Postpartum depression and anxiety are the parts of postpartum we rarely talk about. Around 8 – 10% of mothers experience PPD, which often goes unattended.

Behind The Scenes Of Postpartum Care

Introduction

Your body has endured the most rigorous and remarkable changes to do something extraordinary: give birth to another human being. For 9 months, you took the necessary precautions, went to the best doctors to receive top-notch medical care, and followed all maternity books to ensure your baby finds its new abode comfortable.&nbsp;

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9 months and a healthy baby later, you are enveloped with maternal joy. What worries you now is natal development. While your concern is justified, it is necessary to remember that you need rest as well. For 9 months you were completely selfless and now, for the 12 weeks following the delivery, you must direct your time and energy to recuperate, heal, and recover.&nbsp;

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Understanding The Importance of Postpartum Care

There may have been unprecedented or unanticipated events during delivery. The delivery might have been riddled with complications or it might have been traditionally simple. You might have undergone a cesarean birth (C-section) or the doctor might have suggested a vaginal delivery. Your labor might have lasted for a couple of hours or even a day. Regardless of what your delivery situation resembled, your body has had to deal with an outstanding and remarkable trauma, and consequently, it needs to compensate for it with the appropriate time to recover and heal.&nbsp;

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Your postpartum journey could be by the book or it could be unique. But, at the end of the day, your hormones will fluctuate, and so will your body. You will feel puzzled and bewildered, confused and alone. It&rsquo;s easy to be excited yet intimidated. All these emotions are justified and appropriate.&nbsp;

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Remember, you should never hesitate to <a href="https://merisehat.pk/doctor-now">reach out to a doctor</a> for a safe consultation and to update them on your situation. Finding refuge and comfort with friends and family is also encouraged.

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So, you assumed labor was difficult? Well, think again. Postpartum changes after vaginal delivery necessitate conversations with your OB/GYN before delivery, so that you can have a relatively well-organized recovery. Some changes that you can expect include the following:

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<h5>Vaginal Soreness</h5>

Vaginal tears during labor are medically known as perineal lacerations (episiotomy) or just tears. It can occur in either of the two circumstances: (a) the child&#39;s head is getting through the vaginal opening and is excessively huge for the vagina to dilate around; or (b) the head is a typical size, but the vagina is unable to fully extend. These sorts of tears are normal and are made between the vagina and the anus<a href="#accordion">[6]</a>.&nbsp;

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Post-delivery, these tears heal at a gradual pace and, therefore, cause vaginal soreness and discomfort. To ease and cope with the pain, an individual could try different home remedies and medications, such as:

i) Placing an ice pack on the tear or sitting on a padded pillow.

ii) Use warm water while washing the area, to ensure the prevention of any infection of the wound. Cool water can also be used if an individual finds it to be more soothing.

iii) Investing in a witch hazel pad sanitary napkin, cool for a while before placing it on the tear, which is usually localized between the vaginal opening and anus (perineum)<a href="#accordion">[5]</a>.

iv) Consult the doctor for painkillers and laxatives to help you deal with painful stools or constipation.

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During the postpartum visit to the doctor, inform them of every symptom, as any slight development could be an indication of an infection. 
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<h5>Vaginal Discharge</h5>

Vaginal discharge postpartum is called Lochia and contains a mix of&nbsp; uterine tissue, blood and mucus. The discharge is dark colored and released in copious amounts&nbsp; for the first couple of days, and later it becomes paler and the amount of discharge reduces<a href="#accordion">[4]</a>.&nbsp;

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To be on the safe side,&nbsp; doctors advise against the use of tampons or vaginal douching until 4-6 weeks in the postpartum period. The involvement of such items&nbsp; in the early postpartum period increases the risk for uterine infection.&nbsp;

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If your vaginal discharge is putrid or pungent, refrain from using heavily scented vaginal cleansers and inform your doctor to avoid future complications. If you are experiencing heavy vaginal bleeding, such that the sanitary pad is soaked in a matter of hours then you must contact your primary care physician<a href="#accordion">[4]</a>. 
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<h5>Incontinence</h5>

