Recovery from a vaginal delivery, the early weeks
Labour and birth are often long and tiring. Your body undergoes massive soft tissue change, stretching and possibly even tearing. Many people refer to labour as a marathon and that’s because it is! Did you know, the average woman expels 3 times the amount of oxygen during labour as a marathon runner expels in one race!? Labour and birth requires a LOT of mental, physical and emotional endurance. So expect to be tired after!
Your midwife will help guide you while you are in the hospital, but if you birth at a Birth Centre, then you will likely be discharged home within 24 hours, so it’s good to have an idea of what to expect.
This is the time to prioritise rest. If you are used to being busy then this can be a bit of an adjustment, but your short-term postpartum recovery can make a huge difference to your long term recovery. So read on for crucial tips.
Rest every day
Prioritise horizontal rest, which means lying in bed rather than propped up on the couch, eliminating gravity and allowing your pelvic floor muscles to recover. You can invert slightly by putting pillows under your pelvis to lift it. If you are breastfeeding, try doing this in lying. How long you need to prioritise rest is hard to say, but roughly for 6 weeks. If you had a traumatic delivery with need for assistance then you will need more rest. If you had a caesarean section, you will need to be careful for longer. But that said, if you had an uncomplicated delivery and you feel good, you still need lots of rest to allow your pelvic floor and/or your wound to heal. While YOU may feel fine, your pelvic floor and your body need the rest.
Use ice packs
If you’ve had a vaginal delivery, use ice on and around your perineum for 20mins every 2-3 hours to help reduce pain and swelling, especially in the first 3 days.
Use perineal support
Hold a wad of toilet paper and use it to apply mild pressure and support to your vagina/perineum when you empty your bowels. If you’ve had a caesarean section, create a wound pillow by folding and taping some hand towels together and press this against your wound to support it when you cough or sneeze.
Hygiene
Keep the perineal area clean and dry, especially if you have stitches. Wash from front to back, only using water, and gently pat it dry after toilet or shower. Don’t rub the area. Change your pad every 3-4 hours, even if it’s not full. Your caesarean section wound will likely have a waterproof bandage over it initially. Once this has been removed, you can gently you’re your wound with water only, and then pat it dry afterwards.
Don’t strain
No straining or bearing down while on the toilet! Keep your stools soft by maintaining a healthy diet and getting plenty of fluids and sit in the optimal toileting position. It can be really beneficial to use a stool softener in the early days or even weeks after delivery to help pass a stool with ease. Your midwife should offer you something but you can also chat to your pharmacist.
Wear a compression garment
The SRC pregnancy recovery shorts are a great compression garment to use. These will help support your pelvic floor and abdominal muscles. You can get fitted for these from 36 weeks of pregnancy, or postnatally if you didn’t get a chance while pregnant. Most women find they can start wearing them from 2-3 days post-delivery, although it may take a bit longer for you to feel comfortable getting them on. You can purchase SRC garments in the clinic at Origin and our physiotherapists can measure you to ensure you have the correct size. These garments are great for both perineal support and caesarean section wound support.
Start gentle pelvic floor contractions
Get started as soon as you are able. It’s common for your pelvic floor muscles to feel weak and sometimes women cannot feel them properly for a while after delivery. Alternatively, you may be able to start these exercises straight after delivery, and if that is you, then you should just be trying to engage these muscles, then relax them, not causing any pain. If you needed stitches then be gentle so you don’t cause discomfort or damage to your wound. If you had a caesarean section delivery, make sure you have adequate pain relief and aren’t tensing your pelvic floor muscles subconsciously throughout the day, relaxation of these muscles is just as important. The general rule of thumb is: Hold your pelvic floor on for as many seconds as the number of weeks since delivery. So if you are 1 week postpartum, try to hold for 1 second.
Do daily diaphragmatic breathing
Gentle diaphragmatic breathing will help facilitate pelvic floor relaxation. This is just as important as strengthening your pelvic floor muscles after birth as many women subconsciously hold tension in their pelvic floor. Aim to do some gentle belly breaths every day.
Start walking as soon as you can
Start slowly and increase gradually. Don’t be surprised if you feel tired very quickly. You can’t always prepare for just how tired you’ll be. If you have any vaginal heaviness, leakage or your caesarean wound starts to hurt, this is a sign you’ve pushed too hard, so reduce how far you walk and make sure you get plenty of rest in bed over the next couple of days. We’d definitely recommend using a pram over a carrier in the early stages too.
No heavy lifting
This is a time for recovery and healing, not for any heavy lifting. Lifting causes increased intra-abdominal pressure which puts pressure on your pelvic floor. You can also do damage to your wound if you’ve lift too much, setting your recovery back and potentially running the risk of infection. If you do need to carry anything over 3-4kg, then gently contract your pelvic floor muscles first or better still, ask someone else for help.
Allow others to help
Sometimes this is easier said than done but if there is ever a time to step away from the housework it is now. If people offer, let them help, so you can focus on rest and recovery of your body.
Stitches
If you had stitches then you can start doing some scar tissue massage at 6-weeks postpartum to soften it. It is important to be assessed by your doctor and women’s health physio prior to doing this.
Have a Women’s Health Consultation
Arrange this for around 6 weeks postpartum. We can’t recommend this enough. Of course, we are biased, but this consultation is not to be missed. It compliments your 6-week medical consultation and will include pelvic floor and abdominal separation assessment, bladder and bowel health and guidance on return to exercise. If you can’t get to a women’s health consultation then please get in touch and we’ll do all we can to help.
Hopefully this blog provides you with some guidance on recovery in those first 6 weeks postpartum. Please shout out to us if you have any questions.