Little moments, big questions... Let us help you get off to a great start.

July 6, 2016

Jana’s Birth Story: Trauma and Recovery

Birth is a powerful moment for women. Our birth stories become part of us; something we will carry in our hearts until we leave this earth. Ask any elderly woman and undoubtedly she will remember the details of her baby’s birth.

 

But not all births go as planned… Some women are traumatized, reliving what has happened to their body and to their mind. Supporting women who have been traumatized brings back memories of my own birth story.

 

Jana’s story

My story took place over 18 years ago, yet there are moments of the experience that are as vivid as if they happened last week.

…The panic in my mother’s voice as we were stuck at the red light, the beach towel between my legs saturated with bright red blood.

…The image of my mother waving her arms out the window telling the driver in front to get out of the way as we needed to get to the hospital quickly.

…The feeling of floating as it all drifted away.

 

The trauma in my story happened when my daughter Bryn was 14 days old. My delivery and recovery had been uneventful up to that point. As a nurse, I knew that the gushes of bright red bleeding were not normal, especially when they continued past a week. My doctor sent me for an ultrasound to make sure there were no bits of placenta left in my uterus. When a third person was brought in to examine my ultrasound, I knew that something was up.

 

I was diagnosed with an arteriovenous malformation, basically arteries and veins twisted together and bulging into my uterus. The diagnosis happened on a Friday. I was to return Monday morning to see if it was getting larger or smaller.

 

Sunday night, I prepared supper for my mother, aunt and uncle who were visiting that day. My husband was working late. For some strange reason I remember we were having spaghetti. As I sat down at the table to eat, I felt a small popping sensation, then warm liquid running down my legs. I was bleeding heavily.

 

Thinking it was quicker than calling an ambulance, my mom drove me to the hospital. Thankfully my aunt and uncle were there to stay with my baby. They reassured me that they would be able to prepare formula and give Bryn a bottle if needed. This was something I never wanted to do but sometimes you don’t get to choose.

 

It was only a 6 minute trip to the hospital. We learned that a lot can happen in 6 minutes. My first memory after watching my mom hanging out the vehicle window, yelling for drivers to get out of the way is of bright lights. Not THE bright light, but the light of the trauma room in Emergency.

 

My poor husband was called out of a meeting and told his wife was hemorrhaging. He needed to pick up Bryn and come to the hospital immediately. This experience was so traumatic for him that I was almost unable to convince him to have another baby. (I say “almost” because three years later my son Brett arrived. I got my happy ending.)

 

Memories too painful to forget

Before my happy ending however, there was a nightmare that no one should have to endure. There are memories I won’t forget:

  • my mom trying to help me latch my hungry daughter to my breast.

I was passing out due to blood loss. My bed was tilted downward with my head much lower than my feet. My mom held my daughter nearly upside down as I tried to feed her. My determination should have been my first clue that I would become an International Board Certified Lactation Consultant the following year.

  • hearing the beep on the blood pressure machine and knowing the numbers were much too close to zero.

This “holy crap I might die” moment will never leave me. The memory makes me teary even as I write this 18 years later, especially as I can now look back and realize what I would have missed.

  • the desperation in the voice of the lab tech.

He recognized the severity of my situation. My veins were collapsing, despite the 5 IV’s pumping saline into my body.

  • the experience of being a patient when you are a nurse.

Being given a warm blanket when I felt chilled to my inner core. Having my nurse care enough to share her tears when the bleeding stopped.

  • my grief as the head nurse told me about Sheehan’s Syndrome.

A potential complication of severe hemorrhaging is that your body may be unable to make milk for your baby.

  • my desperation to make my nurse promise to wake me every 3 hours to double pump.

I needed to tell my saline overloaded body that Sheehan’s syndrome would not stand a chance. I was challenged to make  myself upright enough so I could pump, but reclined enough so that I would not pass out!. After 2 weeks, my body began to make milk again and we went on to breastfeed for the next 2 years.

  • I remember lying in bed and learning of Princess Diana’s death and thinking that we could have died the same day.

I also heard about a new mother who lived 1 ½ hours out of my city. She had hemorrhaged the same day but wasn’t so lucky. Hearing of her death made the severity of my situation real.

 

…I am so grateful.

—  Jana

Jana and Bryn today

Jana and Bryn today

 


thumbnail-cindy-and-jana

Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.

1 comments

February 25, 2016

Postpartum Depression and Anxiety: What You Need to Know!

 

 

“I have all but 4 of the risk factors! Why didn’t I hear about this during my pregnancy?? I could have prepared myself”

 

 

Postpartum depression affects 1 out of every 4 or 5 women.

 

If you are experiencing postpartum depression and/or anxiety, you are not alone. 1 out of every 4 or 5 women will experience it in the first year after childbirth.

You are also not to blame! You did not bring this on yourself!

 

Having a baby is the biggest change a woman will experience in her lifetime.

  • She is suddenly responsible for keeping another human alive, 24 hours a day.
  • Her sleep is interrupted; she will feel sleep deprived.
  • She may be in pain.
  • Her hormones are shifting after giving birth.
  • She has lost the freedom to come and go as she pleases.
  • She has lost her former identity.
  • Her schedule is no longer predictable or structured.

 

ALL new mothers are overwhelmed! Caring for a newborn is a big job. It is no wonder this can be a high risk time for the flare-up of anxiety and depression.

 

What are the risk factors?

There are predisposing factors that can make this time of adjustment even more of a challenge. These include:

  • lack of available support people in her life.
  • isolation.
  • marital tension.
  • a demanding, colicky or “high-needs” baby.
  • being a perfectionist.
  • previous history of depression or anxiety.
  • a difficult pregnancy.
  • a traumatic birth.
  • mothers of multiples (see this fact sheet).
  • additional major life stressor (e.g. financial problems, ill family members.)
  • history of trauma or abuse.
  • history of loss (e.g. miscarriage, stillbirth, death of a loved one.)

 

What can help:

  • Talk with your loved ones or a trusted friend about how you are feeling.
  • ppd help is availableSpeak to your healthcare provider and ask for help.
  • Find a support group in your area.
  • Be good to yourself; take time to care for yourself.
  • Do some physical exercise.
  • Ask for and accept help with household tasks.
  • Rest as much as you are able.
  • Try to have a healthy diet.
  • Take medications as prescribed by your doctor.

