<h1>Common physical concerns after birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.4.6.jpg" alt="Woman sitting in yoga pose with her knees splayed and her hands holding the soles of her feet against each other" width="650" height="406" class="alignnone size-full wp-image-1227" />
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<a href="https://admin.mumandbaby.uk/2018/08/21/bleeding/">Bleeding</a>

<a href="https://admin.mumandbaby.uk/2018/08/21/passing-urine/">Passing urine</a>

<a href="https://admin.mumandbaby.uk/2018/08/21/opening-bowels/">Opening your bowels</a>

<a href="https://admin.mumandbaby.uk/2018/08/21/bachache/">Backache</a>

<a href="https://admin.mumandbaby.uk/2018/08/21/829/">Breast changes</a>

<a href="https://admin.mumandbaby.uk/2018/08/21/after-pains/">After pains</a>

<a href="https://admin.mumandbaby.uk/2020/06/05/fatigue/">Fatigue</a>

<a href="https://admin.mumandbaby.uk/2020/06/10/12303/">Carpal tunnel syndrome</a>

</div>
<span style="font-weight: 400;">Find out more about how your body may feel after birth and how to support your physical recovery by exploring the links below.</span>
<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="https://www.nhs.uk/conditions/pregnancy-and-baby/you-after-birth/">Your body after birth</a>

<a href="https://thepogp.co.uk/Resources/113/exercise_and_advice_after_pregnancy">Essential advice and exercises following childbirth</a>

</div>

Common physical concerns after birth

<h1>Commonly used medicines after birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/05/Medications-2-650x406-1.jpg" alt="Pills spilling out of the neck of a medicine bottle onto a table top" width="650" height="406" class="alignnone size-full wp-image-12112" />
<h2>1. Analgesics (pain killers)</h2>
<h3>a) Paracetamol (500mg tablets)</h3>
<i>What is it used for?</i>

<span>Paracetamol works by relieving pain and lowering high temperature. It can provide effective reliefnfrom mild to moderate pain, including headache, toothache, sore throat,
symptomatic relief of rheumatic aches and pains, influenza symptoms and fever.</span>

<i>How do I take it?</i>

<span>Paracetamol can be taken regularly or when required for pain.</span>

<span><i>Dosage:</i> Adults and young persons aged 12 and over: take 2 tablets up to 4 times per day, as required. The tablets should be taken with water. Take only as much as you need to relieve symptom and leave at least 4 hours between each dose. Do not take more than 8 tablets in 23 hours.</span>

<i>What are the side effects?</i>

<span>Paracetamol is generally well-tolerated in most people.</span>

<i>Is it safe to use while breastfeeding?</i>
<span>Paracetamol is commonly used during breastfeeding.</span>

<h3>b) Co-dydramol</h3>
<i>What is it used for?</i>

<span>Co-dydramol (10/500 10mg dihydrocodeine and 500mg paracetamol) is a combination of paracetamol and dihydrocodeine. Dihydrocodeine is stronger than paracetamol and is used for the relief of mild to moderate pain.</span>

<span>If you have had a caesarean section or moderate pain post-delivery, then you may be given a box of 30 tablets of co-dydramol on discharge from hospital.</span>

<i>How do I take it?</i>

<span><i>Dosage:</i> Co-dydramol 1 to 2 tablets every 6 hours when required up to a maximum of 4 times per day. Do not take more than 8 tablets in 24 hours.</span>

<span>We recommend that you step down pain relief and substitute these tablets for paracetamol as soon as possible which is usually after 3-4 days. Since these tablets contain paracetamol you should not take any other paracetamol tablets at the same time.</span>
<span>Do not drink alcohol whilst taking co-dydramol.</span>

<i>What are the side effects?</i>

<span>The most common side effects of dihydrocodeine are drowsiness, constipation, feeling sick or dry mouth. You may be advised to take a gentle laxative if you experience constipation whilst taking co-dydramol.</span>

<i>Is it safe to use during while breastfeeding?</i>

<span>Dihydrocodeine can be used during breastfeeding as a pain killer where paracetamol has not been effective. Use the minimum effective does for the least amount of time.</span>

<span>IMPORTANT: Although there is a small dose of dihydrocodeine in these co-dydramol tablets, if you are breastfeeding whilst taking it, inform your midwife immediately if your baby is showing signs of increased drowsiness, difficulty feeding, breathing problems or anything else unusual. Research has shown that some babies may be more susceptible than others to these side effects.</span>

<span>If you would like any further information regarding the use of dihydrocodeine while breastfeeding, please discuss it with your midwife/doctor.</span>
<h3>c) Ibuprofen</h3>
<i>What is it used for?</i>

<span>Ibuprofen is anti-inflammatory drug used to treat inflammation in a variety of
conditions. It is commonly used after birth to help ease pain and inflammation.</span>

<i>How do I take it?</i>
<span>Swallow tablets whole, with a glass of water. Take the tablets with, or after, food.</span>

<span><i>Dosage:</i> Adults: 400mg three times a day, 8 hours apart, is often prescribed after a procedure. If you have been given a diclofenac suppository after birth or a procedure, you cannot start ibuprofen until 18 hours later.</span>

<span>The dose can be reduced to 200mg three times a day when the pain improves.</span>

<i>Who should not use ibuprofen?</i>

<span>Women with any of the following conditions should consult a doctor, midwife, or pharmacist before taking ibuprofen if there is history of:</span>
<ul>
 	<li>asthma or breathing problems</li>
 	<li>previous stomach ulcer</li>
 	<li>previous reaction to aspirin, diclofenac and other non-steroidal anti-inflammatory drugs (NSAIDs)</li>
 	<li>other medical conditions, e.g. kidney disease, heart disease, blood clotting disorders, liver disease.</li>
</ul>
<i>What are the side effects?</i>

