Normal vs. Concerning Symptoms After Birth




The post-partum period is an incredibly joyous time for new parents, but it is also a period of adjustment and healing.  During this time, it is common for new mothers to focus on their newborn, but it’s equally as important for new mothers to take care of themselves. At Mystic Women’s Health we schedule a post-partum visit after 1 week of delivery if you are breastfeeding, after 2 weeks if you had a C-section, and after 6 weeks if you had a vaginal birth. However, in the mean time, it’s important to know what to expect during your post-partum days and to keep in mind when to call for evaluation.


Wound Healing
Normal: It is normal for vaginal wounds to take a few weeks to heal. Sitz baths can ease vaginal tears and cold packs can help with swelling and pain.


Concerning: If your wound is not healing or you notice redness, heat or oozing, this may be a sign of infection and you should contact us for evaluation right away.


Baby Blues & Postpartum Depression
Normal: It is common for postpartum women to experience some mood swings, or negative feelings after giving birth, as the body is going through a lot of emotional changes. It is also normal to feel anxious about adjusting to life with a new baby. Crying may occur for prolonged periods of time. “Baby Blues” typically lasts for 2-4 weeks, and then goes away. Exercise, breastfeeding, and uninterrupted sleep are very helpful mood elevators.


Concerning: Prolonged sadness that is inhibiting your daily function should be evaluated. If you are experiencing difficulty bonding with the baby, difficulty sleeping or difficulty enjoying things that you previously enjoyed doing, please contact us. Post-partum Obsessive Compulsive Disorder (OCD) may also occur. Mother’s may get unwanted thoughts of hurting the baby, and this can be very distressful if it occurs. Please call us with any of your concerns, we will always listen. If you are feeling thoughts of self-harm or any suicidal ideation please seek medical help immediately or call the national suicide prevention hotline at 1-800-273-8255.
Bleeding
Normal: It is normal for women to have heavy red vaginal bleeding for about 3-4 days after birth. After 4-10 days following birth, the bleeding should minimize to smaller  amounts however can continue for weeks. Flow will increase with activity (visits to pediatricians, picking up a toddler, running around doing errands, etc.) All reasons to slow down! Blood clots may be common, but should not be larger than a golf ball. Bleeding may have some odor, but should not be foul smelling


Concerning: If you are bleeding through more than one pad per hour, seek immediate medical help. Any large clots, or foul odor warrants a follow up and you should call our office. In addition, any pelvic pain or heavy cramping should be evaluated as well. Heavy bleeding while resting is not normal.


Bleeding can last for weeks postpartum not just days overall trend is for decreased flow with slight increases with increased activity. E.g.  visits to pediatricians. Running around doing errands or lifting toddlers. All reasons to slow down Heavy bleeding while resting is not normal.


Breast Engorgement  
Normal: When breast milk comes in, it is common for women to have breast engorgement. This may feel tender as the milk ducts expand. Usually, breast engorgement is bilateral, meaning that it occurs on both breasts. Warm compresses on the breast can help vasodilate the milk ducts. It is also normal to have a low grade fever with engorgement. Breast engorgement tends to happen within the first 2 weeks post-partum.  
Concerning: Mastitis is an infection of the breast tissue, not of the breast milk. Symptoms include: fever, red hot breast (usually on one side only), chills, malaise, and flu-like symptoms. Mastitis can occur if there is a shallow latch, or, if the nipples are cracked and more susceptible to infection. For this reason, it’s very beneficial to meet with our lactation counselor to prevent mastitis by talking about helpful strategies for the proper latch and feeding technique. Prevention strategies for mastitis? Rest, Rest, Rest!! Too much activity increases risk for infection. Same goes for too many visitors entering and exiting the home. Have your troops show up after 2 weeks post partum with their casseroles in hand and ready to do some laundry! Those first few delicate days should be for parents and baby to do skin-to-skin and rest at home.  Treatment for mastitis includes antibiotics and continuing to breast-feed. If you feel that you may have mastitis, please call our office.


If you notice any of the following symptoms after giving birth, seek emergent medical care. Advocate for yourself! A mother’s intuition has a very strong sense of when something is just not right.
  • Sharp Chest Pain
  • Difficulty breathing
  • Rapid Breathing
  • Worst Headache of your life
  • Epigastric Pain (upper abdominal pain)
  • Fever (higher than 100.4 F)
  • Urinary Tract Infection
  • Pain, tenderness and swelling of your leg
.
If you have any questions or concerns, always feel free to call our office.  I wish you a very healthy post-partum time, full of bonding and relaxing with your newborn.
Yours,
Serena Fasano, WHNP, MPH, CLC










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