 

 

To learn about the symptoms of postpartum depression and anxiety, visit these posts from the Postpartum Progress website:

The Symptoms of Postpartum Depression & Anxiety (in Plain Mama English)

6 Surprising Symptoms of Postpartum Depression and Anxiety

 

 If you or someone you love is suffering, please talk to someone.

 

Want to read more? Click here to read about Tamara’s Journey through Postpartum Depression and learn what was helpful in her recovery.

 

ppd blog post and pinterest

References and More Information:

  1. Frequently Asked Questions About Postpartum Depression.” Postpartum Progress. N.p., n.d. Web.
  2. Haddon, Lynda P. “Postpartum Depression and Mothers of Multiples.” N.p.: Multiple Births Canada, 2007. Print.
  3. The Postpartum Journey.” Pacific Post Partum Support Society. N.p., n.d. Web.

 

phpTJhnGTPMCindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.

Download their app NuuNest – Newborn Nurse Answers and Baby Tracking for expert guidance through the first crucial weeks after childbirth.

1 comments

February 17, 2016

Sex After Baby: When and How?

If you have just had a baby, romance may be the last thing on your sleep-deprived mind. While your partner may be still “in the mood”, you may be willing to trade romance for the chance to get more sleep. The thought of being intimate in an area recently evacuated by a baby can be downright scary.  When will the time be right and how will it ever be comfortable?

 

Sex-After-Baby

 

 

When?

 

There is no exact answer as to “when”. The type of delivery (vaginal vs. c-section), medical complications and whether you had stitches or the use of forceps impact how quickly you will heal.

A general recommendation is to wait 4-6 weeks after birth. This allows time for vaginal bleeding to stop, the cervix to close and the uterine lining and any stitches to heal. Many women wait until their 6-week check-up to get the green light from their health care provider.

 

How?

 

We know that you know ‘how’ (you had a baby after all!), but “how after baby” can be a bit different. These tips may help:

  • Hormonal changes, lack of sleep and adjusting to your new role takes a toll.  Your sex drive may not be what it used to be. You may feel ‘touched out’ by caring for your newborn. Talk to your partner and go slowly. Cuddling is a great start; progress when you are ready.
  • Your vagina may be drier. Using a water based lubricant during sex will make you more comfortable
  • If you are not ready for another pregnancy, be sure to use birth control. It is possible to get pregnant before your first menstrual period. There have been babies born 10 months apart!
  • Experiment with different positions. Find one that avoids putting pressure on tender areas. Your body will continue to heal and sex will become more comfortable over time.
  • Be creative. If you are too tired at bedtime, try the morning or afternoon!
  • Do your Kegels. Increasing the muscle tone of your pelvic floor is good for all sorts of reasons (enjoyment of sex included).

Note: Oxytocin (a hormone that causes your milk to let down) is released during orgasm. This letdown of milk may catch you by surprise!

 

Talk to your healthcare provider if:

  •   a lack of sexual desire persists (postpartum depression can be one of the reasons).
  •   sex is painful.
  •   you have foul smelling vaginal discharge (you may have an infection!).

Romance is important! Intimacy helps you remember you are not just “mom and dad”. Communicate your wishes and your fears and encourage your partner to do the same. Having a baby is a time of huge adjustments for you both!

 

Learn more about recovery from birth: Vaginal Birth Recovery: Answers to Top 10 Questions and Answers to the Top 10 Questions after a Cesarean.

 


 

 

Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.

Download their app NuuNest – Newborn Nurse Answers and Baby Tracking for expert guidance through the first crucial weeks after childbirth.

0 comments

January 8, 2016

Bleeding After Birth: What’s Normal and What’s Not

 

Whether you deliver vaginally or by C-section, you will have period-like bleeding after birth. Healthcare professionals refer to bleeding after birth as ‘flow’ or ‘lochia’. The bleeding comes from a raw area where the placenta was attached. Your body controls the bleeding by squeezing down or ‘contracting’ the uterus.

Breastfeeding helps to control this bleeding. As your baby nurses, the hormone oxytocin is released, causing the uterus to contract. These contractions can be quite painful and are referred to as ‘afterpains’.

If you have had an episiotomy or tear, there may also be a little bleeding from this site, but it is typically insignificant. The majority of the bleeding after birth comes from the uterus.

 

BleedingAfterBirth

 

How long do you bleed after giving birth?

For the first three or four days after birth, you can expect to have bright red bleeding, about as heavy as a menstrual period.

By three or four days after birth, the bleeding typically becomes more watery and pinkish in color. You may go back and forth between the pinkish and the more blood-like flow for a few days, especially if you are more active. If your bleeding becomes bright red and heavy again, you may be overdoing it. Try resting to see if it subsides. Bleeding that stays bright red past the first week is unusual.

Around 8-10 days after birth, the pinkish flow typically gives way to a thicker yellowy white discharge.

A little bit of flow or spotty bleeding may occur for 6 weeks after baby’s birth, but for most women, it will resolve sooner.

Seek medical attention immediately by going directly to the closest emergency room if you entirely soak a large maxi pad (from front to back) in less than an hour.

Consult with your healthcare provider if you:

  • have bright red heavy bleeding for more than a week after birth.
  • pass a clot larger than a loonie ($1.00 Canadian coin).

 

Can tampons be used?

Tampon use is not recommended for at least 6 weeks after both C-section and vaginal births, as it increases the risk of infection in your uterus. Give your body to time to heal.

 

Are blood clots normal?

It is not unusual to pass a few small blood clots after giving birth. Blood can pool and jell inside the vagina when you are sitting or lying down. Changing your position causes the clots to pass.

Blood clots are usually dark red or maroon in color and have a jelly-like appearance. Clots the size of a $1.00 Canadian coin (“loonie-sized”) or smaller are considered normal.

If you pass a whitish stringy clot, it may be a piece of placenta that was left behind when you gave birth. If more bits are left inside your uterus, you can develop heavy bleeding or infection.

