Perineal Healing

Along with the joy, exhaustion, and sometimes-overwhelming emotions that you feel after giving birth, you might experience some discomfort-or even pain-in your perineum-which is the area between your vagina and anus. That's because the skin and muscles in that area are very stressed during a vaginal delivery-and might tear as the baby emerges. Perineal tears-which are more common during first-time vaginal deliveries--can range from small nicks and cuts to deeper lacerations that affect both skin AND muscle tissue. If the perineum endures ONLY a first-degree tear that affects JUST the skin, you'll be looking at a quicker bounce-back, likely with VERY FEW stitches and minor discomfort. If BOTH perineal skin AND muscle are affected, MORE stitches are usually needed and healing can take up to a few weeks. Sometimes, to prevent more severe AND IRREGULAR tears and provide a larger opening for the baby, the practitioner MAY cut through that tissue during labor.If that's not done skin and muscle tissues surrounding the vagina, perineum and anus may be badly damaged and the resulting wound could take a few weeks longer. But even if there is no tear, it's very normal for your perineum to be tender or swollen for a week or so after delivery and is not a topic to be worried about. To ease the discomfort: *Cool the area with an ice pack and, if your doctor says it's okay, take pain relievers. * To keep cuts from stinging during urination, pour warm water over the area while you go. *Take a hot sitz bath to soothe the area. *Eat soft foods and try not to strain when you're on the toilet. *To keep stiches secure and prevent reinjury, take stool softeners if needed. It's important that you allow your body ample time to heal - and it will -- and make sure you follow up with your practitioner right away if you are having difficulties.

If you delivered your baby by Cesarean section, you'll need a little extra time to rest, relax and heal. But it should not interfere with your enjoyment or care of your new baby. During a Cesarean section a surgical incision is made in your ABDOMEN and uterus to deliver your baby. Because C-sections are major abdominal surgeries, it can take four or more weeks for the incision to heal. Typically, you'll stay in the hospital two to four days post-surgery so you can be monitored during the initial recovery stages. You'll be encouraged to GET up and move shortly after your surgery to get the healing process started. During this time, you'll be able to care for and feed your newborn as any new mom would. Yes, you CAN breastfeed post-surgery-but if you need pain medications make sure they are safe to take while nursing. You can ask YOUR hospital lactation consultant if you're feeling hesitant or have concerns. Before you head home, be sure to ask any questions you have regarding your at-home care and have your doctor write prescriptions for any medication you may need. At home, it's up to YOU to make sure you do what's necessary to heal properly. So avoid strenuous activity, any lifting other than the baby, and enlist the help of friends and family when you need rest, and drink PLENTY of fluids to keep your bowel movements as regular and as smooth as possible. Prescription narcotics can cause constipation, so you may be better off with an over-the-counter pain medication such as ibuprofen. When caring for your incision, be sure to keep it clean using warm, soapy water. Pat it dry and re-bandage if needed. And be on the lookout for any complications like redness, warmth or swelling at the incision site, odor or drainage. These could be signs of infection and should be addressed by your practitioner. Also, you should avoid sexual activity until you see your practitioner. Don't go in hot tubs or pools. Don't use tampons, lift anything heavier than your baby or take lots of stairs. For more information on your body after baby, watch other videos on this site.

Constipation. Yes, it's pretty common the first few days after giving birth. Your stomach muscles-which help you go-have been stretched and weakened during pregnancy. It also might be harder to have a bowel movement if your perineum, anus or vagina were surgically cut or torn during delivery or if you are taking prescription pain medication. If you're still sore from delivery or have stitches, it's NORMAL to be concerned about extra pain or possible tearing during a bowel movement, but if you listen to your body, you will most likely be just fine.REMEMBER: Don't push or stain too hard and let your body do what it's meant to. While your first few postpartum bowel movements may be uncomfortable, it's important to know that it's very rare for stitches to tear and it WILL get easier to go over time. Meanwhile, stay hydrated. Liquids not only soften your stools but also help replenish fluids lost during delivery. It might be helpful to take a mild stool softener as well, to ease things along. Check with your practitioner first. And make sure you eat soft foods, whole grains, fresh fruits and vegetables. When you're constipated, the fiber in these foods can ease constipation and make post-partum bowel movements less uncomfortable. Plant-based foods take about 24 hours to move through your intestines, but meats can take up to four days. Going for a short walk can also help stimulate your bowels. The more you move around, the more likely it is you'll be able to go comfortably on your own.. But DON'T overdo it. Three or four slow, leisurely strolls each recovery day should do the trick.

