Postpartum Common Questions

After my baby’s born, when can I expect to hold her/him?

Once you deliver your baby, the baby should be able to go to the mom’s chest immediately, as long as there are not any complications. Even if you have had a CS delivery, you can ask to have the baby come to your chest.

Why do many doctors like to get skin-to-skin contact right away, and in what cases might this have to be delayed?

The only reason a baby would not go skin-to-skin on a mom’s chest would be if there are any complications associated with the baby or delivery.

When can women typically go home–and take baby home–if they’ve had a vaginal delivery?

If a woman has an uncomplicated vaginal delivery, she should expect to go home 2 days/nights after the delivery.

How long does a women typically stay hospitalized if she had a C-section?

After a woman has a C-Section she should expect to stay 4 days in the hospital.

After you deliver your baby, either by C/Section or vaginally, how long does your uterus and flappy belly skin need time to get back to its pre-pregnant status?

Immediately after delivery, the uterus will be at the level of your belly button, which is reminiscent of being 20 weeks pregnant. Even though the uterus is smaller, this allows for more unwanted attention to your stretched, loose and weak skin. Women tend to look pregnant for another 6 to 9 weeks as the uterus and saggy, post-baby belly find their way back to normal.

Although I always tell my patients that it took 9 months to go through the pregnancy, so allow 9 months to recover to your pre-pregnant body.

What pain medication will a new mom go home with?

When discharged from the hospital, you would be told to take over the counter Tylenol and non-steroidal anti-inflammatory (NSAID) medications to treat the pain associated with a vaginal delivery. If you had a CSection, you will be discharged home with a narcotic and a NSAID for the first week to help deal with the post operative pain.

How can I recover from vaginal tearing that happened during my vaginal birth?

Take care of a healing vagina if you had a normal vaginal delivery. Daily sitz baths with warm water and ibuprofen will help decrease vaginal swelling and pain. Another soothing and helpful tip is to use a squirt water bottle filled with warm water and pour it over the vagina while urinating or after a bowel movement. The squirt bottle can also be used to clean the area after urinating or having a bowel movement which will be a bit gentler on a bruised and swollen perineum. The best news of all is the vagina is very resilient. The vagina will be close to “as good as new” within 6 to 10 weeks. Until then, keep the vagina and perineum clean, use simple treatment options and sit down slowly not to disrupt the healing process

How long does it take for c-section scars to heal?

Everyday gets a little easier in the recovery of a C-Section. The first few weeks are definitely the most challenging since the body is going through a major physical and hormonal transition. Your ability to move around freely and without experiencing a lot of pain and discomfort in the abdomen and incisional area will be most difficult the first 2 weeks. Don’t overdo it! Move slowly and take it easy. It takes a good 6 weeks to fully recover after having had a C-Section.

What is recovery like in the couple of weeks following a c-section? What do you need in that time to heal?

Our bodies are amazing during the healing process. If you don’t overdo it, be patient and allow the body to heal you will feel more like yourself by 6 weeks postpartum.

Be patient and don’t push yourself. This is the biggest mistake women make, not following the rules of recovery.

Do c-section scars hurt?

Burning sensation-take an ibuprofen, use a heating pad, ask the question if you are over doing it which is often the case.

A Keloids scar is basically a raised scar that can become larger weeks and months after surgery. Keloid scars can become painful and itchy.

Do all the food “do’s” and “don’t’s” go out the window right after delivery?

After your delivery, many of the “do not eat’ while pregnant goes away. Sushi, deli meat, caffeine restrictions are no longer applicable. You can order a tuna roll immediately after delivery if you have been wanting to eat raw fish. If you are breastfeeding, there are no sushi or deli meat restrictions.

What happens at the 6-week postpartum visit?

During the 6-week postpartum visit, your health care provider will do a breast and pelvic exam, discuss birth control options, and give you permission to resume sexual intercourse. If you had a vaginal delivery, your vagina will be checked out to make sure it is completely healed. If you had a cesarean section, your incision will be examined to make sure it is fully healed. If everything checks out, you will also be allowed to take bathes and go into swimming pools.

