Congratulations! You are or are soon going to be a new mummy! For nine months every mummy-to-be focuses on the moment of birth. So much time and energy is put into getting to the end of our third trimester, few of us consider the days that follow - the 'fourth trimester'. New mummies may be caught off guard with some of the physical and emotional changes that occur and while the fourth trimester may certainly not be the most glamorous of months, it is guaranteed to be the most fulfilling as you begin to enjoy every moment with your new baby.
Immediately following birth, you'll experience vaginal discharge known as lochia. Following delivery, your caregiver will likely massage or press firmly on your uterus to help it contract. Initially, the discharge will be heavier than a typical period, and you may notice small blood clots passing. Hospitals typically provide you with large sanitary napkins for the first few days and will instruct you about how much blood to expect and how to care for yourself. Having additional pads of varying sizes for when you arrive home is also helpful for the weeks that follow. Eventually, the discharge will become white or yellowish in color, lessen each day and usually subside within a few weeks.
Whether you plan to breastfeed or not, engorgement for a few days following childbirth is normal as your milk comes in. Don't worry - as your body adjusts and begins to anticipate and produce the amount of milk your new little one needs, your discomfort will be eased. Warm showers and compresses to relieve breast tenderness, as well as nipple shields and creams to reduce cracking and redness are also helpful. While in the hospital, utilize lactation specialists and ask as many questions as you want - establishing a good latch is key to breastfeeding success. Once home, call the specialists or your physicians with any concerns.
You may also experience 'after pains' - these may be felt when you begin to nurse your newborn, causing your uterus to contract, or when given medication to help control your bleeding. Don't worry - these contractions are not as severe as those you experienced during labour and delivery, but can be quite painful and often disturbing if unexpected.
Perhaps one of the most frustrating - and embarrassing - physical realizations is incontinence. Because your muscles stretched during birth, you may not experience the urge to urinate or may do so unexpectantly while laughing, coughing or sneezing - this is even more prevalent if you had a prolonged vaginal delivery. Continuing to wear a liner even after vaginal discharge has begun to subside will help make you more comfortable and less concerned.
Bowel movements in the first few days may also be uncomfortable, either due to sensitive hemorrhoids, episiotomies, or sore muscles. If you had an episiotomy, walking, sitting, coughing or sneezing may also cause pain. Sitz baths initially in cool water and then in warmer water as the days progress, as well as cleansing yourself with warm water from a squirt bottle (sometimes provided by the hospital) after you use the loo, stool softeners and ice packs to help reduce swelling can help manage your discomfort.
It is equally important to be prepared for the emotional ups and downs that follow childbirth. While you may think you should feel happy and carefree now that your new bundle has arrived, many women experience the baby blues or mood swings and feelings of sadness. Remember this is normal - in fact, as many as 80% of women experience the blues. You're physically and emotionally exhausted, your body has gone through significant hormonal changes and despite overwhelming feelings of happiness and joy, you may also feel anxious, scared and nervous about your new role as a mum. For most women, the baby blues subside during the first week and leaning on family members and friends for support, resting and letting your body heal will help significantly.
Exhaustion is also to be expected - your new little one will eat only small amounts of milk or formula initially and need to be frequently fed. With feedings every two or three hours, coupled with small growth spurts when babies may look to nurse or feed even more often, sleep will likely become a rarity. Try your best to nap when your baby sleeps and ignore household chores like cleaning and laundry. If you are formula feeding or able to pump enough milk for a bottle, have your husband or a visiting relative do night-time feedings while you recuperate. In the months that follow, your baby will settle into a more predictable schedule and slowly a sense of normalcy will return. It's important to remember that while the first few weeks may seem overwhelming, they are short lived and do become easier!