Obstetrics Care

Here you will find answers to the most common questions and instructions for pregnancy and postpartum patients. If you have a question regarding a subject which is not listed, please feel free to contact our office for more information.

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Before Pregnancy       What to Expect at Appointments       Common Concerns in Pregnancy       Post Partum Care       Obstetrics Resources

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Post Partum Care

Activity

Restricted activity includes nothing in the vagina for 6 weeks (no intercourse, no douching, no tampons). You should not drive while requiring pain medications and until you feel like pain will not decrease your reaction time or keep you from comfortably wearing a seatbelt. This is usually a few days after a vaginal delivery and about 2 weeks after a c-section. Lifting should be limited to nothing greater than 10 to 15 pounds for the first 2 weeks if you have had a Cesarean delivery. Exercise may be restarted as tolerated after a vaginal delivery and 2 weeks after a C-section but please avoid getting too tired. You may do what you feel like doing, but stop to rest often. Take care of yourself and the baby and allow others to help with cleaning and cooking for the first couple of weeks. If you have no one to help, you may do light household duties after the first week and as you feel able, but stop to rest often. Try to lie down and rest when the baby naps during the day. You may climb stairs but you may need to stop and rest along the way.

Bleeding

Your bleeding should gradually decrease in amount and change from bright red to brown and then to yellow. You should use pads for 6 weeks and then you may use tampons. Call our office if your bleeding greatly increases after you get home. Post partum bleeding may continue for 8 weeks postpartum but has usually stopped by 6 weeks. If you are not breastfeeding, your menstrual cycle will probably resume in 6 to 8 weeks. If breastfeeding you may not have a period until you stop breastfeeding. Call if you have questions or problems.

Pain

Perineal stitch pain can be helped with warm baths 2-3 times daily (see Bathing). The stitches are absorbed by the body and do not have to be removed. Using pillows and selecting soft places to sit may be helpful. Tylenol, Ibuprofen, or Aleve may be taken if needed. Most stitches will be completely healed within 2-3 weeks.

Pain at your incision site after a c-section will also respond to Tylenol, Ibuprofen, or Aleve but you will likely need a narcotic during the first 2 weeks. This will be prescribed by your doctor. If it contains acetaminophen (which is the same as Tylenol) make sure that you do not take this with regular Tylenol as you can exceed the recommended dose this way. You can use a heating pad at your incision and you can try to give support when you cough or sneeze by holding a pillow to your incision. You may wish to take a stool softener, such as Colace, while requiring a narcotic as this medicine can slow your GI tract. You cannot drive while requiring a narcotic for pain control.

"Afterbirth" pains are caused by contraction of the uterus as it attempts to return to its original size. If you are breastfeeding, you may experience more cramping while you are feeding. Tylenol and Ibuprofen may help. Increasing and/or constant abdominal pain may be abnormal and you should notify our office should this occur.

Bowel Movements and Hemorrhoids

Your bowels may be sluggish after delivery. We recommend that you increase the fiber in your diet. You could do this by eating bran cereal daily or by increasing fruits and vegetables and whole grain breads. Remember to drink 6-8 glasses of water daily. Bowel movements may be painful at first due to the stitches, contracting uterus, or hemorrhoids. Sitz baths, Tucks pads, ice packs, and soft pillows may be helpful. Stool softeners may be taken daily if needed. There are certain vaginal lacerations in which suppositories and creams for hemorrhoids are not acceptable so please make sure your doctor has ordered these prior to using them.

Urinary tract

: It will probably feel very different or even painful at first when you empty your bladder. This is due to the stretching and swelling that occurs with the delivery or may occur after catheterization of the bladder. Call the doctor if you have any concerning symptoms such as, fever, chills, pain with urination, inability to empty your bladder completely, or pain in the lower abdomen or back.

Bathing

If you have had a Cesarean delivery, you should not soak your incision. Therefore, either a very shallow bath or showers should be used during the first 2 weeks.

Douching

As Obstetricians and Gynecologists, we suggest that you do not douche during the post partum or ever unless prescribed. However, if you do, please do not douche for 6 weeks.

Breast care if you are not breastfeeding

If breast milk develops, wear a tight supportive bra, preferably without wires both day and night or bind the breast with a breast binder made from a sheet, towel, or ACE bandage. Avoid breast stimulation and use ice packs to the breast (not heat) for swelling and discomfort. Tylenol and ibuprofen may also be helpful. If you think that you have problems with your breasts or if you experience pain, redness, or fever, please call our office.

Breast care if you are breastfeeding

Breastfeeding can sometimes be difficult at first. If you have cracked nipples, lanolin cream can be helpful. Using an electric pump and breast shields might also be needed to allow the nipples to heal. It can take about 5 days for breast milk to letdown from your breasts. Please follow up with your pediatrician to be sure that your baby is gaining weight appropriately. You may also call the Breastfeeding center with questions at (828) 213-1103. Infection at the breast can occur. True yeast infections are very rare… especially if you are healthy, not immune compromised, and not diabetic. Bacterial infections may occur and cause pain, redness, swelling, flu-like symptoms and fever so please call our office if you have any concerns or if these symptoms occur. If you are prescribed antibiotics, please continue to breast feed. It is very important to empty the breast in order to rid your body of the infection and this is not at all harmful to your baby.

Diet

You should continue a nutritious diet as in pregnancy. If you have had a Cesarean delivery, you may need to gradually advance your diet from soft bland foods to a regular diet. You should call our office if you have nausea and vomiting. You should continue your prenatal vitamins. If you are breastfeeding, you will need about 500 more calories than you did before you were pregnant (about 2500 calories total per day). Try to get 1000mg calcium per day and drink 8 glasses of water.

Birth control

You should not have intercourse until 6 weeks after delivery. It will likely be uncomfortable to have intercourse at first. Be gentle and patient with each other. Talk about your feelings and concerns. Use extra lubricants (such as K-Y jelly or a lubricated condom). Please use some form of birth control if you do not want to get pregnant. Breastfeeding can sometimes delay your ability to become pregnant but this IS NOT a reliable means of birth control. Please talk to your physician about the method of birth control that you wish to use.

Follow-up

Please call our office at (828) 253-5381 for an appointment as soon as possible after the birth of your child. The timing of this appointment will be based on the discharge instructions given at the time of your discharge.