If you're planning to breastfeed your twins, congratulations! You--and your babies--will be in for a GREAT experience. While breastfeeding multiples might seem challenging initially, it WILL become easier once all of you get into the routine. In the early stages, your babies may have different feeding schedules and one may feed longer or more frequently than the other. So start off feeding each baby individually to get a feel for how well you--and your babies-respond before moving into simultaneous feeding. It might also help to make a chart or journal to record how long and how often each child feeds. If you pump your breast milk, you can also record HOW MUCH your baby takes during a feeding. Once you and your babies have gotten used to breastfeeding, you probably will be able to feed both babies at the same time. This is called tandem nursing and is usually possible after both babies can comfortably latch on, and can be a very efficient feeding style. Once you get the hang of it, it's also smart to alternate the side you put each child on-to balance out demand. If you feel anxious about breastfeeding, remember that although it takes some getting used to, ultimately your body - and your babies -- know what to do. After carrying and delivering twins, your breasts operate on a 'supply and demand' system so you can trust them to provide as much as your babies need or want to eat.If you find yourself struggling physically or emotionally, DON'T get discouraged. INSTEAD ask your practitioner for referral to a nursing coach or lactation consultant. And don't be afraid to recruit family or friends for their help when you need it.

Hypnobirthing-- the same method Kate Middleton said she was going to use to deliver Prince George-- is a form of natural childbirth that relies on self-hypnosis and relaxation techniques to keep the mom-to-be calm, focused and virtually pain-free while delivering her baby.The philosophy behind hypnobirth is that-women are made to give birth easily BUT that fear makes it more painful and difficult. That's because fear activates your fight-or-flight mechanism, releasing stress hormones that make your heart race and increase blood circulation in your arms and legs. During labor, this can reduce blood flow to the uterus and amp up pain.Hypnobirthing techniques of controlled breathing, mindfulness and deep relaxation are taught in a series of classes, usually beginning in the third trimester . Moms also repeats daily affirmations such as, "When I relax, my baby relaxes." And they work on rejecting negative feelings associated with labor and replacing them with more positive or neutral concepts.For instance, words like PAIN and CONTRACTION are replaced with SURGE and SENSATION. If you're thinking about using hypnobirth, it's important to find a doctor or practitioner who understands the method, but who is flexible if you change your mind and want to opt for pain medications. It's sometimes hard to predict in advance how your labor will go and it's okay to change your mind.Remember, it's about how YOU want to deliver your baby, so having open communication with your doctors and other pregnancy advisors is extremely important.

Many women may think of natural childbirth as painful, but for some, it can also be pleasurable. Rare, but true! For 1% of women, labor triggers orgasms. That's because the vaginal canal, cervix, vagina and clitoris are all stimulated during childbirth. And women who experience orgasmic delivery report that the orgasms lessen labor pains. This is possible because orgasm triggers the release of endorphins and other hormones that act as natural painkillers. If you take pain medications during delivery or have an epidural -and many women in the U.S. do-- such pleasurable sensations are blocked. Perhaps because pain medications are so widely used, many medical professionals and women who have given birth multiple times doubt orgasmic birth can happen. But those women who experience it insist it is a VERY real physical response. To learn more about labor and delivery, check out the videos in this series.

You've heard about celebs like January Jones and Alicia Silverstone - and reportedly Jennifer Aniston - bragging about the health and beauty benefits of placenta pills. And Kim Kardashian debated the idea of ingesting the placenta prior to the birth of daughter North West. But is there any validity to their claims? The placenta is dense in minerals and nutrients and some new moms choose to consume it after birth to improve post-partum recovery. The placenta can be boiled, sauted, or even eaten raw, but the easiest and most convenient way to consume it is by taking placenta pills. But does ingesting your placenta, especially dehydrated in pills, REALLY provide any health benefits? And are there any risks?Placental pills are made by steaming, dehydrating and grinding the placenta and placing the resulting powder into capsules --all for around $300. You can either hire a service to do this or you can do it yourself, IF you want to. Placenta pill supporters claim that consuming placenta nutrients, in any form, boosts the maternal instinct, alleviates fatigue and helps prevent postpartum depression. It may also improve your milk supply if you're breast feeding....and there are even beauty boosting claims to add to the mix.Moms who have tried it--including our celeb moms-- report it gave them a speedy postpartum recovery. But others haven't had as much luck--and some report worsening moods, anxiety, and physical instability. Whether eating your placenta can actually provide post-partum benefits is still up in the air-there's no research to prove or DISprove it-one thing is for sure, whatever nutrients are in the original placenta, steaming, dehydrating or cooking up the tissue could destroy or diminish them. And eating your placenta or taking placenta pills could be especially risky for women hoping they will relieve severe postpartum depression since the pills do NOT replace psychiatric treatment. Even advocates say that the placenta pills can make you hyper if you take more than the suggested 2 a day. On the plus side, there do not seem to be any health hazards from eating a cooked placenta, just remember to handle it with care to avoid contamination or spoilage...the same as you would with any meat or fish. So if you are interested in trying it, talk with your doctor and hospital ahead of delivery to make arrangements for the placenta to be transferred to you.