<span>Common side effects include headache, dizziness, feeling sick and diarrhoea.</span>

<span>IMPORTANT: Stop taking the medicine and seek immediate help if you:</span>
<ul>
 	<li>pass blood in your faeces (stools/motions)</li>
 	<li>pass black tarry stools</li>
 	<li>vomit blood or dark particles that look like coffee grounds</li>
 	<li>suffer any allergic reaction such as itching, drowsiness, swelling of the face, lips, tongue, mouth or throat, which may in turn cause shortness of breath or difficult swallowing.</li>
</ul>
<span>Ibuprofen is considered as a suitable treatment option whilst breastfeeding.</span>

<h2>2. Ferrous Sulphate (Iron supplements)</h2>
<i>What is it used for?</i>

<span>Iron supplements are used to treat iron deficiency anaemia. When the body does not get enough iron, it cannot produce the number of normal red blood cells needed to keep you in good health. It is common for women who are pregnant or who have just given birth to have this condition. These medicines work by replacing body iron. Iron is a mineral that the body needs to produce red blood cells.</span>

<i>How should I take it?</i>
<span>Swallow the tablets who with water. Although iron preparations are best absorbed on an empty stomach, they may be taken after food to reduce the effects on the stomach. Iron supplements should not be taken within one hour before or two hours after eating or drinking the following products: tea, coffee, milk, eggs and wholegrains. These products can reduce the absorption of iron.</span>

<span><i>Dosage:</i> Ferrous sulphate 200 mg tablets</span>
<span>Treatment of iron deficiency anaemia: 1 tablet 2-3 times a day.</span>
<span>Prevention of iron deficiency anaemia: 1 tablet per day.</span>

<i>What are the side effects?</i>

<span>Like all medicines, ferrous sulphate tablets may cause side effects, the most common of which are constipation, diarrhoea, stomach pain, feeling sick and blackened stools (faeces).</span>

<i>Is it safe to use during breastfeeding?</i>

<span>Ferrous sulphate tablets are commonly used safely while breastfeeding. Ensure that you do not take more than the recommended dose.</span>

<span>If you cannot tolerate ferrous sulphate tablets, an alternative is available called ferrous fumarate. This is available as a liquid or tablets. The same side effect and safety information applies as above for ferrous sulphate.</span>

<h2>3. Laxatives</h2>
<i>What are they used for?</i>

<span>Laxatives are used to treat constipation.</span>

<i>What else can I do to prevent becoming constipated?</i>

<span>The following hints are helpful in maintaining regular bowel habits:</span>
<ul>
 	<li>Eat fibre-containing foods, e.g. wholegrain bread, fruit and vegetables.</li>
 	<li>Drink sufficient liquid, preferably water.</li>
 	<li>Take regular exercise.</li>
</ul>
<span>Laxatives may be prescribed after birth. If you think that you need a laxative discuss with your midwife or doctor.</span>

<i>What are the side effects?</i>

<span>Common side effects of laxative include feeling bloated, increased wind (gas) and mild abdominal pain.</span>

<span>Commonly used laxatives in pregnancy/after birth:</span>
<h3>a) Lactulose</h3>
<span>Lactulose is a liquid laxative used to treat and prevent constipation. Lactulose can take 2-3 days to have an effect; it is generally considered to be a gentle laxative.</span>

<span><i>Dosage:</i> Usually 10 mls twice daily. It must be taken regularly to have an effect.</span>
<h3>b) Fybogel (Ispaghula husk)</h3>
<span>Fybogel is a high fibre drink that works to increase the fibre in your diet. Increased fibre in the diet helps to gently relieve constipation. Fybogel is considered to be a gentle laxative. It is important to maintain an adequate intake of fluid whilst using Fybogel.</span>

<span><i>Dosage:</i> The usual dose is one sachet mixed with a glass of water, up to twice daily.</span>

<i>Is it safe to use Lactulose or Fybogel after birth?</i>

<span>Lactulose and Fybogel are not absorbed into the blood and only have a local effect on the gut. Both drugs are generally considered safe to use while breastfeeding, under the advice of a midwife or doctor.</span>

<h2>4. Blood clot prevention</h2>
<span>Enoxaparin (also known as Clexane) is used to prevent blood clots. Blood clots usually present as deep vein thrombosis (DVT) usually in a leg vein, or pulmonary embolism (PE), a blood clot in the lung. Blood clots are more common during pregnancy and some women will be more at risk of blood clots than others. As well as prevention, enoxaparin is also used at higher doses for treatment of DVT and PE.</span>

<i>Is it safe to use during breastfeeding?</i>
<span>Enoxaparin is given as an injection just beneath the skin (subcutaneous). It is usually injected into a skin fold in your abdomen (stomach) or the upper part of your thigh. If this is not suitable, you may be advised to inject into an alternative site. It should not be injected into your muscles. It may be given either once or twice daily. You should adminster the dose at the time recommended by your doctor.</span>

<i>How is exonaparin used after birth/caesarean section?</i>
<span>If you have, or develop risk factors at the time of the birth, you may be started on enoxaparin. Examples of possible risk factors would be having a caesarean section or infection. If you were on enoxaparin during pregnancy, your doctor will want you to stay on the same treatment after the birth. They will inform you how long to continue this treatment.</span>

