fourth trimester, Postpartum, self-care

The Truth about Self-Care after Birth

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I stare at the clock as the hour approaches.  The baby is still feeding, for some reason he has chosen to take longer this time.  I still have to move the clothes from the washer to the dryer, fold the laundry that is in the dryer and cut up some vegetables for dinner.  But, first I have to figure out how I can get this baby off the breast so that I can make my appointment for my pedicure, my chosen weekly self-care activity.   Ugh this is stressful.  There is so much to do and not enough time.  Self-care has become more stressful than relaxing because I have to do time gymnastics to fit it in to my schedule.  Not only am I having a hard time fitting self-care into my routine, but I also feel guilty when I can’t check it off my to do list. Self-care has left me more frazzled than emboldened.

The fourth trimester is emotionally, mentally and physically challenging. Too often, extraordinary demands are placed on a mom leaving her exhausted and empty. Women lose themselves to the daily obligations of caring for a newborn. Moms feel the pressure to be everything to everyone all while keeping the house clean and organized, cooking healthy meals and taking care of themselves. The quest to keep your cup full while filling every one else’s around you was promised to be solved by the addition of self-care as a routine part of your life. Moms have been preached to about the importance of self-care activities in maintaining a connection with one’s self.

The push for self-care is well intended, but the definition of self-care should be clarified.

Most women think of facials, pedicures and coffee with friends when they think self-care.

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While these activities are great and can help recharge a mom struggling to make it through the day, without a change in mindset these self-care activities will become another box to check off the forever-growing to-do list.

Self-care is so much more than pedicures, hair appointments and exercising with a friend.

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Self-care is:

  1. Embodying an understanding of your self worth and finding ways to respect it. Self-care involves caring about yourself by accepting your limits.
  2. It is about having the strength to recognize your limits, set boundaries in line with your limits and having a willingness to say “no” even when it means disappointing someone.
  3. It is about letting go of the pride of being busy and the constant struggle for improved efficiency as a mom.
  4. It means removing some of the unnecessary (but often perceived as necessary) items on your to do list.
  5. Self-care is respecting your feelings, thoughts, and personal needs.
  6. It is accepting that letting down others is not failure, but preservation of your self. We all have our limits that are as individual as we are.

We all reach our limits, leaving us exhausted, overwhelmed and empty.

Setting boundaries and saying no may be uncomfortable at first, but as you free up quality time for yourself and family, you will come to realize that boundaries are empowering. Your time will become your own and will be of greater quality. When you are able to accomplish this you will feel fuller than you ever have.

When you take the step to create boundaries and regard your needs as a priority, you will be a better mom, partner, colleague, and friend. That is true self-care.

THRIVE ON, MOMMA!!

 

body image, Postpartum, self-care

The Struggle of Postpartum Body Image

What do you see when you look in the mirror? Do you see a beautiful, strong, courageous woman, or do you see cellulite, dark circles, stretch marks and wrinkles?

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Do you hate what you see, or can you find the good qualities that outshine the flaws? Body image is an individual’s perception of her physical appearance. It is not how the world perceives your body but how you view your external self from within. Body image can be distorted by a variety of internal struggles such as early life experiences, mood, stress, fatigue, and societal “norms” to list a few. A healthy body image does not mean that you believe that your body is perfect; it means that you are comfortable with your body as it is, flaws and all. A negative body image can have deleterious effects on a woman that can range from distressing to life altering including difficulties in relationships, low self-esteem, eating disorders, anxiety, and depression.