Notify your healthcare provider if you notice any of the following:

  •      Increased cramping or pain in your lower abdomen or back
  •      Fever or chills
  •      A ‘rotten’ odor to your flow. (Note: If you are unsure if your flow has a foul odor, chances are it doesn’t; it is usually quite obvious!)

 

Whether you have delivered vaginally or by C-section, your body needs time to heal. Please don’t rush your recovery.

 

Learn more about recovering from birth in these posts:  Vaginal Birth Recovery: Top 10 Answers You Need To Know and Answers to the Top 10 Questions after a Cesarean Birth.


 

phpTJhnGTPM

About the authors:

Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.

Download their app NuuNest – Newborn Nurse Answers and Baby Tracking for expert guidance through the first crucial weeks after childbirth.

0 comments

October 8, 2015

Depression after Weaning

“I’ve never suffered from depression but since I’ve weaned, I think I might be. Can depression be triggered by weaning?”

 

Depression CAN occur after weaning a breastfed baby. It is not well understood and is not often discussed.

 

Mothers tell us:

 

“The weaning process was very emotional for me. I cried just about every day. It was the kind of “down” that I couldn’t control or talk myself out of. It was overwhelming to know it was the end of something I had treasured so much.”

“I stopped breastfeeding when I found out I was pregnant again. I felt really sad and cried a lot because it was not easy on either of us. I didn’t realize you can continue to breastfeed during pregnancy. I feel really guilty. It kind of consumes me.”

 

Depression after weaning a baby

 

Postpartum depression is known to affect 1 out of every 4 or 5 mothers. It doesn’t always begin immediately after birth but can begin anytime in the first year. (Read more postpartum depression here.)

 

Is depression after weaning part of the postpartum depression continuum or is it something separate? We aren’t sure. We do know that depressed mothers are at risk for discontinuing breastfeeding.

 

 

 

Why does depression after weaning occur?

From a hormonal perspective, it makes sense. Breastfeeding stimulates the production of hormones such as oxytocin, also known as the ‘love hormone’. In its absence, especially after abrupt weaning, mother’s mood may plummet.

 

Women wean their babies for a variety of reasons. Depression after weaning may, in part, be influenced by the reason for weaning.

  • Mothers may wean due to ongoing pain and trouble establishing breastfeeding. (Breastfeeding difficulties are known to increase the risk of depression.)
  • Others may be forced to wean abruptly due to a medical reason.
  • Still others may wean after a long and satisfying breastfeeding relationship.

 

Despite the reason for weaning, women may experience a sense of loss and grief. These feeling are usually short lived and subside within a few weeks. They can be exacerbated, however, if a mother feels she has ‘failed’ at breastfeeding.

 

If you are currently in the process of weaning, a gentle weaning approach, if possible, may be protective. Slowly eliminate one feeding every few days; allow yourself to be flexible with the timing.

 

How common is depression after weaning?

Again, we aren’t sure. We do know that women with a history of depression are more at risk for both postpartum depression and post-weaning depression.

 

Symptoms of depression

Not all women experience depression in the same way. Everyone’s journey is different. Women often describe feeling:

  • Overwhelmed
  • Sad
  • Guilty
  • Worthless
  • Hopeless
  • ‘Lost’
  • Disconnected
  • In a ‘fog’
  • ‘Numb’

Women may also report:

  • Being easily irritated or annoyed; quick to become angry.
  • Difficulty sleeping when they have the chance (or they may find themselves sleeping all the time).
  • Crying often.
  • Lack of appetite (or consistently overeating).
  • A loss of interest in things they used to enjoy.
  • Thoughts of harming themself or their baby.
  • Difficulty focusing on tasks, remembering information and making decisions.

 

What helps?

Knowing that depression can occur after weaning is the first step.

  • Find a trusted friend to confide in. Talk about how you are feeling.
  • Get some exercise, even if it is only walking around the block.
  • Try to get outside, into the sunshine.
  • Be kind to yourself; try to do something for yourself every day.
  • If these feelings persist, talk to your health care provider.

 

Weaning is a change in the feeding relationship between you and your baby. Your emotional relationship will continue. It may look and feel differently, but it will continue to remain strong.

 

Learn more about depression in these posts: 12 Insider Truths About Postpartum Depression and Anxiety and Myths of Motherhood.


thumbnail cindy and jana

Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.

Download their app NuuNest – Newborn Nurse Answers and Baby Tracking for expert guidance through the first crucial weeks after childbirth.

 

0 comments

July 23, 2015

12 Insider Truths About Postpartum Depression and Anxiety

We have the privilege of working with women who are journeying through postpartum depression and anxiety. They have taught us many valuable lessons about what it means to be a woman and a mother. Here are 12 of the most important lessons learned.

 

 

12 Important Truths about Postpartum Depression and Anxiety

 

 

1.  Postpartum depression and anxiety can happen to anyone. Your race, your occupation, your religion and your social status do not guarantee protection.

 

2.  The postpartum period is a time of huge risk for a flare up of anxiety or depression. Becoming a mother is the biggest life change a woman will encounter. Sleep deprivation, coupled with lack of time for usual coping strategies, compounds the risk.

 

3.  Talking about postpartum depression and anxiety is important. Making others aware of its existence helps to remove the stigma and encourages women to get the help they need.

 

4.  Not all women feel a connection to their baby at birth. This can especially be true for those who have had a difficult or traumatic birth. Some begin to feel bonded within a few hours while others take weeks or even months. It is hard for struggling women to believe but the feelings WILL come.

 

5.  Women with postpartum depression and anxiety are adept at putting on a ‘mask’. Outsiders may not realize they are suffering. It takes an incredible amount of energy to maintain this mask.

 

6.  Women are strong, even though they may not feel it themselves. Postpartum women have an incredible desire to become well again.

 

7.  Postpartum depression and anxiety are isolating. Women gather strength when they learn they are not alone.

 

8.  Sleep is important in recovery. When women begin to get more sleep, their symptoms begin to improve.

 

12 Lessons we have learned about postpartum depression and anxiety.

 

9.  Recovery is not a straight upward path. There will be bumps along the way. This is discouraging to a woman who feels she had been improving. Although dips in mood may come as you recover, these dips will not be as low, and will not last as long.