Delivering your baby is a rush, but it can also be a little bit scary. Remember that babies have arrived vaginally since the dawn of time, and that two-thirds of American babies still debut this way! The first-time mom can expect to labor for about fourteen hours, while repeat moms tend to take around eight. But because labor CAN last a few days, it helps to be prepared! Childbirth begins with labor, a three-stage process. The first stage of labor has 2 phases, latent and active phase. Latent labor is the longest phase and lasts from a few days to a few weeks. During latent labor, your cervix will dilate about three centimeters, a process that results in mild, brief contractions, which are spaced five to twenty minutes apart. Your amniotic sac MAY rupture now, but it's more likely that your water will break once you're in the hospital. Expect to notice discharge, known as the bloody show, and to experience back aches and cramping. At the end of latent labor, the active labor phase begins and you'll head to the hospital. During active labor, which usually lasts for several hours, your contractions will strengthen and occur about every three minutes. Try to stay as comfortable as possible during this period. Don't be afraid to ask for a back rub, or for help walking through a contraction. During the active phase of labor, you'll start your breathing exercises, if you plan to use them. If you're having a medicated birth and have not yet done so, you might ask for pain-relief now. At this point your cervix will open past four centimeters and labor will quicken. The result is very strong contractions which last about a minute and are spaced quite closely together. This part of your labor can be VERY intense, and you may experience nausea, fatigue, chills or sweats, and strong pressure in your lower back and rectum. Once your cervix is fully-dilated to ten centimeters, your labor will end and it will be time for stage two of childbirth: the delivery! To push your baby through the birth canal, a process that can take 60 minutes to several hours, you'll get into your preferred birthing position. Following the instructions of your doctor, you'll push as if you're having a bowel movement with each contraction. And don't worry: Your bowels and bladder may empty, or you may vomit, and that's normal! Between contractions, you'll rest and conserve your energy for that next push. Soon, your baby's head will appear, or crown. Once the head emerges fully, your doctor will suck mucous out of your baby's nose and mouth, and then guide him or her the rest of the way. The umbilical cord will be cut and your baby will be in your arms! But YOU'RE not done! It's time for stage three of childbirth: delivery of the placenta. This usually doesn't last longer than 20 minutes and is accompanied by mild contractions. Once the placenta is delivered, your doctor will stitch up any tears and you'll be free to nurse and cuddle your new arrival. Congratulations, Mom!

If your baby is delivered by cesarean section, you're not alone: About 30 percent of babies born in the United States make their arrival this way! So why might a C-section be necessary? Some women walk into delivery already slated to have a cesarean. These high-risk moms may have placenta problems, a breach presentation baby, a multi-fetal pregnancy or have had previous uterine surgery. Women who are HIV-positive or who have an active genital herpes infection may also require a C-section, so as not to pass the virus on to the baby. More frequently, though, a C-section is not scheduled in advance. If a woman's cervix doesn't dilate properly, or if the baby's head is too large to fit through the pelvis, a cesarean section becomes necessary. Other in-the-moment problems can also lead to emergency C-sections, such as fetal distress, a ruptured uterus, or a too-exhausted mom. So what happens during the procedure? First, anesthesia is administered. Most often, you'll get an epidural or spinal block, which numbs the lower half of your body, while still keeping you awake. If you're having an emergency C-section, there may not be enough time to numb you, in which case you'll be put to sleep with general anesthesia and wake up with a baby! Once numb, a catheter will be placed in your bladder and a drape will rest on your abdomen. This is so you don't have to see the incision. The doctor will make a horizontal cut just above your pubic hair line to start your C-section. Then, your baby will be lifted from your body, no worse for wear, and without the pointy cone-head of babies born vaginally. Your surgeon will then cut the umbilical cord and stitch you up, a procedure that can take up to thirty minutes as each layer of tissue is mended. The recovery from a cesarean section usually begins with three days in the hospital followed by six to eight weeks of rest at home. Because a cesarean is a major medical procedure, your mobility may be limited as you recover initially. You may also experience similar symptoms to moms who deliver vaginally, including cramping in your uterus, bloody discharge, and fatigue. Of course, as you wait for your post-surgical symptoms to pass, you can enjoy getting to know your new arrival, a worthwhile reward if ever there was one!