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Pregnancy and postpartum marks a monumental transformation in a woman’s life. The changes are physical, mental and emotional. Our bodies make an incredible transition while pregnant. The miracle of life is held within our ever-growing womb. The physical changes of pregnancy are beautiful and warmly accepted. But then the baby is born and the beauty of pregnancy is gone and you are left with a deflated abdomen, loose skin and stretch marks. The culture in the United States will tell you that this body that created and held life for 10 months is no longer beautiful unless it is nipped, tucked, worked out, and dieted back into a size 0. Our perception of the postpartum body is tainted by unrealistic expectations. There is beauty in the postpartum body. There is strength, there is courage, and there is love in that beautiful body that just carried and delivered a precious new life.mom-1508902__340

Let’s have a reality check. It is EXTREMELY rare for a woman to leave the hospital after giving birth (whether it was a cesarean section or a vaginal delivery) looking like Kate Middleton. Very few of us will be able to wear their pre-pregnancy skinny jeans as their “going home outfit”.   Your body has changed. Your hips are a little fuller, you have extra weight (that is not all lost immediately upon delivery) and your chest is fuller. This is what postpartum looks like and it is ok.

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When the world tells you that your make up should be flawless and your hair should be on point all while fitting in to your pre-pregnancy clothes within 2 weeks after delivery, it is difficult to accept your postpartum body.   How do we go about accepting our new bodies? Here are some suggestions to help in the struggle with postpartum body image:

  1. Speak kindly to yourself. Talk to yourself as if you were talking to your newborn. Imagine yourself as a child and speak kind and supportive words to your child self.
  2. Highlight the qualities you perceive as positive. If your mind starts to ruminate on negative thoughts, attempt to make a conscious switch to focus your thoughts on your positive qualities.
  3. Find your mom tribe. You will discover that you are not so different from all the other postpartum women out there. We all struggle with postpartum body changes.
  4. Get outside and move. Walking outside improves mood by increasing endorphins. Activity is not just about weight loss.
  5. Take a social media break. We naturally tend to compare ourselves to others. Avoid the trap of comparing yourself to women on social media. Life is always sunshine and rainbows on social media. Photographs can be deceiving.
  6. Let go and accept change. Give your self a break. Focus your energy on something you find enjoyable.
  7. Accept compliments by others graciously and believe them.

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For some of us it will not be easy to accept our postpartum bodies. Acceptance may require help through therapy with a psychologist or licensed mental health counselor. A woman should seek help from their physician if body image concerns are causing eating habit changes, anxiety, depression, or thoughts of suicide.

Be kind to your self, momma. Pay close attention to your internal self-talk. Speak kindness and truth to your self. Your body is a temple, it is beautiful and it is strong. Believe this!

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You got this momma!

fourth trimester, Postpartum, self-care

Finding Your Village

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Being a new mom can be isolating. We tend to hole ourselves up in our homes just trying to survive on a daily basis. After several weeks of this “survival” behavior, it becomes a bad habit, and the idea of going out to meet someone seems like a mountain of a hurdle to jump. We feel the pressure of balancing house chores with taking care of a newborn all while being attentive to our partners and trying to feel “normal” ourselves. It does not leave much for anyone or anything else. While some women thrive on being alone, I would argue that a majority of women need stimulus from other women. We need a mom village! While you may already have your tribe prior to having a baby, after baby arrives, sometimes those people change as you begin to identify with other women who have children or are soon to be mothers. This is normal. I would even venture to suggest that it is necessary. I encourage women to get out and meet other new moms to share stories, concerns and help provide support. There is strength and healing in sitting with another mother and hearing “I get what you are going through.” When I had my son I was lost on how to find my mom village. The last time I sought out friends who were not work related was probably in college. I had no idea how to begin. What I failed to realize is that the struggles experienced during the first few weeks of new motherhood can be a uniting factor for women. Here are some tips to consider when you are seeking your mom village.

