Warning signs after birth

Content courtesy of March of Dimes

Your body goes through lots of changes after having your baby. These changes help your body recover from pregnancy and help you get ready to care for your new baby. It’s normal to feel some discomfort, like soreness and fatigue, as your body heals after giving birth. However, other discomforts and health problems may be a sign that you need medical care. Call your doctor if you have any of these warning signs:

  • Bleeding that’s heavier than your normal menstrual period or that gets worse.
  • Discharge, pain or redness that doesn’t go away or gets worse around your C-section incision or episiotomy/perineal tear.
  • Feelings of sadness that last longer than 10 days after giving birth, you might have postpartum depression.
  • Fever higher than 38C.
  • Pain or burning when you go to the bathroom.
  • Pain, swelling and tenderness in your legs, especially around your calves.
  • Red streaks on your breasts or painful lumps in your breast, you might have mastitis.
  • Severe pain in your lower belly, feeling sick to your stomach or throwing up.
  • Vaginal discharge that smells bad.

Trust your instincts. If you feel like something’s wrong, call your doctor. Many of these problems can be treated easily. But if you ignore warning signs and they go untreated, they may cause more serious problems. Call your doctor or go to the hospital immediately if you think your life may be in danger, or if you have any of these warning signs:

  • Bleeding that can’t be controlled.
  • Chest pain.
  • Trouble breathing.
  • Signs of shock, such as chills, clammy skin, dizziness, fainting or a racing heart.

Sanity and self-care after birth

Taking care of a newborn is an incredibly joyful time, but also very stressful; it will likely push all of your coping abilities. You can’t care properly for your baby if you are too exhausted or stressed so please try to:

  • Sleep/rest – one of the biggest problems is not enough sleep. Sleep, or at least rest, when the baby sleeps.
  • Eat well – have healthy food in the house that doesn’t need cooking and can be eaten with one hand. Don’t skip meals, especially if you are breastfeeding. Ask family and friends to prepare you meals.
  • Be kind to yourself – don’t be hard on yourself if you can’t keep the house as tidy as you want, look as good as you hoped, or do other projects you had planned. Let go and focus on what you can do to make things better right now.
  • Forgive easily – that goes for yourself, your partner and your children. Raising a newborn is a stressful time; couples tend to fight and siblings tend to misbehave. Understand this is all temporary and that everyone is doing their best to adjust.
  • Get support – from friends and family, especially other new mothers who are experiencing the same challenges you are. Go out and meet people, for example at playgrounds, as this will help lighten the sense of isolation and overwhelming change. Our Breastfeeding and Baby & Mother classes at our Beba-ks Centers (also known as Women's Health Resource Centers) are a great way to meet other mothers.

The first six weeks after birth

Courtesy of March of Dimes

During pregnancy, your body changed a lot. It worked really hard to keep your baby safe and healthy. Now that your baby is here, your body is changing again. Some of these changes are physical, such as your breasts getting full of milk. Other changes are emotional, such as feeling extra stress. Here's what you can expect.

What is perineum soreness?

The perineum is the area between your vagina and rectum. It stretches during labor and vaginal birth, and it may even tear. It often is sore after you give birth. You may be even more sore if you had an episiotomy (a cut made at the opening of the vagina to help the baby out). Here's what you can do to manage perineum soreness:

  • Do Kegel exercises. These strengthen the muscles in the pelvic area, which helps the perineum heal. To do them, squeeze the muscles that you use to stop yourself from passing urine. Hold the muscles tight for 10 seconds and then release.
  • Put a cold pack on your perineum. Use ice wrapped in a towel. Or you can buy cold packs that you freeze in your freezer.
  • Sit on a pillow.
  • Soak in a warm bath.
  • Wipe from front to back after going to the bathroom. This can help prevent infection as your episiotomy heals.
  • Ask your doctor about medicine to help ease the pain.

What are afterbirth pains?

