Emotional Changes You May Feel
Postpartum Depression
Common Postpartum Changes
Easy Ways to Relieve Postpartum Stress
When to Call Your Doctor About Postpartum Bleeding
What to Do If Bleeding is Heavy
Afterpains: Normal or Not?
8 Ways to Get Your Urinary System Working Again
8 Tips to Relieve Nipple Soreness
4 Ways to End Postpartum Constipation
5 Ways to Reclaim Your Pre-pregnancy Weight

Thrilled and excited. This is a big moment in your life, a natural high. You may find it hard to sleep, hard to think of anyone but your baby. You and your partner may feel compelled to tell your birth story to anyone who will listen. If there are things that happened that you are still a little confused about, talk them over with your doctor or midwife.

Overwhelmed. The full-time care of a tiny baby is a critically important 24-hour-a-day job, and it's yours now. The job begins when you're already worn out from labor and birth, and it may be months before you get more than three or four hours sleep at a stretch.

Let down. Lows often follow emotional highs. It's natural to feel a bit of a letdown, especially with the new challenges you're facing. You may also feel a twinge of sadness about no longer being pregnant. And even though you are his primary caregiver, you now have to share the baby with your partner, family, and friends.

Weepy. "Baby blues" are probably the result of sudden changes in your life and in your hormones. They strike a few days after the birth. You may feel anxious and worried about your ability to care for your baby, and you may feel guilty about having all these feelings. You should feel better in a few days, especially if you are being well cared for and have lots of support.

"Feeling beat up." You've just been through the most strenuous work of your life. Nearly every muscle, joint, and organ of your body has worked overtime to push the baby out. It's no wonder you feel the effects from head to toe. Depending on the length and intensity of your labor and whether you had a vaginal or surgical birth, expect your body to feel the effects of delivery for at least a few weeks. Your eyes may be bloodshot due to broken blood vessels from intense pushing. You may also have popped a few blood vessels in your face. Your baby's face may have similar marks, but these "spider marks" on baby's face will clear up within a few days; yours may take a few weeks. In the days after birth, you may look and feel washed out, pale, and exhausted.

Feeling faint. For a day or so after delivery it's usual to feel lightheaded and dizzy, especially when changing position from lying to sitting, or sitting to standing. You may feel woozy and wobbly when you walk. The end of pregnancy brings a sudden shift in blood volume and total body fluid; it takes a while for your cardiovascular system to adapt and compensate for changes in position. Until this lightheaded stage subsides (usually after a day), you may need to seek assistance when getting out of bed or walking.

Shivers and shakes. Immediately after delivery many women experience chills and whole-body shakes, probably due to a resetting of the body's temperature regulating system after a long bout of hard work. Rest and ask for warm blankets to cover yourself. These chills should subside within a few hours after delivery.

Bleeding and vaginal discharge. For days, sometimes weeks, after birth, the uterus continues to discharge leftover blood and tissue, called lochia. In the first few days the lochia is usually red, in an amount comparable to a heavy menstrual period, and it may contain a few clots. Toward the end of the first week the amount of lochia usually decreases and it becomes reddish- brown and thinner. In the next few weeks this discharge changes from pinkish to yellowish-white, and you will find yourself changing fewer pads. Any activity that increases the emptying of the uterus, such as standing, walking, or breastfeeding, will also increase the amount of discharge.

• Rest
• Soak in a warm bath.
• Get frequent massages, especially on sore muscles.
• Replenish your body's need for fuel by eating and drinking nutritious foods.
• Hold your baby a lot to get your mind off your body.

• If bleeding continues to be bright red and continues to be a large amount. With each day postpartum the amount of your vaginal discharge should decrease and it should become less bloody.
• If after the first few days you are still soaking a sanitary pad with blood every hour for more than four hours at a time, call your doctor.
• If after a week or so of gradually lessening bleeding, you notice a sudden rush of blood that is bright red and that soaks more than one sanitary pad.
• Passage of golf-ball size clots anytime after the first day. Passing clots the size of a grape is normal for the first few days.
• If the lochia has a persistent foul-smelling odor. Normally, it should have no odor or smell like menstrual blood.
• You're experiencing increasing faintness, paleness, feel cold and clammy, and your heart is racing.
• If the bleeding worries you, don't hesitate to call your doctor.