Pregnancy and consequently labor has been associated with the stretching of the pelvic floor muscles, which bolster the uterus, bladder, and rectum<a href="#accordion">[4]</a>. This stretching can weaken the pelvic floor muscles leading to a possibility of incontinence or the lack of bladder control. For instance, urine might leak when you laugh, sneeze, or cough.&nbsp;

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While incontinence decreases after a few weeks, it is incredibly frustrating and embarrassing, especially in public. To avoid any unfortunate incidents, you could try wearing protective pads or diapers and exercising to tone the pelvic floor muscles. A specific set of exercises called Kegel (also known as pelvic floor muscle training) can be practiced thrice a day. Sit on a stable and flat surface and tighten the pelvic floor muscles as if you&rsquo;re stopping yourself from going to the toilet. Begin with tightening and quickly releasing the muscles. After some time, you can hold a contraction for at least 5 seconds. Try doing 8 squeezes for each set<a href="#accordion">[6]</a>. 
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<h5>Hemorrhoids</h5>

If you feel discomfort during bowel movements and there&#39;s swelling near your anus, then you might have a case of hemorrhoids. It is a swelling of veins in the rectum, which is usually caused during your pregnancy. If not, you might have gotten them from the excessive strain and forceful pushing at the time of your delivery. Hemorrhoids are extremely painful, and cause itching and bleeding after defecation<a href="#accordion">[2]</a>.

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Here are a few things you can try to ease the pain:

i) Use a topical hemorrhoid cream that is easily accessible at pharmacies or any cream containing hydrocortisone.

ii) Opt for pads that are made of witch hazel to soothe the affected area.

iii) Go for a Sitz bath i.e. Soaking the hips and buttocks in warm water for around 10-15 minutes twice or thrice a day. Sitz baths help in reducing swelling.&nbsp; &nbsp;

iv) If you are avoiding defecation due to hemorrhoids and if the situation has been aggravated due to constipation after delivery, then it is suggested to consult a doctor for laxatives. Also, make sure you have a diet rich in fiber and you&rsquo;re staying hydrated. 
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<h5>Tender Breasts</h5>

It is common for breasts to fill up with milk after delivery for lactation. They become firm, tender, and sore; this is called breast engorgement<a href="#accordion">[2]</a>. It is suggested to alternate between breasts or even try alternating feeding positions during breastfeeding to minimize engorgement.&nbsp;

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If your breasts remain engorged for a prolonged period, then it would be difficult for the baby to latch on to the nipple. To help the baby while feeding, you might rely on hand compressions or a breast pump. Additionally, to relieve yourself of pain, you could try easily accessible pain killers, take long warm showers before breastfeeding, and place cold damp cloths on your breasts during feeding<a href="#accordion">[5]</a>. 
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<h5>Hair Loss And Skin Changes&nbsp;</h5>

Physical changes after delivery do not just involve weight gain or weight loss. As the body is producing an abundance of hormones, hair is also produced at a faster rate than it sheds, therefore you may experience substantial hair loss, too.&nbsp;

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And in addition to the permanent stretch marks that transition from red to silver as they start to fade, you might witness scaly, irritated skin. This would disappear as well, but for the time being, it&rsquo;s going to be more prone to acne.&nbsp;

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Consulting an endocrinologist and a dermatologist after delivery could help with the management of such symptoms. These are primarily due to the hormonal changes and thus could be accompanied by other side effects such as mood swings and excessive perspiration<a href="#accordion">[5]</a>.

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A postpartum visit to the doctor follows a personal objective. Your doctor would discuss your symptoms in detail, such as the inconsistent contractions or uncomfortable vaginal soreness and help you find solutions to relieve your pain. Furthermore, the discussion could also involve future birth spacing, contraception, and your emotional well-being.&nbsp;

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The doctor would also perform a physical examination. This includes&nbsp; a thorough examination of the abdomen, vagina, cervix, and uterus to ensure there is no physical scarring or post-delivery injuries.&nbsp;