A word of comfort to new moms and dads: You WILL figure this out! Newborns are a lot of work, but knowing some baby basics will help. Of course, one of your more unpleasant (and frequent!) jobs will be diaper duty. This isn't hard and will become second nature in no time. Before you start, be sure that you have everything you need at your fingertips. That means diapers, baby wipes, diaper rash ointment, and a change of clothes (just in case!) Lie your baby down and open the diaper. Parents with boys, watch out for that penis! Keep it covered with a cloth when he's undressed to avoid a spray surprise. Now fold over the diaper so that the clean side touches your baby's bottom. Lift your baby's legs and wipe the area well. If you have a girl, wipe her from front to back to keep her vagina bacteria-free. If you have a boy, prevent leaks by quickly fastening his diaper. As you replace the dirty diaper with a clean one, remember that disposables have tabs that go in the back and wrap around to the front. So what if your baby's made a REALLY big mess in his or her diaper? Bath time! Once again, have everything you'll need handy before you begin. Ensure that the room is between 75 and 80 degrees. Because babies lose body heat very quickly, this keeps them comfortable. Use an infant tub, or the sink, until your baby can sit up unassisted. Once the sink is filled with enough water to cover your baby's bottom half, slide him or her into the tub. When washing a newborn, use soap sparingly and stick to the hands, bottom and genitals. The rest of your baby's body can be washed with water alone. If you want to shampoo, use a drop of tear-free product once a week. If you have an uncircumcised boy, it's fine to wash his penis with soap and warm water. But a circumcised boy shouldn't be bathed until his penis is healed, so stick to sponge baths for now. It seems like when babies aren't dirtying diapers, they're nursing, and feeding babies need to be burped. Burp your baby when you switch breasts, or halfway through a bottle. Remember to have a burp cloth handy in case the baby spits up! The classic burping position is to hold your baby upright, with his or head on your shoulder. Support the bottom with one hand and use the other to pat the back firmly. If this doesn't work, try placing your baby stomach side down across your lap, turning him or her sideways. Or hold your baby in a seated position, supporting the neck and chest with one hand, and patting with the other. A newborn baby is a lot of work. But take heart in knowing that every couple DOES get the hang of burping, bathing, diapers, and everything in between!

No part of your body is harder hit by giving birth than your vagina and breasts. In the several days following birth, your breasts will produce a yellowish fluid called colostrum. In the several days following birth, your breasts will produce a yellowish fluid called colostrum. When your infant suckles, it will cause the release of hormones that trigger your milk. However, even if you choose not to nurse, your breasts will produce milk for several days to a week. If you want the milk to stop flowing, you shouldn't allow your baby to nurse, nor should you remove the milk in any other manner. However, these drugs come with additional health risks to the mother, so they are not commonly prescribed. You will notice discharge known as lochia from your vagina. This occurs as cells from the lining of your uterus slough off. Lochia starts out as bright red blood, then tapers off before finally stopping. After you give birth, your uterus is 15 times heavier than it was when you got pregnant! For this reason, you'll be able to feel it a few finger widths below the top of your belly button. But by six weeks after delivery, your uterus will return to its old size. Having a baby definitely changes your body, but take comfort in the fact that most alterations are only temporary.

If you're pregnant, you've no doubt begun to hear a lot about cord blood. Here are the basics. First, the facts. After a baby is born and the umbilical cord is cut, some blood remains in the vessels of the baby's placenta and the cord attached to it. This is known as cord, or placental, blood. Cord blood has all the elements of normal blood, plus a rich supply of hematopoietic, or blood-forming, stem cells. These are similar to the cells found in bone marrow. For this reason, cord blood is increasingly replacing bone marrow in stem cell experimentation. In addition, cord blood transfers can be used to treat and improve some pediatric cancers and blood disorders. Today, cord blood can only be transplanted from a donor into a recipient who is a match. This is similar to how a bone marrow transplant works, although cord blood transplants use less stringent matching criteria. The cord blood from a baby will also have a high likelihood of matching with the baby's parents and any of the baby's siblings, so the benefits of familial cord blood extend beyond the donor. As of today, only a few illnesses can be treated with cord blood, so it is statistically unlikely that any individual will need the use of his or her cord blood. But because stem cell research is always evolving, many people believe that cord blood will have even more uses in the future.