Recovery after childbirth. The postpartum period and all the most important things about this time

The likelihood of conception after childbirth is of interest mainly to those who are in no hurry to immediately have another after the birth of one child. However, there are (albeit much less frequently) other situations: parents want the difference between their children to be as small as possible; Unfortunately, tragic circumstances happen (for example, artificially caused premature birth due to severe fetal deformity or high risk for the life of the mother). Regardless of the reasons for which you are interested in the likelihood of conception after childbirth, it is useful to first understand what happens to a woman’s ovarian-menstrual cycle during the postpartum period.

Even during pregnancy, a woman’s pituitary gland begins to actively produce the hormone prolactin, which prepares the mammary glands for lactation, stimulates lactation and at the same time suppresses ovulation. At the moment when the baby suckles, the secretion of prolactin intensifies, and as the time between feedings increases, it decreases. As a rule, while a woman is breastfeeding only, prolactin completely suppresses ovulation - lactational amenorrhea occurs (lack of menstruation during breastfeeding). However, there are, and often are, cases when, with quite sufficient lactation menstrual cycle recovers relatively quickly.

Regarding the likelihood of conception, the following can be stated.

When can you get pregnant after childbirth?

Firstly, it is almost impossible to establish any patterns in the timing of restoration of the ability to conceive. That is, of course, it is known that breastfeeding causes a delay in ovulation, but it is impossible to accurately predict the date of the first postpartum ovulation. The timing of the resumption of ovulation after childbirth is very individual. Moreover, they can be different for the same woman after different births, so you should not rely on your previous experience in this matter. The main indicator of ovulation restoration is the first postpartum menstruation. Non-breastfeeding women begin menstruation earlier than breastfeeding women. It is known that the earliest ovulation is recorded in the fourth week after birth in non-breastfeeding women and in the seventh week in lactating women. In order not to miss the first postpartum ovulation, it is recommended to use a temperature test1. Breastfeeding women should start measuring from the 6th week after birth, and non-breastfeeding women from the 4th week: so as not to miss the moment of its increase, indicating ovulation.

Secondly, after the restoration of menstruation, anovulatory cycles (i.e., menstruation without ovulation) may occur.

Thirdly, the absence of menstruation does not mean that a woman cannot conceive a child. The fact is that the moment of conception may occur exactly in the middle of a newly restored cycle.

It was noticed that when next pregnancy the child often refuses mother's milk. It is assumed that one of the mechanisms of a child’s refusal to breastfeed in this situation is the following. At the moment when the baby begins to suckle, the mother reflexively releases the hormone oxytocin, which stimulates the contraction of smooth muscles. This leads to a reduction in the terminal ducts of the mammary gland (milk is, as it were, “injected” into the baby’s mouth). At the same time, the muscles of the uterus contract. This is very useful after childbirth, but in the case of a new pregnancy, increased uterine tone can lead to miscarriage. Therefore, apparently, when the next pregnancy occurs, the secretion of oxytocin is suppressed, and the baby becomes unusually difficult to suck. Moreover, under the influence hormonal changes in the body, accompanying the onset of pregnancy, the taste of milk may change. However, there is a natural connection between a child’s refusal to breastfeed and repeat pregnancy does not exist.

How long does it take to recover after childbirth?

Modern medicine claims that for full recovery of the female body after childbirth, the interval between childbirth and the next pregnancy should be at least two years, although, of course, this should be considered more of a recommendation than an immutable rule: many women have successfully given birth and are still giving birth to children of the same age.

Moms, don't rush. How long should you wait before planning your next pregnancy?

Agree, if there are certain WHO medical recommendations on the length of the interval between births, then it was not without reason that they were developed and written? In addition, unfortunately, not all women who want to have a bunch of children can be called practically healthy. For them, a certain period of break between children is not the last thing.

Why is the period measured: what should be the break between pregnancies?

From a physiological point of view, nothing prevents a healthy woman from becoming pregnant again literally immediately after giving birth (as you know, lactation does not prevent this at all). Often this is what happens, and identical brothers and sisters are born just a year or so apart. If the mother is healthy and the previous pregnancy went well, then everything will most likely go smoothly this time too.

Although, probably, there are very few parents who consciously plan for the same weather. Because, having barely given birth to one baby, immediately bearing the next one is not a lifting burden for all modern women (and their husbands). And the reasons do not always lie in the body after a recent birth. The fact is that both physically and psychologically the female body at this time is not yet fully adapted to external life. A woman who has given birth, together with her child, has been in a rather closed “mother-child” system for a long time. All the strength and feelings of a woman are directed towards the baby, for whom, in turn, the whole world is concentrated for a long time in one single person - the mother. Such a relationship continues as long as the baby is breastfed, which means at least a year or two.

Officially, doctors believe that the optimal interval between births should be at least two years. Please note that this is the period between births, that is, before the next conception and pregnancy, the body needs to rest a little more than a year. The basis for similar medical recommendations served a number of anatomical, biochemical, hormonal and other studies. According to doctors, the body needs to be given at least a year and a half (before conception) so that the functioning of all organs is finally restored, vascular system, blood flow, hormonal levels returned to normal.

All the will of God?

It is quite natural that women who intend to endure a certain period of time and recover properly need to use protection. However, there are many in Russia who do not do this for fundamental, most often religious, reasons. Some of these women are already experiencing their sixth or seventh birth by the age of 25. Unfortunately, almost all of them are at risk. In practice, this means the threat of bleeding during childbirth and the postpartum period, the development of diseases such as anemia, thrombophlebitis, thrombosis lower limbs and external genitalia (since the veins located at the same level as the inferior vena cava experience constant compression syndrome).

Due to the short break between pregnancies, the uterus does not have time to grow the necessary basal layer, to which the placenta should normally attach. As a result, fetoplacental insufficiency is formed, or a violation of blood flow between the placenta and the child. Children born to such mothers are often prone to malnutrition (stunted growth in the womb and low birth weight).