If you experience heavy and worrisome bleeding, lie flat and place an ice pack over your uterus just above the center of your pubic bone while waiting for a return call from your doctor or while en route to the emergency room. Or place the ice pack against the episiotomy site if the pain and bleeding seem to be coming from there. Usual causes of bleeding are failure of the uterus to contract sufficiently, retained fragments of placenta, or infection. Your doctor will examine you to see if any of these problems have occurred or if what you are experiencing is just normal postpartum vaginal discharge.

Even after birth the uterus must continue contracting to get back to its original size. Uterine contractions also help to pinch off the blood vessels in the uterine lining to control postpartum bleeding. For a few hours after delivery, these contractions may be regular and intense. They will decrease in frequency and intensity over the next few weeks. Afterpains may resemble menstrual cramps or the Braxton-Hicks contractions you experienced in the final few months of pregnancy. They intensify during breastfeeding, since sucking stimulates the release of oxytocin. This hormone is nature's way of contracting the uterus and stopping bleeding. Birth attendants often suggest mothers encourage their baby to suck right after delivery to help the uterus contract.

Afterpains are not usually very intense following a first delivery, but they will be quite noticeable after subsequent births. To cope with the discomfort, use whatever relaxation techniques worked for you during labor. This will help make breastfeeding more comfortable.

1. Drink lots of fluids, at least two 8-ounce glasses of liquid (water or juice) immediately after delivery.
2. Run the water in the sink. Hearing running water gives your system the same idea.
3. Relax your pelvic floor muscles.
4. Be upright. Stand or walk. Allow gravity to help you urinate.
5. Try to relax your pelvic floor muscles as you try to urinate. Try to relax your whole body.
6. Soak your bottom in a warm tub, and urinate right there if that's more comfortable for you.
7. The nurse may massage your bladder (if it's enlarged) to get it going.
8. If your perineum has raw spots from a cut or a tear, ask for a "peri-bottle" (a plastic squeeze bottle). Fill it with warm water and squirt it onto your perineum as you urinate. The water will dilute the urine and lessen the burning.

Leaking urine. It's normal to leak a few drops of urine when you cough, sneeze, or laugh. This "stress incontinence" is a temporary nuisance that occurs while your bladder and pelvic organs are rearranging themselves back to their pre-pregnancy positions. Wear a sanitary pad for a few weeks until this annoyance subsides.

Profuse sweating. Another way your body gets rid of the excess fluids accumulated during your pregnancy is by perspiring more, especially at night. For the first night or two wear cotton clothing to absorb the perspiration and cover your sheet and pillow with a towel to absorb the night sweats. Excessive sweating is most prominent during the first week and gradually subsides by the end of the first month.

Painful perineum. Your sensitive perineum has been stretched to the limit and it may possibly have been bruised or torn. If it has been cut into, it's bound to smart. Ask the nurse to instruct you on "peri-care". Heat increases blood flow and promotes healing; cold numbs pain and decreases swelling. Both measures are necessary to heal a traumatized perineum. The nurse will tuck an ice pack up against your perineum as soon as possible (it will feel so good). She will advise you about soaking in a warm bath and show you how to squirt warm or cool water over your perineum, using a "peri-bottle." Try using cool witch hazel pads between your perineum and the sanitary pad.

Constipation. Your bowels may be as reluctant to work as your bladder is, and for similar reasons. The muscles involved in passing a stool may have been traumatized during passage of the baby. Drugs and anesthetics temporarily cause the intestines to be a bit sluggish; and your bowels were probably emptied naturally by the normal "diarrhea" that normally precedes birth. Besides these physical causes for problems with bowel movements, many mothers have a psychological reluctance to do any pushing with their perineal muscles, either for fear of hurting these tissues or because of a desire to rest them. Yet the sooner you get your intestines moving, the better you will feel. (See )

Gas and bloating. The bowel sluggishness that contributes to constipation also may make you feel gassy, especially if you are recovering from a cesarean section. Drinking and eating frequently, but in smaller amounts, and getting your body moving again, will ease these discomforts.