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This is a terrific opportunity to discuss any worries you have, including continuing sexual activity and how you are adjusting back to routine with a child, while maintaining a healthy sleep cycle and nourishing your body with sufficient nutrients. 
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During a C section, most individuals are conscious and are only provided local anesthesia during their surgery. Afterwards, the patient is kept under observation at the hospital for a day or two to monitor vitals and gauge any abnormal behavior of the body. This might exclude the usual grogginess and nausea after surgery, which is easily managed through prescriptions.&nbsp;

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While most of the changes will be similar to vaginal birth, if you are delivering your baby via a C-section, please note there would be some additional circumstances which require different care. 
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<h5>Rest</h5>

A cesarean is an intense surgery that drains an individual. While normally an individual is admitted for only a couple of days after a cesarean, complications might persist for a couple of weeks. It is important to soak in as much rest (both physical and mental) as you can. This is quite difficult as the individual might have to care for a demanding newborn child or there could be numerous unexpected visitors to deal with. But it&rsquo;s important that you prioritize yourself.

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Organize and plan for effective postpartum care before delivery. This includes hiring help, constructing a workable timetable, and asking friends and family to pitch in. Moreover, you can be happy that everyone&rsquo;s coming to meet your new bundle of joy and, at the same, excuse yourself from gatherings for some alone time to recover faster<a href="#accordion">[3]</a>.

 
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<h5>Minimal Activity</h5>

While moving around could help with the prevention of blood clots, most doctors advise against participating in strenuous activities such as driving, competitive swimming, vigorous exercise, and handling heavy objects.&nbsp;

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Take things slowly and gradually. It would take 4-8 four to eight weeks after surgery before you have enough stamina to rejoin usual activities. Listen to your gut; your body will tire easily reminding you to take a break and just rest<a href="#accordion">[2]</a>.&nbsp; 
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<h5>Incision Care</h5>

The region where the incision was made, is naturally covered after surgery. Consult the doctor to know when it is safe to remove the bandage. Until then, keep the incision covered. Once you receive the green signal from the doctor, remove it and clean the region with saline water regularly to protect it from infection<a href="#accordion">[2]</a>. 
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Postpartum depression is a type of clinical depression experienced by women after delivery<a href="#accordion">[1]</a>. It is often trivialized and misconceived. A common blunder is how frequently it&rsquo;s used interchangeably with &lsquo;baby blues&rsquo; when it&rsquo;s so much more distressing and can also worsen.&nbsp;

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It is characterized by a prolonged and complicated mix of emotions, where the individual frequently feels severe anxiety, despair, dejection, fear of the unknown, and gut-wrenching guilt.&nbsp;

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If you experience such emotions and think about harming yourself or the child, then it is extremely important to inform relevant authorities for the necessary help.&nbsp;

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Moreover, if partners, friends, and family members observe concerning signs and symptoms then they must consult a therapist before anyone gets hurt<a href="#accordion">[1]</a>. 
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Conclusion

Your post-pregnancy or postpartum care will not be the same as an 8-hour long sleep after a tiring day at work. Complete recovery from pregnancy, labor, and any other complication can take several months. While numerous individuals begin to feel better and invigorated after 12 weeks, it might take more time to feel like your pre-pregnancy self.&nbsp;

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While your concerns are totally real, however, there&rsquo;s no need to rush the healing stage. Postpartum is not a race. Do not challenge or tire or exhaust yourself to reach a weight goal, or to go back to your corporate life. During this time, you might feel like your body has betrayed you. Do whatever it takes to not get disappointed with your progress. Look for ways you can reassure yourself that your body is recovering at its own pace.&nbsp; The smartest option for you is to rest, eat well, and enjoy some well-earned respite.

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Key Points

<ul><li>Postpartum care refers to the period of recovery after delivery.&nbsp;</li><li>It involves physical and mental healing.</li><li>Changes and symptoms differ according to the type of delivery - vaginal or cesarean.&nbsp;</li><li>Individuals should rest, focus on their diet, and consult a doctor for better and personalized guidance.</li><li>Postpartum depression is a condition of prolonged grief and anxiousness after delivery. Individuals should reach out for professional help if they experience symptoms of Postpartum depression. </li></ul>

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