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  1. Get out of the house and socialize. Go to a park, walk around the mall, go to the gym or head to a coffee shop.
  2. Meet women in person. Research local mom groups on-line, but plan meet-ups in person. You are more authentic self when you are face to face. It is easier to project only successes on social media and avoid failures.
  3.  Keep your mom village local. You will find that it is difficult to meet up with women who do not live in the same proximity as you. Keep the logistics simple to improve the chances of being able to spend time together.
  4. Be vulnerable. Be willing to share your experiences of motherhood (the good, the bad, the ugly) with other new moms.
  5. Listen. Most women aren’t looking for a fix, they are just looking for someone who will listen and commiserate.
  6. Ask for help when you need it. Offer help when you can.
  7. Include family in your village such as aunts, cousins, sisters, mothers and even grandmothers.
  8. Ask for support and share support.
  9. Spend your time building each other up and avoid talking about other women, which will only serve to bring you down.
  10. Be open to learning to mom together.

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Sharing in the experience of new motherhood with other women, being authentic and vulnerable can lead to some of the tightest, longest lasting bonds you can forge. Your new mom village can lead to life long friendships that you will share the highs and lows of life with. You will find joy and comfort sharing in your struggles together. You will learn how to mom together. Your village will help you to thrive as a new mom. It takes a village to raise a mom!

You got this momma!

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body image, fourth trimester, Postpartum, self-care

Postpartum Hair Loss is REAL!

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I knew it was an inevitable part of the fourth trimester, but for some reason I was still alarmed when it started. Hair loss, ladies, that is what I am talking about. Lots and lots of hair everywhere! Hair in the shower, on the bathroom floor, in the brush, on the baby! Ugh, so gross. I thought for sure I was going bald! How can this be normal? Well, thankfully, it is.

Postpartum telogen effluvium also known as postpartum hair loss is completely normal. Ninety percent of mothers will experience some degree of hair loss during the postpartum period. It usually begins one to four months after delivery. It is self-limited, so by six to fifteen months after delivery your normal hair growth/loss pattern will usually return.

What is the cause you ask? During pregnancy, the change in the hormonal milieu results in the ratio of hair follicles that are in the growth phase (called anogen phase) relative to the hair follicles in the resting phase (called telogen phase) increases drastically. The result of this change is lusciously full locks by the third trimester. Then once you have had your sweet little nugget, those same hormones change abruptly which affects your entire body, to include your hair. After delivery, the ratio of hair in the growth phase (anogen phase) compared with the hair in the resting phase (telogen phase) reverses resulting in more obvious hair loss. As the hormones balance out over time you will notice that your hair growth and loss returns to its original pattern usually by about 15 months after delivery.

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What can you do to encourage healthy hair growth and reduce further damage?

  1. Eat a healthy diet full of fruits, vegetables and lean meats (such as eggs, chicken, fish).
  2. Avoid over styling your hair with heat (blow dryer, curling iron, flat iron) or chemicals (improper coloring techniques).
  3. Avoid wearing your hair up in tight ponytails or buns.
  4. Get plenty of sleep.
  5. Continue your prenatal vitamin – especially if you are breastfeeding.
  6. Reduce stress.
  7. Gentle scalp massage – encourages blood flow to the hair follicles.

Because postpartum telogen effluvium is self – limited there are no medications that are FDA approved to treat this condition. Your normal hair growth and loss pattern will return on its own. I get a lot of questions about Rogaine. Rogaine for women is not appropriate for postpartum hair loss.

What if your hair loss seems excessive? If you feel like your hair loss is excessive, you are noticing bald spots, or your hair is not re-growing over time, you may have an underlying medical condition that should be evaluated. A dermatologist would be able to evaluate your symptoms, medical history and perform testing to determine the source of hair loss. A few of the common medical conditions that can be associated with hair loss include:

  1. Anemia
  2. Thyroid disease
  3. Diabetes
  4. Polycystic ovarian syndrome
  5. Lupus
  6. Skin conditions such as seborrheic dermatitis or psoriasis

 

You got this momma!

fourth trimester, Postpartum, self-care

Surviving with “Mom Brain”

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It is pouring rain outside as the car window fogs, I forgot the umbrella (of course), and now I have to run back into the grocery store because I forgot to grab diapers during my first grocery run. How did I forget to grab diapers? I had a living reminder staring at me from the shopping cart. As I plan my strategy to dodge the raindrops and run back into the grocery store for the second time with my little guy in tow (fun), I wonder what has happened to my brain. I am more forgetful, my brain feels foggy, and I have the emotional lability of a toddler. What is happening to me??

