Sensations of the mothers
Immediately after birth, the woman feels a strong weakness, sadness after stretching the muscles of the perineum, painful contractions of the uterus, notes abundant spotting from the genital tract. In a significant part of the puerperas, the onset of the postpartum period is accompanied by a chill that lasts for 5 minutes (this is due to a significant release of metabolic products of muscle cells into the bloodstream). A strong palpitation may occur at the slightest physical exertion. Often there is a slight increase in body temperature in the next 12 hours after delivery (up to 37.5 ° 0 due to overstrain of the autonomic nervous system or the release of muscle products into the blood.) Usually, the elevated temperature persists for several hours and normalizes without treatment. contact with the baby "skin to skin." In the first 30 minutes after giving birth, or even better - immediately after the birth of a crumb (before the umbilical cord bandage), the newborn is laid to the mother on the abdomen, and then implanted The first attachment is applied to the chest.
The first two hours the newly mummy is in the delivery room, since it is at this time that complications are most often caused by a breach of the uterus contraction accompanied by massive bleeding, as well as complications associated with anesthesia during childbirth. Doctors carefully observe the condition of the woman in the hospital, conduct an examination of the birth canal. If necessary, the integrity of the tissues is restored. At this time, it is strictly forbidden to get up, because the woman is still very weak and can lose consciousness. In addition, complete rest is important for stopping bleeding from the vessels of the placental area (the place where the placenta was previously attached to the uterus). It is necessary to attach an ice pack to the lower abdomen to prevent bleeding, as this stimulates uterine contractions, which can cause some discomfort to the woman due to the effects of cold and strong pressure on the lower abdomen. After 2 hours, the puerpera on the gurney is transported to the ward of the postpartum department. In most maternity homes, a young mother is in a joint room with the baby. To begin to rise to the woman it is recommended in 4-6 hours after sorts.
Potential troubles
Unfortunately, the happiness of communicating with the child can cloud some unpleasant sensations or problems of the postpartum period. Most women in the first days after childbirth are concerned with cramping pains in the lower abdomen. These sensations are caused by contraction of the uterus muscles, due to a significant decrease in its size after delivery. Within 1.5-2 months the uterus should restore its former size (that is, decrease from 1000 g to 50 g). Uterine contractions in all women are of different intensity: in some people they generally pass unnoticed, someone reminds the state of hypertension of the uterus during pregnancy, and some have severe pain that requires the use of spasmolytic drugs. More often the most painful uterine contractions are found in the re-born, which is associated with intensive production of oxytocin and a strong overgrowth of the uterine muscles during repeated labor. Also, puerperas note that these painful sensations intensify when breastfeeding the baby, as when sucking in the body begins to actively develop a hormone oxytocin, which just helps reduce the uterus. Postpartum uterine contractions usually do not require any medication. Only occasionally, with severe pain, antispasmodics (eg, NO-SHPA) or pain medications are prescribed. Some people are helped by a warm, relaxing shower. Many women in the first days after childbirth are concerned about pain and raspiranie in the perineum. This is not necessarily caused by ruptures or incisions in the perineal tissues. The painful sensations are due to the overgrowth of perineal muscles during childbirth, as well as possible abrasions and hematomas (hemorrhages). To eliminate or alleviate the pain will help periodic application to the perineum of an ice pack wrapped in a diaper. Usually these feelings pass on their own for several days. Another thing if there was a gap or a section of the perineum. Then the pain will bother longer - about 10-14 days: this is the time required for complete healing of tissues. During this period, it is advisable to avoid sitting posture: sudden erections, torso and weight lifting (of course, except for the baby), as this may lead to a divergence of the joints, a worsening of the healing period. In the first week after childbirth, the woman is treated with seams on the perineum with disinfectant solutions (brilliant green, potassium permanganate). You should also make a hygienic shower after each visit to the toilet. Modern suture materials used for suturing incisions and perineal ruptures promote faster healing and shorten the period when one can not sit for up to 7-10 days.
