Author: Judy Cohen

It takes about 4-6 weeks for your body to go back to its pre pregnancy state. Many changes occur during this time. If you experience any warning signs you need to contact your Provider right away.

Chest pain or shortness of breath, difficulty breathing.

Seizures

You or your baby have a fever over 100.4 notify your provider/Pediatrician.

Heavy vaginal bleeding , soaking more than a pad an hour, passing clots.

Red, swollen or pain in calf.

Headaches, visual changes, pain in the upper abdomen area.

Feeling depressed and having problems coping with caring for your new baby.

Thoughts of hurting yourself or others.

Worsening pain in perineum, warm, tender, incision with foul discharge, fever , chills could indicate infection.

Contact provider with any concerns regarding your healing after birth

There is so much to learn on caring for your newborn once you get home. Your Nurse will review this vital information with you before discharge.

1. Safe sleeping: your baby should sleep on their backs only on a flat firm mattress in a crib at night. You do NOT want your baby propped up on pillows or sleeping in bed with you at night , they can fall, suffocate and because of SIDS (crib death). You do not want to place objects and toys in the crib. Keep the baby in the room with you ideally for the first year. Do not swaddle them tightly let their arms be free to move.
2. If your baby is crying, that is how they communicate with you, they may be telling you they are wet, have gas, hungry or want to be held. First check the diaper, then burp them, then feed, sometimes they just want to be held.
3. Before leaving the hospital the nurse will remove the cord clamp, that will leave a cord stump. This will fall off in about 2-3 weeks, just keep it clean and dry. Do not immerse the baby in water until this falls off, just fold the diaper down. You may do a sponge bath, no soap on the face, mild soap on the body and not a lot of lotions, their skin is sensitive and they could break out in a rash. For sharp nails use a baby emery board, do not cut them and NO mittens they can choke on them.
4. If your baby has a circumcision, the nurses will give you instructions on caring for this, usually you place gauze with petroleum jelly on the penis . Make sure the baby urinates at least 12 hours after the procedure. Any questions or concerns call your Pediatrician.
5. Some babies get a little jaundice caused by bilirubin built up in the blood. It’s passed in the urine and stool so it is very important to keep tract of the number of urine and stools the first week. Check the diaper BEFORE each feeding. Frequent feedings help to excrete this, so breastfeed every 2-3 hours on demand. Formula feed every 3-4 unless otherwise specified by your Pediatrician. If your baby wont’t eat and becomes lethargic and has yellow eyes and skin , you need to contact your Pediatrician right away. There is a blood test done in the hospital and DR’s office to check this before discharge. Some babies need to have phototherapy if levels are too high.
6. Babies need to go home in the car seat , make sure you know how it works before your discharge day.
7. If the baby is spitting or choking, turn the baby on the side, or upright and pat their back and use a bulb syringe to gently remove secretions from the mouth or nose if needed. It is also a good idea to take a Baby CPR class before you delivery.
8. Be sure to keep your follow up appointment usually within 1-2 days with the Pediatrician.
9. Be sure your baby is not around any sick people and anyone holding your baby should wash their hands. Babies can not fight off many infections at birth. Moms should be encouraged to get the TDAP, FLU, and COVID vaccines which helps protect your baby. Discuss this with your Doctor ideally before delivery. See the CDC site for more information.
10. It is also NOT recommended to post your babies birth information and photos online or social media. It is also not recommended by the National Center for Missing and Exploited Children to decorate the outside of your house with balloons, announcements, or other lawn ornaments for you and your babies safety. See their information on “What Parents Need to Know”.
11. Before you leave the hospital, find out what Lactation consultants and support groups are available for new Moms.
12. Enjoy your new baby! Again for any concerns you have contact your Pediatrician.