I think most new moms can relate to this (please say yes!). If you are a mom then you have probably heard of, or experienced “mom brain”.   Most women complain of increased forgetfulness, lapses in judgment, and/or emotional instability after baby is born. So what is up? Is this normal? Are we all losing our minds?

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Well, the answer is not so simple, but I can assure you that you are not losing your mind. The brain is a complex organ that we in the medical field have yet to completely understand. It truly is the final frontier. Pregnant and postpartum brains have been even more elusive because up until recently there has been very little research to evaluate the changes that may occur in the brain as a result of pregnancy.   A new research paper published in 2016 describes visible changes in the brain in women during pregnancy and lasting up to two years after delivery. A group of researchers from Barcelona scanned the brains of women during pregnancy and again at intervals postpartum. These researchers demonstrated definite changes in the grey matter of the brain in the areas associated with social cognition. These changes are believed to help women understand the needs and emotions of their babies. While this change is extremely helpful for new moms to connect to their new babies, it also can explain why postpartum women have more intense emotional responses in general. This may explain why I now can no longer watch movies, TV shows, and commercials that have anything to do with children in distress.

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As far as cognition and judgment… “Mom brain” really should be called “a preoccupied, hyperemotional, sleep deprived woman”. I know it feels like you are getting dumber by the second, but there is no research at this time to suggest that memory, cognition and overall judgment is affected by physical changes in the brain as a result of pregnancy or postpartum. Rather, the foggy feeling many women describe as “mom brain” is more likely a result of a combination of sleep deprivation, preoccupation with other tasks and thoughts, and distraction. A new mom goes from just thinking of herself, her partner and her job to suddenly thinking of a new mini person with all of the associated necessities that this little peanut comes with on little to no sleep and a hyperemotional brain. Sounds like fun! Let a man try to remember anything under those conditions!

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Unfortunately, the causes of “mom brain” are difficult to avoid, but we can learn to manage symptoms. Here are some tips on how to function in the world with “mom brain”:

  1. Be patient with yourself. Remember there are physical changes your brain has undergone to make you the best mom you can be, but it does have other effects. So don’t cringe when you start crying at the Hallmark commercials. Give yourself room to be emotional and don’t judge. However, if your emotions are affecting your daily living or your ability to care for yourself or your family, then you should seek help from your physician or midwife.
  2. Make lists, lots and lots of lists. Find a good app on your phone for lists or do it the old fashion way with pen and paper. Just don’t leave home without it!
  3. Give yourself time to get tasks done. Rushing intensifies the feelings of fatigue and absentmindedness.
  4. Plan ahead. In my pre-baby life, I was accustomed to doing everything very last minute and in general flying by the seat of my pants. I have found out the hard way that the more I do it the old way, the more I forget. I have invested in a good calendar that I can share with my husband. I have made it a habit to prepare for the day the night before.
  5. Engage your partner with tasks to help you throughout the day.
  6. Get as much sleep as possible, even if it means frequent naps when baby naps.
  7. Make time for yourself daily, even if it is only thirty minutes. Make it a time to relax, decompress and allow your mind to wander.

You’ve Got this Momma!!!

fourth trimester, Postpartum, self-care

Prioritizing Sleep as a New Mom

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I don’t know about you, but I require 8 to 9 hours of sleep daily to feel rested. Sleep requirements differ between individuals, but studies show that most people require 6 to 8 hours of sleep daily to feel rested and function at their highest capacity. Sleep is imperative for our bodies to heal, recover and rejuvenate.

