Caring for Yourself

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New mothers who are mourning the death of their baby will have many emotions and physical symptoms that can be challenging and confusing.  It is common to feel sadness, anger, disbelief, frustration, and more.  Physical symptoms of grief can include aching arms, nausea, headaches, loss of appetite, sleep disturbances, and fatigue.  

Many physical changes are normal.  
After pains may feel like menstrual cramps.  If this is not your first baby, they may be more intense than you remember from previous deliveries.  This can happen intermittently for several days.  Heating pads, urinating frequently, or using over the counter pain medication may help with the discomfort.  

Vaginal Delivery
If your baby was born vaginally, you will experience dark red bleeding for 2-3 days.  After that, the discharge will become pinkish brown for 1-2 weeks.  A light brownish discharge will often follow for up to 6 weeks.  Call your health provider if you return to bright red bleeding after the first few days, pass clots larger than a silver dollar, the discharge has a foul odor, or you experience heavy bleeding (soaking more than one pad per hour).  Tampons, vaginal medications, or douches should not be used for at least 6 weeks.  Sexual intercourse should be avoided for 6 weeks.  

Easy walking and daily activities are usually recommended after a vaginal deliver.  Physical activity can also increase your discharge.  Avoid heavy lifting, rest often, elevate your feet frequently throughout the day, and decrease your activity level if this occurs.  

Regular periods may begin within 2 or 3 weeks of delivery, but it is also common for them to resume 2 or 3 months after delivery.  It is possible to become pregnant even if your periods have not restarted.  Talk to your health provider about birth control if this is a concern for you or if you should avoid becoming pregnant for any reason.  

Daily showers or baths are acceptable.  Cleansing with warm water after using the toilet can provide comfort and prevent infection.  Change your pad frequently to avoid skin irritation and bacteria growth, usually every 2-3 hours.  Women who have stitches may experience itching and tenderness.  Sitting in warm water can be healing and provide some relief.  These stitches do not need to be removed.  

Cesarean Delivery
If your baby was born by cesarean section (c-section), healing will usually take longer as you are recovering from major abdominal surgery.  You should avoid heaving lifting (more than 8-10 pounds), vacumming, or any activities that strain your incision site.  You should not drive while you are taking narcotic pain medications.  

The bandage is usually removed within 48 hours.  If you are still having drainage from the site, you can apply additional bandages that should be changed daily.  Showering is acceptable after the first bandages are removed.  If you have stitches, they will dissolve with time.  If you have staples, they will be removed by your health provider.  If you have steri-strips, they will loosen and fall off on their own.  

Look at your incision daily for signs of infection.  Contact your health provider immediately if you see the incision has come open, areas of redness or swelling, new drainage, or hard lumps.  If the pain is severe or gets worse after it was improving, you should report it immediately.  Finally, you should call your provider if you have a fever over 101F.  

Bladder and Bowels
It is common to urinate more frequently for the first several days after delivery.  Call your health provider if it hurts to urinate.   The bowels move slower, so a bowel movement may not occur for a few days after delivery.  Constipation and pain can be prevented or lessened by drinking lots of water, eating raw fruits and vegetables, and walking.  Your health provider may also recommend a stool softener.  Call your health provider if you are having trouble having a bowel movement or experiencing severe pain.  

During pregnancy and delivery, it is common to develop hemorrhoids.  These are veins in your anus that may be large and painful.  They may also bleed slightly or itch.  It can be helpful to take warm baths, use witch hazel pads, elevate your feet throughout the day, drink extra fluids, and avoid straining during bowel movements.  Call your health provider if they ever throb, feel hard, or are bleeding heavily.  

Breasts
Your milk will begin to come in within a few days after delivery.  This can be traumatic for somen who are grieving their babies.  Your breasts will usually be swollen and tender.  Contact your health provider if your breast(s) are warm and red, you have a fever over 101F, or you have body aches.  

To lessen the discomfort, wear a supportive bra 24 hours a day (sports bras work well), apply ice packs to the breasts, use breast pads to keep the nipples dry, or use over the count pain medications.  Cabbage leaves or cabbage extract has been used to provide relief as well.  Cabbage extract may be available as CaboCreme.  You may release some pressure by expressing a small amount of milk.  The less often you do this, the faster your body will stop making milk and the engorgement will resolve.  Most women report their breasts returning to normal in about 2 weeks.  

Some women wish to donate their breat milk.  Your health provider or local hospital can give you information about donating to a local milk bank.  

Emotional Care
It is common to have many emotions during this time.   You may find it helpful to talk to friends and family; participate in activities such as yoga, aromatherapy, or journaling; attend a support group or talk to another person who has had a similar experience; or talk to a professional counselor.  Call your health provider or 911 immediately if you have thoughts of hurting yourself or someone else.  

Postpartum depression can occur after any delivery.  It can be hard to know if your emotions are grief or depression.  You should ask for help if your emotions feel out of control, it is difficult to focus on daily activities, you are having trouble sleeping, you feel significant anxiety or panic, you are experiencing new health problems, or your relationships are struggling.  Many of these feelings are common when mourning, but it is appropriate to seek help if they are concerning to you or not slowing improving in a few weeks or months. Reaching out for help is a sign of health and strength.  There are resources available to assist you.  

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