Questions after giving birth

1. Will my period/menstrual flow change after giving birth?

A. Once a woman’s period returns after having a baby, they commonly do not experience any change in their periods, since the body generally returns to its pre-pregnant state by the sixth week after childbirth. However, if you find that you are having problems with your periods e.g. a heavier flow or increased cramping, then it is a good idea to discuss this with your doctor.

2. Can I wear tampons after having a baby?

A. While most of us may prefer to use tampons, it is not recommended in the early weeks after having a baby.

This is because your cervix or neck of the womb is still partially open and the placental site has not healed, making you vulnerable to infection. Wearing a tampon will only add to you vulnerability and increase your risk of getting an infection.

Therefore, wearing maternity pads are the best choice. They are specifically designed for this time of your life and will offer you the best protection.

3. How long will I bleed for after my baby is born?

A. Whatever type of birth you have had, you will bleed from the vagina, because the special lining of the uterus (womb) is no longer needed. The colour should gradually lighten from bright red to pink/brown and by the tenth day it should be a whitish yellow. It should stop entirely after three to four weeks.

Notify your midwife or doctor if the discharge has a foul smell (the discharge should have the same smell as your normal menstrual flow); if a large clot is passed on more than one occasion or if you are worried about anything to do with the amount or consistency of your blood loss.

4. Can you give me some tips to help with pain/swelling around my vagina after birth?

A. Sometimes it is bruising that causes the discomfort. This can be relieved with ice packs applied to the area for the first few days after delivery.

The following are some other comfort measures that you may find useful to help reduce the pain and/or swelling:

• Wear loose clothing and cotton underwear.
• Change your maternity pad regularly to help prevent infection
• Avoid constipation by eating plenty of fibre and drinking water.
• It is important to commence regular, gentle exercise e.g. going for a walk with your baby and to do pelvic floor exercises as instructed by your doctor or midwife, as this will improve circulation and healing.
• Inform your midwife or doctor if the pain or swelling is causing you a lot of discomfort.

5. When can I have sex again after giving birth?

A. Most couples start having sex again by three months after the birth, however a loss of desire is common in both sexes, especially women.

If you feel pain during intercourse, perhaps because stitches from an episiotomy have not healed well, then this is bound to put you off, too. You should speak to your doctor about this.

6. After having my baby when will my period return?

If you are not breastfeeding your baby, your next period will probably start two to four weeks following the birth. However, if you are breastfeeding, you may not have any periods until your baby is weaned

7. Can I become pregnant even before my periods have returned?

A. Yes, most definitely. If this is not what you want then it is a good idea to have a chat with your doctor or midwife about the most suitable method of contraception for you and your partner.

8. Do you have less blood flow after a caesarean section and why/why not?

A. Interestingly, the amount you bleed from the vagina after having a caesarean birth should be about the same as if you had a vaginal birth. This is because it is the lining of the womb that is being shed and the type of birth that you have will not alter this.

9. I find when I breastfeed that my blood loss gets heavier – is this usual?

A. Yes, many women experience an increase in flow when they are actually breastfeeding, as the hormones released by the stimulation of breastfeeding encourage the womb to contract. This is why breastfeeding is thought to help you get your figure back more quickly!

10. Can you explain why my flow seems to change during the day?

A. Most women find the flow will vary throughout the day. It usually increases when you stand up after lying down for a while.

You may have less discharge at night when you are lying down, but the flow might suddenly increase just after standing up in the morning, as a result of gravity. If you are breastfeeding you may notice the flow increasing as you actually breastfeed your baby. You may also pass some clots, though they shouldn’t be too big. If you are concerned about anything to do with the amount or consistency of blood loss, then talk to your midwife or doctor.

11. Why does it sting when I go to the toilet?

A. During the birth of your baby you may have had some grazes or a tear to the skin around the vaginal opening. These grazes are usually the cause of the stinging when you pass urine during the first few days following childbirth.

It is very important to:

• Keep the area clean and dry.
• Change your maternity pad regularly to avoid infection
• After every visit to the toilet, always wipe from the front to the back, wash yourself with plain water and dry gently with toilet tissue.
• Drink plenty of water to dilute the urine.