• Postpartum tips for the next 4-6 weeks after giving birth
• Did you know it takes your body about 4-6 weeks to get back to its pre pregnancy state?
• Be sure to nourish yourself with a healthy diet and drink lots of fluid to help your body heal and recover after birth, you need to replace blood and fluids lost at delivery and stay hydrated.
• You may be sleep deprived and exhausted after delivery so try your best to REST when the baby sleeps, like in between feedings. Let others help you if you can and rest when you can.
• Activity: do NOT lift anything heavier than your baby, no strenuous activity, some Dr’s say not to drive for a few weeks as your reflex’s may be off. Speak with your Dr./Midwife.
• You may take Showers but NO tub baths, swimming pools, jacuzzis, you do not want to sit in water others are sitting in to prevent infection, the only exception is a sitz bath if prescribed by your provider for lacerations and hemorrhoids. Continue peri care as you did in the hospital.
• If you are breastfeeding, wear a good supportive bra and attempt to feed every 2-3 hours on demand. If you are not breastfeeding, wear a supportive bra and do not have any stimulation to the breast like letting warm water run down your chest in the shower.
• Pain control : your provider will give you pain meds after delivery, if you take motrin, be sure to take it with food so it does not upset your stomach, narcotics may make you drowsy and constipated. You may have afterbirth cramps especially after nursing, this occurs when your uterus contracts. You may also try to ease your discomfort with ice, heat, rest, relaxation.
• Baby blues or Postpartum depression, some women may feel happy one minute and tearful the next, this is normal and can last a few days, it is due to the lack of sleep, hormones and adjusting to your new routine. If this last more than 2 weeks or so and you are having trouble coping with taking care of you and your baby, contact your provider.
• If you have pain, swelling or feel heat in the back of your calf, contact your provider it could be a blood clot. To prevent this , stay hydrated, keep moving every hour while awake. Report any symptoms to your provider.
• The big 3 complications to be aware of after delivery are these below and call your Provider. Call also for any other concerns you have with instructions your provider gave you at discharge.
• 1. Infection if you have a fever over 100.4, fever, chills, foul discharge, painful breasts, tenderness or swelling around incision.
• 2. High Blood pressure if you develop headaches, visual changes, epigastric pain, sudden swelling, decrease urine output, shortness of breath, call your Dr.
• 3. Heavy bleeding: if you soak more than a pad an hour, passing clots, feeling weak and dizzy. Call your Dr.
• Nothing in the vagina until the provider says you can resume activity, you could get pregnant or get an infection. NO tampons, or douching. You may or may not get a period in 4-6 weeks. You may not get one at all if you are breastfeeding, however you may still be ovulating and you could get pregnant even though you are not having a period.
• Vaginal bleeding should get less and less and turn from red to brown to yellow or white over the next few weeks.
• If you have any problems with urination or bowel problems contact your provider.
• If you had a cesarean section, keep the incision clean and dry, in the shower let water run over it but do not scrub it, just pat dry and follow any other instructions.
• Be sure to keep follow up appointment with your Provider.

It is highly recommended that pregnant, non pregnant and lactating women get the Covid Vaccine. Get the facts. Pregnant women are coming in sick with covid, some winding up in the ICU. You can protect yourself and unborn baby by getting the vaccine before you deliver. There is NO evidence or reports that the vaccine causes infertility. Please get vaccinated before you deliver to protect you and your unborn baby. Please continue to wear a mask to protect you and your baby. Avoid large crowds and being around unvaccinated people. Hold off on baby showers and gender reveal parties, your life and your babies life could be at risk being around people unvaccinated. Talk to your OB/GYN Doctor and get the facts at CDC.gov and ACOG.org and AWHONN.org

You are the only one that can protect you and your baby. Be smart and be safe!

Get Vaccinated.

