Life After Labour

Pregnancy is such a time of preoccupation and preparation;  it can be hard to envisage life after the birth and in the early weeks of new motherhood. HILARY PEREIRA guides you through what to expect and how to cope.

 

For most expectant mums, the idea of giving birth is the most daunting part of pregnancy. By the time you come to give birth, you may feel you’ve been on something of a nine-month long rollercoaster ride of ups and downs, highs and lows. Hopefully, your birth will have gone smoothly and you’ll finally be feeling the overwhelming sense of achievement and recognition – as well as powerful love – that comes from giving birth. So what next?

How you may feel immediately after the birth… Emotionally

Joy and tears

Many news mums report feeling euphoric immediately after the delivery of their babies, and this is largely due to the exhilaration of finally meeting their newborns as well as a rush of oxytocin, the pregnancy hormone that floods in after a vaginal delivery. Some women, however, feel battered, bruised and emotionally shattered as a result of the birth, and those who’ve had Caesareans – especially under emergency circumstances – may not feel an immediate bond with their babies because of a lack of oxytocin. It’s by no means inevitable, though, and in some cases even the most traumatic of births can’t detract from the sheer joy of new motherhood. In other words, there’s really no predicting how each individual mum will feel, but don’t worry if the love doesn’t come immediately.

Baby blues

Some mums spend the early hours after delivery in tears, or are perfectly joyful for the first day or so, then find themselves very tearful and down. This is known as the ‘baby blues’ and is a common reaction to your hormones undergoing a sudden readjustment, and should last only a few days. If you feel depressed, very sad or continually tearful after a week, though, do seek help.

Tiredness

Do expect to feel physically and mentally exhausted, especially if your labour has been prolonged or if you’ve had injectable pain relief, which can leave you feeling drowsy. Your baby may also be a bit drowsy if you’ve had this type of pain relief, as it does cross the placenta, so expect a few false starts when you first try to feed him.

After Caesarean

If you’ve had a Caesarean, you may feel as if you haven’t given birth ‘properly’, especially if you had to have a general anaesthetic. This can make it harder for the emotional connection with your baby to be established. Some new mums have even described feeling like failures as their bodies ‘let them down’ when it came to delivering naturally. The thing to focus on here is that you have a beautiful new baby – and the mechanics of how that came to be are really irrelevant now he’s finally here. Cuddle him close, try to breastfeed, enjoy skin-to-skin contact and let the love grow.

…And physically

Down below

If you’ve delivered your baby vaginally, you may have suffered a tear to your perineum (the area of tissue between your vagina and anus) or you may have had an episiotomy (a cut performed by your midwife to facilitate delivery of your baby). Any stitching is performed straightaway after the third stage of labour (delivery of the placenta) and many mums report having no memory of this procedure. You’ll have been given a local anaesthetic to your perineum in any case, so you shouldn’t have felt any pain. As the anaesthetic wears off, though, you’ll feel sore and bruised. Lots of new mums with stitches feel a bit apprehensive about going to the loo. You’ll find it helps if you use a maternity pad to support your stitches until you’re more confident.

Bleeding

You will bleed quite heavily at first following delivery. This is the thick lining of your uterus shedding now that your baby no longer needs it. You may see blood clots as well as fresh red blood. You should show your midwife any clots that are larger than about two centimetres in diameter, though, as this could indicate that a piece of placenta has been left behind, and this will need removing, if so. No need to feel embarrassed – they’re used to inspecting maternity pads. Expect to bleed for up to six weeks, with the flow gradually reducing. Eventually it’ll turn a thinner consistency, turn pink rather than red and then turn brownish before subsiding altogether. You’ll need plenty of maternity pads in the early days, and it’s a good idea to wear paper pants, too, rather than ruining all your good knickers.

Boobs

Your boobs will be producing colostrum now – the first, highly nutrient-rich creamy substance that will feed your baby for the first few days. After two or three days your milk will ‘come in’ – meaning it’ll fill your breasts and they may feel a bit like over-inflated footballs! Don’t worry: if you have problems latching your baby on because they’re over-full, ask your midwife to show you how to express a little milk to make the tissue a little softer and the nipple a bit more pliable. If you’re not planning to breastfeed, your milk supply will dry up quickly but, in the meantime, your breasts will feel engorged and uncomfortable. Wearing a supportive bra and taking paracetamol should help.

Tummy

Your belly will feel soft, loose and jellylike immediately after birth and for some weeks afterwards. This is perfectly normal, and there’s no need to feel inferior if your tummy doesn’t spring straight back to ironing-board flat, like so many celebrities would have us believe has happened to theirs! you may find you never quite regain your pre-pregnancy shape, but the weight will drop off if you breastfeed and if you’re careful about what you eat and try to get back into a little light exercise gradually. You’ll be shown some postnatal exercises to help strengthen your abdominal muscles so they come back together. Don’t ignore these important exercises.

Caesarean scar

If you have a Caesarean scar, keep a close eye on how it’s healing. You should have a midwife coming to check it for you once you’re home, and she’ll be able to see if there are any problems, but if between visits it becomes very sore or feels hot and the surrounding skin looks red, or if it oozes pus or you develop a fever and feel unwell, seek medical help straightaway as you may have developed an infection. The scar will take about six weeks to heal, during which time you should avoid driving (unless your insurance company is happy for you to do so) and try not to lift anything heavy.

The early weeks

Getting to know each other

Once you start to recover physically and emotionally from the birth, you can begin to focus on really connecting with your baby. At first you may feel that you don’t know how to cope or where to start with being a mum, but give yourself and your baby time and you’ll find a rhythm that suits you both. Remember: your baby’s needs are very limited at the moment, although critical. As long as you feed and change him regularly, you’re fulfilling his basic requirements. Obviously, the more time you can spend cuddling him and getting to know him, the better, but don’t panic if the love takes a little while to grow. Involve your partner and extended family and friends in your baby’s care as much as you can; it’ll take the pressure off you and allow you some time to adjust to your new role.

Breast or bottle?

There’s no question that breastmilk is best for your baby; it’s perfectly formulated to give him everything he needs – he doesn’t even need water, as it’s both food and drink for him. If, however, you just can’t get along with breastfeeding or it simply doesn’t feel right for you, formula milk is a very good substitute and your baby will still thrive on it. The important thing is that you make the right decision for you – don’t feel pressured to give your baby a bottle because breastfeeding hasn’t got off to a flying start. Ask for help and guidance from midwives, a breastfeeding counsellor or another experienced breastfeeding mum. Try expressing and feeding your baby milk from a bottle or special feeding cup. Or, if you instinctively feel that bottle-feeding is right for you, go ahead and get started without feeling guilty.

Finding a rhythm

If you’re breastfeeding, it’s best to feed on demand for the first few weeks and months. your baby is unable to manipulate you at such a young age and needs the reassurance that you’re there for him whenever he needs feeding. Bottle-fed babies tend to fall into more of a routine more quickly. Once your baby has stopped, more or less, sleeping round the clock, try to set some sort of routine in place. The earlier your baby catches on to set things happening at set times of day (feeds, daytime naps, wakeful time, bathtime, and so on) the better. It doesn’t have to be set in stone at first, but it’ll give him a sense of security, and help you to feel more organised and find a little time for yourself, if you have some kind of routine laid down.

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