<i>How to inject Enoxaparin (Clexane)</i>
<span>You will be able to inject enoxaparin once you have been shown how to do so by your doctor or midwife, or by following the instruction leaflet that will be given to you upon discharge. It is a simple process and one that you can do at home.</span>
<span>Follow these steps:</span>
<ul>
 	<li>Wash and dry your hands.</li>
 	<li>Clean the injection site. If someone else is doing it for you it is advisable that they wear gloves.</li>
 	<li>Choose the injection site either on the outer aspect of your left or right thigh or your stomach if advised to do so. It is important that you change the site each time. If there is any oozing of blood at the injection site, apply gentle pressure. Do not rub as this may cause bruising.</li>
 	<li>Dispose of the syringe in the yellow sharps box provided. This box should be kept out of the reach of other people.</li>
</ul>
<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2020/05/21/commonly-used-medicines-during-pregnancy/" internal="true">Commonly used medicines during pregnancy</a>
</div>

<span>Produced by pharmacists at Chelsea and Westminster Hospital NHS Foundation Trust and used with permission.</span>

Commonly used medicines after birth

<h1>Deep vein thrombosis (DVT) and pulmonary embolism (PE)</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/10/3.4.4.jpg" alt="Woman's hand holding her leg below the knee" width="650" height="406" class="alignnone size-full wp-image-3430" />
<h2>Are you at increased risk of developing a blood clot?</h2>
<span style="font-weight: 400;">After giving birth, women are at a slightly increased risk of developing blood clots in the veins in their legs, known as deep vein thrombosis (DVT). This risk is increased for roughly six weeks following birth.</span>

<span style="font-weight: 400;">On rare occasions, these blood clots can become very large and travel in the body to the lungs. This is known as pulmonary embolism (PE) and can be very serious.</span>
<h2>Signs/symptoms:</h2>
<ul>
 	<li><span style="font-weight: 400;">pain/tenderness in the leg behind the knee or in the calf</span></li>
 	<li><span style="font-weight: 400;">feeling of heat in the affected area or a red discolouration of the skin</span></li>
 	<li><span style="font-weight: 400;">swelling of the affected area</span></li>
 	<li><span style="font-weight: 400;">a pulmonary embolism may cause shortness of breath and chest pain, which comes on suddenly and worsens with deep breaths, coughing or chest movement.</span></li>
</ul>
<span style="font-weight: 400;">If you have any of these symptoms you should speak to a health professional immediately, or attend your local A&amp;E department.</span>
<h2>Treatment</h2>
<span style="font-weight: 400;">These conditions are serious and will require urgent treatment in hospital with medications that prevent the clot from getting bigger and breaking off and travelling to another part of the body.</span>
<h2>Prevention:</h2>
<ul>
 	<li><span style="font-weight: 400;">keep mobile and rotate your ankles regularly</span></li>
 	<li><span style="font-weight: 400;">wear compression stockings if your midwife or doctor have advised you to do so</span></li>
 	<li><span style="font-weight: 400;">consider taking short walks when you feel up to it</span></li>
 	<li><span style="font-weight: 400;">stay well hydrated</span></li>
 	<li><span style="font-weight: 400;">avoid sitting/lying down for prolonged periods i.e. in a car/on a train.</span></li>
</ul>
<span>Some women will be prescribed injections to self-administer at home to reduce the risk of blood clots if they are considered to be at a higher risk of developing them.</span>

<span>Staff use a venous thromboembolism risk scoring system to determine each women's risk. These include caesarean section, postpartum haemorrhage, pre-eclampsia and preterm birth, or any family or medical history that makes the risk higher.</span> 

<span>Before you are discharged you will be shown how to administer the pre-filled syringe and safely dispose of the sharp into a sharps container.</span>

<span>If you have been prescribed injections it is very important to complete the course – and to dispose of the needles safely. Your midwife will explain this to you before you go home.</span>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/pregnancy/related-conditions/complications/deep-vein-thrombosis/" type="nhs">Blood clots in pregnancy</a>

<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/reducing-the-risk-of-venous-thrombosis-in-pregnancy-and-after-birth/." type="rcog">Reducing the risk of DVT</a>

</div>

Deep vein thrombosis (DVT) and pulmonary embolism (PE)

<h1>Feeling unwell</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.4.5.jpg" alt="Graphic of three mercury thermometers showing no reading, a mid-range reading and a maximum reading" width="650" height="406" class="alignnone size-full wp-image-1220" />
<h2>Infections</h2>
<span style="font-weight: 400;">Infections following birth are rare; however some women may contract infections which require treatment with antibiotics. Infections may occur in perineal stitches, caesarean section wounds, the uterus, breasts or in urine and can worsen rapidly. </span>
<h2>Signs/symptoms:</h2>
<ul>
 	<li><span style="font-weight: 400;">a high temperature (more than 37.5°C)</span></li>
 	<li><span style="font-weight: 400;">feeling unusually hot or cold/shivery</span></li>
 	<li><span style="font-size: 1rem;">feeling unusually lethargic and sleepy</span></li>
 	<li><span style="font-size: 1rem;">flu-like aches and pains in the body.</span></li>
</ul>
<h2>Stitches or caesarean wound infection</h2>
<span style="font-weight: 400;">If your stitches or wound are infected you may notice pus, an offensive smell or an unusual amount of pain or tenderness in the area. You may also notice the skin is red and hot to touch.  </span>
<h2>Uterine infection</h2>
<span style="font-weight: 400;">An infection in the uterus may cause symptoms of excessive vaginal bleeding, passing of clots and offensive smelling blood loss. You may also note severe pain and/or heat on touching the lower abdomen. </span>
<h2>Breast infection</h2>
<span style="font-weight: 400;">If breasts become infected (known as mastitis) they may appear red, swollen and be painful/hot to touch. You may notice a burning sensation during feeds. Seek help urgently and read more about this here.</span>
<div data-cat="goto" class="goto">