 

10.  Women who planned to breastfeed, encountered difficulties and had to stop breastfeeding are most at risk to develop PPD. Be kind to yourself. You are still a wonderful mother, even if you have to use formula.

 

11.  Not every doctor or healthcare professional is knowledgeable about postpartum depression and anxiety. If you are not getting the help you need, keep reaching out. Speak to another health care professional. Help is available.

 

12.  Every woman’s journey will be different. No two women will follow exactly the same path for recovery. Some may require medication, some may require counselling for trauma in their past. All can benefit from the unwavering support of people in their lives.

 

If you are suffering from postpartum depression and anxiety, please know you can and WILL feel better. Please reach out for help.

 

Other posts you may find helpful: Postpartum Depression and Anxiety: What You Need to Know! and Postpartum Depression Recovery: Tamara’s Story.

 

References and More information:

  1. Frequently Asked Questions About Postpartum Depression.” Postpartum Progress. N.p., n.d. Web.
  2. The Postpartum Journey.” Pacific Post Partum Support Society. N.p., n.d. Web.

 


thumbnail cindy and jana

Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.

Download their app NuuNest – Newborn Nurse Answers and Baby Tracking for expert guidance through the first crucial weeks after childbirth.

0 comments

July 2, 2015

Answers to the Top 10 Questions after a Cesarean Birth

One in every four or five babies in North America will be born by cesarean section (C-section). Sometimes, the C-section is planned in advance; others are done with little or no warning due to last minute complications.

Regardless of the reason, if you have given birth by C-section you will need more recovery time than a woman who has given birth vaginally.  Your questions will also differ. (For answers to questions after a vaginal birth see this post.)

Here are answers to the top 10 questions women ask after their C-section birth.

Answers to the Top 10 Questions after a C-Section Birth

 

1)   How will I control the pain?

 

You will have pain after your C-section but there are excellent medications to make you comfortable. Take your pain medications regularly to stay ahead of the pain, rather than waiting until you are already uncomfortable. If your pain is under control, you will be able to walk, move around and care for your baby more easily.

 

When you are ready to be discharged from the hospital, you will be given a prescription for medication you can use at home. Be sure to take a dose of pain medication before you leave the hospital. Getting home and settled in involves a lot of movement.

 

Once you are home, you may find it helpful to have a written medication schedule, or a phone reminder to take your next dose. You will have better pain control if you take more medication before the last dose has completely worn off.

 

Learn about medications and breastfeeding in this post.

 

How will I control the pain Answers to the Top 10 Questions after a C-section.

 

2)   How will I know if my incision is infected?

 

The first sign of an infection is usually increasing incisional pain, despite taking the same amount of pain medication. Other signs include:

  • fever
  • redness of the skin around the incision
  • thick yellow or yellowish-green drainage (pus)

 

A small amount of bleeding or pinkish colored drainage from your incision can be normal: it is important to watch the color of the drainage. If you notice thick pus, be sure to contact your health care provider.

 

The stitches you can see on the outside hold only the outermost layer of skin together. There are multiple layers of sutures underneath. If the outer skin edges of your incision  separate slightly, don’t be alarmed. It is important, however, to watch for signs and symptoms of infection (reddened skin, fever, thick yellow or green discharge). If the separation appears to be deeper than just the skin edges, notify your doctor.

 

3)   Will I be able to breastfeed?

 

Yes! You can breastfeed as soon after surgery as you are comfortable. Most C-sections are done with an epidural or spinal block. With this type of anesthesia, you will be awake but free from pain. Many hospitals are beginning to put baby on mom’s chest in skin to skin contact after a C-section birth.

If you had a general anaesthetic for your c-section, you may breastfeed as soon as you are awake.

It can be more challenging to find comfortable nursing positions after a C-section birth. Many women like to use the football hold, side lying or laid back positions as it keeps the weight of baby off their incision.

 

P.S We’ve created a free ebook to help pregnant women get ready for breastfeeding: “5 Crucial Ways to Prepare for Breastfeeding.” Download it here.

 

4)   Why am I feeling so emotional?

 

Women feel emotional after the birth of their baby! Sometimes the emotions may be those you were expecting: euphoria, instant love. Other times, the emotions may not be what you expected. If your C-section was unplanned, you may feel even more emotional. Some women feel their body has let them down. Others report feeling a dull, flat or disappointed feeling after birth. Still others are embarrassed to admit they feel no connection to their baby.

Having a baby can be a very overwhelming experience. There is no right or wrong way to feel. A difficult delivery, or one that didn’t go as you envisioned may make it worse. Talk to your loved ones or your health care provider about the way you are feeling. Please know that even if you feel disconnected from your baby, feelings of connectedness will come in time. Taking time to rest and care for yourself is important.

Postpartum blues are common in the first few weeks. If these feelings do not resolve in the first few weeks or the symptoms worsen, you could be suffering from postpartum depression and may benefit from treatment and a support group. Please talk to your loved ones and your health care provider about the way you are feeling.

 

 

5)   How soon can I resume regular activity?

 

Even if you do not feel like it, it is important to get up and begin moving within 24 hours after surgery. Get assistance, as you might feel a bit weak at first. Start with just a few steps and gradually increase the distance you walk. Walking is important to keep the blood circulating in your legs and to lessen the chance of developing a blood clot. Walking also helps to get your bowels moving. Your body will tell you if you are overdoing it. If your blood flow increases in amount or becomes bright red, you may be doing too much.

When can I resume excercise after a c-section Answers to the Top 10 Questions after a C-section

 

6)   How much weight can I lift?

 

You have had surgery involving your abdominal muscles. Heavy lifting heavy can put too much strain on your incision. Try not to lift anything heavier than your new baby for at least the first 3 weeks (some doctors would suggest 6 weeks). Pay attention to your body. If it seems like too much, it probably is.

 

 

7)   When can I drive?

 

It may take 3-6 weeks before you can comfortably resume driving. Pushing on the brakes or turning your body to shoulder check can be hard on your incision. Do not drive if you are taking narcotics for pain.

 

 

8)   When can I have a bath or shower?