In the first couple of days postpartum you will notice only slight changes in your breasts. You may even wonder where all the milk is supposed to come from, as you produce only small amounts of the first milk, called colostrum. But then, around the third day, you may suddenly awake with breasts the size of a melon, and nearly as hard. You find that you've grown two-cup sizes overnight. This is breast engorgement. Some mothers find that their breasts become suddenly and painfully engorged, while others, especially those whose babies have been nursing frequently and effectively since birth, experience only a gradual increase in breast fullness. Yes, it's hormones at work again; as estrogen and progesterone levels drop in the days after birth, prolactin -- the milk-making hormone -- takes over. As the breasts begin to do their work, the tissues swell, partly with milk and partly with other fluids. These dramatic breast changes may not have been part of the lovely, peaceful breastfeeding experience you envisioned during pregnancy. After your baby learns to latch on properly and your breasts settle into a comfortable balance of milk production where supply equals demand, you will be well on your way to a gratifying, nurturing experience. If your breasts seem too full for baby to latch-on properly, use a breast pump or hand expression to soften your areola enough that your baby can latch onto more than just your nipple. The best remedy for engorgement is frequent breastfeeding. Nothing relieves breast fullness as quickly as a baby who is nursing well. Frequent feedings will also bring your milk supply in line with your baby's demands

Sore nipples. Most sore nipples are the result of a baby who is not latching-on to the breast correctly. When a baby latches and sucks effectively, your nipple goes to the back of his mouth, away from the tongue and gum action that can irritate skin. Sore nipples are not an inevitable part of breastfeeding. If your nipples are starting to get sore, you need to pay some attention to what's going on during feedings. While you may want to call in some helpers (a knowledgeable nurse, a lactation consultant, an experienced friend, or a La Leche League Leader) for expert advice, you are the expert on your baby.

1. Be sure to break the suction before removing baby from the breast. Press down on the breast tissue, or slide your index finger inside his mouth between his gums. "Popping" a baby off the breast hurts!
2. Nurse on the least sore side first. Nipple pain usually lessens as the milk begins to flow. Switch to the other side after you notice signs of the milk ejection reflex, i.e., milk dripping from the other nipple, a tingling sensation in your breasts, and a change in the baby's suck and swallow rhythm.
3. Try stimulating the milk ejection reflex before you put your baby to the breast, using warm compresses, massage, or gentle pumping.
4. Breastfeed frequently -- every two hours or so during the day. This will lessen engorgement and make it easier for baby to latch on.
5. Let your nipples air-dry between feedings. Express a few drops of milk and let them dry on the nipple. The immunities in your milk will help heal your skin.
6. Use a purified lanolin product (such as Lansinoh) on your nipples between feedings to keep the skin moist so it will heal more quickly. Avoid using preparations that must be wiped off (ouch!) before feeding the baby.
7. Wear an all-cotton bra that fits well, or go braless under a cotton tee shirt. Avoid bras with plastic or synthetic linings that hold moisture against the skin.
8. Nursing pads with plastic in them can aggravate sore nipples. If a pad sticks to your breast, moisten it with water to release it and avoid skin damage.

1. Walk. Moving your body is likely to move your bowels.
2. Drink plenty of fluids.
3. Eat and drink natural laxatives, nectar (prune, pear, apricot), fresh fruits, whole grains, and vegetables. Avoid caffeine-containing foods and beverages, such as chocolate, coffee, and colas.
4. Relax. Don't worry that passing a bowel movement will pop your stitches. While straining may not be friendly to your hemorrhoids, you can start using your perineal muscles as you did before delivery.

1. Figure out your daily basic caloric needs. This means the number of calories of balanced nutrition you can consume to maintain your feeling of well being yet not gain weight. Remember, most breastfeeding mothers will need approximately 500 extra calories for lactation. Most postpartum mothers can eat around 2,000 nutritious calories per day and still expect a gradual weight loss
2. Exercise one hour a day. This could be something as simple as walking briskly while carrying baby in a sling. Brisk walking or swimming for one hour burns off around 400 calories. This exercise plus abstaining from one unnutritious treat each day (one chocolate chip cookie is around 100 calories) means you have a deficit of 500 calories each day or 3,500 calories per week -- enough to lose one pound of body fat. Gradual weight loss is best during breastfeeding. Burning off fat quickly is not safe because the body stores pesticides and other contaminants in fat. Quick weight loss releases these contaminants into your milk.
3. Breastfeeding women often experience their greatest weight loss between three and six months postpartum, when they are producing a lot of milk for their babies. So don't get frustrated if the pounds aren't coming off at first.
4. Chart your weight loss, and tailor your exercise and eating habits to reach the goal you set.
5. Invest in some nice, comfortable clothes that fit your postpartum figure. If you focus only on getting back into the jeans you were wearing nine months ago, you could get very depressed. And no one wants to keep on wearing maternity clothes for weeks after the birth. Some pants or leggings with an elastic waist and a few colorful tops will help you feel better about your still-changing body. Two-piece outfits that are easy to breastfeed in will make it easier for you to get out and around with your baby.