<a internal="true" href="https://admin.mumandbaby.uk/2018/08/21/829/">Breast changes</a>

</div>
<h2>Urinary infections</h2>
<span style="font-weight: 400;">Symptoms include the increased need to pass urine or pain on passing urine.</span>

<span style="font-weight: 400;"><b>If you are experiencing any of these symptoms please speak to your midwife or GP urgently, or attend the local maternity triage/assessment unit where you had your baby.</b></span>

<h2>Other infections</h2>
<span>If you experience other infections not directly linked to having had a baby, like a severe cold/flu or chest infection, or diarrhoea and vomiting, seek help urgently.</span>

<h2>Deep vein thrombosis/Pulmonary embolism</h2>
<span>Read more about this here.</span>

<div data-cat="goto" class="goto"> 
<a href="https://admin.mumandbaby.uk/2018/08/21/deep-vein-thrombosis/" internal="true">Deep vein thrombosis (DVT) and pulmonary embolism (PE)</a>
</div>

<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Explore maternity units</a>

</div>

Feeling unwell

<h1>Healthy eating after birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/08/vegetable-skewer-3317055_650x406-300x187.jpg" alt="vegetable kebab skewers" width="300" height="187" class="alignnone size-medium wp-image-13074" />

<span>Eating healthily after the birth of your baby is as important as it was during pregnancy. Eating a balanced diet with plenty of clear fluids helps your body to recover. Speak to your midwife, health visitor, infant feeding specialist or GP if you have specific concerns relating to weight loss, diabetes or breastfeeding.</span>

<div data-cat="video" class="videoplayer">Nutrition after pregnancy from Nutribytes
<iframe width="560" height="315" src="https://www.youtube.com/embed/GI0_7QJtzTc?rel=0" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="allowfullscreen"></iframe></div>

Healthy eating after birth

<h1>Heart health after giving birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/05/heart-66893_650x406.jpg" alt="Graphic of red heart with a jigsaw shaped piece missing" width="650" height="406" class="alignnone size-full wp-image-11636" />
<span>Chest pain in pregnancy and/or after your baby's birth should never be ignored. Some chest pain can be serious and can head to a heart attack, heart failure, cardiac arrest or even death. Most women do not suffer from these conditions during or after pregnancy but it is important to recognise the symptoms and, if you have any of them, to seek treatment quickly.</span>
<h2>Pre-exisiting heart conditions</h2>
<span>If you have a known heart condition, were born with a congenial heart defect or have been diagnosed with heart disease, your midwife/GP/cardiologist will monitor your heart health before, during and after pregnancy.</span>

<h2>Symptoms of a heart attack can include:</h2>
<ul>
<li>central chest pain</li>
<li>arm pain or numbness</li>
<li>pain in the jaw, back or shoulders</li>
<li>nausea</li>
<li>sweating/clamminess</li>
<li>breathing difficulties</li>
</ul>
<span>Some people experience indigestion-like chest or throat pain that does not respond to indigestion remedies.</span>

<h2>When should I contact the midwife or doctor?</h2>
<span>If you feel unwell, contact your midwife or GP for guidance. If you experience some/all of the above symptoms, dial 999 and ask for an ambulance as yoru heart health needs to be investigated quickly. An ECG monitor and a troponin blood test should be carried out to find out if you have had a heart attack.</span>

<h2>When am I more likely to have a heart attack?</h2>
<span>You are more likely to have a heart attack if you:</span>
<ul>
<li>have a family history of heart problems</li>
<li>have high blood pressure</li>
<li>have high cholesterol</li>
<li>smoke</li>
<li>drink excessively</li>
<li>are obese</li>
</ul>
<span>Rarely, women with no risk factors or history of heart disease in their family will experience heart attack symptoms.</span>
<span>Heart attack symptoms are pregnancy should never been ignored. Contact your midwife or GP for further advice.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/women/pregnancy-and-heart-disease">Pregnancy and heart conditions</a>

<a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/women/misdiagnosis-of-heart-attacks-in-women">Misdiagnosis of heart attacks in women</a>

<a href="https://www.nhs.uk/conditions/heart-attack/" type="nhs">Heart disease in pregnancy</a>

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/coronary-heart-disease-pregnant/">More on heart disease in pregnancy</a>

<a href="https://www.tommys.org/pregnancy-information/im-pregnant/pregnancy-news-and-blogs/pregnant-women-should-be-aware-heart-disease-symptoms" type="tommy's">Heart disease symptoms</a>
</div>