 

Once your dressing has been removed (usually 24 hours after surgery), you can take a shower. This will help to keep your wound clean. Gently pat your incision or allow it to air-dry. (Some women use a hair dryer on the low setting to dry their incision.) If you find your tummy folds over your incision, hold your abdomen back to expose it to allow air. Do not soak in a bathtub for at least 2-3 weeks as this can increase the chance of infection.

How soon can I have a bath or shower Answers to the Top 10 Questions after a C-section

 

9)   What if I have to cough or sneeze?

 

After a C-section, coughing or sneezing can be painful! Using a small pillow or a folded towel, put gentle pressure on either side of the incision as you cough. This will help to lessen the discomfort.  Keep your pillow or towel close by; you never know when you are going to need it!

 

 

10)  Will I have vaginal bleeding?

 

Many women are surprised to learn that they will have vaginal bleeding after a C-section. The bleeding comes from the place where the placenta was attached to the uterus and from the sloughing of the lining of the uterus. The bleeding is lighter than after a vaginal delivery and usually only lasts up to 6 weeks.
Recovery after a C-section takes time and will vary from mother to mother. Try to be patient with your body throughout this healing time.

 

 

Other suggested posts: How to Know When Fatigue is More Than Just Fatigue and 6 Tips for Surviving the Newborn Period.


thumbnail cindy and jana

 

Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.


 

 

3 comments

May 1, 2015

Vaginal Birth Recovery: Top 10 Answers You Need To Know

After a vaginal birth, you will have tons of questions! Much of your time and energy will be spent focusing on your newborn. It can be easy to forget that you have just been through labour and delivery. You may have some special questions and concerns of your own. 

Here are the answers to the top 10 questions women ask after a vaginal birth. (We answer the top questions after a C-section in this post.)

Answers to the Top 10 Questions after a Vaginal Birth

1) How long will I bleed?

Blood flow can last for up to 6 weeks after baby’s birth but for most women, it will subside sooner.

  • For the first few days after baby’s birth, your blood flow will be bright red and about as heavy as your menstrual period. You may notice a small gush when you stand up after sitting or lying down. Although this may seem alarming, it can be normal. The blood can pool in your vagina while you relax. When you suddenly change position, it comes out in a ‘gush’. If you have flow so heavy that you completely soak a maxi pad, from front to back, in less than an hour, you need to seek medical attention.
  • By the time baby is three or four days old, your blood flow should start to become more watery and pinkish in color.
  • By 8-10 days after delivery, your blood flow should be mostly yellowish-white in color.

If your flow had subsided but it becomes bright red and heavy again, it could be your body’s way of telling you that you are overdoing it. Try resting to see if it subsides. Bleeding that stays bright red past the first week is unusual; see your healthcare provider.

2) Are blood clots normal?Are-blood-clots-normal2-254x300

Occasional small blood clots are normal. By “small”, we mean clots the size of a $1.00 Canadian coin or smaller. Blood clots are dark red in color and appear jelly-like. After passing a clot, it is important to watch your blood flow carefully for the next hour. If you should completely soak a maxi pad, from front to back, in less than an hour, seek medical attention immediately (go to the closest emergency room).

It is rare, but a piece of the placenta can be left behind in your uterus after you give birth. When you pass this tissue, it will appear whitish and stringy. Monitor your symptoms a little more closely with this type of clot, as you are more at risk to develop heavy bleeding and infection.

3) How do I take care of my stitches?

  • Keep them clean:

Not all women get stitches after a vaginal birth but if you do, you will need to keep them clean to prevent infection. Use a squirt bottle filled with warm water to clean your bottom after using the washroom. If your stitches sting when you pee, try squirting water as you pee to see if that removes the sting. Drink enough water to keep your urine dilute, as it will then burn less. Your urine should be colorless and not yellow!

  • Decrease swelling:

If your bottom is swollen, using an ice pack during the first 24 hours can be helpful. Some women put water on a sanitary pad and freeze it to use as an ice pack.

  • Soak your stitches:

Soak your stitches in a tub of warm bath water 2 or 3 times a day. This helps to keep the stitches clean and brings blood to the area to speed healing. Some women find air-drying helpful. To air dry, lay on the bed with nothing on your bottom for a few minutes or use a hairdryer on the low setting.

If-it-hurts-to-sit-use-a-rolled-up-towel-to-fashion-a-donut-to-sit-on.-297x300

Fashion a ‘donut’ from a rolled up towel.

  • Sit on a ‘donut’:

If your stitches are painful, try sitting on an inflatable ring (available at most drug stores) or a homemade ‘donut’ (towel rolled up and made into a ring). This helps to take the pressure off your bottom when you sit.

  • Stitches are dissolvable:

Most stitches take up to 3 weeks to heal and will dissolve on their own. If you lose a stitch prematurely, doctors will not re-suture the area. Continue to keep the area clean and air dry to promote healing.

4) Can I take something for pain?

After a vaginal birth, you may have 3 types of pain: pain from an episiotomy or tear, ‘afterpains’ or hemorrhoid pain. Or, you may be lucky enough to have none of these!

  • Episiotomies and tears:

Some tears are quite small and will cause little discomfort. Extensive tears or episiotomies take longer to heal. Tub soaks (as mentioned in #3) help to decrease perineal pain. You may need to take pain medication regularly for the first few days. Most pain medications are compatible with breastfeeding. Ask your healthcare provider for instructions.

  • Afterpains:

You may feel labour-like cramping as your uterus shrinks to its pre-pregnancy size. These cramps are strongest in the first few days after childbirth and should subside a little each day. When you breastfeed, the hormone that releases your milk also causes your uterus to cramp. Although it is uncomfortable, it helps to keep your bleeding under control. Taking regular pain medication can help to stay on top of this pain. If you wait until you experience an afterpain to take medication, the afterpain will be gone before the medication can take effect.

  • Hemorrhoids:

Hemorrhoids can begin during your pregnancy or appear after delivery. Tub soaks may be soothing. Over the counter ointments and creams will help to shrink the hemorrhoid and relieve the pain. If your hemorrhoids are severe, you may need a prescription ointment. Taking oral pain medications regularly can also be helpful.