Sleep in the fourth trimester can be quite elusive. I am pretty sure I didn’t sleep for the first two weeks my little guy came home, and I have very little memory of those days with him. I was so exhausted. I was trying to do it all…visit with friends when they wanted to stop in, cook, clean and take care of my little peanut. I felt guilty for wanting to sleep. It gives me the heebie-jeebies just thinking it about it now! If I could go back and tell my new mom self one thing, it would be sleep, make it a priority. Lack of sleep affects the body in such a profound way. You may not feel the results of fatigue immediately, but believe me it will hit you eventually.

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Here are 5 ways sleep deprivation affects your body:

  1. Your body produces stress hormones causing you to be in a constant state of flight of fight.
  2. It increases your heart rate and blood pressure.
  3. It increases your risk for depression and anxiety.
  4. It depresses your immune system so your body has a harder time fighting off infections.
  5. It distorts your judgment depressing your ability to make sound decisions.

 

I encourage every momma out there living through the fourth trimester to take control of your health and well being by making sleep a priority every day. A well- rested momma is a more effective, loving, nurturing momma.

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Here are some quick tips to help you prioritize and improve sleep:

  1. Sleep when baby sleeps. I know this seems obvious, but it is very tempting to spend baby’s nap times cooking, cleaning, doing laundry, visiting with guests, watching TV, interacting with social media, etc. All of these activities are fine as long as you are not sacrificing sleep to do them. Nap times are a precious commodity especially when baby is not yet sleeping through the night, so use this time to your advantage and get some rest.
  2. Ask for help and don’t turn down help. Let other people do chores for the first few weeks, until you and baby get the hang of each other. This frees up time for you to rest.
  3. Maximize your room for comfortable sleep. Make sure your room is quiet, dark and cool.
  4. Invest in a white noise machine or app.
  5. Avoid feeling guilty for sleeping.
  6. Avoid TV, computers, smart-phones within 30 minutes of sleeping. These devices will actually stimulate your brain making it more difficult to fall asleep.

 

Sleep will change your fourth trimester experience. It is vital to self-care during the fourth trimester. Prioritize sleep and you will be better prepared to care for your new baby, your family and yourself.

Postpartum, vaginal delivery

Vaginal Lacerations: The low down on a tear down there during delivery

Vaginal lacerations are extremely common during delivery. Not to be graphic, but you did just fit a cantaloupe through a hole the size of a tennis ball. Fortunately, the vaginal tissue is forgiving and stretches significantly during the vaginal birthing process. However, the vagina still does tear. There are four main categories of tears that occur during delivery based on the depth of the tear: first-degree laceration, second-degree laceration, third-degree laceration, and fourth-degree laceration. First and second-degree vaginal lacerations are the most common tears that occur during a vaginal delivery. Third-degree vaginal lacerations are less common, and fourth-degree vaginal lacerations are the least common of the types of tears; only occurring in about 1-2% of non-instrumented (forceps or vacuum) vaginal births. Unfortunately there is no fail proof way to prevent vaginal tearing. Most of it is dependent on your anatomy, the size of the baby, length of labor and use of instruments to aid in delivery (forceps or a vacuum).

First-degree lacerations are the most shallow of the four types of tears involving the outer most surface layer of vaginal tissue. First-degree tears usually heal quickly without complication. In general, first-degree tears will require some stitches to repair the tissue so that it heals correctly. Your physician or midwife places those stitches immediately after delivery. The stitches will dissolve in 6-8 weeks.

Second-degree lacerations involve slightly more tissue than the first degree, but only involve vaginal tissue and do not extend any deeper. Just like first-degree tears, second-degree tears heal quickly without any major complications. Stitches are required to bring the vaginal tissue back together to allow for healing. The stitches will dissolve in 6-8 weeks.

Third-degree vaginal lacerations involve the vaginal tissue and the anal sphincter, which is the ring of muscle that prevents you from leaking stool. These tears require stitches to repair the muscle as well as the vaginal tissue. The stitches will dissolve in 6-8 weeks. These tears have a higher risk of poor healing. Women with third degree vaginal tears can experience incontinence of stool and flatus (uncontrolled passing of stool and gas) even after repair. Many women will require pelvic floor physical therapy and a few women will require additional surgery in the future.