Problems with urination and stools
Some women in the first hours after childbirth may have problems with urination, when the bladder is full, and there is no urge to go to the toilet. This condition is associated with bladder hypotension because of strong compression of its walls by the baby's head during childbirth. And the larger the baby, the greater the likelihood of such a problem. A full bladder does not allow the uterus to contract and may contribute to urinary tract infection. For the prevention of complications it is recommended to visit the toilet every 2-3 hours, even if there is no urge to urinate. If you did not have urination within 8 hours after delivery, you need to take action. To begin with, it is worth trying to cause reflex urination by turning on a flow of water in the sink or in the shower. Sometimes it helps to warm up: try to put a hot water bottle on the bottom of the stomach for 20-20 minutes. If all this is unsuccessful, you should contact your nurse - it will help to remove urine with a soft rubber catheter.
In addition to problems with urination, a new mother may have problems with a stool. Usually a chair should be expected on the 2-3th day after birth. In order not to have constipation, one should adhere to a diet rich in fiber, eat sour-milk products (better than usual fresh kefir with a short shelf life), prunes, compotes from dried apricots, dried fruits, boiled beets. If all the same difficulties with a chair arose and on the 4th day of stay in the maternity hospital there was no emptying of the intestine, you should apply a laxative candle (with glycerin), and if this does not help, ask the nurse to make an enema. But at seams on a perineum doctors all the same do not recommend to have a chair the first 3-4 days and ask to adhere to a special diet. From the nutrition of a young mother, one should exclude foods rich in dietary fiber, especially coarse fiber, which can lead to an increase in intestinal motility (cuts): bran, beans, nuts, dried fruits, bread from coarse flour, pearl, barley, buckwheat, oatmeal, millet, raw vegetables and fruits. After each defecation it is necessary to produce a hygienic shower of the perineum, preferably slightly cool water.
Quite an actual problem is also the appearance after the birth of hemorrhoids (varicose veins of the rectum) and cracks in the rectum, which cause considerable discomfort to the woman. Cracks of the rectum arise because of a strong stretching of the mucous anus in the period of attempts. The cause of hemorrhoids is an increase in intra-abdominal pressure and pressure in the small pelvis with attempts, blood overflow of the rectum veins, which sharply increase in volume, their walls thicken and knots are formed. If a similar problem occurs, do not be shy and try to deal with it yourself. Be sure to tell your doctor about it. He can prescribe special ointments and rectal suppositories that are allowed during lactation. In addition, it is recommended that the rules of personal hygiene after each act of bowel movement and urination, a diet for the prevention of constipation, contrasting douches on the hemorrhoids, the restriction of physical activity - these measures will help reduce discomfort.
Discharge from the genital tract
After giving birth, a young mother notices the presence of secretions from the genital tract (lochia). They are blood from the vessels of the placental area, blood clots, scraps of small vessels. In the first few days after the birth, the lochia is like a copious menses, spotting is dark red and can contain many clots. Gradually, their number begins to decrease. In the first day after giving birth, a young mother is recommended to use diapers. This is done to monitor the amount of blood loss, then it is possible to use gaskets. If there are too many bloody discharge, the diaper is instantly soaked with blood, this should be reported immediately to the doctor, as this may be a sign of postpartum hemorrhage (it arises from the remnants of the placenta in the uterus). In such situations, ultrasound of the uterus is usually performed, and if there is evidence of the presence of the remains of placental tissue, an instrumental emptying of the uterus (scraping) is required.