It is also the perfect time for you to ask questions about all the changes that are happening in your life, hormonally, emotionally and physically.

What are some questions new moms should ask their doctor?

When can I start exercising?

When should I start doing Kegel exercises?

Can I stop taking my prenatal vitamins?

Are there any other supplements I should be taking?

Why are my nipples still sore when I breastfeed?

When can I start having sex?

After a vaginal delivery, when is my vagina ready to for sex?

Will sex be painful?

Why do I have burning in my vagina?

How long will it take to lose the weight I gained during pregnancy?

Why is it harder to lose weight when I am breastfeeding?

When will I get my period?

What type of birth control can I take when I breast feed?

What type of birth control can I take if I don’t breast feed?

What issues should you discuss with your doctor?

Issues to discuss if you are having problems with:

breastfeeding
not producing enough milk to breastfed
getting enough sleep
feeling depressed beyond the baby blues
have unexplained crying, irritability or anger
unable to care for your baby
problems with your partner
Excessive bleeding
Poor appetite
Still using pain medication

What do you look for, in terms of mental health, at the 6-week appt?

During the 6-week postpartum visit, most women feel as though they are more in control of handling the hormonal storm that comes with the first 6 weeks of having a baby. I go through a check list to make sure new moms are able to feed and care for their baby and that they are eating a healthy diet and getting enough rest.

Breastfeeding can be challenging, and I always remind new moms that this can be an uphill battle and can take time to master.

I also ask what kind of support they are getting from their partner, other family members, friends, or paid help.

If I find a woman is struggling with their mental health, I strategize with them in providing a support team including a therapist and anti-depressants to help get them back on track.

My best piece of advice for women in the 4th trimester.

I always tell my patients that they get a “pass” for one year following the birth of their baby. It takes you 9 months to go through the pregnancy process. Allow yourself 9 months during the postpartum process to have your body and vagina return to normal…and hopefully your sex life too! The excitement of your old life will return and now you have a wonderful addition to create that perfect family. Don’t pressure yourself to get your pre-pregnant body back and create other expectations that you may not achieve. Life usually gets back to normal as everyone adjusts with an open mind, patience and understanding.

Do I need to continue taking my their prenatal vitamins?

Many women think once they had the baby they don’t need to continue taking prenatal vitamins any more. Unfortunately, this is not the case. If you are breastfeeding your body requires more vitamins and mineral than during your pregnancy. Continuing to take your prenatal vitamins, extra vitamin D and omega 3 fish oil to help ensure your growing newborn gets those vital nutrients it needs.

What are some of the most common challenges for new mothers?

The most common challenges for new moms include not producing enough milk to breastfeed, not getting enough sleep, feeling depressed and inadequate as a mom, having unexplained crying, irritability and anger and having problems with your partner.

Here’s my best advice for new mothers trying to balance the new pressures of motherhood?

I always tell my patients that they get a “pass” for one year following the birth of their baby. Don’t pressure yourself to get your pre-pregnant body back and create other expectations that you may not achieve. Life usually gets back to normal as everyone adjusts with an open mind, patience and understanding.

Tips during the Postpartum Period:

Get your rest even if it means taking naps alongside your newborn.
Drink plenty of liquids-at least 8 to 12 glasses of water or the equivalent a day!!
Eat healthy, well-balanced meals regularly.
Don’t forget to take your prenatal vitamins, vitamin D and omega 3 fish oil.
Communicate openly and honest with your partner
Use KY or another lubricant during sex
Don’t put extra pressure on yourself or your partner.
Don’t be afraid to ask for help, especially from your family and friends.
Be patient-everyone who has ever had a baby has gone through the same experiences

How long does it take for c-section scars to heal?

When is the next follow up appointment with your healthcare provider after having a C-Section?

You should follow up for an incision check with your healthcare provider 2 weeks after your discharge from the hospital.

What does pelvic rest for 6 weeks mean?

