A New Beginning

Postpartum Changes Beyond the First Day

UTERUS After delivery, you can feel the top of your uterus near your navel (belly button). It should feel like a firm grapefruit. This firmness is important because it means your uterus has contracted, decreasing your risk of a postpartum hemorrhage. Nurses

body of the extra tissue and fluid in your uterus that was needed during pregnancy for the baby. It has a distinct earthy smell. Lochia changes in color, consistency, and amount as your uterus heals. It may be heavier when you first stand if you’ve been sitting or lying down because the blood collects in your vagina. Breastfeeding may also increase the amount because your uterus contracts more from hormones released when you breastfeed. Too much activity can also cause a heavier flow. If your lochia becomes heavier, slow down and rest. Only use sanitary pads, not tampons, while experiencing lochia. Tampons can increase the chance of a uterine infection. Do not douche, use vaginal suppositories, or get into a hot tub, swimming pool, or the ocean until your health care provider says it’s OK.

SCAN + PLAY

will check your uterus each shift to ensure that it feels firm. It will be uncomfortable at first, so take deep, slow, relaxing breaths while they check. Northside Hospital does not use warm compresses. • If your uterus feels firm but it is off-center and not near the middle, try to urinate. A full bladder can push on your uterus and may cause you to bleed heavier. • If your uterus feels soft or mushy, tell your nurse and they will gently massage it to prevent you from bleeding heavily. Involution is the process of your uterus returning to its pre-pregnancy size and weight. This usually takes 6 weeks. Women often feel cramping or after-birth pains as the uterus contracts. They are most noticeable the first 3 to 4 days following birth and may last up to 7 to 10 days. After-birth pains are normal but can be uncomfortable, especially during breastfeeding or after the birth of your second or third baby. Let your nurse know if these pains become severe or do not improve with medications or comfort measures. To ease after-birth pains: • Use pain medications that your provider prescribes • Practice breathing and relaxation techniques that helped during labor • Keep your bladder empty and urinate frequently INVOLUTION AND AFTER-BIRTH PAINS

FIRST 1 TO 3 DAYS

• Bright to dark red

• Heavy to medium flow

• May have small clots

ABOUT DAYS 3 TO 10

• Pink or brownish

• Medium to light flow

• Very few or no clots

ABOUT DAYS 10 TO 14 (MAYBE LONGER)

• Yellowish-white

VAGINAL DISCHARGE (LOCHIA) A vaginal discharge called lochia occurs after childbirth. This discharge rids your

• Very light flow

• No clots or bright red color

Tell your nurse if you:

• Soak more than 1 pad in an hour • Have a steady flow that continues over time • Pass clots the size of an egg or larger after the first hour

• Have bright red vaginal bleeding day 4 or after • Notice your lochia has a bad odor • Have a fever of 100.4°F or higher • Have severe pain in your lower abdomen

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A New Beginning