5) Will it hurt to have a bowel movement? Will my stitches let go?

Women are often scared to have their first bowel movement after giving birth, worrying they will split their stitches open. This trick can help: Using a clean pad, apply gentle counter pressure over your stitches as you push. This can help you to relax enough to pass that first stool.

Drink lots of fluids and eat high fiber foods (such as bran, raw fruits and vegetables) to keep your bowel movements soft. Sometimes, a mild stool softener such as Docusate Sodium is suggested for the first week.

6) When will my milk come in?

You have milk as soon as your baby is born! The first milk is called colostrum. It is a thick yellowish fluid and is produced in small volumes, perfect for the small size of your baby’s tummy. Colostrum is full of antibodies and properties that are important for your baby’s health.

Around the third day after birth, you will notice your breasts becoming heavier. This signals a change to the more mature type of milk. The color changes from a golden to a whitish color and larger volumes will be produced. Read more about milk coming in here.


P.S We’ve created a FREE 3-lesson online video breastfeeding course,“Getting Ready to Breastfeed.” Download it here.


Do-you-need-to-eat-a-special-diet-when-breastfeeding-300x200

7) Do I need a special diet when breastfeeding?

There is no need to worry about a special diet when breastfeeding. A healthy diet is all that is needed.

You may hear well-meaning advice from family or friends about avoiding gassy foods such a beans or cabbage etc. This is an old wives tale. Gas from the mother’s intestinal tract cannot be passed into her breast milk. The foods we eat can flavor breast milk but this doesn’t harm the baby; it is thought to be an early introduction to flavors.

An exception to this can be cow’s milk protein found in dairy products. It is rare (only 2-7% of babies), but some babies may be allergic to dairy and react to it in the mother’s diet. You can read more about this problem here.

It is recommended to limit your intake of caffeine to no more than 1 or 2 cups a day. Excessive caffeine may make baby fussy.

Learn more about how to prepare for breastfeeding Download our FREEE ebook:  5 Crucial Ways to Prepare for Breastfeeding.

8) Why am I feeling so emotional?

Women feel emotional after the birth of a baby! Sometimes the emotions may be those you were expecting: euphoria, instant love. Other times, the emotions may not be expected. Many women report feeling a dull, flat disappointed feeling after birth. Others are embarrassed to admit they feel nothing for their baby.

Why-am-I-feeling-so-emotionalHaving a baby can be a very overwhelming experience. There is no right or wrong way to feel. A difficult delivery, or one that didn’t go as you envisioned, may make it worse. Talk to your loved ones or your health care provider about the way you are feeling. Please know that even if you feel disconnected from your baby, feelings of connectedness will come in time. Taking time to rest and care for yourself is important.

Looking after a newborn is more than a full time job. Coupled with the lack of time to sleep, it is no wonder this is a high-risk time for the flare-up of anxiety and depression.

Postpartum blues are common in the first few weeks. If these feelings do not resolve in the first few weeks or the symptoms worsen, you could be suffering from postpartum depression and may benefit from treatment and a support group. Please talk to your healthcare provider.

9) How will I know if I have an infection?

The most common places to develop an infection after a vaginal birth are your stitches, your uterus and your bladder.

  • Stitches:

The first sign of an infection is increasing pain in your stitches, despite taking the same amount of pain medication. Reddened skin around the stitches or a thick yellow or greenish discharge is also signs to watch for.

  • Uterus:

A foul or rotten odour to your vaginal blood flow can be a sign of an infection in the uterus. (Note: If you are unsure if your flow smells foul, it probably isn’t!) A smell similar to your regular menstrual flow is normal.

  • Bladder:

Symptoms of a bladder infection include burning when you pee, having to pee frequently and a feeling of ‘urgency’ (needing to use the washroom NOW!). Remember, it is not unusual to feel some burning around the stitches when you pee (see point #3).

  • General:

If you should develop a fever in the first 6 weeks after giving birth, please notify your healthcare provider. You may have developed an infection that will require treatment.

10) When can I have sex again?

Let’s face it; it is not the new moms who are asking this question! It is, however, high on the new dad’s list of questions.

The general recommendation is to wait 6 weeks after before resuming sexual intercourse. There are a few reasons why.

The first is an increased risk of infection. Your uterus needs to heal at the site where the placenta was attached. This area is susceptible to infection if bacteria is introduced during intercourse.

Secondly, it may take 6 weeks for the stitches to fully heal and become less tender.

When-can-I-start-exercising-after-birth-300x200

*Bonus:

11) When can I start exercising again?

The answer to this question can depend on your delivery, the extent of any tears, your hemoglobin and your fitness level throughout your pregnancy. If you exercised throughout your pregnancy and did not have a difficult delivery, you could safely do light exercises such as walking and stretching within a few days.

It is important to listen to your body and cut back if your body says you are overdoing it. Signs you are overdoing it are an increase in your vaginal blood flow or feeling pain and discomfort.

If you were not active during your pregnancy or had a difficult delivery with lots of tearing or stitches, please check with your healthcare provider prior to exercising.

Other posts you may find helpful: Nutrition for New Moms and What you need to know about Breastfeeding and Exercise.

 


thumbnail-cindy-and-jana

Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.

 


 

2 comments

April 5, 2015

Nutrition Necessities for New Moms

 

Guest post by Brooke Bulloch, Registered Dietician from Food to Fit. 

 

Congratulations on your new baby!

Or perhaps you’re a supportive friend or family member. Regardless, it’s an exciting time for everyone. A new mom requires appropriate support, rest, and a nutrient dense diet in order to maintain her energy for a recovering body and for a new baby.

What new moms need to know about nutrition for breastfeeding and recovery from childbirth. CindyandJana.com

 

Postpartum Nutrient Needs

Most women can meet their postpartum nutrient needs from food. A general recommendation is to continue taking your prenatal supplement for 6 weeks after birth. If you are anemic, gave birth to twins, or follow a vegan diet, you should consult a dietitian or health care provider about supplementation.