And all these problems are caused by one thing - insufficient time between births. After all, even if absolutely healthy body do not give rest, at some point violations cannot be avoided. Some may argue that in the past, children were born one after another, without thinking about the timing. In general, it was believed that if a woman is able to get pregnant immediately after giving birth, this is normal. So be it. However, it is also known that not all children survived, and many were born weakened. It would seem that the progress of medicine instills certain hopes these days. But in other way, ecological situation and living conditions leave much to be desired. All this does not make a person healthier.

What issues need to be resolved before getting pregnant again?

Of course, plans to expand the family are a purely personal matter. And yet, the recommendations of doctors should not be neglected. They are usually based on how your first pregnancy went. When making predictions for the future, doctors must take into account the difficulties that the woman encountered the previous time. The patient may be suffering from illness general. In this case, they need to be eliminated and only then think about a new pregnancy. If serious anomalies affected labor activity, we need to carefully understand the reasons. Women who have undergone surgery during childbirth are automatically at risk. There is a certain order for them mandatory examinations. It also applies to those who suffer from chronic somatic diseases, blood diseases (clotting disorders, chronic anemia). Patients with nephropathy require special attention. Against the background of this disease, in the last trimester of pregnancy, pressure increases significantly, swelling and unfavorable changes in the urine appear. If a woman is not cured or at least has not undergone the necessary examination, her new pregnancy will be more difficult than the previous time. Old problems inevitably overlap with new ones. And of course it’s better to get rid of them before the next pregnancy.

When should you wait before planning another pregnancy?

When preparing to become a mother again, a woman who is Rh-negative should take special care. It is not uncommon for the first child to be born with a positive Rh factor. But doctors do not conduct the necessary examinations; in the first 24 hours after birth, they do not administer the anti-Rhesus immunoglobulin necessary in this situation. The consequences of such mistakes are quite serious. Firstly, antibodies entering through mother's milk into the child’s body, can cause serious changes in him nervous system, up to kernicterus. Secondly, if antibodies are detected already during another pregnancy, it is necessary to call artificial birth ahead of time so as not to aggravate the situation.

With a caesarean section, doctors recommend waiting at least 2-2.5 years in order to then conceive and carry the next child to term normally. Whether the mother will be able to give birth naturally this time depends on the reason for the cesarean section. It’s one thing if a woman had a large fetus, breech presentation, or the weight of the fetus did not correspond to the size of the mother’s pelvis. In this case, after passing necessary examinations, she can give birth herself. If we're talking about about diseases in which it is impossible to independently endure such a load as childbirth (indications of a neurologist, traumatologist or ophthalmologist), then avoid reoperation it won't work. It is clear that chronic diseases spine, an obliquely displaced pelvis or a fracture of the spine will not improve for the next birth.

Extensive cervical ruptures that occur during childbirth also limit a woman’s desire to become pregnant again as soon as possible. In this situation, cervical plastic surgery and an appropriate adaptation period are necessary. Moreover, in this case, natural childbirth is impossible. The only option left is a caesarean section.

At multiple pregnancy uterus healthy woman returns to normal within the same time frame as during normal birth. However, according to doctors' observations, mothers of twins do not soon decide to have a second birth. Their workload is already considerable.

If a woman has suffered diseases such as syphilis and hepatitis, then several years must pass between present and future births.

The golden mean: the optimal break between pregnancies

The interval between births should not be too long. After all, when a woman decides to have a child 15-20 years after her first birth, it is difficult for both doctors and her. Over time, as a rule, sores appear in the form of infection, inflammatory processes in the appendages, often. Abortion is often added to this. Age cannot be discounted either. The woman has become older, which means that in addition to medical problems psychological ones also arise.

After so much time, they decide to have a second baby, as a rule, for the sake of a new husband. It is fair to assume that a woman is tormented throughout her pregnancy by questions: how will the stepfather treat the first child, and the older child - the newborn, etc. A woman is often forced to seek the help of a psychologist.

Of course, it is better to stick to the golden mean. However, it is clear that you need to prepare and plan for a new pregnancy in the same way as the previous one. Again, you will have to take the same tests and undergo all the necessary examinations.

By the way, in schools for expectant parents you can often meet experienced mothers who have decided to have another baby in our difficult times. They want everything to work out well this time too.

Elena Petrovna Ozimkovskaya, chief doctor of the maternity hospital

The first month after childbirth is often called the tenth month of pregnancy, thereby emphasizing its importance for the woman’s body. Strictly speaking, the first month after childbirth is only part of the postpartum period, the duration of which is the first 6-8 weeks after childbirth. The postpartum period begins from the moment of birth of the placenta and continues until the end of involution (i.e., reverse development) of all organs and tissues of the woman’s body that have undergone changes during pregnancy. During the same period, the formation of the function of the mammary glands occurs, as well as the formation of a sense of motherhood and associated fundamental changes in the psychology of a woman.

What happens in the body

In the postpartum period, the normal tone of the cerebral cortex and subcortical centers is restored. Pregnancy hormones are removed from the body, and gradually the function endocrine system comes back to normal. The heart takes its normal position, its work becomes easier, as the blood volume decreases. The kidneys are working actively, the amount of urine in the first days after childbirth is usually increased.

The changes are most significant in the reproductive system. The uterus contracts and decreases in size every day; during the postpartum period, its weight decreases from 1000 g to 50 g. Such a significant and rapid contraction is due to several mechanisms. Firstly, contraction of the uterine muscle, both constant tonic and in the form of postpartum contractions. In this case, the walls of the uterus thicken, it takes on a spherical shape. Secondly, the contracting muscles compress the walls of the blood vessels and lymphatic vessels, many of them collapse, which leads to a decrease in nutrition of muscle elements and connective tissue, and as a result hypertrophy disappears muscle tissue that occurred during pregnancy.