Heart health after giving birth

<h1>Pelvic floor exercises</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.4.7.jpg" alt="Cross section diagram of female abdomen showing where the pelvic floor muscles are located" width="650" height="406" class="alignnone size-full wp-image-1228" />
<span style="font-weight: 400;">The pelvic floor muscles support your pelvic organs, stabilise the pelvic joints and are responsible for the control of bladder and bowel functions. These muscles are stretched during pregnancy and birth – which can sometimes lead to weakness or dysfunction during pregnancy and particularly after birth.</span>
<span style="font-weight: 400;">Strengthening these muscles will:</span>
<ul>
 	<li><span style="font-weight: 400;">maintain or improve bladder and bowel control</span></li>
 	<li><span style="font-size: 1rem;">reduce the risk of prolapse of the pelvic organs</span></li>
 	<li><span style="font-size: 1rem;">help to stabilise the joints of the pelvis and lower spine.</span></li>
</ul>
<span style="font-weight: 400;">Exercises should be started as soon as your catheter (if you have had one) is removed and you have passed urine. The exercises can help reduce swelling and pain as well as treat/prevent incontinence. They should be completed at least three times a day. It can take up to three months for the muscles to regain their strength.</span>
<h2>How to do your pelvic floor exercises</h2>
<span style="font-weight: 400;">Lay or sit down comfortably and begin by imagining you are trying to stop yourself from passing wind/urine by squeezing the muscles around the back passage and vagina. Don’t do this whilst on the toilet, and don’t hold your urine as this can lead to problems with bladder function. You should work this muscle in two ways:</span>
<ul>
 	<li>Hold the squeeze for a few seconds and then relax. Repeat this up to 10 times, gradually holding the squeeze for longer (up to 10 seconds).</li>
 	<li>Squeeze and release straight away. Repeat this 10 times.</li>
</ul>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/your-body-after-childbirth.aspx" type="nhs">Your post-pregnancy body</a>

<a href="http://www.squeezyapp.com/">Information on the Squeezy app</a>

<a href="https://thepogp.co.uk/patients/pelvic_health_advice/pelvic_floor_muscles.aspx">Pelvic floor exercises</a>
</div>

Pelvic floor exercises

<h1>Perineal after-care</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.4.2.1.jpg" alt="Close up of hands covered in soap lather being rinsed under a running tap" width="650" height="406" class="alignnone size-full wp-image-1216" />
<ul>
 	<li><span style="font-weight: 400;"><b>Always wash your hands</b> before caring for your stitches or changing your sanitary towels. This is particularly important if anyone in your household has a cough or cold</span></li>
 	<li><span style="font-weight: 400;">shower or bath daily if possible for the first two weeks. Prolonged bathing can cause the stitches to dissolve too quickly. Rinse with warm water and avoid soaps and perfumed products. Dry with a clean towel and avoid rubbing the area</span></li>
 	<li><span style="font-weight: 400;">do not apply any creams, salts, oils or lotions to the stitches</span></li>
 	<li><span style="font-weight: 400;">sanitary towels should be changed frequently, and leaving the stitches exposed to the air can assist with healing</span></li>
 	<li><span style="font-weight: 400;">when passing urine, some mild stinging can be expected in the first few days. Avoid dehydration which can worsen this sensation. Rinsing with plain water during or after urination may reduce this discomfort</span></li>
 	<li><span style="font-weight: 400;">when opening your bowels the stitches won’t come apart. Avoid constipation or excessive straining and ensure good personal hygiene is maintained to reduce the risk of infection
</span></li>
 	<li><span style="font-weight: 400;">mild/moderate discomfort is to be expected in the first few days after birth and can be relieved with common pain relief medications such as paracetamol and/or ibuprofen. Please speak to your midwife regarding the recommended dose and other methods to relieve discomfort of your stitches
</span></li>
 	<li><span style="font-weight: 400;">using ice can reduce inflammation and pain. You can use ice wrapped in a clean towel or use a sanitary pad that has been placed in the freezer for couple of hours. Place over the tender part of your perineum for 10 minutes. Repeat the process three to four times each day for the first few days</span></li>
 	<li><span style="font-weight: 400;">if your stitches are gaping, oozing, severely painful, offensive in smell or unusually hot, please contact your GP, midwife or local maternity triage/assessment unit urgently.</span></li>
</ul>
<div data-cat="video" class="videoplayer">

Recovering from tearing

<iframe width="560" height="315" src="https://www.youtube.com/embed/ZTS7Qud6yZY?rel=0&amp;showinfo=0" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen="allowfullscreen"></iframe>

</div>

<div data-cat="goto" class="goto">
<a href="https://mumandbabyaccessible.imagineear.com/2018/08/21/understanding-perineal-tears/" internal="true">Understanding perineal tears</a>

</div>

Perineal after-care

<h1>Pregnancy conditions affecting you after birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.4.1.jpg" alt="Graphic of a profile of the same woman shown five times in different stages of pregnancy and then shown with a baby in her arms" width="650" height="406" class="alignnone size-full wp-image-1213" />
<span style="font-weight: 400;">Some of the medical conditions that occur in pregnancy can have an impact on your pregnancy, but also your future health and wellbeing. If you have experienced any of these conditions, please take some time to read this information.</span>
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/20/793/">Pre-eclampsia (PET) after birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/20/gestational-diabetes-2/">Gestational diabetes after birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/20/intrahepatic-cholestasis-of-pregnancy/">Intrahepatic cholestasis of pregnancy (obstetric cholestasis) after birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/20/epilepsy/">Epilepsy</a>

<a href="https://admin.mumandbaby.uk/2020/04/27/spontaneous-coronary-artery-dissection-scad-2/">Spontaneous coronary artery dissection (SCAD) after birth</a>
</div>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/perinatal-care-
and-covid-19">Mental health and wellbeing concerns</a>

<a href="https://www.btf-thyroid.org/pregnancy-and-thyroid-disorders-guidance-for-patients">Thyroid disease and pregnancy</a>

<a href="https://www.crohnsandcolitis.org.uk/about-crohns-and-colitis/publications/pregnancy-ibd">Crohn's Disease, Ulcerative Colitis and other forms of inflammatory bowel disease</a>
</div>

