Published June 7, 2020
Dr. -Sylvester -Ikhisemojie
The recovery of any woman from a recent delivery can take many different patterns . For the most part, the pattern will depend on the mode of the delivery and that is to say that it depends on whether it is a normal vaginal delivery or it has had to do with an operative delivery , more frequently known as caesarian section .
Other factors which can often play a role in helping to determine how the newly delivered mother fares depends on whether it has been merely the latest among a series of deliveries in which case it is not the first as against the situation which occurs during a woman ’s very first time . A lot is also dependent on whether a woman has had one baby as is often the case or she has had a multiple delivery of twins, triplets or even quadruplets . I am sure many readers of this page would have heard of various cases from around the country in the past where the fathers of many babies delivered at once often went into hiding .
However , running away from the responsibility of caring for the mother and the offspring is not a solution. In our communities which are deeply rooted in the extended family system , grandmothers from either side of the family are often at hand to assist . Sometimes , siblings usually of the female gender are there as well to help . In the end , it is in the new mother ’s best interests to focus on healing physically , emotionally and psychologically from any delivery .
During pregnancy , remarkable changes take place affecting all those aspects of a woman. After delivery , some of those changes go into reverse with oestrogen for example falling so rapidly that some women , most women , develop post-partum blues whereby feelings of helplessness, worthlessness and even suicidal thoughts in a complex emotional state known as postpartum depression is sometimes found . This affects more than three -quarters of all newly delivered mothers and men may also be affected .
The recovery from a recent delivery is known as the puerperal period. It usually takes about six weeks when there have been no complications. Some people have said , however , that this period lasts as much as six months and yet others say it may even be as long as one year . That may be part of the reason why maternal leave has inched upwards in a number of places over the last half century .
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While the period of leave remains three months in a number of states in Nigeria , it is six entire months in Lagos state and one whole year in some provinces of Canada . During the first one week after a delivery , there is an obligatory vaginal discharge which occurs that is known as the lochia. This is a mixture of the blood and the lining of the uterus . The lining is a mixture of cells , mucus and secretions and it is present whether a woman has had a vaginal delivery or an operative one. The flow can range in duration from a few days to six weeks . The uterus itself most also shrink gradually to a size as close to its normal size as possible within six weeks .
The breasts become full , engorged and tense with milk for some days before delivery and for several more days after delivery before the milk starts to flow if it is a woman’s first time . In the more experienced mother , milk flow can begin within a few hours of delivery . There is also pain as the uterus contracts , which is worsened by the baby sucking at the nipples and can often require pain killers to help mothers cope with the pain . The nipples can get cracked and sore as well.
Some women add the use of the hot -water bottle to pain relief to improve the soothing sensation they might get . The area around the vagina is usually sore from soon after delivery till the end of the second week . The vagina itself remains uncomfortable . It may have sustained a tear or been cut by the doctor or midwife to allow for a smoother , controlled delivery . The sore area needs tender loving care using analgesics , hot water bottle massage and sitz bath in which a woman sits inside a small bowl containing water and either salt or an antiseptic lotion .
If it was an operative delivery , there are various choices of anaesthesia . Pain is more severe than when delivery is normal and the perineum may also feel sore with associated pain on passing urine . While the average hospital stay following a caesarian section is now between 3 and 4 days it is important to begin to move around early so as to avoid the formation of blood clots in the legs and pelvis . The wound ’s dressing must be protected from bath water so as to prevent an infection taking hold . Mothers would also be safer using external sanitary pads than using tampons . The latter are more often associated with causing infections and are a bad choice . By the end of the first week , most of the soreness around the body goes away and women enter the second week with some more comfort . After urinating , it is safer to wash the area with warm water than use tissue paper for the same reason of avoiding an infection .
The lochia also changes colour from red in the first several days to pink by the second week . It can often contain several blood clots during this early period and is considered normal . By the fourth day or thereabout to the tenth day , the lochia becomes more watery and brownish . After the tenth day , it can change further to pink . Up until six or even eight weeks , it gradually becomes thinner and thinner with a constantly diminishing volume of flow until it stops fully .
If a woman has had a tear that required suturing , or an episiotomy , the vagina could be sore for more than a fortnight . Sitz bath done several times a day helps a great deal as well as pain relievers and antibiotics at the initial period. It is important to avoid touching the area with bare hands so as to prevent infections from taking place . The sore feeling in that area gradually subsides over a six week period by which time the vagina is comfortable enough once more to resume sex. The flow of lochia would also have stopped and some women might even have resumed their periods. When a woman has had an operative delivery , the vagina is sore for a much shorter time but even with that , many women are not ready at less than six weeks to resume sex. What such women must not do, however , is to resume lifting of weights like buckets of water and similar things until after six weeks have gone by.