These processes are called involution of the uterus and are most accurately expressed by the height of its fundus. By the end of the first day, the fundus of the uterus is at the level of the navel, then daily it drops by approximately 1 cm. On the 5th day it is already in the middle of the distance between the womb and the navel, by the end of the 10th day it is behind the womb. By the end of the 6-8th week after birth, the size of the uterus corresponds to the size of the non-pregnant uterus.

Along with the reduction in the size of the uterus, the formation of its cervix occurs. The formation of the pharynx occurs due to contraction of the circular muscles surrounding internal hole cervical canal. Immediately after birth, the diameter of the internal pharynx is 10-12 cm; it will completely close by the end of the 10th day, and by the end of the 3rd week, the external pharynx of the uterus will also close, acquiring a slit-like shape.

The inner wall of the uterus after separation of the placenta is an extensive wound surface; there are remnants of glands on it, from which the epithelial cover of the uterus, the endometrium, is subsequently restored. During the healing process inner surface postpartum discharge appears in the uterus - lochia, representing wound secretion. Their character changes during the postpartum period: in the first days, lochia is bloody; from the 4th day their color changes to reddish-brown; by the 10th day they become light, liquid, without any admixture of blood. Total lochia in the first 8 days of the postpartum period reaches 500-1400 g, from the 3rd week their number decreases significantly, and by 5-6 weeks they stop altogether. Lochia has a peculiar musty odor, which gradually decreases. With slow involution of the uterus, the release of lochia is delayed, and the admixture of blood lasts longer. Sometimes there is a partial retention of discharge in the uterine cavity.

In the first days after birth, the mobility of the uterus is increased, which is explained by stretching and insufficient tone of its ligamentous apparatus. The uterus easily moves to the sides, especially when the bladder and rectum are full. Normal tone ligamentous apparatus the uterus acquires by the 4th week after birth. As the uterus involutions, the fallopian tubes also return to their normal position, their swelling disappears. The ovaries also undergo significant changes. The regression of the corpus luteum, which was formed at the very beginning of pregnancy, ends, and the maturation of the follicles begins. For most non-breastfeeding women, menstruation begins in the 6th to 8th week after childbirth; more often it comes without the release of an egg from the ovary. However, ovulation and pregnancy may occur during the first months after birth. For breastfeeding women, the onset of the first menstruation after childbirth may be delayed for many months.

The tone of the pelvic floor muscles is gradually restored. The tone of the vaginal walls is restored, its volume is reduced, and swelling disappears. Abrasions, cracks, and tears that occurred during childbirth heal. The abdominal wall gradually strengthens, mainly due to muscle contraction. The stretch marks on the skin are still purple, they will lighten by the end of the first year after giving birth.
Unlike most organs, which undergo reverse development after childbirth, the mammary glands, on the contrary, reach their peak. Already during pregnancy, they begin to secrete a thick yellowish liquid containing protein, fat, epithelial cells from glandular vesicles and milk ducts. This colostrum, which the baby will eat for the first couple of days after birth. It is rich in proteins, vitamins, enzymes and protective antibodies, but it contains fewer carbohydrates than milk. On the 2-3rd day after birth, the mammary glands become engorged and painful, and under the influence of the lactogenic hormone of the pituitary gland, the secretion of transitional milk begins. The process of milk formation largely depends on the reflex effects associated with the act of sucking. From the second to third week after birth, transitional milk turns into “mature” milk, which is an emulsion of tiny droplets of fat found in the whey. Its composition is as follows: water 87%, protein 1.5%, fat 4%, carbohydrates ( milk sugar) about 7%, salts, vitamins, enzymes, antibodies. This composition may vary depending on the nature of the mother’s diet and regimen.

Feel

Immediately after giving birth, almost all new mothers note extreme fatigue, drowsiness. And already from the second day with normal course postpartum period, the woman feels well. Body temperature is usually normal. In the first days, pain in the area of ​​the external genitalia and perineum is possible, even in the absence of ruptures. This is due to the strong stretching of tissues during childbirth. Usually the pain is not very intense and goes away after a couple of days, in case there were tears or cuts in the perineum, up to 7-10 days. If a caesarean section was performed, there will be pain in the area of ​​the postoperative sutures.
Uterine contractions occur periodically, feeling like weak contractions. After repeated births the uterus contracts more painfully than after the first. Contractions intensify during breastfeeding, this is due to the fact that when the nipple is stimulated, the level of a substance that promotes uterine contractions, oxytocin, increases in the blood.
On the first day after childbirth, a woman does not feel the urge to urinate. This is due to decreased tone abdominal wall, swelling of the bladder neck as a result of its compression by the fetal head. A psychological block plays a certain role in horizontal position women, as well as discomfort burning sensation when urine gets into the area of ​​ruptures and cracks. To stimulate the bladder, you need to move more, sometimes the sound of water flowing from a tap helps. If no urination occurs within 8 hours, you need to void bladder using a catheter.
In the first days after childbirth, a woman may experience constipation. Their cause is most often relaxation of the abdominal wall, limitation of physical activity, poor nutrition and fear of the sutures in the perineum coming apart. There's no reason to worry about seams. You just need to move more and adjust your diet.
From the second or third day after birth, there is a sharp increase in the amount of milk in the breast. At the same time, the mammary glands enlarge, harden, become painful, and sometimes the body temperature rises. Sometimes the pain radiates to the axillary region, where nodules are felt - swollen rudimentary lobules of the mammary glands. To avoid severe engorgement, it is recommended to limit fluid intake to 800 ml per day from the third day after birth and try to feed the baby more often. Within 1-2 days, with proper attachment and feeding regimen, engorgement gradually disappears.