What are the first few days like? What do you need to do initially to heal?

The first few days are definitely the most challenging since you body is going through a major physical and hormonal transition. You are moving slowly trying to navigate many nuances, from caring to your baby and caring for your own needs in the recovery process. You are not only recovering from surgery but also recovering from having gone through underwent a major surgery, although it doesn’t feel that way since you are awake during the surgery. It takes 4 weeks for the sutures used during surgery to dissolve.

Avoid lifting anything heavier than the baby for the first 4 weeks.

Wear comfortable and loose clothing especially around your abdomen and near the incision. Where supportive belly bands are also helpful. After a cesarean section belly wraps can support the uterus and belly taking pressure off the abdominal incision. It’s important not to wrap yourself too tight since it might affect the healing of the incision.

What is recovery like in the couple of weeks following a c-section?

Our bodies are amazing during the healing process. If you don’t overdo it, be patient and allow the body to heal you will feel more like yourself by 6 weeks postpartum. Be patient and don’t push yourself. This is the biggest mistake women make, not following the rules

Do c-section scars hurt?

Burning sensation-take an ibuprofen, use a heating pad, ask the question if you are over doing it which is often the case

Is it normal for the scar to be itchy/irritated?

When something injures your skin, your body’s nerve endings can become damaged, too. The nerve endings can become very sensitive and cause itchy sensations as they start healing. New scars form for a number of reasons: due to acne blemishes

When should women go back on birth control?

When a woman goes for her 6-week postpartum visit it’s at this time the conversation occurs as it relates to birth control.

Safe birth control options for breastfeeding moms include progesterone only birth control pills, non-hormonal or hormonal IUD, Nexplanon, a diaphragm or condoms. If permeant conception is warranted, then a vasectomy or tubal ligation is an option.

If you are not breastfeeding, you have all the usual options for birth control including using the combination estrogen-progesterone pill.

What is a keloid scar? 50

A keloid scar is an overgrowth of tissue from the existing scar. It occurs when there is too much collagen produced at the site of the wound. A keloid can continue to grow even after the incision has healed. It’s associated with pain, itching and tightness.

Is it normal to have a numb scar?

Superficial nerves on the skin are cut and that is why women feel numbness when touching the scar.

What is the healing process like?

The healing process is slow and steady, women often forget they had a major surgery. Sitting up and turning to get out of bed can be challenging.

Even though abdominal muscles haven’t been cut there is some rearranging but ultimately putting all the pieces back together the way we found them… that takes place once the babies out.

Sutures take 4 weeks to dissolve under the skin. One side may hurt more than the other. By 6 weeks you are feeling more like yourself.

How long do steri strips stay on?

Steri-strips are applied during the CSection or when you are discharged from the hospital. They are removed during the 2-week post op visit. When you are discharged from the hospital, the steri-strips cover the incision, so you should use a hand towel or coverlet while showering not to get them wet.

What will the healing process likely look like?

The first 2 weeks the incision will feel numb due to the superficial nerves cut at the time of the CS and you will feel a small ridge along the incision. By 6 weeks the ridge will flatten.

Are there cosmetic fixes to C-section scars?

Although scars cannot be completely removed, their appearance can be improved to some extent. Methods for improving the appearance of scars include:

