Vaginal Childbirth: Care Instructions

Overview

Vaginal birth means delivering a baby through the birth canal (vagina). During labor, the uterus tightens (contracts) regularly to thin and open the cervix and to push the baby out through the birth canal.

Your body will slowly heal in the next few weeks. It's easy to get too tired and overwhelmed during the first weeks after your baby is born. Changes in your hormones can shift your mood without warning. You may find it hard to meet the extra demands on your energy and time. Take it easy on yourself.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

Vaginal bleeding and cramps

  • After delivery, you will have a bloody discharge from your vagina. This will turn pink within a week and then white or yellow after about 10 days. It may last for 2 to 4 weeks or longer, until the uterus has healed. Use sanitary pads until you stop bleeding. Using pads makes it easier to monitor your bleeding.
  • Don't worry if you pass some blood clots, as long as they are smaller than a golf ball. If you have a tear or stitches in your vaginal area, change the pad at least every 4 hours. This will help prevent soreness and infection.
  • You may have cramps for the first few days after childbirth. These are normal and occur as the uterus shrinks to normal size. Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve), for cramps. Read and follow all instructions on the label. Do not take aspirin, because it can cause more bleeding.
  • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.

Stitches

  • If you have stitches, they will dissolve on their own and don't need to be removed. Follow your doctor's instructions for cleaning the stitched area.
  • Put ice or a cold pack on your painful area for 10 to 20 minutes at a time, several times a day, for the first few days. Put a thin cloth between the ice and your skin.
  • Sit in a few inches of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps with pain and itching. If you don't have a tub, a warm shower might help.

Breast fullness

  • Your breasts may overfill (engorge) in the first few days after delivery. To help milk flow and to relieve pain, warm your breasts in the shower or by using warm, moist towels before nursing.
  • If you aren't nursing, don't put warmth on your breasts or touch your breasts. Wear a bra that fits well and use ice until the fullness goes away. This usually takes 2 to 3 days.
  • Put ice or a cold pack on your breast after nursing to reduce swelling and pain. Put a thin cloth between the ice and your skin.

Activity

  • Eat a balanced diet. Don't try to lose weight by cutting calories. Keep taking your prenatal vitamins, or take a multivitamin.
  • Get as much rest as you can. Try to take naps when your baby sleeps during the day.
  • Get some exercise every day. But don't do any heavy exercise until your doctor says it is okay.
  • Wait until you are healed (about 4 to 6 weeks) before you have sexual intercourse. Your doctor will tell you when it is okay to have sex.
  • If you don't want to get pregnant, talk to your doctor about birth control. You can get pregnant even before your period returns. Also, you can get pregnant while you are breastfeeding.

Mental health

  • It's normal to have some sadness, anxiety, sleeplessness, and mood swings after you go home. If you feel upset or hopeless for more than a few days or are having trouble doing the things you need to do, talk to your doctor.

Constipation and hemorrhoids

  • Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • Eat plenty of fiber each day. Have a bran muffin or bran cereal for breakfast. Try eating a piece of fruit for a mid-afternoon snack.
  • For painful, itchy hemorrhoids, put ice or a cold pack on the area several times a day for 10 minutes at a time. Follow this by putting a warm compress on the area for another 10 to 20 minutes or by sitting in a shallow, warm bath.

When should you call for help?

Share this information with your partner, family, or a friend. They can help you watch for warning signs.

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have thoughts of harming yourself, your baby, or another person.
  • You passed out (lost consciousness).
  • You have chest pain, are short of breath, or cough up blood.
  • You have a seizure.

Call your doctor now or seek immediate medical care if:

  • You have signs of hemorrhage (too much bleeding), such as:
    • Heavy vaginal bleeding. This means that you are soaking through one or more pads in an hour. Or you pass blood clots bigger than an egg.
    • Feeling dizzy or lightheaded, or you feel like you may faint.
    • Feeling so tired or weak that you cannot do your usual activities.
    • A fast or irregular heartbeat.
    • New or worse belly pain.
  • You have signs of infection, such as:
    • A fever.
    • Vaginal discharge that smells bad.
    • New or worse belly pain.
  • You have symptoms of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in the calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You have signs of preeclampsia, such as:
    • Sudden swelling of your face, hands, or feet.
    • New vision problems (such as dimness, blurring, or seeing spots).
    • A severe headache.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • Your vaginal bleeding isn't decreasing.
  • You feel sad, anxious, or hopeless for more than a few days.
  • You are having problems with your breasts or breastfeeding.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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