You should find that the stinging will go away after a few days. However, if it persists it could mean that you could have a urinary infection. Always report any signs of a urinary infection to your midwife or doctor such as frequency, a temperature, persistent burning or stinging when passing urine.

12. Do you have more blood loss if you have twins?

A. You may have a slightly heavier blood loss though it shouldn’t exceed a maternity pad per 3 – 4 hours. If it does exceed this, then advise your midwife or doctor.

13. What is the best way to care for my stitches after having a tear or episiotomy during the delivery?

A. During the birth you may have had a natural tear or an episiotomy and required stitches. These can be quite sore for several days. The stitches don’t have to be taken out; they should dissolve on their own.

To follow are some general tips on relieving the painful area and how to avoid problems:

• Keep the area clean and dry.
• Change your maternity pad regularly to avoid infection
• After every visit to the toilet, always wipe from the front to the back, wash yourself with plain water and dry with toilet tissue.
• It may be helpful to use a hairdryer to the area for a few seconds to ensure it is dry after showering.
• Ice packs applied to your stitches for the first few days after delivery should help to reduce swelling.
• Wear loose clothing and cotton underwear.
• Avoid constipation by eating plenty of fibre and drinking water.
• When your bowels open it is a good idea to avoid straining and hold a clean maternity pad over the stitches to support them.
• It is important to do pelvic floor exercises regularly and gentle exercise, as this will improve circulation and healing.
• Inform your midwife or doctor if your stitches are causing you a lot of pain or discomfort.

14. What should I do if I experience heavy clotting or heavy bleeding?

A. It is very important that you report this to your midwife or doctor. This should always be investigated. Keep track of how many maternity pads you use a day and the approximate number/size of the clots that you pass, as it is likely that you may be asked for this information.

15. How can I avoid constipation after having my baby?

A. Whilst it is common not to have a bowel motion for a few days after delivery, many women find that constipation is a problem in the early days. This can be due to a number of factors e.g. fear of going to the toilet if you have stitches. In order to avoid constipation a high fibre diet, drinking plenty of water and gentle regular exercise such as walking is recommended.

If you are experiencing pain in the perineum (area between the vagina and anus) it is a good idea to take pain relief medication as recommended by your midwife or doctor e.g. paracetamol, before passing a bowel motion. It may feel more comfortable if a clean maternity pad is held against the perineum (area between the vagina and anus) when passing a bowel motion. If the condition persists report this to your midwife or doctor.

16. Can you tell me what my 6-week check-up will be all about?

A. Generally about 6 weeks after you have had your baby, your doctor should check that your body has more or less returned to its pre-pregnant state and that any problems are identified.

Here are some of things that he/she will be checking/examining:

• Your abdomen will be examined to check that your womb has returned to its pre-pregnancy size.
• If you had a Caesarean section the wound site will be examined.
• The area between your vagina and anus will examined particularly if you have had stitches to check for healing.
• You will probably be offered a cervical smear test if you have not had one in the last two years. It is wise to take this opportunity to have a smear test if you have not had one recently.
• You will be given an opportunity to discuss family planning and the various methods of contraception. Even if you are breastfeeding, you can still get pregnant.
• You will probably be asked about your energy levels and your mood/emotions.
• Bring your baby, as the doctor will probably have a look at him or her also.
• You should be given a chance to discuss any worries or concerns. Try not to be embarrassed as the problem may not go away without treatment and there are solutions. You will not be the only new mum feeling as you do.

Remember, if you have any concerns or worries it is really important that you consult a health professional e.g. your midwife, obstetrician, G.P., or the nurse at your local Early Childhood Health Centre. Many women encounter difficulties after childbirth so don’t be embarrassed to tell them.

For more information see Postnatal.

Author: Rosemarie Bartels, Midwife. Note: The author does not accept any liability for any advice given in this general information site. All information in this article is intended for your general knowledge. It is not a substitute for professional medical advice or treatment. You should at all times seek prompt medical advice on any health matter, however minor, that concerns you. Resources used to support this information:

Bibliography

• Henderson, S., & MacDonald, C. (2004). Mayes’ Midwifery: A textbook for midwives. (13th ed.). Sydney: Bailliere Tindall.
• Fraser, D. and Cooper A. (Eds). (2003). Myles Textbook for Midwives. Sydney: Churchill Livingstone.