Topical treatments, such as vitamin E, cocoa butter cream, and several commercial skin care products sold over the counter may be somewhat effective in helping to heal scars.
Surgery. Although it will not remove a scar, surgery can be used to alter a scar’s shape or make it less noticeable. Surgery is not recommended in cases of hypertrophic or keloid scarring (raised scars) because there is a risk of recurring scars as well as more severe scarring that results from the treatment.
Steroid injections. A course of steroid injections into a scar may help flatten it. Injections may help to soften the appearance of keloid or hypertrophic scars.
Radiotherapy. Low-dose, superficial radiotherapy is used to prevent recurrence of severe keloid and hypertrophic scarring. This treatment is used only in extreme cases because of potential long-term side effects.
Dermabrasion. This treatment involves the removal of the surface of the skin with special equipment. Dermabrasion is useful to blend in the irregularities of a scar whether it is raised or depressed.
Microdermabrasion is a much less invasive form of dermabrasion but is minimally useful for very superficial scars.
Laser resurfacing . This procedure, similar to dermabrasion, removes the surface layers of the skin using different types of lasers. Newer types of lasers may achieve more subtle results by working on the collagen in the dermis without removing the upper layers of skin. This advancement results in little down time as opposed to traditional laser resurfacing and dermabrasion, which requires a longer recovery.
Filler injections. These treatments can be used to raise sunken scars to the level of surrounding skin. The effects of these injections are only temporary, however, and the procedures may need to be regularly repeated. Newer forms of injectable fillers are now on the market and may be an option for some people.
Microneedling. Many small puncture holes are made into the superficial skin to stimulate collagen production and smooths, firms and improves the appearance of scar tissue.

When can women drive a car after having a baby?

After having a baby, you can drive a car as long as you are not taking pain medications, with codeine or other narcotics, and are having an easy recovery.

How long do women have to wait to exercise after having a baby?

How soon to resume your exercise regimen will vary according to your physical and mental condition, your regimen prior to and during your pregnancy, and, of course, your delivery experience. If you had a traumatic delivery and/or an episiotomy you may not be able to resume even the easiest exercises until three to four weeks postpartum. The sutures used in repairing an episiotomy typically dissolve within four weeks, so it’s best not to overextend yourself during that time. If you begin a strenuous workout sooner than your body is able to handle, you’ll set back your postpartum recovery. Be reasonable in your workout routine. You don’t want to ride a bicycle or take a spinning class for at least six weeks following an episiotomy repair (you may even wince just thinking of it). Walking and strolling with your newborn 20 to 30 minutes a day is a perfect way to begin once your health care provider gives you the go-ahead. Start those Kegels as soon after delivery as you remember to. Pregnancy and childbirth can weaken your pelvic floor muscles, resulting in uncomfortable pelvic pressure and unwanted leakage of urine (try sneezing without those muscles). Kegel exercises are a simple and effective way to strengthen those pelvic floor muscles, which support the uterus, bladder and bowel. They can help delay or even prevent pelvic organ prolapse (protrusion of the pelvic organs into or through the vaginal canal) and other related symptoms.

When can women have sex again?

When a new mom leaves the hospital after giving birth, either vaginally or by Cesarean section, her OBGYN tells her “pelvic rest for 6 weeks until I see you for your postpartum visit”, which translates to “no sex”. A women’s body is still healing regardless of the mode of delivery for at least 6 weeks so at this visit you get restarted on birth control and are given the A-OK to have sex again. Fantasizing about the next time to have sex with their partner is usually not at the top of a woman’s postpartum wish list.

It’s well known amongst mommy group’s that the first 6 weeks are the hardest hormonally and physically for both women and men. If breastfeeding is involved there are hormonal changes that make life miserable. Plus all the nuances of dealing with a newborn make the hormonal changes even worse…not sleeping well, feeling exhausted, breasts leaking all over day and night and carrying all the extra weight that you gained in pregnancy.

Between 6 weeks to 3 months, many women experience painful intercourse. The cause of painful intercourse can be due to vaginal tears, episiotomy, damage to the pelvic floor muscles and the hormonal effects of low estrogen if you are breastfeeding. The low estrogen levels make the vagina to undergo the changes associated with atrophy. These changes cause the vaginal tissue to be thin, dry and pale. There is less blood flow to the vagina resulting in decrease vaginal lubrication. Vaginal dryness, irritation, burning, itching, painful urination, and painful intercourse are common symptoms.

When does sex feel less uncomfortable after having a baby?

At the 3 months postpartum timeline, life is getting better in every way. The nuances of having a newborn in your lives are easier to handle. For those that breastfed they are either in the rhythm of nursing and those who struggled has most likely stopped. Your vagina is now healed after a vaginal delivery and your scar is healed after a Cesarean section. You probably have had sex a couple of times but the routine of intimacy is usually delayed for as long as possible by women more so than men. Exercise is now happening regularly and the pregnancy weight is coming off.