Fourth-degree vaginal lacerations involve the vaginal tissue, the anal sphincter and the rectum. These tears require a great deal of stitches to repair all of the torn tissue. These tears often do not heal well. Women who have fourth-degree tears are at high risk of developing a fistula (connection) between the vagina and the rectum. It is common after a fourth degree laceration to have incontinence of stool and flatus. Frequently these tears require multiple surgeries after delivery to correct the injury. Women with fourth degree tears will need pelvic floor physical therapy.

Postpartum, preeclampsia, self-care

What every new mom needs to know about postpartum preeclampsia:

Preeclampsia is generally thought of as a complication diagnosed during pregnancy. However, preeclampsia can occur after pregnancy too. Preeclampsia during the fourth trimester can be devastating because it is often overlooked and under diagnosed.   Preeclampsia (whether it is diagnosed during pregnancy or postpartum) puts women at risk for seizures, strokes, liver damage, kidney damage and even death. It is imperative for all women to be aware of the signs and symptoms of preeclampsia so that they can seek help immediately.

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Here are signs and symptoms you need to look for after delivery:

  1. Unrelenting headache that is not relieved with Tylenol or ibuprofen.
  2. High blood pressures. Your blood pressure is considered high when the top number is 140 or higher and/or the bottom number is 90 or higher. If you don’t have a blood pressure cuff at home, you can check your blood pressure at a drug store, grocery store, or local fire station.
  3. Right upper quadrant abdominal pain.  Pain whether it is sharp, gnawing or burning pain in the right upper abdomen, just under the right rib cage.
  4. Intractable nausea/vomiting.
  5. Visual disturbances such as difficulty seeing in all visual fields, or experiencing “squiggly lines” in your visual field.
  6. Chest pain and/or shortness of breath.

 

If you experience any one of these signs/symptoms listed above, you need to be evaluated by your physician. Contact your physician immediately, these symptoms cannot wait until tomorrow. If your physician is unable to see you, then you should go to the hospital for evaluation.

fourth trimester, Postpartum, self-care

What you need to know about Gestational Diabetes After Pregnancy

Gestational diabetes is a change in how your body manages sugar during pregnancy. It is diagnosed by a blood test drawn after drinking a sugar loaded drink at around 26-28 weeks pregnant. Gestational diabetes can either be diet controlled or require medications to control blood sugar levels during pregnancy.  Women who are diagnosed with gestational diabetes, particularly gestational diabetes requiring medications to control blood sugar levels during pregnancy are at a higher risk for developing diabetes later in life.

 

If you were diagnosed with gestational diabetes while you were pregnant here are a few things you need to consider after delivery:

  1. You should have a diabetes-screening test performed after your six week postpartum visit with your obstetrician.
  2. Start exercising. Thirty to forty minutes of aerobic activity at least 5 days a week has been shown to reduce the risk of obesity and diabetes. Brisk walking is a fantastic choice for the postpartum momma. Walking is low impact, free, and easy to do in the company of your baby.
  3. Practice mindful eating to avoid over eating. Pay attention to your food when you are eating. Avoid eating while chatting with friends, watching TV or reading.
  4. Drink water. Avoid excessive sugar in sodas, sports drinks and fruit juices. Try flavoring your water with cucumbers, lemon, lime, or other fruits using a diffuser or just cut them up and put them directly in your water.
  5. Reach for fruit when you need a quick snack. Apples and bananas are easy to eat one handed and are not super messy.
  6. Eat your veggies. Fill most of your dinner plate with veggies instead of bread and pastas.
  7. Avoid eating foods that come out of a bag or box. These foods are usually high in sugar.