These are cramps that you feel as your uterus shrinks back to its regular size. Right after you give birth, your uterus is round and hard and weighs over 1kg. By about 6 weeks after birth, it weighs only 50gr. The cramps should go away in a few days. Ask your doctor about over-the-counter medicine you can take for pain.

What body changes can happen after a C-section?

A C-section (cesarean section) is major surgery, so it may take a while for you to recover. You may be really tired for the first few days or weeks after a C-section. This is because you lost blood during the surgery. Also, your incision (the cut on your belly) may be sore. Here's what you can do:

  • Ask your doctor for pain medicine and check with them before you take any over-the-counter medicine for pain.
  • Ask your husband, family and friends for help with the baby and around the house.

What is vaginal discharge?

This is bodily fluid that comes out of your vagina. It is also called lochia. Vaginal discharge may increase during and after pregnancy. After your baby is born, your body gets rid of the blood and tissue that was inside of the uterus. For the first few days, it’s heavy, bright red and may contain some blood clots. Over time, the flow gets less and lighter in color. You may have discharge for a few weeks, or even for a month or more. Use sanitary pads until the vaginal discharge goes away.

What is breast engorgement?

This is when you breasts swell as they fill with milk. It can be painful. Once you start breastfeeding, it should go away. If you’re not breastfeeding, it may last until your breasts stop making milk. Click here for ways to manage breast engorgement.

What is nipple pain?

If you are breastfeeding, you may have sensitivity or pain in the area in and around your nipples during the first few days, especially if your nipples crack. Click here for ways to manage nipple pain. But breastfeeding shouldn’t be painful; if it is there is likely a problem with baby’s latch; click here to see how to get a good latch.

What is swelling?

Lots of women have swelling in their hands, feet and face during pregnancy. It is caused by extra fluids in your body that helped you get ready for labor and birth. It may take time for the swelling to go away after you have your baby. Here's what you can do to manage swelling:

  • Lie on your left side or put your feet up.
  • Try to stay cool and wear loose clothes.

What are hemorrhoids?

Hemorrhoids are painful, swollen veins in and around the anus. Lots of women get them during pregnancy. They may get worse after giving birth. Here's what you can do to manage hemorrhoids:

  • Soak in a warm bath.
  • Use an over-the-counter spray or cream to help relieve pain. Ask your doctor which ones are OK to use.
  • Eat foods that are high in fiber, such as fruits, vegetables and whole-grain breads and cereals.
  • Drink lots of water.
  • Try not to strain when you’re having a bowel movement.

What is constipation?

This is when you have painful gas or trouble having a bowel movement. It may happen after you give birth. Here's what you can do to manage constipation:

  • Eat foods that are high in fiber; nuts (almonds, pecans and walnuts), beans, fresh fruit (pears, kiwi and berries) and dried fruit (prunes, apricots and figs).
  • Drink lots of water.
  • Ask your doctor about medicine to take.

What urinary problems can happen after giving birth?

You may feel pain or burning when you urinate. Or you may try to urinate but find that you can’t. Sometimes you may not be able to stop urinating; this is called incontinence. If you have pain, burning trouble urinating or you have incontinence:

  • Drink lots of water.
  • Run water in the sink when you go to the bathroom.
  • Soak in a warm bath.
  • If the pain continues, tell your doctor.
  • Do Kegel exercises to strengthen your pelvic muscles. This can help with incontinence.

Why may you sweat after giving birth?

This happens a lot to new moms, especially at night. It’s caused by all the hormones in your body after pregnancy. Here's what you can do:

  • Sleep on a towel to help keep your sheets and pillow dry.
  • Don’t use too many blankets or wear warm clothes to bed.

Why may you feel tired after giving birth?

You may have lost blood during labor and birth. This can make your body tired. And your baby probably doesn’t let you sleep all night. Here's what you can do:

  • Sleep when your baby sleeps, even when he naps during the day.
  • Eat healthy foods, like fruits, vegetables, whole-grain breads and pasta, and lean meat and chicken. Limit sweets and foods with a lot of fat.
  • Ask your husband, family and friends for help with the baby and around the house.