How will I feel around 6 month postpartum?

By 6 months, life is getting back to normal. Hormonally you are back on track. Even those that are breastfeeding have a handle on their hormones and they are not causing so much disruption. Most women have their pre-pregnant bodies back so are feeling better physically and psychologically. For women, an interest in sex improves the further away from delivery you become.

Time, patience and stopping breast feeding are usually all you need to get back into the mood. The connection between you and your partner during this stressful time of life needs to be filled with support, understanding, kindness and love. As soon as you are physically able to have sex you hope you and your partner have grown in all the beautiful ways you dreamed of.

When will I feel most like my non-pregnant self, especially sexually?

I always tell my patients that it takes you 9 months to go through the pregnancy process. Allow yourself 9 months during the postpartum process to have your body and vagina return to normal…and hopefully your sex life too!

How soon can I receive oral sex after giving birth?

For some women, it’s not a matter of “can you”, it’s a matter of “do you” want to have oral sex after giving birth.

After a vaginal or C-section delivery your doctor will tell you “pelvic rest” for 6 weeks which means nothing inside the vagina including tampons, douching, bathes and sex. The reason being is there is an increased risk of infection after having a baby. It takes 6 weeks for the uterus, cervix and vagina to come back to their pre-pregnant state.

Since oral sex involves the outside of the vagina there is less of a concern of causing an infection. Salvia and fingers still carry unwanted bacteria in and around the vagina so be careful and have fun!

How long does it take for a woman’s belly to go down after birth?

After you deliver your baby either by C/Section or vaginally, your uterus and flappy belly skin need time to get back to its pre-pregnant status. Immediately after delivery, the uterus will be at the level of your belly button, which is reminiscent of being 20 weeks pregnant. Even though the uterus is smaller, this allows for more unwanted attention to your stretched, loose and weak skin. Women tend to look pregnant for another 6 to 9 weeks as the uterus and saggy, post-baby belly find their way back to normal.

I always tell my patients give yourself a full 9 months to recover completely after having a baby….after all, you have just gone through a physical, emotional and hormonal storm!

Does having a c-section affect the timing of how long it takes your belly to go down and/or how long it takes for your ab muscles to regain their strength?

Everyday gets a little easier in the recovery of a C-Section. The first few weeks are the most challenging since the body is going through a major physical and hormonal transition. Your ability to move around freely and without experiencing a lot of pain and discomfort in the abdomen and incisional area will be most difficult the first 2 weeks. It takes a good 6 weeks to fully recover after having had a C-Section. There is still ongoing healing taking place as your transition into the “4th trimester”. (as above) I always tell my patients give yourself a full 9 months to recover completely after having a baby….after all, you have just gone through a physical, emotional and hormonal storm!

How long does it take to normalize your hormones after pregnancy?

The least talked about time during the pregnancy cycle is the postpartum period. From the moment the baby is delivered until the body completely recovers is the true postpartum transition period. The exact time for this period varies with each women beginning immediately after delivery and lasting throughout the first year.

The first 6 weeks are definitely the most challenging hormonally, physically and emotionally. Breastfeeding creates a new level of hormonal chaos which I refer to as “breastfeeding menopause”. If you breastfeed for longer periods of time you will feel more out of balance with your hormones. I always tell my patients they get a “pass” for one year following the birth of their baby. Realistically, it takes least 9 months to get your hormones back on track to how you were feeling before you got pregnant. Don’t pressure yourself to get your pre-pregnant body back and create other expectations that you may not achieve.

Life usually gets back to normal as everyone adjusts with an open mind, patience and understanding feel and look like you did before you embarked on the pregnancy journey.

So many major physical and emotional changes are happening in a relatively short period of time and it definitely counts as a major life milestone. Don’t pressure yourself to get your pre-pregnant body back and create other expectations that you may not achieve. Life usually gets back to normal as everyone adjusts with an open mind, patience and understanding.

