Please refer to these guidelines and recommendations during your postpartum period. For your postpartum exam, please call the office ASAP to schedule a 6-week follow up visit. You may also be interested in viewing our Postpartum Resources Page.

ACTIVITY

Do not drive a car for the next week unless necessary. If you are taking a narcotic pain medication, do not drive until you complete your course of medication.

Walking outside is therapeutic unless your doctor advises otherwise.
Be sure you are in a safe environment and if you feel weak or light-headed when you change positions, ask for help.
Use all hand rails on steps, use non-skid footwear, and plan your trips ups and down stairs to be more efficient. Never carry baby on stairs until you are confident of your ability.
If you had a Cesarean Section, see special considerations.

BATHING

You may shower as desired. Take special care if you feel weak or dizzy.

CONTRACEPTION

DO NOT CONSIDER BREASTFEEDING A METHOD OF CONTRACEPTION. At your six week postpartum visit, your doctor will discuss contraception based on your desires. It is possible to become pregnant as early as 4-6 weeks postpartum.

EXERCISE

The most important thing to remember about exercise is to listen to your body. If you experience cramping, increased bleeding, or dizziness, stop and rest. Light exercise like walking or stretching may be started about 1 week after discharge from the hospital, but strenuous exercise like aerobics or jogging should be delayed until your six week postpartum visit unless instructed otherwise.

HOUSEWORK

For the first week, do only light housework. Let others help you as much as possible.

INTERCOURSE

Should be avoided until the bleeding has stopped and discomfort is gone; this is 6 weeks for most women. We recommend waiting until you see your provider at your 6-week postpartum visit to ensure that you have fully healed prior to resuming intercourse.

BLADDER SYMPTOMS

Notify the office if you experience burning with urination, frequent urination, fever, chills, or unusual bladder discomfort.

BLEEDING

While every woman is different, you will likely have menstrual-like flow (lochia) for about two to six weeks. For the first few days, the flow will be bright red. It will gradually change color to pink, brown, then yellow-white. Bleeding may increase with activity. If you are having heavy bleeding with clots, or are soaking a pad in an hour or less, call the office immediately.

BOWELS

Labor can cause decreased muscle tone of the bowels immediately following delivery. You may not have normal bowel movements during the postpartum period. Hemorrhoids, stitches, pain medication, and dehydration can disrupt normal digestion. Stool softeners, such as Colace, are recommended for the first postpartum days, as well as increasing clear liquids in your diet. A diet with lots of fruits and vegetables can aid digestion. If you become constipated, prune juice or Miralax can be used postpartum.

BREASTS

Breast-feeding mothers, refer to “Guide for Successful Breastfeeding” for detailed breastfeeding instructions.

Whether you are breastfeeding or formula feeding, your milk usually comes in on the third or fourth postpartum day. Your breasts will feel very firm and tender. You may alternate ice packs (which decreases milk production) and warm compresses (which increases milk production) for comfort. Ibuprofen or Tylenol may aid in discomfort; follow the medication directions and do not exceed daily limits.

If you do not desire to breastfeed, wear a supportive bra 24 hours a day for at least two weeks and avoid any breast or nipple stimulation such as loose clothing, running water directly on your breasts, or handling your breasts. In addition to ice packs, cold cabbage leaves may be applied to your breasts and reapplied every 15 minutes. There are no safe medications to “dry up” your milk but ibuprofen and Tylenol can be used for pain relief.

If you develop a red or hardened area on your breast, and/or develop a fever greater than 100.4 degrees with or without muscle aches and chills, call the office immediately.

HEMORRHOIDS

Hemorrhoids are common during pregnancy and the postpartum period. The most important way to prevent hemorrhoids is to avoid constipation by drinking plenty of fluids, having a nutritious diet with fiber, fruits, and vegetables, and using Stool Softeners as needed. Warm baths and soaks, Tucks pads, and Dermaplast spray (available over the counter) are helpful for comfort. OTC hemorrhoid creams, such as Preparation H, are also helpful, along with suppositories as needed. If OTC methods are not providing relief, contact the office for a prescription.

MENSTRUATION

Every woman is different and your periods may resume as early as 4 weeks postpartum. If you are breastfeeding, your periods may not resume for 6-12 months or until weaning. It is normal to have irregular or heavier periods after delivery.

PAIN

Many women have mild to moderate after-birth pains or uterine cramping, perineal discomfort, and/or breast discomfort during the first 10-14 days postpartum. Acetaminophen and Ibuprofen will usually suffice; make sure to follow all package dosing instructions.

PERINEAL CARE

Use warm water in the spray bottle from the hospital after all toileting for the first postpartum week. If you have stitches, this material will dissolve on its own in 2-6 weeks. Your stitches should be kept clean and dry; warm water is all you need for cleansing. Warm sitz baths, tub baths, and Dermoplast spray may be comforting.

POSTPARTUM DEPRESSION AND ANXIETY (PPD)

IF YOU HAVE ANY THOUGHTS OF HARMING YOURSELF OR OTHERS, CALL 911 IMMEDIATELY. Baby blues are common and expected after delivery, and include feelings of exhaustion, overwhelm, and emotional lability. This is usually transient and mild and resolves around 6 weeks postpartum. PPD is a more severe state of feeling lost, hopeless, angry, ambivalent, or anxious. Call the office for help; this is not something to feel embarrassed about. Here are some additional local resources:

Sentara Out of the Blues Postpartum Support Group

Postpartum Support International - VA Chapter, Charlottesville resources: They can help put you in touch with local therapists and also have a free virtual support group for Charlottesville moms

SPECIAL CONSIDERATIONS FOR C-SECTION

No heavy lifting for 6 weeks; do not lift anything heavier than your newborn. Your incision will heal best if kept clean and dry. After showering, make sure to dry your incision thoroughly. Keep an eye on your incision daily, and if you notice drainage, redness or swelling, call the office immediately. Strenuous exercise should be avoided for 6 weeks, and increase exercise slowly and as tolerated. Listen to your body and if something doesn’t feel right, stop and rest. Do not drive until you are sure your reflexes are normal.

Postpartum Instructions