Pregnancy conditions affecting you after birth

<h1>Pressure sores</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/03/bed-soresv2-300x187.jpg" alt="Close up of woman's back showing large areas of red skin" width="300" height="187" class="alignnone size-medium wp-image-10012" />
<span>Pressure ulcers, also known as bed sores or pressure sores, are areas of damage to the skin and deeper layers of tissue.</span>
<span>Pressure ulcers may cause pain or become infected leading to a longer hospital stay.</span>
<span>Pressure ulcers are caused by a combination of:</span>
<span><b>Pressure:</b> body weight and some medical equipment can squash the skin and damage the blood supply to the area. Lying or sitting in one position for a long period of time can cause this.</span>
<span><b>Shearing:</b> sliding down the bed or chair can damage the skin and deeper layers of tissue. The skin may split or break.</span>
<span>Pressure ulcers can develop anywhere in the body but are more commonly found over boney areas such as bottom, heels, elbows, hips, ankles, spine, back of the head and shoulder blades. Usually people can relieve the effects of pressure and shearing by turning in bed and getting out of bed. You may be at risk of developing pressure ulcers if you stay in the same position for too long. Ask your healthcare professional or partner to help you move around safely. Ensure your clothing or bedding is not too tight so that you can move freely.</span>
<span>Early signs of pressure ulcers will appear as: a change in skin colour (redder or darker), change in skin temperature (hotter or colder) discomfort or pain, blistering and skin damage. You can check your own skin for signs of pressure ulcers, if you notice anything different on your skin, please contact your healthcare professional.</span>
<span>Whilst in hospital, your healthcare professional team will perform a risk and skin assessment to see if you are at risk of developing a pressure ulcer. After the birth, you can ask your healthcare professional to look at your skin if you feel any discomfort.</span>
<h2>Protect your skin</h2>
<ul>
<li>Keep your skin clean and dry. Wash your skin every day using mild soap and warm water. Do not use heavily perfumed soap or talcum powder, as these can soak up the skin’s natural oils leading to vulnerable dry areas.</li>
<li>If you suffer from incontinence please inform your healthcare team as they can assess the best way to support you.
Rubbing and massaging skin is bad for it.</li> 
<li>If you are given compression stockings (TEDS) to wear, do not allow them to roll down as this can cause pressure and skin damage. Remove the stockings once a day to wash, moisturise and inspect your skin.</li>
</ul>
<span>Ensure you continue to eat and well balanced diet and drink plenty of fluids.</span>

<div data-cat="relatedlinks" class="relatedlinks"><a href="https://www.nhs.uk/conditions/pressure-sores/" type="nhs">Pressure sores</a></div>


Pressure sores

<h1>Recovery from caesarean birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.4.3.jpg" alt="Close up of woman's tummy showing a caesarean scar" width="650" height="406" class="alignnone size-full wp-image-1218" />

<span style="font-weight: 400;">Following a caesarean you may feel sore and swollen for a few days. To help with pain, regular pain relief is recommended in combination with early and gentle movement.</span>

<span style="font-weight: 400;"><b>Always wash your hands</b> before caring for your caesarean wound.</span>

<span style="font-weight: 400;">Your scar will take up to six weeks to heal, and to assist with healing you should:</span>
<ul>
 	<li><span style="font-weight: 400;">look out for any signs of infection such as severe pain, parting of the wound, redness, oozing of pus and bleeding</span></li>
 	<li><span style="font-weight: 400;">bath or shower daily and clean your incision site gently with warm water and pat dry</span></li>
 	<li><span style="font-weight: 400;">keep the scar dry and exposed to the air when possible</span></li>
 	<li><span style="font-weight: 400;">wear loose, comfortable clothing and cotton underwear </span></li>
 	<li><span style="font-weight: 400;">avoid lifting anything heavier than your baby.</span></li>
</ul>
<span style="font-weight: 400;">Gentle activity such as a daily walk is recommended to prevent the formation of blood clots. Advice on resuming exercise can be found elsewhere in this section.</span>
<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="http://www.nhs.uk/Conditions/Caesarean-section/Pages/Recovery.aspx">Recovery from caesarean</a>

</div>

Recovery from caesarean birth

<h1>Resuming sex and contraception</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.4.8.jpg" alt="Couple on a sofa together in a hug" width="650" height="406" class="alignnone size-full wp-image-1229" />

<span>After you have had a baby it is important to wait until you and your partner feel happy, ready and comfortable before resuming sexual intercourse. The timing of this will be individual to each couple. Some factors may increase the time you choose to wait before having intercourse. If the birth has been traumatic, physically or mentally, it may take longer for you to feel ready to have intercourse.</span>

<span>Some women have reduced interest in intercourse following childbirth, particularly if breastfeeding. More often than not your libido will slowly return to what was normal for you. A lasting low libido can be a sign of postnatal depression or post-birth trauma. It can help to talk to your partner, midwife, friends, family, health visitor, or GP to see what help and support might be available.</span>

<span>Many women find that sex is painful after birth, and that they are less lubricated naturally than they were before. Using a lubricant can help, as can taking it gently and communicating with your partner. If sex continues to be painful, you can always seek support from your healthcare provider. Intimacy can take on many forms and does not necessarily need to include penetrative vaginal intercourse. Kissing, 
foreplay, cuddling, mutual masturbation, oral sex and other forms of intimate play can 
be less pressured whilst helping you to connect with your partner.</span>

<span>It is possible to become pregnant again from just three weeks after the birth even if you have not had a period and are breastfeeding, therefore it is important to consider using contraception to avoid an unplanned pregnancy. Research suggests that becoming pregnant again within 12 months of having a baby can increase the chance of your baby being small for gestation, premature or even stillborn.</span>