When can you get pregnant again?

If you're not breastfeeding, your period may start again in 6-8 weeks after giving birth. If you are breastfeeding, you may not start again for months. Some women don’t have a period again until they stop breastfeeding. It’s possible that you may ovulate (release an egg) before you get your period again. This means you could get pregnant, whether you're breastfeeding or not. Use birth control to help make sure you don’t get pregnant again until you’re ready. If you’re breastfeeding, ask your doctor about which birth control to use as not all kinds are safe when breastfeeding.

Can you lose weight after giving birth?

Now’s a great time to get to a healthy weight, no matter how much you weighed before you got pregnant. You feel better and are less likely to have health conditions, like diabetes and high blood pressure, if you’re at a healthy weight. And just in case you get pregnant again, or if you plan to have another baby sometime in the future, it’s best to be at a healthy weight before your next pregnancy. Here's what you can do to lose weight:

  • Talk to your doctor about your healthy weight. If you were overweight before pregnancy, you may want to lose more weight than you gained during pregnancy.
  • Eat healthy foods. Limit sweets and foods with a lot of fat.
  • Drink lots of water.
  • Do something active every day. Walking and swimming are great activities for new moms.
  • Breastfeed your baby. Breastfeeding helps you burn calories. This can help you lose the weight you gained during pregnancy faster than if you weren’t breastfeeding.
  • Don’t feel badly if you don’t lose the weight as quickly as you’d like. It takes some time for your body (and your belly) to get back into shape.

What skin changes can happen after giving birth?

You may have stretch marks on your belly, thighs, breasts and bottom where your skin stretched during pregnancy. Use creams or lotions on your skin to manage stretch marks.

What hair changes can happen after giving birth?

Your hair may have seemed thicker and fuller during pregnancy. After your baby is born, your hair may thin out. You may even lose hair. Hair loss usually stops about 3-4 months after your baby’s birth. Here's what you can do:

  • Eat lots of fruits and vegetables. These may help protect your hair and help it grow.
  • Be gentle with your hair. Don’t wear tight ponytails, braids or rollers. These can pull and stress your hair.
  • Use the cool setting on your hair dryer.

The first year after birth

When will I get back to my pre-baby weight?

The good news is you will probably lose about 5-6kg immediately and continue to lose weight as your body sheds all the excess water. Breastfeeding mothers tend to lose weight faster because of the extra calories their baby consumes. You will probably still look pregnant for several weeks or months as your uterus contracts and your belly gets back into shape. Exercise and eating healthy (not skipping meals) will help. Most first-time mothers take 6-12 months to get back to their pre-pregnancy weight.

Will I be ‘looser’ after giving birth?

Research has proven that long-term sexual function remains the same and is not impacted by vaginal birth. Vaginal tightness returns within 6 months post-partum for at least the first birth. You can do kegel exercises to tighten your vagina and this will also increase sexual pleasure for both you and your husband.

What kind of diet and exercise should I do?

It’s fine to slowly start exercising as soon as you feel up to it, but if you have concerns, wait until your six-week postpartum checkup. Start slowly with a low-impact aerobic activity such as walking. Even if you have had a C-section, walking at an easy pace a few weeks postpartum will promote the healing and prevent blood clots. Also, keep taking your prenatal vitamins if you are breastfeeding. Don’t start dieting until baby is about two months old and even then remain focused on eating regular healthy meals versus simply reducing calories.

What other hormonal changes can I expect?

You are in for a hormonal rollercoaster ride. The major hormone changes can give you mood swings and skin changes such as breakouts or clearer skin and also lightening of any dark spots and stretch marks. You might also find your hair falls out in fistfuls but don’t be scared, you won’t go bald, this is normal as you don’t tend to lose as much hair during pregnancy so it is just the excess hair falling out. You might also get the Baby Blues or postpartum depression (see below).