Psychology of the postpartum period

Could anyone be happier women giving birth, feeding and kissing her baby? Why do we so often see tears of despair on the faces of young mothers who have been waiting for their baby for so long? Why are they depressed, irritable and exhausted? Let's try to figure it out. During pregnancy, the level of female sex hormones reaches its maximum values ​​in a woman's entire life. Immediately after the birth of the placenta, the level of these substances decreases significantly. A drop in hormones in a woman’s blood is observed every time before the onset of menstruation, “thanks to” this, many women monthly have a mini-depression in the form of the so familiar premenstrual syndrome (PMS). Now let’s multiply PMS ten times (in comparison, this is how much hormone levels drop after childbirth) and we get “postpartum blues” - the psychological state of a new mother. It is not surprising that 70% of women after childbirth report irritability, a feeling of unreality of what is happening, devastation, unrelenting anxiety about any reason, and sleep disorders. These phenomena occur on the third or fourth day after birth and reach their apogee on the fourth or fifth day and pass without any medical intervention in just two weeks. In 10% of women, these phenomena drag on and become painful.
It is impossible to prevent the occurrence of postpartum depression. The most important thing is to remember that this will soon pass. Worst advice The advice that can be given in this situation is to “pull yourself together.” There is no need to fight with yourself, much less blame yourself for being a bad mother. Your body has done a lot of work, you are physically and mentally exhausted and have every right to rest. No need for parental feats! Let the baby sleep on the balcony, and the sink is overflowing with dishes, use any extra minute to sleep. Accept any help from your loved ones, do not pay attention to the fact that they will do something not exactly the way you read in a respected magazine or book. Everything will gradually get better. Be sure to find minutes to clean yourself up and chat with your husband on topics not related to the child.
If symptoms of depression persist for more than two days, this may be a sign of a disease for which it is better to seek professional help. Signs that depression is getting out of control include:
- acute feeling of fear, fear next day;
– apathy, refusal to eat, desire for complete loneliness;
– constant hostile attitude towards the newborn;
– insomnia, recurring nightmares;
– constant feeling own inferiority, feelings of guilt towards the child.
With such severe depression Drug therapy may be needed. And in mild cases, best medicine- this is Love. Love for your baby, in whose eyes the whole world is reflected for the mother

Possible deviations from the norm

Unfortunately, the first month after childbirth does not always go smoothly. Situations may arise when medical assistance is necessary. Monitor your health and regularly measure your body temperature, as an increase in temperature is most often the first sign of complications in the postpartum period. All complications of the postpartum period can be divided into several groups:

1. Complications from the uterus.

The most dangerous complication of the first day after birth is postpartum hemorrhage. They begin immediately after childbirth, are not accompanied by any pain and are very abundant, so they can pose a danger to a woman’s life. The causes of bleeding are various injuries during childbirth, disturbances in the separation of the placenta and membranes, as well as disturbances in uterine contraction. Various surgical interventions, medications and drugs are used to treat bleeding. donated blood. In order to monitor the woman, she is left in the maternity ward in a very dangerous first a couple of hours after birth. In the following days, the risk of bleeding decreases, but other problems arise.
Subinvolution of the uterus– decreased rate of uterine contraction due to retention in the uterus postpartum discharge. The disease most often occurs 5-7 days after birth, due to the closure of the cervical canal by a blood clot or a piece of membranes, as well as kinking of the uterus due to relaxation of the ligamentous apparatus.
Infection of the contents of the uterus can lead to inflammation of the uterine mucosa - endometritis. Predisposing factors for the occurrence of endometritis are difficult childbirth, disturbances in the separation of the placenta during childbirth, genital tract infections during pregnancy, immunity disorders, and abortions. Symptoms of the disease are: increased body temperature, unpleasant odor in lochia, It's a dull pain lower abdomen. To clarify the diagnosis, an ultrasound examination and, if necessary, surgery are performed, during which the contents are removed from the uterine cavity (washing or curettage of the uterus). After surgical intervention Antibiotics must be prescribed.

2. Complications from the mammary gland.

Lactostasis– stagnation of milk in the mammary gland. In this case, the breast swells and becomes painful, pockets of compaction appear, and a short-term rise in body temperature is possible. Lactostasis itself is not a disease, requiring only careful pumping of the breast, limiting fluid intake and frequent feeding painful breasts. However, when an infection attaches, it turns into lactation mastitis, requiring immediate medical care, antibiotic therapy, and sometimes surgery. The question of the possibility of breastfeeding with mastitis is decided individually, depending on the stage of the disease.
Another complication of the breast is the appearance cracked nipples. The main reason for their appearance is improper attachment of the baby to the breast, when the baby grasps only the nipple, and not the entire areola. Such a grip is very painful for the mother - and this is the main danger signal. Feeding your baby shouldn't be painful. Breastfeeding consultants provide good advice and practical assistance for lactostasis and cracked nipples. Treatment of cracks involves treating the nipple with wound-healing preparations.
Hypogalactia– insufficient milk production. In order to increase the amount of milk, a mother needs to increase the frequency of feedings, not skip night feedings, offer the baby both breasts at one feeding, drink more, eat well and sleep a lot.

3. Complications from the tissues of the cervix, vagina and skin.

Inflamed wounds of these tissues are called postpartum ulcers. When infection occurs, these wounds swell, become covered with purulent plaque, and their edges are painful. For the purpose of treatment, they are treated with various antiseptics, sometimes requiring surgical treatment.

4. Complications from the venous system.

Hemorrhoids (varicose veins rectum) also cause pain. When pinched, they enlarge, become swollen, tense and painful. Careful hygiene (showering after each visit to the toilet) and applying ice to the perineum helps reduce pain. Some medications can be used as prescribed by your doctor.
Thrombophlebitis– a venous disease characterized by inflammation of the venous wall and thrombosis of the vein. After childbirth, thrombophlebitis of the pelvic veins most often occurs. This disease usually occurs in the third week after childbirth. Its symptoms are very similar to endometritis, but require different treatment. Surgeons treat complications from the venous system.
Complications after childbirth require immediate treatment, since it can lead to generalization of the process - postpartum peritonitis or sepsis. Therefore, if anything bothers you about your condition, be sure to consult a doctor.

