Postpartum Care After Vaginal Delivery

This sheet gives you information about how to care for yourself from the time you deliver your baby to up to 6–12 weeks after delivery (postpartum period). Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

Follow these instructions at home:

Vaginal bleeding

• It is normal to have vaginal bleeding (lochia) after delivery. Wear a sanitary pad for vaginal bleeding and discharge.
  • During the first week after delivery, the amount and appearance of lochia is often similar to a menstrual period.
  • Over the next few weeks, it will gradually decrease to a dry, yellow-brown discharge.
  • For most women, lochia stops completely by 4–6 weeks after delivery. Vaginal bleeding can vary from woman to woman.
• Change your sanitary pads frequently. Watch for any changes in your flow, such as:
  • A sudden increase in volume.
  • A change in color.
  • Large blood clots.
• If you pass a blood clot from your vagina, save it and call your health care provider to discuss. Do not flush blood clots down the toilet before talking with your health care provider.
• Do not use tampons or douches until your health care provider says this is safe.
• If you are not breastfeeding, your period should return 6–8 weeks after delivery. If you are feeding your child breast milk only (exclusive breastfeeding), your period may not return until you stop breastfeeding.

Perineal care

• Keep the area between the vagina and the anus (perineum) clean and dry as told by your health care provider. Use medicated pads and pain-relieving sprays and creams as directed.
• If you had a cut in the perineum (episiotomy) or a tear in the vagina, check the area for signs of infection until you are healed. Check for:
  • More redness, swelling, or pain.
  • Fluid or blood coming from the cut or tear.
  • Warmth.
  • Pus or a bad smell.
• You may be given a squirt bottle to use instead of wiping to clean the perineum area after you go to the bathroom. As you start healing, you may use the squirt bottle before wiping yourself. Make sure to wipe gently.
• To relieve pain caused by an episiotomy, a tear in the vagina, or swollen veins in the anus (hemorrhoids), try taking a warm sitz bath 2–3 times a day. A sitz bath is a warm water bath that is taken while you are sitting down. The water should only come up to your hips and should cover your buttocks.

Breast care

• Within the first few days after delivery, your breasts may feel heavy, full, and uncomfortable (breast engorgement). Milk may also leak from your breasts. Your health care provider can suggest ways to help relieve the discomfort. Breast engorgement should go away within a few days.
• If you are breastfeeding:
  • Wear a bra that supports your breasts and fits you well.
  • Keep your nipples clean and dry. Apply creams and ointments as told by your health care provider.
  • You may need to use breast pads to absorb milk that leaks from your breasts.
  • You may have uterine contractions every time you breastfeed for up to several weeks after delivery. Uterine contractions help your uterus return to its normal size.
  • If you have any problems with breastfeeding, work with your health care provider or lactation consultant.
• If you are not breastfeeding:
  • Avoid touching your breasts a lot. Doing this can make your breasts produce more milk.
  • Wear a good-fitting bra and use cold packs to help with swelling.
  • Do not squeeze out (express) milk. This causes you to make more milk.

Intimacy and sexuality

• Ask your health care provider when you can engage in sexual activity. This may depend on:
  • Your risk of infection.
  • How fast you are healing.
  • Your comfort and desire to engage in sexual activity.
• You are able to get pregnant after delivery, even if you have not had your period. If desired, talk with your health care provider about methods of birth control (contraception).

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Activity

• Gradually return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Rest as much as possible. Try to rest or take a nap while your baby is sleeping.

Eating and drinking

• Drink enough fluid to keep your urine pale yellow.
• Eat high-fiber foods every day. These may help prevent or relieve constipation. High-fiber foods include:
  • Whole grain cereals and breads.
  • Brown rice.
  • Beans.
  • Fresh fruits and vegetables.
• Do not try to lose weight quickly by cutting back on calories.
• Take your prenatal vitamins until your postpartum checkup or until your health care provider tells you it is okay to stop.

Lifestyle

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Do not drink alcohol, especially if you are breastfeeding.

General instructions

• Keep all follow-up visits for you and your baby as told by your health care provider. Most women visit their health care provider for a postpartum checkup within the first 3–6 weeks after delivery.

Contact a health care provider if:

• You feel unable to cope with the changes that your child brings to your life, and these feelings do not go away.
• You feel unusually sad or worried.
• Your breasts become red, painful, or hard.
• You have a fever.
• You have trouble holding urine or keeping urine from leaking.
• You have little or no interest in activities you used to enjoy.
• You have not breastfed at all and you have not had a menstrual period for 12 weeks after delivery.
• You have stopped breastfeeding and you have not had a menstrual period for 12 weeks after you stopped breastfeeding.
• You have questions about caring for yourself or your baby.
• You pass a blood clot from your vagina.

Get help right away if:

• You have chest pain.
• You have difficulty breathing.
• You have sudden, severe leg pain.
• You have severe pain or cramping in your lower abdomen.
• You bleed from your vagina so much that you fill more than one sanitary pad in one hour. Bleeding should not be heavier than your heaviest period.
• You develop a severe headache.
• You faint.
• You have blurred vision or spots in your vision.
• You have bad-smelling vaginal discharge.
• You have thoughts about hurting yourself or your baby.

If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. You can go to the nearest emergency department or call:

• Your local emergency services (911 in the U.S.).
• A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

• The period of time right after you deliver your newborn up to 6–12 weeks after delivery is called the postpartum period.
• Gradually return to your normal activities as told by your health care provider.
• Keep all follow-up visits for you and your baby as told by your health care provider.