What's Happening Down There - Vaginal Birth Postpartum Care

In my first year working as a doula and childbirth educator, I have found that what surprises women the most is not how tired they feel in the third trimester, not the intensity or duration of labor, and not the overwhelming joy they feel when they see their baby for the first time, but rather, what it feels like to recover from a vaginal birth. First, let me be very clear: every woman experiences birth and recovery differently. Some women may feel like doing cartwheels just hours after birth, some women may experience mild discomfort, and some women may experience a rough recovery. Much like other variables in birth, there is no way to predict what your experience will be.

The ease or difficulty with which you recover from a vaginal birth may (or may not) depend on many factors: your level of fitness prior to birth, how many vaginal births you've had before, how your care provider cares for your perineum during pushing, how you pushed during birth (directed vs. following your natural urges), positions used for pushing, and the length of time that you spend in labor and during pushing. The following information shares tips for soothing some of the more common discomforts women experience after a vaginal birth. As with anything, be sure to with consult your care provider about treatment options.

Swelling - Unless you have a very rapid birth, you will most likely experience swelling "down there." Your vulva will look and feel swollen. Don't worry, though -- it will go away within a few days. For soothing, many hospitals have special pads that turn magically into ice packs. You can also wet and freeze a regular pad -- it will feel wonderful, trust me.

Soreness - As with most things on your body that swell (see above), your vagina and surrounding parts will most likely feel sore for a few days to a couple of weeks after giving birth. Even if you do not tear (see below), you still may feel tender from stretched and swollen tissues. The best thing you can do to recover is to take it easy and rest your body.

Burning/stinging - If your perineum tears (or if you have an episiotomy) during birth, you will most likely experience additional discomfort in the days and first couple of weeks after birth. Your best source of soothing is the peri bottle that is given to you during your hospital stay (basically, a squeeze bottle to squirt warm water over your perineum as you urinate to prevent stinging and to cleanse your genitals). Home birth mamas can purchase these online or use any small, clean squirt bottle. Some women also find that witch hazel pads and an anesthetic spray (like Dermoplast) can also provide soothing relief.

Hemorrhoids - You may have developed hemorrhoids during your pregnancy, and if you didn't, you may experience them after birth (as a result of pushing). Either way, these swollen, bulging vericose veins near your anus can cause irritation, itching, and can even be painful. There are many remedies to soothe your sore bum, including ice packs, witch hazel pads, a sitz bath, medicated hemorrhoid cream, and over-the-counter anti-inflammatory medication (ibuprofen, acetaminophin). Avoiding standing or sitting for long periods of time will also aid in reducing swelling.

Weak abdominal muscles - Your mid-section goes through an amazing transformation from pregnancy to postpartum. Immediately after you have your baby, your "tummy" will still look as though it's about 6-8 months pregnant, as a result of your uterus, which takes time to shrink back down. Additionally, similar to late in pregnancy, you may find yourself having a hard time sitting up from lying down and getting up from a sitting position. This difficulty comes not from the weight of your baby, of course, but from weak core muscles. Some women experience the normal stretching of skin and muscle that occurs with pregnancy and some women experience what is known as "diastasis recti," which is the separation of the right and left side of your abdominal muscles. To aid in postpartum abdominal strength, you might consider wearing a belly binding apparatus, which provides more stability as you move around. For diagnosis and healing of diastasis recti, you will want to consult with your doctor and/or a physical therapist.

Lingering contractions - Otherwise known as "after pains," these post-birth contractions are necessary to shrink down your uterus to its pre-pregnancy state, but may also may cause you to tap back into your deep breathing coping methods used for labor! The good news is that many first-time moms may not even notice these contractions, and for second-time moms and beyond, they are brief and will disappear completely after a few days.

What was your postpartum vaginal birth experience like? Did you experience something not on our list? Share in the comments!