Behavior rules

During the first week after birth, while the woman is in the hospital, she is monitored daily by a doctor and midwife. They assess the general condition of the postpartum woman, measure pulse, blood pressure, body temperature, determine the condition of the mammary glands, uterine involution, and the nature of lochia. In most cases after normal birth You can do without medications; only with very painful contractions can you use painkillers. In case of complications of the postpartum period, the doctor will prescribe necessary treatment. The postpartum woman is discharged on the 5-6th day after an uncomplicated birth.
One of the most important rules which a new mother must observe is sufficient sleep. Its total duration should be at least 8-10 hours a day. This amount of sleep will allow you to recover after childbirth and give you strength to care for your baby. Naturally, it is impossible to provide long sleep at night, because you will have to feed the baby repeatedly, so try to devote any free minute to sleep during the day.
People are asked to get out of bed after a normal birth within six hours of delivery. At first, get out of bed carefully, avoiding sudden movements, otherwise you may feel dizzy. Already on the first day after birth you can do breathing exercises and help contract the uterus through self-massage. To do this, you need to lie on your back, relax your stomach as much as possible, carefully feel the bottom of the uterus (just below the navel) and gently stroke from the sides to the center and up. It is better to sleep and lie down for the first 2-3 days after birth (before the milk arrives) on your stomach. Periodic application of a heating pad with ice to the lower abdomen also helps with contraction. To avoid hypothermia, the heating pad should be wrapped in a diaper and kept for no more than 20 minutes at a time.
On the second day after birth, you can proceed to therapeutic exercises. Perform gentle exercises to squeeze and relax your pelvic floor muscles daily and often. This will help get rid of involuntary urination and promote the healing of sutures in the perineum. For training abdominal muscles alternately lift and abduct your feet, as if pressing the pedals of a bicycle. Exhale and draw in your stomach, holding your breath; then relax. You need to perform these simple exercises several times every hour when you are awake. They are also recommended for women who have had a caesarean section. From the second week, expand the set of exercises, adding turns, bending the torso, and by the end of the month, abdominal exercises.
It is very important to carefully observe the rules of personal hygiene. You are still too weak to resist the microbes around you well, so get rid of them constantly. It is necessary to wash yourself with soap, especially if there are stitches on the perineum, after each visit to the toilet. Twice a day, the seams are additionally treated with special antiseptics. It is necessary to ensure the cleanliness of the gaskets. Best suited for this period special postpartum pads, in extreme cases, ordinary ones, but with a cotton surface. In the maternity hospital, you cannot use pads with a top layer of synthetic material. Regardless of how full it is, it is necessary to change the pad every 2-3 hours. Be sure to take a shower 2 times a day, and then wash the mammary gland with soap. There is no need to wash your breasts after each feeding; just leave a drop of milk on the nipple and let it dry in the open air. You should not take a bath in the first month after giving birth. Underwear and bed linen should be cotton. We change underwear daily, bed sheets at least once every three days.
Stool should be present within the first three days after birth. If there are stitches on the perineum, the first voiding causes fear that the stitches may “come apart”. This fear is completely unfounded, but during defecation you can hold the suture area with a napkin, which will reduce tissue stretching and defecation will be less painful. To facilitate this process, include dried apricots, prunes in your diet, and drink a glass of mineral water without gas or kefir. If there is no stool on the 4th day, then you need to use a laxative or give a cleansing enema.
The diet of a nursing mother should be high in calories (2500-3000 kcal). In the first 2 days after birth, food should be easily digestible. From the 3rd day, a regular diet with a predominance of lactic acid, cereals, fruits and vegetables is prescribed. Spicy, fatty, smoked foods, canned food, alcohol and potential allergens for the child should be excluded from the diet. The amount of protein should be about 100 g, mainly from animal proteins, fats 85-90 g, of which a third are vegetable, carbohydrates - 300-400 g. Try to drink milk or kefir (at least 0.5 l) every day. there is cottage cheese (50g) or cheese (20g), meat (200g), vegetables, fruits (500-700g each), bread and vegetable oil. Clean water with established lactation, you should drink an additional 1.5-2 liters per day.
Sexual activity after childbirth can be resumed after 6 weeks. By this point, the woman’s body has already completely returned to normal. During the same period, it is necessary to undergo a medical examination antenatal clinic or your doctor. You will be weighed and measured blood pressure, they will take a urine test and examine the mammary glands. A vaginal examination will be performed to determine the size and position of the uterus, check how the stitches have healed, and take a smear from the cervix. The doctor will advise you on contraception.
To fully recover after childbirth, at least two years must pass before the next pregnancy.

During the postpartum period, women have many questions about the restoration of their body. One of them concerns vaginal secretion, because discharge after childbirth is an integral component of the holistic rehabilitation process. Basic knowledge on how to carry out self-diagnosis bleeding, allow you to quickly respond to possible deviations from the norm.

After the baby is born, the mother’s body is rebuilt. The changes concern internal organs And hormonal levels. The uterus of a woman who has just given birth contracts in volume, and vaginal flow occurs. Together with bloody discharge Remnants of intrauterine fluids accompanying pregnancy also come out. Such flows are called lochia. Their duration, intensity and color allow the doctor to conclude whether the restoration of the patient’s internal organs is proceeding normally.

Duration of bleeding

Every body is individual, and every postpartum recovery story is special. Doctors are guided by a general scheme within which the rehabilitation process takes place for most young mothers. Many people are concerned about how long the discharge lasts after childbirth, since it causes a certain amount of discomfort. How long do currents last and why are they the main indicator? women's health?