 

Small changes now could make a huge impact on your health in the future. In addition, you are teaching your children how to eat properly. They learn many of their habits by mimicking you. So improving your eating and exercise habits now will not only benefit you but also your children. Postpartum is the perfect time to take control of your health!

body image, Postpartum, self-care

Five Things Every Mommy Needs to Keep in Mind when Recovering from a Cesarean Section

Cesarean sections are the most commonly performed abdominal surgery in the United States. Approximately 30% of all deliveries are cesarean sections. A majority of cesarean sections are performed due to complications of the labor process. Only about 1% of cesarean sections are elective. In my experience with my patients as well as being a patient recovering from a cesarean section, it is commonly forgotten that a cesarean section is major abdominal surgery. Here are five important things to keep in mind when recovering from a cesarean section:

  1. Time.  I thought I would be able to hop right up and start back into my normal routine within two weeks of surgery. Ummm…that was a big fat NO. I have seen some patients be able to do this and I credit these ladies for their strength, incredible pain tolerance and faster than normal healing process. However, this is very rare and you should not compare your experience to anyone else’s because it can vary so widely.   Most of us will need good old fashion time. Remember to give yourself time to recover. Six weeks is the minimum amount of time to allow for healing prior to returning to full activity. Now, of course, light activity is encouraged immediately after surgery, as tolerated. My rule of thumb is: if it hurts don’t do it. The first 6-8 weeks after a cesarean section is not the time to push your body. Do not push past the warning signs. At the least be sure to give yourself a full 6 weeks to recover after your cesarean section.
  2. Patience.  I found this one difficult too. If you are normally a very active person, recovery from a cesarean section can be frustrating at times. Pain and fatigue will limit your activity for the first 4-6 weeks and even longer. I found that I wasn’t able to run normally without pain for about 12 weeks. Have patience to give your-self the time to recover. I think I was afraid that the first 4-6 weeks after delivery were the new norm, so I tried to push myself, which always ended in frustration resulting in impatience with everyone around me to include myself. If you are patient, nine times out of ten your body will return to its pre-pregnancy state. The pain will resolve, the swelling will resolve, the fatigue will resolve.
  3. Help.  You need help. You can’t recover from a cesarean section and take care of your new baby all by yourself. The more help you can enlist, the better. You will need help with routine chores (ie washing clothes, vacuuming, mopping floors, cooking dinner, etc) for at least the first two weeks after delivery, but potentially longer depending on how you feel. Do not feel guilty asking for help. Help does not mean you are an incapable momma.
  4. Sleep.  Hahaha, yah, I know sleep and newborn are an oxymoron, but this is where help comes in. The adage of sleeping when baby sleeps cannot be overstated for women who have had a cesarean section. During the first 4-6 weeks postpartum the household chores can be completed by helpers (family, friends, or paid professionals). The most important activities for you during the first 4-6 weeks after your cesarean section are feeding baby, bonding with baby and sleeping. When you are breast-feeding, sleep is definitely a commodity because unless you are pumping, no one else can help you feed the baby in the middle of the night so that you can sleep. You will have to remind yourself that every time baby naps, you should be napping as well, day or night. Do not underestimate the importance of sleep. During the time you are sleeping, your body is healing itself. Sleep deprived individuals do not heal as well and are at risk for both physical and mental illness. Even though it may feel like ground hog’s day for a month or so, getting good sleep in the first 4-6 weeks after your surgery will set you up for a healthier postpartum period.
  5. Pain relievers.  I have not encountered a patient (myself included) who was able to tolerate the postoperative pain of a cesarean section without some kind of pain medication.  Some women are able to tolerate the pain with ibuprofen and Tylenol, and that is fantastic as long as the pain is managed well enough that you are able to get out of bed and perform activities of daily living (i.e. get dressed, move around the house, fix a meal, sit on the toilet, etc) without agonizing pain.  A majority of women will require some sort of narcotic containing pain medication for the first 3 to 5 days after their cesarean section.  It is ideal to take the lowest effective dose of narcotics to control pain and to wean off narcotics within 5-7 days after surgery.  You should be able to control postoperative pain with ibuprofen and Tylenol by 5-7 days after surgery.