Your uterus contracts down from being large enough to hold a baby to the size of a fist by 5 - 6 weeks.

• Some women feel these contractions as "afterpains" during the first 2 - 3 days after delivery. You may not feel these contractions after the birth of your first baby. They may be painful if you have had previous births (due to the stretching of the uterine muscles which have lost some of their elasticity).
  
  
• These contractions are often felt more strongly during breastfeeding due to the release of oxytocin. This hormone is produced in response to the baby's suckling.
  
  
• Walking, breathing and relaxation techniques, and frequently emptying the bladder can lessen these pains.
  
  
• Your doctor or health care professional may prescribe a mild pain-relieving drug.

Perineum

• The area "between your vagina and anus" (perineum) may be sore, bruised or swollen due to the pressure and stretching during a vaginal birth. If you have stitches you may feel more discomfort.
  
  
• Cooling the area with ice may give some short-term relief. Avoid direct contact with the skin by placing a towel between the ice and skin.
  
  
• Keep the perineum very clean to prevent infection and odour (sitz baths, tub baths and showering).
  
  
• Make sure you clean the area after going to the bathroom.
  
  
• Sitting is made easier by tightening buttock muscles, lowering oneself squarely on the chair and then relaxing buttock muscles.
  
  
• This area normally heals in about ten days.
  
  
• Important to continue to do pelvic floor exercises (Kegels).
  (See Baby's Best Chance page 48 )

Lochia (Flow)

• There is bleeding and discharge from the vagina for 2 - 6 weeks after birth. This happens as the uterus sheds and renews its lining.
  
  
• For the first two to three days this flow is dark red with small "loonie" sized clots and has a non-offensive odour.
  
  
• Gradually the flow lessens and becomes brownish to pinkish in colour.
  
  
• By the tenth to the fourteenth day the flow becomes yellowish - white.
  
  
• Your flow may increase in amount or change due to any emotional upset, cold, lack of sleep or drastic increase in exercise.
  
  
• Use pads not tampons until any stitches/sutures or vaginal tears are healed.

Menstruation

• If you do not breastfeed your baby, menstruation should return within four to nine weeks after birth.
  
  
• Menstruation may not occur as long as your baby's sole source of nourishment is breastfeeding.
  
  
• In both cases, pregnancy can occur before menstruation recurs.
  
  
• Birth control: It is necessary to use some form of contraception to avoid pregnancy even before menstruation returns.
  See Baby's Best Chance page 94. The Pregnancy Prevention section gives a good overview of available methods.

Urination

• The nerves to the uterus, bladder and lower intestine are closely linked. They may be affected by the stretching during delivery.
  
  
• For a short time after birth the mother may lose the sensation that her bladder is full.
  
  
• It is important to urinate at regular intervals to prevent the bladder from becoming over full.
  
  
• Sensation usually returns in 1 - 2 days.

Bowel Movements

• By the third day after delivery, mothers usually have a bowel movement.
  
  
• The bowel may become relaxed and lazy due to pressure and inactivity during pregnancy and labour.
  

Some helpful hints to make bowel elimination less difficult

• Include course fibrous foods (whole grains, bran, dried fruits, fresh fruits and veggies) in your diet
  
  
• Drink plenty of fluids
  
  
• Do moderate exercise
  
  
• Take the needed time to go!!

If the above hints do not work, try using stool softeners that can be purchased at drugstores after discussion with your Health Care Provider

Hemorrhoids

• May appear for the first time or increase in size after the pushing stage in labour.
  
  
• Avoid standing for long periods and keep bowel movements soft to avoid straining.
  
  
• May relieve discomfort by use of ice packs, warm sitz baths, or topical analgesics such as Tucks and Preparation H.