Minimum normal period for postpartum hemorrhage – 5 weeks. If they stop earlier, you should be wary, since there is a risk of insufficient “cleaning” of the body;

The maximum period is 9 weeks when the course ends. Wherein long course is a signal of insufficient blood clotting;

Duration assessment does not occur separately from other indicators. With intense discharge, a short bleeding cycle is expected;

Mothers after cesarean section have different normative periods. In their case, restoration of uterine tone occurs more slowly than in those who gave birth naturally, and the upper limit for the duration of the flow is set personally by the doctor.

So, the answer to the question of how long the discharge lasts after childbirth depends on the course of the birth of the child itself, and on other factors. What helps reduce the duration of secretion?
Breastfeeding the baby. Lactation stimulates the contraction of the uterus and the removal of fluids from it. Experienced moms notice light contractions directly during breastfeeding.

Ingestion of large amounts of liquids. One way or another, a young mother needs to restore the body’s water balance. If she is breastfeeding, the fluid intake rate increases by 1.5 - 2 liters per day. With the correct water balance, discharge after childbirth is intense, and cleansing occurs quickly.

Kegel exercises. Many women are familiar with special movements in the vaginal area even before pregnancy - they are designed to maintain the tone of the internal organs. As soon as after the birth of the baby, the tension and relaxation of the internal muscles does not cause discomfort to the young mother, the exercise is performed daily. They also stimulate the contraction of the uterus and the removal of fluids from it.

Quality of bleeding

To assess the progress of recovery of a woman’s internal organs, doctors use a number of characteristics of postpartum processes. Taking into account how long the discharge lasts after childbirth is just one of the indicators. Others include the appearance of the bleeding and its smell. Together, they make it possible to determine the normal discharge rate after childbirth and possible deviations.

Compound

The recovery period determines normal composition secretion:

• 1-3 days: blood;
• Week 2: blood clots, mucus is allowed;
• end of 1 month – blood smears.

Purulent fluids at any time indicate an internal infection.

The appearance of clots and mucus in the first days after childbirth.

Transparent discharge, approaching the consistency of water.

Color

• 1-3 days: scarlet currents;
• after 3 weeks, brown flows begin (the blood coagulates, the wound heals);
• By the end of the restoration of the uterus, secretion fluids become transparent, light pink or with a yellowish tint.

The bright yellow and greenish color of the currents signals inflammation. An obvious green color indicates an advanced form of endometritis and suggests immediate consultation with a doctor.

Smell

The smell of blood in initial stage secretion is normal. After the third week it takes on a slight mustiness, which again is ok.

Discharge after childbirth with an unpleasant odor is a signal of inflammation! The characteristic smell of rot indicates inflammatory process. Sour - about the possible fungal disease. If such bleeding is accompanied by deviations in color, an examination by a gynecologist is required.

It is important to remember several subtleties of diagnosing discharge.

• Dangerous bleeding is accompanied by general malaise and dizziness. The temperature reaches 38 degrees Celsius. There is a pulsating heaviness in the lower abdomen. It is important to listen to your body and monitor how you feel.
• Redness of the vaginal mucosa along with a “cottage cheese” discharge indicates thrush. This is not uncommon when recovering from childbirth, but it is still better to consult a doctor for treatment.
• Dark secretions look scarier than they actually are. At the end of 3-4 months, black-brown or black flows are normal.

Number of allocations

The amount of bleeding after childbirth can also be used to judge women's health. What should the discharge be like after childbirth - intense or weak? The strength of secretion varies depending on the period. So, in the first few weeks the normal intensity is one, and as time passes it is another. The amount of liquid released is indicated by the fullness of special sanitary pads for young mothers.

Normal secretion strength:

• in the first two weeks after birth the flow is very profuse;
• the course becomes more sparse after 2-3 weeks;
• at the end of the recovery process (week 8-9), the discharge is only smears. For hygiene, you no longer need special postpartum pads with maximum absorbency.

Deviation from the above diagram is a signal of disease. If bleeding in the first days is not intense, the cause may be a congestion or blood clot that prevents the release of contamination.

The reverse situation is also dangerous: profuse bleeding ends by the end of 2 weeks. If this does not happen and by the third week a large amount of fluid continues to be released, the patient may have poor blood clotting.

In both extreme cases, an urgent visit to the doctor is necessary.

Resumption of discharge

How many times do they go bloody issues after childbirth? Nature provides for the cleansing of a woman’s body only once. However, sometimes women report resumption of bleeding. Should I worry?

The most obvious option is to quickly restore the cycle. Menstruation occurs individually for each woman, at the moment when she has completely restored the function of childbearing. Since postpartum blood flow and menstruation have similar characteristics in appearance, they are easy to confuse. Using an ultrasound, the gynecologist determines whether the young mother’s cycle has arrived or whether the cleansing of the body continues.

The release of the remaining endometrium and placental particles. In rare cases, the cleansing of internal organs from the remaining elements that accompanied pregnancy occurs at the end of the recovery process. If the liquid has a slimy, transparent appearance and unpleasant odor no, most likely this is just such a situation. Usually such delayed discharge does not last long.

All repeated currents of yellow, Green colour that smell unpleasant are a signal of an inflammatory process. To avoid the risk of pathology female organs, it is important to see a doctor as quickly as possible.

How to maintain hygiene during postpartum discharge

Unfortunately, bleeding that comes out is a fertile environment for an increase in the number of dangerous bacteria. To prevent their development, it is necessary to strictly follow hygiene measures.

To collect secretions, doctors recommend using special pads with enhanced absorbency. During the first days, a special product is used, which is sold at the pharmacy. Then regular night pads marked “5 drops” will do.

The use of tampons is strictly prohibited. In order to ensure the free flow of liquid, nothing should stop its movement. In addition, tampons cannot absorb the blood clots that inevitably pass after the first week.