We have now been coping with this pandemic for over a year. This is a public health crisis. THIS IS NOT A JOKE. People of all ages are getting very sick, critically ill and dying. We can all do our part to get this under control. We all know we must continue washing our hands, social distancing, wearing a mask, and getting a vaccine. It is now recommended that pregnant woman get the vaccine. This is not the time for large family gatherings, hold off , you may be saving a life or even yours. I’m referring to baby showers and reveal parties. Why do I continue to wear a mask? I am trying to protect myself from others who may not have been vaccinated and could have the virus. I am also protecting them in the event I am exposed even though I have been vaccinated. You are protecting yourself and others. Also this is extremely stressful on our health care system. Nurses are getting burnt out. Beds are filling up in hospitals, elective surgeries are being cancelled. You don’t want to be the one in the ICU or needing a hospital bed and there aren’t any because the hospitals are full of covid patients who could have but did not choose to get vaccinated, now they are exposing everyone to the disease. The only way to get back to some type of normal is for people to get vaccinated. We need to listen to the experts, MEDICAL experts who have studied viruses for decades.

Please get the best facts at CDC.gov and for information for pregnant woman see ACOG.org. You can smartly choose you are either part of the solution or part of the ongoing problem.

Prior to admission to labor and delivery at my hospital at this time, you will be given a covid test. You will only be able to have one support person with you during your stay. No other visitors will be permitted. This is for the safety of you, your baby and the staff. Your significant other will not be permitted to come and go, but must stay with you during your short hospital stay, so bring snacks. Many new moms may be discharged home 24 hours after their delivery time, others stay 2-3 days depending on you and your baby’s condition. We are trying to get you home as soon as possible, so please pay special attention when nurses are giving you discharge teaching and breastfeeding assistance. You and your support person must wear a mask at all times when staff are in the room. The best guidelines are on the CDC.gov and ACOG.org websites. If you are positive for covid and sick, you may be separated from your baby. You may still pump and breastfeed. Your Physician and Pediatrician will decide what is best for you and your baby. Safety for you and your baby is our biggest concern. Please try to stay well during this time, wash hands, wear masks and stay away from large groups of people.

There is so much we do NOT know about this new virus. The best we can tell you at this time is stay away from crowds, good hand washing, try to stay as healthy as possible. Stay away from sick people. Stay home. Pregnancy changes your immune system so you are at risk for infections in general. We saw this with the H1N1 outbreak. So far they do not think the pregnant women did not pass this to the fetus in China. To keep informed refer to ACOG.org and CDC.gov for the best information.

Another tip, STOP asking your Drs and midwives to be induced, unless it is medically necessary. Your body will most likely go into labor as its should. Stop asking for elective Cesarean section for no medical reason. You do not want to be in the hospital if you do not need to be at this time. Visitation is limited and early discharge is going on to get you out as soon as possible, remember your baby’s immune system is not mature yet so your baby should not be around anyone sick. Many people have the virus and do not know they have it so keep them away from your baby.

Whenever you go to the doctors or hospital you will be asked about your health history and other important information. Fill in the following information as a quick reference for you and take a picture of it to have on your phone. Keep it with you at all times. Share with your loved ones.

Your name

Your Physicians and their contact numbers

Allergies

Family history

Father

Mother

Medical history

Surgery history

List your Medications you take with doses, all supplements & over the counter meds

Do you have a living will yes or no

List your health care surrogate and contact number

Are you a organ donor yes or no

Any family member that had bad reaction to anesthesia yes or no

Emergency contact with phone number

Ask your provider for a copy of these test needed when you go in for delivery. These are some of the routine test taken during pregnancy.

Your blood type and Rh factor

Rubella (checks for immunity to German measles virus which can cause birth defects). If you are not immune, the hospital may offer you the vaccine before discharge.

Hepatitis B and hepatitis C detects infection of hepatitis B and C

HIV check for HIV infection so steps can be take to reduce transmission to the baby

Gonorrhea , Chlamydia, and Syphilis ( check for STD infections which can cause miscarriage or infect baby during delivery)

Group B strep ( Detects infection which can harm baby )

Finally you are ready to take your baby home, but you may not have practiced or learned how the car seat works, or perhaps it is still in the box. This can be very frustrating as you are being discharged home and struggling with the car seat.

TIP: Practice with a doll, read the instructions, and practice adjusting the car seat so you know how it works before discharge. If you need help, many local fire departments can check out your car seat for you. YOU are responsible for knowing how to safely place your new baby in the car seat.