<span>Some maternity units are able to supply contraception before you are discharged home from the hospital. Your midwife will discuss your options during your pregnancy as it is easier to think about these before the arrival of your baby. Babies can be time-consuming and it may be difficult to access reliable contraception once you are home. All of the methods listed below are safe whilst breastfeeding. Ask your midwife for information on what is currently available in your maternity unit.</span>

<span>Intrauterine contraception can be inserted at a planned (elective) caesarean section. A device (coil) is inserted into your uterus after birth and can remain there providing reliable contraception for 5 to 10 years, depending on the type (hormonal or non-hormonal).</span>

<span>An implant, which is a matchstick sized rod inserted under the skin of your upper arm, can also befitted before discharge. The implant slowly releases progestogen hormone and provides reliable contraception for 3 years. The benefit of these methods which are known as long acting reversible contraception (LARC) is that you don’t need to remember to use contraception every day and therefore they have very low failure rates. Both intrauterine contraception and implants can be removed at any time at your GP Practice or local Family Planning/Sexual Health Services.</span>

<span>Alternatively, a six month supply of progestogen-only pills or a progestogen-only injection which provides contraception for 13 weeks can be made. The failure rates of both these methods are much higher if they are not taken exactly as recommended, for example if you forget to take pills or do not receive your next injection when it is due. Your GP practice or local Family Planning or Sexual Health Clinic can provide you with further supplies of these methods.</span>

<span>Ask your midwife about the advantages and disadvantages of each method to help you decide which method might be suitable for you.</span>

<span>Find further information here:</span>
<a href="https://www.nhs.uk/conditions/baby/support-and-services/sex-and-contraception-after-birth/">Sex and contraception after birth</a>

<div data-cat="video" class="videoplayer">

When can we have sex again after birth?

<iframe width="560" height="315" src="https://www.youtube.com/embed/VnGfuJQdpys?rel=0&amp;showinfo=0" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen="allowfullscreen"></iframe>

</div>

Resuming sex and contraception

<h1>Returning to exercise</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.4.9.jpg" alt="Close up of the back of woman's legs as she pushes a pram" width="650" height="406" class="alignnone size-full wp-image-1230" />

<span style="font-weight: 400;">Exercise is an important aspect of a healthy lifestyle and generally the time you can resume exercise is a matter of personal choice. If you’ve had a caesarean it is important to wait at least eight weeks. Most women choose to wait until after their six week postnatal check with the GP before resuming exercise. </span>

<span style="font-weight: 400;">When you start exercising it is important to remember to:</span>
<ul>
 	<li><span style="font-weight: 400;">stop if it hurts</span></li>
	<li><span style="font-weight: 400;">stop if you have any pelvic floor concerns, eg, if you notice any leakage of urine or experience a feeling of vaginal heaviness during exercise</span></li>
 	<li><span style="font-weight: 400;">stop when you are tired</span></li>
 	<li><span style="font-weight: 400;">never exercise when you are feeling unwell.</span></li>
</ul>
<span style="font-weight: 400;">Try to avoid high impact exercise (jogging and jumping) for at least three months after birth. High impact exercise can put unnecessary strain on muscles, joints and the pelvic floor.</span>

<span style="font-weight: 400;">Find out if there are any local postnatal exercise, yoga or Pilates classes near you. This can help with motivation and provide a social outlet.</span>

<span style="font-weight: 400;">Remember that each woman’s recovery after birth is different, and avoid comparing yourself to others or setting unrealistic goals. Trying to incorporate gentle exercise into your daily activities is a great start, and it’s important to have plenty of rest as well.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="https://www.nhs.uk/conditions/pregnancy-and-baby/keeping-fit-and-healthy">Keeping fit and healthy</a>

<a type="rcog" href="https://www.rcog.org.uk/for-the-public/browse-our-patient-information/being-overweight-in-pregnancy-and-after-birth/">Being overweight in pregnancy and birth</a>

<a href="https://thepogp.co.uk/Resources/119/fit_for_the_future">Fit for the future</a>

</div>

Returning to exercise

<h1>Sepsis after birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2019/06/sepsis-300x187.jpg" alt="Sepsis infection particles under a microscope" width="300" height="187" class="alignnone size-medium wp-image-6118" />