The sanitary pad is changed every 2 hours, regardless of the intensity of the currents. It is accompanied by washing the external genitalia (if possible, if the woman is at home, also every one and a half to two hours).

The minimum number of ablutions is reduced to two or three per day. When using the toilet, you must use a mild cleanser labeled “for intimate hygiene.”

If natural childbirth has complications and there are ruptures in the birth canal, it is necessary to continue to take care of the injured skin areas at home. Upon discharge, the doctor gives detailed instructions on hygiene in this case. Most often, liquid antiseptics such as a solution of potassium permanganate or furatsilin are used.

For young mothers who have had surgical births, maintaining hygiene is especially important. Since there is an incision in the uterus, the recovery process must be protected from infection. In addition, daily hygiene includes taking care of the seam. The two-hour shift rule must be followed exactly.

Maintaining women's health is not the last task of a young mother. Observing how long the discharge continues after childbirth, and what its characteristics are, allows women to avoid risks recovery period and provide yourself wellness. Despite the fact that young mothers have a lot of worries related to their newborn, it is important to follow the doctor’s recommendations for diagnosing the flow and maintaining hygiene during this special period.

Restoring the body after childbirth

During the process of bearing a child and during childbirth, significant hormonal changes occur in the body. The changes concern not only reproductive system, but also other organs. Many things change dramatically, and therefore, of course, recovery of the body after childbirth takes a certain amount of time: not one or two weeks. How long does it take for the body to recover after childbirth - in each specific case The deadlines are different, but it is possible to generalize and derive a certain average norm.

• The female body after childbirth
• Myths and truth about rejuvenation

The female body after childbirth

After childbirth, a woman’s body does not immediately begin to function as it did before pregnancy. It took a long 9 months to give a start to a new life, so recovery will also take place gradually, step by step, and a complete return to the previous state will occur no earlier than in 2-3 months - and this is only in the case when the woman is absolutely healthy and doesn't practice.

Knowing what's going on with female body after childbirth, you can more clearly imagine the entire recovery period. Let's try to record all the changes in the form of a table to make it easier.

Table 1.

Myths and truth about rejuvenation after pregnancy and childbirth

Nowadays you can often come across statements online that the body of a “newly made” mother is rejuvenating. What happens to the body after childbirth - is this opinion true?

What happens to a woman’s body after childbirth?

If you pay attention to how long it takes the body to recover after childbirth, it becomes clear: in fact, it is significantly weakened by the stress experienced. In a woman who has hidden chronic illnesses, may first appear:

• arthritis and other joint diseases;
• pyelonephritis;
• hormonal problems;
• diabetes mellitus (if a woman develops it during pregnancy).

If you notice that your body takes a long time to recover after childbirth, perhaps one of these diseases is making itself known. Old “sores” that already existed also become aggravated, especially after the second birth: for example, hemorrhoids, herpes. Based on how the body recovers after childbirth, some conclusions can be drawn about the woman’s health. If recovery processes take too long, you should consider a comprehensive examination.

Data medical examinations also indicate a decrease in the level of “bad” cholesterol. Many women seem to become “smarter” with the birth of a child: they have to constantly keep their finger on the pulse of events, engage in the development of the child, and therefore develop themselves.

During the entire 9 months of pregnancy, eggs do not mature in the ovaries, which means that reproductive function- the ability to become a mother is extended. before all other cells in the body - this is a proven fact. Pregnancy delays this irreversible process.

Almost all women, when they calm down a little after the birth of the baby, wonder how to restore the body faster after childbirth, especially if it is not “behaving” very well and does not return to normal.

The transition time is different for everyone. When breastfeeding, the body usually recovers quickly.

When the uterus is completely cleansed and birth injuries have healed, you can begin physical exercise - little by little and very carefully. After 2 months (for complicated childbirth, for caesarean section - discussed with the doctor) are allowed sexual relations. The orgasm experienced by a woman helps speed up the recovery and healing processes due to a powerful rush of blood to the pelvic organs.

It is advisable to take special vitamins, especially if your hair is falling out more than usual and your nails are peeling.

Keep yourself in good health physical fitness At first, caring for the baby and walking with a stroller help. Then you should add a series of exercises. For example, if weakness of the vaginal muscles and urinary incontinence are observed, you need to do Kegel exercises: alternately squeezing and relaxing the muscles. Another exercise from this series: you need to push for about 30 seconds, then sharply relax the vaginal muscles. After some time, the tone will return.

In order not to lose the beautiful shape of your breasts, you need to wear a supportive bra and use creams and masks for stretch marks.

The situation is somewhat more complicated with fat deposits in the waist and abdomen. You cannot lose weight sharply, even if you are no longer breastfeeding - this is harmful for the woman herself. Stretch marks and sagging skin in such cases are almost inevitable.

The emphasis should be placed not on reducing the diet, but on physical activity: 2.5-3 months after giving birth, start pumping your abs from a lying position (this reduces the load on your back). Daily long walking at an energetic pace, gentle stretching of muscles, pumping up the abs - all this will help you quickly get back into good shape.

And one more important point: a young mother must definitely find time for herself to get enough sleep, relax a little in silence, just lie down. Therefore, do not try to do everything yourself, ask household members for help in caring for the baby. The more and better you rest, the sooner you will recover, and your former health and energy will return.

Many pregnant women feel that after giving birth they can finally forget about worries and relax a little. In fact, with the birth of a baby, the most exciting and responsible stage in life begins - motherhood. How will the first days after childbirth be? How to behave immediately after natural childbirth? When can you get up? How long will you have to wait until the baby is delivered? What else happens in the maternity hospital in the first hours after a natural birth or cesarean section?

How are the first hours after the birth of a child?

Immediately after giving birth, the young mother remains in the delivery room. If the delivery process went well, without complications, then the woman will be transferred to the postpartum ward within a couple of hours. During this period of time, the doctor will examine and interview the mother, and the medical staff will observe her condition. In some clinics, in agreement with the patient, they place an IV with medications that stimulate uterine contractions.

