?

Yes

Do you have pain and you have had a pulmonary embolus or a blood clot (deep vein thrombosis, or DVT) in the past?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have breast problems?

See significance of breast problems if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer "Yes" to any of the following questions.

Yes

Are your breasts red and painful?

Yes

Are your nipples cracked and bleeding?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Are you having problems breast-feeding?

See significance of breast-feeding problems if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer "Yes" to any of the following questions.

Yes

Do you have sore, red or very pink nipples, sometimes with stabbing or burning breast pain during or between feedings?

Yes

Do you have a hard lump that does not go away after you breast-feed?

Yes

Is your baby having trouble latching on to your breast to feed?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have a fever?

See significance of fever if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If you need information on how to take a temperature, see the topic Body Temperature.

Call your health professional immediately if you answer "Yes" to any of the following questions.

Yes

Do you have a fever of 102° (39°) or higher?

Yes

Do you think you have a moderate to high fever, but you are not able to measure your temperature?

Call your health professional today if you answer "Yes" to any of the following questions.

Yes

Do you have a fever of 100° (38°) to 102° (39°)?

Yes

Do you think you have a mild to moderate fever, but you are not able to measure your temperature?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have ongoing symptoms of postpartum depression?

See significance of postpartum depression if you need information to help you answer the question below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If your doctor has given you specific instructions to follow after your delivery, be sure to follow those instructions.

Call your health professional immediately if you answer "Yes" to any of the following questions.

Yes

Do you think a lot about death or suicide?

Yes

Are you afraid you might hurt your baby or yourself?

Call your health professional today if you answer "Yes" to any of the following questions.

Yes

Do you have ongoing symptoms of postpartum depression?

Yes

Are you often tearful or grumpy?

Yes

Do you have feelings of worthlessness or guilt?

Yes

Do you have ongoing trouble falling asleep or staying asleep (insomnia)?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have any urinary problems?

See significance of urinary problems if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer "Yes" to any of the following questions.

Yes

Are you not able to urinate?

Yes

Do you have symptoms of a kidney infection?

Yes

Do you have symptoms of a bladder infection?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have a change in your bowel habits?

See significance of a change in your bowel habits if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional immediately if you answer "Yes" to any of the following questions.

Yes

Have you had a bowel movement that is mostly blood, but you do not have signs of shock?

Yes

Do you have constipation with other symptoms, such as fever, shaking chills, or vomiting?

Call your health professional today if you answer "Yes" to any of the following questions.

Yes

Have you had a bowel movement that is black and tarry or a bowel movement in which less than half of the stool is blood, but you do not have signs of shock?

Yes

Have you noticed blood in the toilet water after having a bowel movement?

Yes

Do you have pain caused by constipation?

You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions.

Yes

Have you had a small amount of bleeding or bleeding that comes and goes for longer than 1 week?

Yes

Have you had a small amount of bleeding in your stool more than once?

Yes

Do you have constipation without other symptoms that has not gotten better after 1 week of home treatment?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Do you have abnormal vaginal discharge?

See significance of abnormal vaginal discharge if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional today if you answer "Yes" to any of the following questions.

Yes

Do you have abnormal vaginal discharge, such as yellow, green, brown, or bad-smelling discharge?

Yes

Do you have abnormal vaginal discharge and itching or burning around your genital area?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home Treatment

If you develop problems and your doctor has given you specific instructions to follow, be sure to follow those instructions.

Feeling tired (fatigue)

Most women feel tired after labor and delivery. Caring for a new baby, loss of sleep, and the normal physical changes you experience as your body returns to its nonpregnant condition can add to your fatigue.

To help with fatigue in the first few weeks and months after delivery:

• Eat regularly. Do not skip meals or go for long periods without eating. Choose healthy foods.
• Exercise regularly. Get outside, take walks, or keep your blood moving with your favorite workout. If you do not have your usual energy, do not overdo it.
• Try to take rest breaks often during the day.
• Do only as much as you need to, and do not take on extra activities or responsibilities.
• Spend time with family and friends and let them help you care for your baby.

Sleep problems

Sleep problems are common when you are caring for a new baby. These tips may help you get a good night's sleep.

• Sleep when your baby is sleeping or napping.
• Keep your naps as short as possible.
• Use your bed only for sleep.
• Try to have a regular feeding pattern if you are breast-feeding. If you are bottle-feeding, have others feed the baby sometimes so you can rest.
• Limit your caffeine, such as coffee, tea, cola drinks, and chocolate.
• Try relaxation methods. For more information, see the topic Stress Management.
• Limit what you drink after 6 p.m. so you do not have to get up to go to the bathroom during the night.

Nonprescription medicine to help relieve discomfort

Most women have some mild discomfort after delivery. You may have some cramping as your uterus returns to its nonpregnant size. If you had an episiotomy, you may have pain in your genital area. Women who have had a cesarean section (C-section) will have some pain at the incision site.

If you are breast-feeding, it is safe to use acetaminophen, such as Tylenol or Panadol, to help with mild discomfort.

• Acetaminophen dosage: The usual dose is 650 mg; recommended doses may range from 500 mg to 1,000 mg. You can take 650 mg every 4 hours or 1,000 mg every 6 hours in a 24-hour period. Do not take more than the maximum adult dose of 4,000 mg in a 24-hour period.
• Be sure to follow these nonprescription medicine precautions.
  • Use, but do not take more than the maximum recommended doses.
  • Carefully read and follow all labels on the medicine bottle and box.