What are the pros of a postpartum belly wrap, corset or binder?

I prefer women who just gave birth to wear belly wraps and leave the waist trainers for a date night with their partner 6 months after having a baby. Belly wraps play a more supportive role for floppy and redundant skin and a shrinking uterus without creating an over-the-top type of compression. Waist trainers are more of a modern-day corset with the ability to potentially cause more harm than good.

If you had a vaginal delivery a belly wrap can give you additional support and comfort. After a cesarean section belly wraps can support the uterus and belly taking pressure off the abdominal incision. It’s important not to wrap yourself too tight since it might affect the healing of the incision. You need to breath comfortable and not feel restricted in your movements when wearing a belly wrap or waist trainer.

The waist trainer can be used immediately postpartum as long as your doctor gives you the ok. If you had a vaginal or cesarean section delivery the waist trainer can give you additional support, comfort and a thinner appearance.

What are the cons of a waist trainer postpartum?

I have more concerns with postpartum women using a waist trainer during the first 6 weeks of this physically transitional time. The waist trainer can be used safely if it’s not tied too tightly or worn for extended periods of time. When the waist trainer is tied up too tightly it could cause rib fractures, limit your mobility, affect your breathing capacity, restrict your abdominal muscles and affect your posture. If you are working out with your waist trainer it could limit your ability to strengthen your core muscles.

If you had a cesarean section, it’s important not to wrap yourself too tight since it might affect the healing of the CSection incision. You need to breathe comfortably and not feel restricted in your movements when wearing a waist trainer.

Any potential health risks moms-to-be should be aware of?

When the waist trainer is tied up too tightly it could cause rib fractures, limit your mobility, affect your breathing capacity, restrict your abdominal muscles and affect your posture. If you are working out with your waist trainer it could limit your ability to strengthen your core muscles.

Postpartum women who should not be wearing postpartum corset or binders are those who have any signs of a CSection wound infections or other medical complications such as pre-eclampsia (pregnancy induce hypertension) or amnionitis.

Can I wear a postpartum binder or corset if I had a c-section delivery?

If you had a c-section delivery, postpartum corset and binders can cause addition stress and pain on the abdominal incision. If you want additional abdominal support you may want to wait 2 to 4weeks to use these types of binders wraps.

How can I safely wear a postpartum corset or binder?

Comfort is key when using postpartum clothing to hide the weight gain and jiggly skin remanence of pregnancy. Dark/solid colors, soft, stretchy and comfortable cottons, mild to moderate compression fabrics that are seamless, thin with nonbinding edgings are also suggested. Clothing designers who know postpartum women often run hotter in body temperature and use breathable fabrics and know the importance of convenient on and off access to going to the bathroom easily. Some brands offer a built-in inner layer of light support in the tummy, thighs and back that are useful for additional support. Other brands have an open gusset (special “trap door”) that allows frequent trips to the bathroom stress-free.

If you want to wear a postpartum corset or binder make sure your healthcare provider gives you permission to do so. Once you have the green light, wear a loose-fitting binder 2 to 4 hours a day initially to see if it provides the appropriate comfort and support. You can increase the amount of time wearing a postpartum binder by 2 hours each day if you find it’s providing additional comfort and support.

Can belly wraps and waist trainers help me loss weight?

Unfortunately, the claims of belly wraps and waist trainers helping control water retention, weight loss and shrinking the uterus cannot be medical proven. Their best effects are helping provide support for a postpartum uterus and belly.

What is the difference between colostrum and milk coming in?

Colostrum is the first nutrient-rich fluid that comes out of breast to feed a newborn during the first few days of life. It’s protective, high protein, low sugar and fat competition makes it the perfect healthy “meal” for the newborn.

Milk does not have the same rich nutrient composition that colostrum has but is around for the long-haul for a growing newborn.

Both colostrum and milk are protective from diseases, easy to digest and benefit cognitive functioning.

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