Childbirth and parenthood is a special and wonderful experience, however, many women find that this is also a time full of challenges.
Perth Obstetrician, Gynaecologist, Fertility Specialist Dr Joo P. Teoh
gives his advice on the following 10 commonly discussed topics related to the delivery of a baby and the postpartum period.
1. Delayed cord clamping (DCC)
DCC has been scientifically proven to improve the health of most term and pre-term babies. There may be circumstances that DCC is not suitable e.g. when the paediatrician needs to attend to the baby immediately.
DCC can also reduce the yield for cord blood banking resulting in fewer stem cells being collected. Apart from that, for most deliveries, DCC is recommended.
Early skin-to-skin is encouraged. It has been shown to help to establish breastfeeding and to also develop bonding between the baby and mother.
The long-lasting effect of its benefit on the child’s physical and emotional development may be noticeable even up to many years later. Immediate skin-to-skin may be possible in a caesarean section when the mum is awake. Sometimes skin-to-skin has to be delayed when the baby needs more attention from the paediatrician.
3. Pain control
Dr Joo P. Teoh
After deliveries women should have adequate pain control measures to feel comfortable. Most women would need to take at least some form of pain control tablets; many of these tablets are safe for breastfeeding. The amount of pain control needed after childbirth is very different between women; do not hesitate to discuss with your doctors and midwives about the right amount you need.
4. Wound care
A caesarean section wound can be left with the dressing on for a few days. If the dressing gets wet, it will need to be changed. The wounds from an episiotomy or vaginal tear usually do not have any dressing on. For all wounds, wash with clean water when showering, avoid putting soap or shower gel directly onto the wound.
Baths and even salt baths should be avoided. Ensure the wound is adequately dried after washing. Report any redness or discharge on the surrounding skin to the doctor or midwife, as they may be signs of infection. An infected wound can also produce a foul smell.
Debriefing means discussing the events of the delivery, usually with the doctor or midwife. Sometimes the events surrounding the time of delivery may happen very quickly so debriefing allows you to ask questions and understand the sequence of events that happened during your delivery. For some mums, debriefing helps them to feel more reassured or in control of their emotions.
Normally the womb contracts and shrinks in size immediately after the delivery of the baby and placenta. This compresses on the bloods vessels in the womb, and thus reduces the bleeding from childbirth. Breastfeeding helps to enhance this contraction of the womb.
The bleeding after birth is called lochia. In the first few hours following the birth of your child, you may have to change your soiled maternity pads every few hours. Bleeding that is filling or soaking up pads quickly is abnormal. Sometimes you may pass moderate size clots (size of a small orange). The amount of bleeding should reduce further after the first few hours and days. The colour should change from bright red to brown over the first couple of weeks. The light lochia can continue for a few weeks but usually stops by 12 weeks after the delivery.
Please discuss with your friendly obstetrician or midwife at any time if you are worried that the bleeding is heavier than expected.
7. Exercise after delivery
After delivery your scar will need time to heal; the ligaments and joints are still lax for up to 3 months after birth. Mums should take time for the body to adjust before going back to high-impact exercises or vigorous stretching. Start with lighter exercise, building up the intensity over time.
Recommended post-natal exercises include brisk walking, swimming, aqua-aerobics, yoga, pilates, low-impact aerobic workouts, light weight training and cycling. It is beneficial to start pelvic floor exercise (PFE) as soon as you are ready for the delivery. PFE helps to strengthen the muscles and enhances the healing from the delivery. This is important to prevent or treat urine leakage (incontinence), as well as pelvic floor prolapse.
You should be able to find information on PFE from your hospital or reliable web pages. Physiotherapists are more than happy to give advice and guidance, ensuring that the correct muscles are trained in PFE. Think of it as going to the gym – it takes time (at least a few weeks) and effort to strengthen the muscle. Be determined and persistent in PFE to have the greatest positive effect.
The healthy pregnancy diet is still beneficial to your body even after the delivery. At this stage, your body needs nutritious food that is rich in iron, calcium and protein to help with the healing, and also the production of milk for mums who are breastfeeding.
After the delivery, there is no need to worry about the risk of listeriosis directly affecting the baby from your breastfeed (good news for those craving soft cheeses!). With adequate diet and exercise, the weight gained during pregnancy is usually shed over 6-12 months. A loss of up to half a kilo per week is sufficient during breastfeeding; avoid crash diet or losing too much weight during this time. On the other hand, mums have to be careful not to carry this extra weight for too long or into another pregnancy, as this makes it much harder to return to a healthy
Prepared by Perth Obstetrician, Gynaecologist, Fertility Specialist Dr Joo P. Teoh
(Subspecialist in Reproductive Medicine, UK)
Concept Fertility; SJOG Mt Lawley
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