- If a woman is not already if she is doing it correctly. Of alleviating perineal discomfort, it is a good one toadd on the third day. She would tighten and relax her perineal muscles 10-15 times in succession as if the trying to stop voiding. Shewill feel her perineal muscles working if she is doing it correctly.
. Arm raising helps both the breasts and the abdomen return to good time is a good exercise to add on the fourth day.Lying on back, arms at her sides, a woman moves arms out from her sides until they are perpendicular to her body. She time raisesthem over her body until they are perpendicular to her body. She then raises them over her body until her hands touch and lowersthem slowly to her sides. She should rest a moment, then repeat the exercise 5 times.
. It s advisable to wait until to 10
day after delivery before attempting abdominal crunches. Lying flaton her back with knees bent a woman folds her arms across her chest and raises herself to a sitting position. This exercise expenses agreat deal foe effort and tires a postpartum woman easily. She should be cautioned to begin it very gradually and work up slowly todoing it 10 times in a row.
Post Partum Blues:
There are many changes, which have happened to you in the past 9 months, and even more are happening now. You may befeeling a little left out or dissociated from your surroundings. Link to introduction of puerperium the swings in your hormone levels aremaximum in the first week. Your baby may be keeping you awake all the time, your breasts feel sore, and your stitches are hurting.Many things add up to make you feel down. Many women feel low or depressed soon after delivery - in fact, it is so common that thereis a medical team for it, called ‘fifth day blues’! Talk to your partner, your friends, an older relative or your health care persons. Ask forhelp with the baby if you are tired. Have a good cry. Take a break, sleep for a while and you will feel better. If this feeling of depressiondoes not settle in a few days, then perhaps you should see your doctor for help, Sometimes an underlying hormonal problem like lowthyroid function may be causing these feelings. Remember that these feelings are not uncommon. You are not the only mother who isnot feeling ‘100% maternal love’ all the time, particularly soon after delivery. Be good to yourself, pamper yourself also, and talk aboutwhat you feel. Soon, you too will feel on ‘top of the world’!
As discussed earlier, it takes up to 6 weeks for your body to recover from the changes of pregnancy. So, be
patient with you.Listen to your body and do as much as you feel up to, Different women have different abilities to deal with their health changes.However, in most cases, after a normal vaginal delivery, you will be able to resume your daily personal care activities within a day, andyour household routine within a week, don’t overexert yourself - This is the time you need to devote to yourself and your baby. Takehelp; involve your partner, Link to Father’s role, and others available to make your life easier. After a complicated childbirth, or after acaesarean delivery your recovery may take twice as much time, so be patient.
Sexual Activity is best avoided in the early post delivery period. This is because your stitches may be raw or painful, and yourgenital tract is prone to infection, particularly in the 1<sup>st week. Complete restoration of the lining of the uterus, including theplacental site, is not complete. Hence traditionally some advise abstinence till 6 weeks following delivery. However, if you have had anuncomplicated birth, and are not having any problems, you could resume your sexual life earlier. You and your partner may have beendeprived of each other, particularly in the last month of pregnancy. Hence, it is not unusual to feel the need to renew your sex - life.Until you feel comfortable for actual penetrative sexual intercourse, other displays of caring and affection can suffice. Hugging, kissing,petting or touching is not forbidden at anytime during pregnancy or post-delivery.
Link to lactation amenorrhoea in preventing pregnancy. While you are exclusively breastfeeding, Link to exclusivebreastfeeding in Breastfeeding, the hormonal changes is your body act on the genital tract to suppress ovulation and menstruation.Link to female reproductive, tract, ovulation, and menstruation. You may not get your periods for a few months. Some women do notstart menstruating for up to a year, depending on the pattern and frequency of breastfeeding. Timing No lactation If lactation established Menstruation 6 - 12 weeks 36 weeks (average) Earliestovulation 4 weeks 12 weeks Average time for ovulation. 8 - 10 weeks 17 weeks (variable)Does this mean you cannot get pregnant? The answer is NO. About 5% of women get pregnant before they start menstruating,post-delivery. Lactation amenorrhoea (absence of periods) does protect you from pregnancy to some extent. However, you can relycompletely on Lactational amenorrhoea as a method of preventing pregnancy ONLY IF ALL 3 preconditions listed below are satisfied:
If you are relying on lactational amenorrhoea. If not, that brings us to the important question: Are you ready for anotherpregnancy? You need to give your body time to recover; your baby time to grow up and yourself time to adjust to the new role of ‘mother’. Of course, it is a question of personal choice but a minimum gap of 2 years is recommended between successive pregnancies.So, how can you prevent pregnancy during the post-delivery period?There are many methods available. During the post partum period,however, certain factors need to be kept in mind:
Condoms are a good, locally acting method, which are reliable if used correctly and consistently. They have no side effects andare useful for couples with less frequent sexual intercourse.
IUCDs or ‘loops’:
These are a very reliable method, requiring one visit to the doctor for insertion, which can be done easily without anaesthesia. They are effective for average 3 - 5 years (depends on the device) and are independent of the sexual act, unlike condoms. This is a verypopular method for women with one or more children. Infact, can be used as an option to permanent procedure. The IUCD can beinserted at the first postnatal visit. Link (6 weeks from childbirth) or later, even if you do not have periods, provided your internalchecking is normal.
Oral Contraception pills:
These are a type of hormonal contraception. During the period of exclusive breastfeeding the combined Oral Contraceptionpills (containing Estrogen + Progesterone) may reduce the breast milk flow. Hence are not popularly recommended. Once weaning isbegun, there can be used safely.
This is a permanent method, which can be opted for after you have completed your family. This is a procedure which can bedone easily immediately post-delivery (puerperial sterilization) or at the time of caesarean section. For both these options, you need todiscuss the pros and cons with your doctor and spouse before delivery, ideally in one early antenatal period. Some prefer to wait untilthe youngest child is older, preferably above 1 year old, before doing this permanent procedure. As an interval procedure, 6 weeks ormore after delivery, it is usually done by laparoscopy.
First Postnatal Visit:
You and your baby have been through a lot. After you go home, and you recover from childbirth, your doctor will need to seeyou at least once to confirm that your recovery is complete. The first check up is usually 6 weeks from delivery. It may be earlier, about3 weeks, if you have needed special care or had any problem in delivery. At the first visit, your doctor will check
You may need to do some tests. You need to discuss the following issues with your doctor