Baby blues and postpartum depression (PPD)

Baby Blues

You could be more emotional after giving birth due to hormonal changes, pain from the birth, lack of sleep and other emotional adjustments to motherhood. You could be happy most of the time, but at times be more irritable, cry more easily, feel sad or feel confused. This is the “Baby Blues” and affects up to 80% of new mothers. It peaks three to five days after delivery and last for a few weeks after birth. Although the “blues” are not pleasant, you can function normally. The feeling usually lessens and goes away over time on its own. But if it doesn’t and you think you are getting worse rather than better, you might have postpartum depression (PPD) and need help.

Postpartum Depression (PPD)

PPD is more common than you might think. Around 1 in 7 new mothers get PPD. It often starts within 1-3 weeks after birth but it can occur anytime within the first year. Symptoms differ but can include:

  • Feelings of anger or irritability.
  • Lack of interest in the baby.
  • Appetite and sleep disturbance.
  • Crying and sadness.
  • Feelings of guilt, shame or hopelessness.
  • Loss of interest, joy or pleasure in things you used to enjoy.
  • Possible thoughts of harming the baby or yourself.

Don’t worry; postpartum depression is temporary and treatable. If you feel you may be suffering from it, know that it is not your fault, and there are things you can do to help cope and recover. If you think you have PPD, see a doctor or check with your local Beba-ks Center (Women's Health Resource Center) for a referral to a specialist.

There are three things you can start doing for yourself right away to feel better:

1. Stay healthy and fit:

  • Do something active every day. Go for a walk or get back to the gym.
  • Eat healthy foods. These include fruits, vegetables, whole-grain breads and lean meats. Try to eat fewer sweets and salty snacks (even though that is what you might crave).
  • Get as much rest as you can. Try to sleep when your baby sleeps
  • Don’t drink alcohol; it is a depressant, which means it can slow your body down and make you feel more depressed.
  • Don’t take street drugs. These affect the way your body works and can cause problems with the medicine you might be taking for PPD.

2. Ask for and accept help:

  • Keep in touch with people you care about and who care about you. Tell your husband, family and friends how you’re feeling. 
  • Take time for yourself. Ask someone you trust to watch the baby so you can get out of the house. Visit a friend, get outside or do something you enjoy. Plan for some time alone with your partner. 
  • Let others help around the house. Ask your friends and family to watch the baby, help with housekeeping or go grocery shopping. Don’t be afraid to tell them what you need.
  • Join an online support group. You can get more information and talk to experts at Postpartum Support International and Postpartum Progress (both in English only).

3. Lower your stress:

  • Do the things you liked to do before you had your baby. Listen to music, read a good book or take a class.
  • Do the things that used to make you feel good about yourself before you got pregnant.
  • Try not to make any major changes in your life right after having your baby. These include moving or changing jobs. Major changes can add stress to your life that you don’t need right now. 
  • Talk to your boss about going back to work. Maybe you can work at home or part-time when you first go back to work.

If these things help, great! Keep doing them as if you stop you might find your symptoms return. If these things don’t improve your symptoms within two weeks, you should definitely see a doctor or check with your local Beba-ks Center (Women's Health Resource Center) for a referral to a specialist. You might need additional therapy, including prescription antidepressants. It’s very important you take PPD seriously as it can make it hard for you to take care of your baby and will only get worse if left untreated. If you have thoughts of harming your baby or yourself, see a doctor immediately.

How will a doctor treat your PPD? They will first ask you some questions to help determine if you have PPD. They may do tests to see if you have other health problems that may lead to PPD. For example, they may check your thyroid hormones as low levels of thyroid hormones may lead to PPD. The sooner you see your provider about PPD, the better. You can get started on treatment to make you feel better so you can take good care of yourself and your baby. These are treatments your provider may suggest:

  • Counseling: this also is called therapy. It’s when you talk about your feelings and concerns with a mental health professional. They help you to understand your feelings, solve problems and cope with things in your everyday life.
  • Medicine: PPD often is treated with medicine, including 1) Antidepressants - some have side effects and some are not safe to take if you’re breastfeeding so talk to your doctor to decide if one is right for you. 2) Estrogen - this hormone plays an important role in your menstrual cycle and pregnancy, but check with your doctor if you are breastfeeding.