Breast engorgement or mastitis

If you are breast-feeding, your breasts may be sore as they fill with milk. Place ice packs on your breasts for the pain and swelling. Be sure to put a cloth between your skin and the ice pack. Some women find a hot shower or warm towels on the breasts help the pain. You can also use acetaminophen, such as Tylenol or Panadol.

Mastitis is an inflammation of the breast that is most commonly related to breast-feeding. This inflammation can be related to tissue injury, infection, or both. Mastitis while breast-feeding usually affects only one breast and starts as a painful area that is red or warm. Fever, chills, and flu-like symptoms or body aches can also develop. You can develop mastitis at any time while breast-feeding, but it most commonly occurs during the first 2 months after delivery, before your baby's feeding patterns become regular.

If you are not breast-feeding, do not stimulate your nipples or warm your breasts. Instead, apply cold packs, use medicine for pain and inflammation, and wear a supportive bra that fits well.

Postpartum depression

Many new mothers may feel "blue" after the birth of their baby. This may be caused by a change in hormones, not getting enough sleep, feeling too busy, or just worried about taking care of the baby.

Postpartum depression is a medical condition, not a sign of weakness. Be honest with yourself and those who care about you. Tell them about your struggle. You, your doctor, and your friends and family can team up to treat your symptoms.

• Plan activities and visit with friends and family, and ask them to call you regularly.
• Eat a nutritious diet. Eat small snacks throughout the day to keep up your energy.
• Get daily exercise, such as outdoor stroller walks. Exercise helps improve mood.
• Get as much sunlight as possible—keep your shades and curtains open, and get outside as much as you can.
• Ask for help with food preparation and other daily tasks. Family and friends are often happy to help a mother with newborn demands.
• Don't overdo it. Get as much rest and sleep as possible. Fatigue can increase depression.
• Do not use alcohol or caffeine.
• Join a support group of new mothers. No one can better understand and support the challenges of caring for a new baby than other postpartum women.

Managing postpartum depression

Constipation and hemorrhoids

Constipation and hemorrhoids may bother you after delivery. To prevent or ease these symptoms:

• Eat a high-fiber diet with lots of fruits, vegetables, and whole grains.
• Drink plenty of fluids, especially water and fruit juices.
• Try a stool softener, such as Colace.
• Do not strain (push hard) during a bowel movement.
• Get more exercise every day.

To treat the itching or pain of hemorrhoids:

• Keep the anus clean by wiping carefully after each bowel movement. Gently wipe from the front to the back. Baby wipes or hemorrhoid pads are usually more gentle than toilet paper. If you use toilet paper, use only soft, undyed, unscented toilet paper.
• Take warm soaks in a tub or a sitz bath. Warm water can help shrink or soothe hemorrhoids. Add baking soda to the water to relieve itching.
• Use cold packs.
• Do not sit for long periods, especially on hard chairs.

Let your doctor know if you are having problems with constipation or hemorrhoids. He or she may recommend a nonprescription or prescription medicine to treat your hemorrhoids.

Weight loss

Just as you slowly gained weight during your pregnancy, it may take some time to lose weight after your baby is born. Eat a nutritious diet and try to exercise daily. It may take 6 to 8 weeks for you to get back to your normal activities. As your body returns to its nonpregnant condition, many women feel they can manage their weight with healthy eating and exercise. If it is hard for you to lose weight from your pregnancy, talk to your doctor about your goals. If you are breast-feeding, it is important to get the right amount of calories and nutrients for your baby.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

• Abnormal or increased bleeding
• Pain in your lower belly
• Urinary problems
• Fever
• Symptoms that become more severe or occur more often

Prevention

It is important to make healthy lifestyle choices to lower your chance for problems after your delivery.

• Get plenty of rest.
• Limit your use of caffeine if you are breast-feeding.
• Eat a healthful diet. Get enough protein, vitamin B12, vitamin D, and zinc. These nutrients are vital to your baby's growth, development, and weight gain. Pay attention to your nutrition, especially if you are breast-feeding. Be sure to get the right amounts of calcium.
• Try to get 30 minutes of exercise on most, if not all, days of the week.
• Do pelvic floor (Kegel) exercises to prevent urine control problems (incontinence) after childbirth.

Things to avoid if you are breast-feeding

• Alcohol
• Smoking or using tobacco products
• Illegal drugs
• Misusing medicines
• Fish that may have mercury. This includes shark, swordfish, king mackerel, tilefish, more than 7 oz (0.2 kg) of white albacore tuna per week, or fish caught in local waters that have not tested as safe.
• Hazardous chemicals, certain cosmetic products, or radiation

Call your doctor if you have any questions about breast-feeding. This may help prevent any problems.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

• What are your main symptoms?
• How long have you had your symptoms?
• Have you had this problem before? If so, do you know what caused the problem at that time? How was it treated?
• What activities make your symptoms better or worse?
• Do you think that activities related to your job or hobbies caused your symptoms?
• Do you do sports activities?
• What home treatment measures have you tried? Did they help?
• What prescription or nonprescription medicines have you taken or used? Did they help?
• Do you have any health risks?

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