 

Vitamin D is a nutrient that helps the body to build and maintain strong bones and teeth. Not enough can lead to soft, brittle bones. Health Canada recommends that adults up to 70 years of age receive 600 IU daily, but not more than 4000 IU daily. There are very few food sources that contain enough vitamin D to meet this requirement and Canadians may not produce enough in the skin due to reduced sun exposure during the winter months (and sunscreen use in the summer). Often a vitamin D supplement is necessary.

 

Lactation is an energy expensive process! A breastfeeding woman requires roughly 500 additional calories daily (yup, slightly more than your 3rd trimester!).

This might look like:

1 slice of whole grain toast with 1 tablespoon of almond/peanut butter

and

½ cup lower fat yogurt (2% or less)

and

1 fresh fruit

throughout your day.

 

Breastfeeding women have higher recommended dietary intakes for vitamin A, C, B12, and zinc, but the additional calories from a variety of food groups will make up for these increased needs.

 

Iron needs are lower than non-breastfeeding women due to the difference in blood loss from menstruation. However, iron-rich foods provide energy and keep the blood healthy so it’s important for everyone to include these daily.

 

 

Working Towards your Pre-pregnancy Weight

For the first 4 to 6 weeks, just rest! Ignore that pressure (wherever it’s coming from) to get out and work off that “baby weight”. Keep in mind, you just spent 9 months gradually putting the weight on, it’s realistic to expect 9 or more months to adjust towards your natural, healthy weight.

Restricting calories too much can affect milk volume and composition, and consequently infant growth. Nutrition NecessitiesThree separate studies looked at the impact of energy restriction and exercise on lactation. The results from each study suggest that:

a) lactation must be well-established prior to reducing calories or incorporating exercise (45 minutes moderate exercise, 5 days per week)

b) weight loss of 0.5 kg/week did not negatively affect the growth of the baby nor the composition of breast milk in overweight women.

 

Whether you were overweight or not prior to conceiving, avoid actively trying to lose weight for the 4 to 8 weeks postpartum. After that point, aim to lose no more than 2 kg (4.5 pounds) per month by incorporating moderate exercise and reducing mostly “junk food” calories.

 

Putting it altogether – Practical Tips

Stock your cupboards, fridge and freezer and have a friend or family member help with the shopping and prepping. Below is my list of nutrient-packed must have foods:

 

Healthy fats
• From vegetable oils, salad dressings, avocado, mayonnaise, nuts and fish
Fish (fresh or canned)
• Eating a small portion of fish twice per week will provide the essential omega 3s called EPA and DHA. If you don’t eat fish, you might consider a fish oil supplement containing 500-1000 mg of EPA + DHA daily

 

Iron-rich foods
• Meat, fish, poultry, eggs, nuts, pumpkin/sunflower seeds, tofu, tempeh, blackstrap molasses, spinach, kale, potato with skin, lentils, chic peas, beans, enriched flours (pasta, breakfast cereals), oats

 

Quick, low maintenance snacks to keep you going
• 100 gram yogurt containers
• Individual cheese packets (not the processed slices) e.g. baby bell, Cracker Barrel
• Dried cereal (that has less than 8g sugar/serving) + unsalted nut mixtures
• Washed, peeled and cut carrot and celery sticks (have with a side of hummus, or a homemade Greek yogurt dip)
• Washed cherry/grape tomatoes, snap peas, fresh green beans, radishes stored in a dish or Tupperware
• Washed strawberries, grapes, cherries, apples
• Frozen berries and mango
• Hard-boiled eggs
• Peanut or almond butter on whole rice, corn, wheat, or rye crackers
• Fruit Smoothies: frozen fruit, + a leafy green (kale or spinach) + yogurt + milk or juice (boost protein with tofu, hemp seeds or chia seeds)

 

fruit-700007_640

 

You may not always have the time or energy to plan and eat 3 square meals and organized snacks. With assistance from family and friends, stock your home with nutrient-dense foods that are easy to prepare or “grab-and-go” when time and energy are limited.

 

Have something to eat every 3-4 hours in order to maintain mental and physical energy, energy requirements for adequate lactation, and nutrient needs.

Rest up and enjoy your new babe!

 

Works Cited

  1. VitaminDCouncil.org, Vitamin D during Pregnancy and Breastfeeding
  2. Linus Pauling Institute, Micronutrient Needs during Pregnancy and Lactation
  3. Health Canada
  4. Lovelady, C. (2011). Balancing exercise and food intake with lactation to promote postpartum weight loss. Proc Nutr Soc 24:1-4
  5. Dewey, KG (1998). Effects of maternal caloric restriction and exercise during lactation. Journal of Nutrition. 386S-389S
  6. Lovelady, C.A. (2004). The impact of energy restriction and exercise on lactating women. Adv Exp Med Biol. 554: 115-30.

Screen Shot 2015-04-05 at 12.00.53 PM

 

Brooke Bulloch is a Registered Dietitian (BSc) from Saskatoon, SK. Brooke shares her thoughts and yummy recipes on her website Food To Fit.

2 comments

March 30, 2015

C-section: Guide to Recovery

Approximately 25-35% of all deliveries in North America are by Cesarean section (C-section). Some of these are planned while others are the result of complications that arose during labour.

 

A C-section is major surgery and will require recovery time. If you have gone through labour in addition to the surgery, you can expect an even longer recovery time.

 

When people have surgery, such as having their appendix removed, they know must rest and take time to heal. The same should apply when you have a C-section. The difference, however, is that in addition to needing to heal, you also have a newborn to care for. Your rest will be in 1 or 2-hour blocks only and there may even be company to entertain!

 

It is important to be realistic in your expectations of yourself; enlist the help of others with tasks such as cooking, cleaning and laundry.

C-Section Guide to Recovery

 

 

Getting mobile

Most women will stay in hospital for 2 to 4 nights after a caesarean. Nurses will assist you to get up and walk a few steps as soon as possible after your surgery. Although this will no doubt be uncomfortable, it will help to speed your healing. Start with just a few steps and gradually increase the distance you walk.

 

Walking is important to keep the blood circulating in your legs to lessen your chance of developing a blood clot (deep vein thrombosis or DVT).