<span>Infection in pregnancy and/or after your baby’s birth should never be ignored. Some infections can progress to a more serious situation known as sepsis, where the infection spreads to the blood stream and through the whole body. If left untreated sepsis can lead to shock, organ failure and death. Whilst most women do not suffer from infection or sepsis during or after pregnancy, it needs to be recognised and treated quickly if they do.</span>
<h2>Signs of sepsis</h2>
<span>The first signs of infection are usually a rise in your temperature, heart rate and breathing. You may also feel unwell, have chills and flu-like symptoms and a worrying pain in your tummy and/or diarrhoea. Sepsis can progress very quickly so it is important to seek advice if you are concerned about your health.</span>
<h2>How can infection in pregnancy or after childbirth be prevented?</h2>
<span>Good personal hygiene helps. This can include: daily showers/baths, proper hand washing and drying, perineal hygiene to include keeping the perineal area (between the vagina and back passage) clean, dry with frequent changes of maternity/sanitary pads. It is important to wash your hands before and after going to the toilet and changing maternity/sanitary pads.</span>
<h2>When am I more likely to get an infection or sepsis?</h2>
<span>Sepsis may happen in pregnancy or after your baby is born. The risk of getting an infection is increased in the following circumstances:</span>
<ul>
 	<li>After having a miscarriage or an ERPC (ERPC - evacuation of retained products of conception is a surgical procedure to remove tissue from the womb)</li>
 	<li>Premature rupture of membranes (when your waters break long before your baby is due)</li>
 	<li>If your waters break more than 24 hours before your baby is born</li>
 	<li>If you develop a urine infection (UTI)</li>
 	<li>If your baby was born prematurely/early (before its due date)</li>
 	<li>After you have had your baby – this is the most common time for serious infection to develop; especially if you had your baby by an emergency caesarean section, by forceps or vacuum delivery, or if you had a perineal wound or an episiotomy).</li>
</ul>
<h2>When should I contact the midwife or doctor?</h2>
<span>You should contact your GP or the maternity unit if you are worried, unwell and/or if you notice any of the following:</span>
<ul>
 	<li>Pain/burning on passing urine or struggling to pass urine, this could be a symptom of a urinary tract infection</li>
 	<li>Vaginal discharge which may be foul smelling and/or an unusual colour, this could be a sign of a genital tract infection (vaginal/womb infection)</li>
 	<li>Abdominal pain that does not seem to be getting better with simple analgesia, this could be a sign of womb/wound infection or abscess</li>
 	<li>Chills, flu type symptoms or feeling faint and unwell</li>
	<li>Fast breathing or shortness of breath</li>
 	<li>Fast heart rate</li>
	<li>Persistent cough with or with sputum, shortness of breath or chest pain could be a sign of chest infection or pulmonary embolism (blood clot in the lung)</li>
 	<li>A wound that is not healing well, broken down or is red</li>
	<li>Severe pain in one area of breast</li>
 	<li>Diarrhoea</li>
 	<li>Sudden increase in vaginal bleeding (after your baby is born).</li>
</ul>
<span>Contact the maternity unit where you gave birth, your midwife or GP for urgent advice.</span>
<span>For more information:</span>
<div data-cat="goto" class="goto"><a href="https://sepsistrust.org/about/about-sepsis/faqs/">UK Sepsis Trust</a></div>

Sepsis after birth

<h1>Sleep</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.4.10.jpg" alt="Sleeping woman hugging a pillow" width="650" height="406" class="alignnone size-full wp-image-1214" />

<span style="font-weight: 400;">Some tips for coping with lack of sleep:</span>
<h2>Deep relaxation</h2>
<ul>
 	<li><span style="font-weight: 400;">as little as five to ten minutes of deep relaxation can refresh you</span></li>
 	<li><span style="font-weight: 400;">you can learn relaxation techniques online</span></li>
 	<li><span style="font-weight: 400;"> sleep when your baby sleeps</span></li>
 	<li><span style="font-weight: 400;">rest when your child has a daytime rest.</span></li>
</ul>
<h2>Sharing responsibility</h2>
<ul>
 	<li><span style="font-weight: 400;">where possible, share the responsibility of getting up in the night with your partner</span></li>
 	<li><span style="font-weight: 400;"> if you're on your own, see if a friend or relative may be prepared to have your children overnight occasionally.</span><span style="color: #666666; font-size: 1.25rem;"></span></li>
</ul>
<h2>Excessive tiredness</h2>
<ul>
 	<li><span style="font-weight: 400;">excessive tiredness or difficulty coping with tiredness can be a sign of postnatal depression. Please read the section on <b style="font-size: 1rem;">Your emotional wellbeing</b> if you think you or your partner may have symptoms of postnatal depression.</span></li>
</ul>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/09/13/your-emotional-health-and-wellbeing-after-birth/" internal="true">Emotional wellbeing</a>
</div>

<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="https://www.nhs.uk/conditions/pregnancy-and-baby/sleep-and-tiredness/">Sleep and tiredness after having a baby</a>

</div>

Sleep

<h1>Your physical health and wellbeing after birth</h1>
<img class="alignnone size-full wp-image-1231" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.4.jpg" alt="Mother leans on pram handle to look in at her baby" width="650" height="406" />
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/20/pregnancy-conditions-affecting-you-after-birth/">Pregnancy conditions affecting you after birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/21/perineal-after-care/">Perineal after-care</a>

<a href="https://admin.mumandbaby.uk/2023/03/22/recovery-from-vaginal-or-assisted-birth/">Recovery from vaginal or assisted birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/21/recovery-from-caesarean-birth/">Recovery from caesarean birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/21/deep-vein-thrombosis/">Deep vein thrombosis (DVT) and pulmonary embolism (PE)</a>

<a href="https://admin.mumandbaby.uk/2018/08/21/feeling-unwell/">Feeling unwell</a>

<a href="https://admin.mumandbaby.uk/2019/06/11/sepsis-2/">Sepsis after birth</a>

<a href="https://admin.mumandbaby.uk/2020/05/14/heart-health-after-giving-birth/">Heart health after giving birth</a>

<a href="https://admin.mumandbaby.uk/2020/03/30/pressure-sores/">Pressure sores</a>

<a href="https://admin.mumandbaby.uk/2018/08/21/common-physical-concerns-after-birth/">Common physical concerns after birth</a>

<a href="https://admin.mumandbaby.uk/2020/05/21/commonly-used-medicines-after-birth/">Commonly used medicines after birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/21/pelvic-floor-exercises-2/">Pelvic floor exercises</a>

<a href="https://admin.mumandbaby.uk/2018/08/22/844/">Resuming sex and contraception</a>

<a href="https://admin.mumandbaby.uk/2020/08/05/healthy-eating-after-birth/">Healthy eating after birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/22/returning-to-exercise/">Returning to exercise</a>

<a href="https://admin.mumandbaby.uk/2018/08/22/sleep/">Sleep</a>

</div>

COOKIE SETTINGS

MANAGE COOKIE PREFERENCE

Your physical health and wellbeing after birth