MemorialCare - Your Guide to Postpartum and Newborn Care

PREGNANCY SPACING The amount of time between

giving birth to one baby and getting pregnant with your next baby is called

pregnancy spacing . And it’s an important part of planning your family. In addition to affecting how close your children are in age, pregnancy spacing may also impact the health of you and your next baby. The American College of Obstetricians & Gynecologists (ACOG) issued the following guidelines about how long to wait between pregnancies. • Minimum: Wait at least 6 months. Pregnancy sooner than 6 months puts you at highest risk of serious pregnancy and birth complications, including uterine rupture (if you had a prior cesarean). • Best: Wait until 18 months. Waiting this long gives your body time to fully recover. It also lowers your chances of complications in your next pregnancy, including gestational diabetes, preterm (premature) birth, and low birth weight.

VARICOSE VEINS Varicose veins are soft, blue bulges in your legs that can form during pregnancy. They are caused when the vein walls weaken and swell with blood. Varicose veins usually improve without treatment, although there are some things you can do to help relieve discomfort.

What can help • Elevate your legs to improve blood circulation

• Wear compression hose or socks to reduce swelling • Do low-impact exercises like walking and swimming • Take an over-the-counter pain reliever (ibuprofen, naproxen, acetaminophen)

Signs & Symptoms

SEXUAL ACTIVITY Experts agree that couples should be honest about how they’re feeling about having sex after pregnancy and childbirth. Open communication can help minimize the possibility of frustration or misunderstandings. It’s a good idea to talk with your doctor and make sure you have their approval before putting anything in your vagina. If you had a tear, episiotomy, or cesarean incision, you may have concerns about resuming sexual activity. Tears and incisions can take a full 6 weeks to heal, so you’ll want to share this information with your partner. Ongoing pain may be caused by things like tight scar tissue, muscles that stay tense to protect the area, or changes in hormones. Your health care provider can help determine the cause and recommend the right treatment, which may include pelvic floor physical therapy. Challenges to intimacy Pregnancy and breastfeeding hormones may cause vaginal dryness and reduced lubrication for a few weeks after giving birth. This is completely normal and will improve. If this is a problem, a water-based lubricant can help. If you have trouble with sexual intercourse, always discuss it openly with your partner. Make time for each other several days a week to help enhance intimacy and rebuild a satisfying sex life. Sharing your feelings about sexuality is the most effective way to get and stay close, both physically and emotionally.

Tell a nurse or your health care provider immediately if you have: • Worsening pain • Redness or hardness around veins • Ulceration (open sore) around veins

MENSTRUAL CYCLE You will probably have your next menstrual cycle sometime within 7 to 9 weeks after giving birth. If you are breastfeeding, your cycle will usually return between months 2 and 18. But it’s

important to know that your body may begin producing eggs before your next period starts. This means you could become pregnant again before your next menstrual period! Because of this uncertainty, it’s a good idea to talk with your partner and your health care provider about resuming sex and how to manage the possibility of becoming pregnant again. Getting pregnant again sooner than recommended can be risky for you and your next baby. That’s why you’ll want to read and understand the pregnancy spacing section.

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Your Guide to Postpartum and Newborn Care