Change of a body after childbirth
● What is “lochia”?
Women get vaginal discharges mixed with blood after birth called lochia. These are a part of the placenta which came loose, bleeding of a wound in the uterus caused by egg membrane coming loose, and a mixture of blood pooled in the uterus, discharge and mucus. As days go by, it changes in color and amount, and this can be an indicator of recovery of the uterus after childbirth.
● How does lochia change?
◎0 day – 3rd day
Red colored lochia
It is dark red and mostly blood. It has a unique sweet smell.
◎3rd day – 8th day
Hemoglobin changes its color and becomes the color of something like gravy. White blood cells are found within.
◎8th day – 14th day
Epithelium came loose from the uterus and may be found within.
◎14th day – 28th day
It becomes mainly a clear discharge and eventually disappears.
Amount: very small
● What should I do when lochia smells or a lump comes out?
For up to three or four days after childbirth, use maternity pads which is a size of diaper for newborns. After that, when the amount is decreased, sanitary napkins should serve their purpose. It most likely changes to regular vaginal discharges in a month or two after childbirth. In addition, to avoid the infection of bacteria, always wipe from front to back with antiseptic cotton after using the toilet.
● When does the uterus recover?
The uterus which was stretched to near the stomach just before the childbirth becomes small, going down to under the belly button. After that, it shrinks little by little, and returns to the size before pregnancy in approximately a month and half.
The perineotomy surgical wound at childbirth is closed around a week after childbirth when leaving the hospital and it is almost healed clearly after a month.
● When does menstruation start after childbirth?
When menstruation starts after childbirth varies considerably from person to person. Some start menstruation after a month, and some has no menstruation for a year or two. It is largely concerned with breast-feeding. It is said to be four or five months after childbirth in general, but just for your reference.
Breast-feeding women tend to restart menstruation late. During breast-feeding, a lot of hormones called prolactin are produced, and this hormone has a suppressive effect on ovulation, therefore while breast-feeding, ovulation is not likely to occur and menstruation is not started soon.
However, it also varies from person to person and can’t be completely denied as there are cases where menstruation started early in spite of breast-feeding. There is also the case where ovulation occurs without menstruation, so it is better to be careful about birth control even if menstruation has not started yet.
● How do I distinguish between menstruation and lochia?
It can be said that bleeding within one month after childbirth is lochia, and bleeding after two months is very likely menstruation in general. If fresh blood continues for a week or so, then it is more likely menstruation.
Moreover, because the amount of blood is considerable in the beginning stages of lochia, it smells like iron, but the color and smell gradually disappear. However, if it is bleeding due to menstruation, the amount of blood may decrease but there is no particular change in smell. Pain in the lower abdomen is also one of the indications of menstruation.
This means that the three points below can be the things to distinguish menstruation from lochia.
・Fresh blood continues for a week or so
・No changes in smell
・Have a pain in the lower abdomen
However, you may have symptoms of lower abdomen pain even for lochia, so if the pain gets worse, there is possibility you might have a trouble in the uterus. It is recommended to see a doctor.
How to spend time after childbirth
● How should I spend my time after childbirth?
The emotions of mothers after childbirth may become temporarily unstable, caused by rapid changes in hormones and due to anxiety about child-raising, called maternity blues. It is a period to avoid overdoing and getting too tired, because the body is also damaged by the delivery. You may still have congestion in the female genital area and may get an infection easily, therefore being clean and taking rest is more important than anything else. Please try to take an adequate amount of rest of at least up to one-month before the next medical checkup.
● When can I start having sex after childbirth?
Please start having sex after your doctor approves at the time of the one-month checkup. If you don’t use birth control, if you think you feel safe because menstruation is not started yet, you may get pregnant anytime since you never know when ovulation starts. If you are not planning to have another baby sooner, don’t forget to use birth control such as condoms or IUD (intrauterine device).
● What is after birth exercise?
Many women worry about becoming out of shape after childbirth; after birth exercise is very effective to develop abdominal muscles and the pelvic bottom muscle that became loose during pregnancy. Some exercises can be started right after childbirth and some are pretty hard, so try to incorporate them into your daily life little by little in accordance with your recovery.
● Does after birth exercise also help improve incontinence?
Many women suffer temporary incontinence due to child birth delivery. However, most women recover soon after childbirth, so it is not necessary to worry so much.
The major cause of incontinence after childbirth is the straining of the pelvic bottom at the time of delivery. Exercising the pelvic bottom muscle often improves incontinence, so puerperal exercises are effective from that perspective as well. However, you should start after the pain in perineum goes away.
Also, if incontinence continues and you feel uneasy about it, try to consult a urological physician.
● What are other advantages of after birth exercise?
After birth exercise are exercises to speed up the recovery of muscles extended due to delivery and recover from fatigue. Other advantages include improving the circulation of the blood, which promotes recovery, helping to produce breast milk, and more. Start with light exercises without overdoing it, and continue it on regular basis by increasing the number of exercises gradually. It may be nice to do exercise while listening to your favorite music.
● 1st day --- exercise of moving shoulders and neck in circles and taking deep breaths
◎Exercise of moving shoulders and neck in circles
Try to remove stiffness/tiredness in your upper body
Sit on a chair or on the floor. Put your fingertips on your shoulders, and move elbows inside/outside in circles.
1：Relax your shoulders and bend your neck forward.
2：Bend your neck slowly to the back as much as you can.
3：Move your neck slowly in circles. Right and left.
Isn’t your whole body still stiff? Relax yourself with exercises to get rid of fatigue. It speeds up the recovery after childbirth.
1：Breathe in well from your nose slowly.
2：Release your breath slowly and deeply from your mouth.
◎Foot exercises 1
1：With both legs together, point your toes and stretch.
2：Bend your ankles toward your body.
3：Point your left toe and stretch, and bend right one.
4：Repeat the same for the right and left alternately.
◎Foot exercises 2
1：Place the bottom of your foot opposite to the other with your toes facing inside.
2：Keep as it is and bend toes to the opposite side.
● 2nd day --- Exercises for breast muscles, and breast-feeding
◎Exercises for breast muscles, and breast-feeding
Let’s do an exercise to develop your breast muscles for smooth breast-feeding.
1：Put your fists to your shoulders, and press on your elbows.
2：Put your elbows together in front of your breasts, like a pendulum.
3：Move your elbows from inside to outside in circles, and return to the original pose.
◎Toning up of abdominal muscles and pelvic bottom muscles
Exercises to recover muscles to their original state which were weakened by pregnancy/delivery.
1：Bend your knees and put both hands under your waist.
2：Move your back downwards while releasing your breath.
3：Cross your legs, and tap your lower leg lightly with the upper leg.
● 3rd day --- Raise your legs up, and strengthen your pelvic bottom muscles and abdominal muscles
If you are doing great up to here, let’s gradually move to harder exercises in order to keep in shape.
1：Bend your knees, and put both hands under your waist.
2：First, move your right leg up onto the bed so that it becomes at a right angle.
3：Stretch your leg upward, and move down after pausing for a moment.