 

Symptoms of a blood clot in your leg include:

  • severe pain that is worsened when you pull your toes up towards your head
  • red area on your leg that is warmer to touch than surrounding areas
  • one leg that is significantly more swollen than the other

 

These symptoms should be reported to your healthcare provider.

 

Your bowels temporarily shut down during surgery. This can result in a painful accumulation of gas. Walking helps the gas to work its way through the bowel. Some women will experience a “referred gas pain” in their shoulder area. You could try drinking Peppermint tea; some women say it helps!

 

Managing the Pain

You will require pain medication after your surgery. Most pain medication is compatible with breastfeeding. Check with your healthcare provider or pharmacist if you are unsure.

 

Try to take your pain medication regularly for the first couple of days after surgery. Being pain-free will allow you to move more easily and care for your baby more comfortably.

 

It is important to take pain medication before you are discharged from the hospital. The effort involved in transferring to your vehicle, then getting settled at home can result in increased pain.

 

Incision pain should decrease each day. If you find that you are starting to forget your pain medication, it is a good sign that you are healing well.

 

Coughing or laughing

It can be uncomfortable to cough or laugh after surgery. “Splinting” your incision can help. Use a folded towel to put firm pressure with your hands on either side of the incision while you cough or laugh.

It is important to know that while it may be uncomfortable, your incision is sutured in many layers and can withstand sudden movements.

 

Bowels

Keeping your bowel movements soft will make them easier to pass without using your stomach muscles. A gentle stool softener may be prescribed. Drinking plenty of fluids and having a high fibre diet will also help.

 

Vaginal Bleeding

You will have some type of vaginal discharge for several days following a C-section.

 

Your discharge will typically be a red bloody flow for 3-5 days, followed by a pinkish watery flow for another 10 days.

 

Breastfeeding

Breastfeeding can begin as soon as you are comfortable after a C-section. If you have had a general anaesthetic, you may breastfeed as soon as you awake. If your C-section was done without a general anesthetic, you will likely be able to breastfeed as soon as baby is born.

It can be challenging to find comfortable nursing positions after a C-section. Many women like to use the football hold, side lying or laid-back position to keep the weight of baby off their incision.


Learn more about positions for breastfeeding in this free video lesson. Scroll to the bottom of the page and click preview for the Comfy Breastfeeding Positions lesson.


 

C-Section, what to expect

Emotions

Women can experience a wide range of emotions in the weeks after a C-section. Some may feel relief that surgery finally ended a long and difficult labor. Others may feel let down that they were unable to give birth vaginally, the way they had envisioned during their pregnancy. Still others have mixed emotions. There is no one right way to feel after a C-section.

 

If you are having feelings of disappointment or frustration regarding your C-section, it is important to talk about it. Talking about your feelings helps to resolve the issue in your mind. Feel free to ask your doctor or midwife for explanations about why the surgery was necessary. Give yourself time to reconcile your birth experience with what you had envisioned.

 

If you find you are struggling with your feelings beyond the first few weeks, talk to your healthcare provider. Postpartum blues are quite common in the first few weeks but if they do not resolve or the symptoms worsen, you could be suffering from postpartum depression and may benefit from treatment and a support group.

 

Hospital discharge

The day of discharge from hospital will be a busy day. You will likely see your doctor and be given discharge instructions by your nurse. Packing up baby and transferring from your hospital room to the car to your home can take a lot of energy. This will not be a good day to entertain company at your home.

 

Once home, remember to rest as much as possible. Try to limit trips up and down stairs. Ask your support people to help you set up diaper change stations close to where you will be resting.

 

You will need help for the first few days at home. Enlist the help of your partner, other family members or friends. If you can afford it, hire someone to do the cleaning and laundry.

 

Incision

Most C-sections are done with a bikini incision, a 4 to 6 inch incision just above your pubic bone. The incision has many layers of stitches. The outermost layer may be stitched with dissolvable sutures or metal staples. If you have staples, a healthcare provider will remove them five to seven days after the surgery.

 

At first, the incision will be bright red and may be slightly raised. It will take 4 – 6 weeks for the incision to fully heal and it may feel itchy as it heals. The red scar will gradually fade and become flush with your skin.

 

It is not unusual for the area around the incision to be numb. This is due to a disruption of the nerves during surgery. The numbness may last for several months but normal sensation should eventually return.

 

It is normal to have a small amount of a watery yellow discharge from your healing incision. Notify your healthcare provider if:

  • your incision is red, warm to touch, and swollen
  • you have a fever
  • you have increasing pain, despite taking your pain meds
  • you have thick yellow or yellowish-green discharge from your incision

 

Activity guidelines

Because your abdominal muscles have been cut, it is important not to lift anything heavier than your baby for approximately 6 weeks. 2 – 6 weeks. Car seats are heavy. If you need to make a trip alone with your baby, leave the car seat in your car and carry only your baby.

 

Avoid driving until your incision is well healed. Lifting your foot from the gas to the brake pedal contracts your stomach muscles. You will want to be sure you can do this without hesitation before you resume driving.

 

Be patient with yourself. Your recovery will take time but you will eventually be able to return to your former level of fitness. Continue with short walks but avoid strenuous exercise for at least six weeks. Check with your healthcare provider before resuming your fitness regime.

 

Sexual intercourse

After a C-section, you should be physically ready to resume sexual intercourse in about 6 weeks. You may or may not be emotionally ready at that time. It is normal to feel tired and “touched out” with the demands of caring for a newborn. Discuss with your partner what is right for you.

 

It is normal for breastfeeding women to have decreased vaginal secretions. Using a water-based lubricant may help intercourse to be more comfortable.

 

You may need to be creative with positioning to find one that is comfortable for you, not putting too much pressure on your incision.

Pregnancy can occur before you have had your first menstrual period. Speak to your healthcare provider about methods of family planning and choose one that is right for you.

 

Recovery after a C-section takes time and will vary from mother to mother. Women who have gone through labor prior to their C-section will need more recovery time than those with a planned C-section. Try to be patient with your body throughout this healing time and take advantage of any help offered.

 

Other related posts you may enjoy: New Baby? 11 Ways to Cope with Sleep Deprivation and Nutrition for New Moms.


IMG_9687 4

Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.

2 comments