By the end of the first week after childbirth (usually starting from the 4th day), the lochia gradually change its character - become serous-sucronic. ie, in large quantities can contain veins of mucus, acquire a pale red or pale brown color. The number of them is also gradually decreasing. Approximately 10-14 days after delivery, the lochia become serous, almost transparent (have a yellowish white color). Completely postpartum discharge stops after 5-6 weeks after delivery. Sometimes, even in the maternity hospital, lousy can be delayed in the uterine cavity. Usually it can be seen with ultrasound of the uterus, which is performed by all the women in the womb for 2-3 days after the birth. This condition is dangerous by joining the infection and the occurrence of a serious complication of the postpartum period - postpartum endometritis (inflammation of the uterine mucosa). Therefore, with any increase in body temperature (above 37.5 ° 0, with severe pain in the lower abdomen should immediately tell the doctor.
Changes in the mammary gland
Particular mention should be made of the changes that occur in the mammary glands in the first days after birth. Even during pregnancy, the mammary glands begin to prepare for the state of lactation. After birth, they begin to actively develop first colostrum (the first 2-3 days), then transitional milk, and after about 10-14 days - mature breast milk. In the first 2-3 days after delivery, the woman does not experience any particular discomfort in the mammary glands. During this period, the baby should be applied to the breast more often, although it seems that there is nothing in it. Colostrum is allocated literally drop by drop, a little, but it is enough for the baby, it contains a concentrate of nutrients and immunoglobulins (antibodies), so necessary for the child. On the 2nd-4th day, a rush of breast milk begins. In this case, the mammary glands are overfilled, significantly increasing in size. There may be severity, raspiranie and tingling in the chest, a brief increase in body temperature to 37-37.5 ° C. The most important thing in this situation is to put the baby to the breast more often, so that the midsection empties uniformly. It is very important that the baby is applied correctly (the baby must grasp not only the nipple, but also the greater part of the areola, there should be no smacking, the child's spout is pressed tightly to the chest, the baby is heard swallowing). If after breastfeeding the baby remains heavier, there are seals, at the first time after childbirth it is possible to express a little milk (by hand or breast pump), but not until complete emptying, but only to a sense of relief. Later, when the child begins to fully empty the breast and the lactation is finally established, there will be no need to express it. Also for the prevention of milk stagnation (lactostasis), the first few days should limit the intake of liquid to 800 ml per day.
At first, due to the fact that the mother does not always correctly put the baby to the breast, cracks in the nipples may form, which causes severe pain during feeding. Prevent this will help the proper technique of applying to the chest, contrasting douche on the area of the mammary glands, treatment of the nipples after feeding with healing ointments (BAPANTEN, D-PANTHENOL) or a drop of breast milk. Do not wash the chest with soap before each feeding: it destroys the protective film on the areolas and nipples, promotes traumatization and, possibly, infection of the resulting cracks. If nevertheless there are pronounced cracks in the nipples and feeding causes unbearable pain, you can temporarily use special silicone pads on the nipples. When the cracks are healed (and this happens quite quickly), you can return to the usual method of feeding. The most important thing is the mother's confidence that she is able to fully and continuously feed her baby with breast milk. If there is a firm conviction in this, then any difficulties will be surmountable and resolvable.
After birth, some women are unpleasantly surprised by the ugly look of their belly. In the standing position, it extends considerably forward, which is explained by the still enlarged uterine size. In the sitting position in the middle of the abdomen, a vertical cavity is formed due to overstretching of the muscles of the abdominal wall during pregnancy. Completely the size of the uterus is restored a few weeks after childbirth, which leads to a certain decrease in the abdomen. To restore the elasticity of the abdominal muscles, special exercises are recommended, which can be started already in the maternity hospital in the absence of contraindications. The rate of return of a woman to a beautiful flat belly is strictly individual and depends on the initial state of the muscles of the press, the degree of muscle strain during pregnancy (weight of the fetus, polyhydramnios, multiple pregnancies), the total weight gain for pregnancy, nutrition and physical activity after childbirth. With a very strong stretching of the muscles, the attending physician recommends that the woman wear a postpartum bandage. Now you know how the recovery occurs after the birth, to improve your mum's health will help a constant rest.