Possible ailments in the mother in the first days after childbirth

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Despite the fact that childbirth is a completely natural process, a woman’s body undergoes severe stress. Fatigue, dizziness, general weakness, nervous tension often accompany the first days of motherhood and are not considered deviations from the norm. The first day after giving birth, a young mother should devote to rest and caring for the newborn (we recommend reading:). Immediately after the baby is born, the following may appear:

1. pain, numbness at the suture sites (especially after cesarean section);
2. fatigue;
3. muscle pain;
4. slight increase in body temperature;
5. thirst and hunger;
6. chills.

How long before you can get up?

The process of childbirth takes a lot of energy from a woman, and it is quite natural that she wants to give her overstrained muscles a rest. However, you should not lie around the clock without getting up - physical activity promotes normal contraction of the uterus.

Of course, you can’t do exercises or actively engage in sports, but walking along the corridor and visiting the toilet and bathroom on your own is possible and necessary.

How long should you lie down? After an uncomplicated natural birth, a woman is allowed to get up after 6 hours. If the young mother feels well, the doctor will allow her to “walk” to the toilet herself even before this period expires, but for now you cannot visit the toilet room alone - you may suddenly feel dizzy and require emergency help.

If a caesarean section was performed, the woman will have to stay in the delivery room (or in the ward intensive care) for at least 24 hours after birth. A doctor will monitor the condition of the young mother during this period, and the medical staff will antibacterial therapy, blood loss is corrected, and if necessary, intestinal function is stimulated.

When do they bring the baby?

Almost every mother is worried about how soon she will have a baby. It all depends on the condition of the woman and baby, as well as on the policy of the maternity hospital. In some medical institutions babies are put to the breast after a natural birth, then the medical staff weighs, measures and dresses the newborns, and if the condition of mother and child is satisfactory, then from that moment they are in the postpartum ward together.

In some medical institutions, mothers are allowed to rest for several hours after childbirth (see also:). During this period of time, the infants are monitored by a neonatologist, they receive the first vaccination (if the mother has given consent to vaccination). If a caesarean section was performed in the maternity hospital, the waiting time will depend on a number of factors:

1. after elective surgery under local anesthesia the baby is brought and can be left with the mother immediately after birth;
2. If surgical intervention was carried out under general anesthesia, mother and baby will see each other only when the anesthesia wears off (that is, no earlier than 3 hours);
3. after an emergency caesarean section performed at night, the mother will be able to rest before meeting the newborn until the morning.

After the young mother has been transferred to the postpartum ward, she can already take a shower (for now only accompanied by nurse). For genital hygiene, it is not recommended to use soap on the first day - it is better to rinse with warm water. Washing from front to back should also be done after each visit to the toilet.

Due to heavy postpartum discharge, you will have to change special pads or disposable mesh panties very often in the first days. In some medical institutions, the doctor may recommend using a diaper rather than a pad - this will make it easier for him to assess the amount of discharge and notice deviations from the norm in time.

Being in " interesting position", a woman gets used to eating what she wants. Having become a mother, she must carefully monitor her diet, because... not everything that an adult likes will be useful for a baby (following a diet is important only for those who plan to breastfeed). It is recommended to include the following products in the menu from the first days:

• soup with low-fat broth or borscht (it is not recommended to eat cabbage from borscht);
• boiled low fat beef;
• pasta made from premium or 1st grade flour;
• mashed potatoes;
• rye crackers;
• vegetables – stewed or steamed;
• fruit drink;
• mineral water without gas;
• dried fruits compote;
• warm tea with a little sugar added.

Over time, mom will be able to make her menu more varied. The main thing is to introduce new foods gradually, in small portions, in order to have time to monitor the baby’s reaction. In general, the diet of a nursing mother should comply with the principles healthy eating– light, fractional, without hot spices and seasonings, no allergens, smoked foods or canned food, and, of course, a complete refusal of alcohol.

Breastfeeding and child care

If the condition of the mother and baby allows, then the newborn is put to the breast immediately after birth. The mother does not have milk yet, but the baby will have enough colostrum in the first hours of life - it contains all the necessary nutrients and vitamins. In addition, early latching helps to establish lactation faster.

A newborn should be put to the breast upon immediate request. It is important to remember that a healthy baby will only cry if he is hungry. If a child constantly cries and refuses to breastfeed, you need to urgently show him to a neonatologist - perhaps something hurts him. The nurse will tell you in detail how to feed the baby correctly and what hygiene rules to follow.

Possible complications after childbirth in the first days

On the first day after delivery medical staff carefully monitors the condition of the postpartum woman in order to identify and stop it in time possible complications. The doctor will often enter the postpartum room and examine and interview new mothers. When the following signs You need to urgently consult a doctor:

1. too much copious discharge– if the pad fills faster than 1 hour on the first day after delivery, or many clots appear, this is already considered a complication;
2. appearance hemorrhoids– if they greatly bother the postpartum woman, she will be prescribed rectal suppositories containing an anesthetic;
3. rashes on the face or redness of the eyes - usually this is not a cause for concern; rashes and dots on the skin appear with strong efforts when small capillaries burst (everything should go away on its own within 2 weeks);
4. cracks in the nipples - if the nipples begin to hurt, the skin may be too dry, and a painful crack will soon form; this can be avoided by properly placing the newborn to the breast and using special creams to treat the nipples;
5. impaired urination - if a woman was unable to urinate on her own within 5-6 hours after giving birth, she should definitely consult a doctor;
6. pain in the perineal area - pain occurs even if there were no cuts or tears, but if stitches were applied, then the doctor will give recommendations for care and pain relief;
7. pulling or cramping pain in the lower abdomen indicates that the uterus is contracting, these sensations may intensify during feeding, and if the pain is very severe, you should talk to your doctor about it.