Sex and intimacy after baby

Both you and your husband are getting used to having a baby around. Your husband may be just as nervous about being a parent as you are. Make sure you talk to each other. Talking about your feelings can help keep you both from feeling hurt and frustrated. As soon as you can, make time for just the two of you. Ask someone you trust to take care of the baby for an hour or two and go for a walk or out to dinner.

Generally, it is OK to have sex 4-6 weeks after birth, although not everyone waits that long, and not everyone is ready that soon. If you had a difficult birth, you might need longer to physically recover. Even if you are ready physically, you might not be ready emotionally. Having a baby is a hormonal rollercoaster and you may need more time to adjust. You also might be afraid of pain and could be tired from the demands of your newborn. Even if you don’t have sex, you can still be intimate; stroking, kissing, masturbation and oral sex are all be options if you are interested.

You might feel self conscious of your body after having a baby. Don’t. You just brought a human being into this world; your body is amazing. Never forget that. Generally, it takes first-time mothers 6-12 months to get back to their pre-pregnancy weight. Sex might also feel different. Often women experience vaginal dryness due to hormonal changes so use a lubricant. Experiment with different positions to find out what is most comfortable for you. Take it at your own pace and stop whenever you want to. Don’t worry, your sex life will return to normal soon enough.

Maternity leave in Kosovo

Following is what is currently allowed for under Kosovo law:

  • Paid leave for childbirth or adoption: Two working days (Article 50)
  • Unpaid leave for childbirth or adoption: Two weeks at any time before the child reaches the age of three (Article 50)
  • Maternity leave: 45 days up to 12 months (first 6 months – compensation is 70% of basic salary, next 3 months – compensation is 50% of average salary, last 3 months – unpaid) (Article 49)
  • Mandatory maternity leave: 28 days before expected delivery up to 6 months (Article 49) Parental leave: After the lapse of the mandatory maternity leave, if the parents so agree, the right to maternity leave can be used by the child's father (Article 49)
  • Paternity leave: If the mother of a child has died or abandoned the child, or for other justified reasons is not able to take care of her child, the rights are the same as mother’s (Article 49, 50)
  • Child in need of greater care – one parent: Upon the expire of maternity leave, right to work half of full-time working hours until the child is two years of age if the child (Article 52)
Law No. 03/L–212 on Labor, http://www.assem- bly-kosova.org/common/docs/ligjet/2010-212-eng. pdf. Source: State of the World’ Fathers, Balkan Review, Care International Balkans & MenCare

Family Planning

What are my birth control options?

For information about your birth control options, contact your doctor or visit your local Beba-ks Center (Women's Health Resource Center). Make sure you tell your doctor if you are breastfeeding as some birth control methods are not compatible with breastfeeding.

Am I protected if I am breastfeeding?

It is a well-known fact that breastfeeding is a safe, convenient and short-term way of preventing pregnancy. But maybe you have been told otherwise, or know someone who became pregnant while breastfeeding. Extensive scientific studies have proven that when breastfeeding you have less than a 2% chance of getting pregnancy, but only if all three of the following conditions are met:

  1. Your period has not returned; and,
  2. You are exclusively breastfeeding both day and night (without long intervals between feeds i.e. no more than 4 hours during the day and 6 hours at night), not using pacifiers and not feeding other foods or liquids regularly; and,
  3. Baby is younger than 6 months old.

If any one of the three above conditions changes, then you are no longer fully protected and you should use another contraceptive method.

How long should I wait before getting pregnant again?

It's best to wait at least 18 months between giving birth and getting pregnant again. This means your baby will be at least 1½ years old before you get pregnant. Too little time between pregnancies increases your risk of premature birth and these babies are more likely to have health problems than babies born on time. Your body needs time to fully recover from your last pregnancy before it’s ready for your next pregnancy.

Category: Mother Care

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