Post-Partum Instructions  Congratulations on the arrival of your child. The following instructions are compiled to help you in the next few weeks at home. Please also refer to the post partum section of What To Expect When You Are Expecting. If specific problems arise, please call our office for further advice.   Appointments: Be prepared to discuss birth control options at your post-partum appointment. Cesarean section:  schedule an appointment 2-3 weeks after surgery. Vaginal delivery:  schedule an appointment 6 weeks after delivery, unless otherwise instructed by physician.  Activity: Rest as much as possible.  During your first weeks at home, restrict your activities to caring for the baby.  You will heal faster and be at less risk for depression.  Take frequent naps. Limit your visitors.  You may begin light exercise when you feel like it.  Do not push yourself.  Walking is better for you than running or lifting weights the first six weeks after birth.  After six weeks, you may slowly build back up to your normal exercise routine.   If you had a cesarean section, walking up and down stairs will not harm you.  You probably should not carry anything heavier than the baby for the first week or two.  Use common sense – if it hurts, don’t continue with that activity.  Intercourse is permissible after the vaginal discharge and bleeding stop, usually at three to four weeks.  If you have had vaginal stitches, you should wait six weeks.  Condoms should be used with a water-soluble lubricant such as K-Y jelly or Astroglide.  You may drive when you feel comfortable and have stopped taking pain medications.  Wait two weeks or more if you have had a cesarean section.  Sitz baths, showers, and baths are safe after delivery.  Do not use a Jacuzzi until the vaginal discharge stops.   Vaginal delivery: After delivery, you will experience bleeding and a discharge for 4-6 weeks. It may last longer. The discharge is called lochia. It may be any color, and often has an odor. This continues until the uterus has healed. If you had a vaginal tear or episiotomy, your vaginal area may be swollen or sore. Urination may cause external stinging and should resolve after several days. Taking sitz baths or a warm tub bath 2-3 times a day will help with the discomfort and promote healing. You may use Tucks on stitches or hemorrhoids for comfort. These may be purchased without a prescription. The stitches will dissolve by themselves, and do not need to be removed. Do not worry if you see a stitch or knot fall off.   Cesarean section: Cesarean section incisions have many layers that heal at the same time. There are strong stitches below the skin. Steri-strips should be removed one week after C-section, if they have not already fallen off. If you have "glue" on your incision, peel it off prior to your 2-week visit with the doctor. It is not necessary to cover the incision while showering. Use a blow dryer to keep the incision dry if your skin folds over the incision. Your incision may ooze slightly as the skin heals. If your incision opens, has a large amount of discharge or bleeding, or if it becomes red or painful call the office for an appointment.   Diet, Bowel and Bladder Care: You may return to your regular diet at home. Drink more water than usual and eat lots of fresh fruits and vegetables.   If you are breast-feeding and took prenatal vitamins during your pregnancy, continue them for the duration of breast-feeding. Increase your diet by 500 calories, and drink 8-10 glasses of water each day. Avoid chocolate, alcohol, spicy foods, and gas-producing foods like onions and garlic.   After delivery, you may become constipated. Fiber supplements and stool softeners (Colace) may be purchased without a prescription. Citrucel, Metamucil, and Fibercon are all equally effective. Drinking water is very important for the stool softeners or fiber supplements to work.  If you become constipated, with no bowel movement for a few days, you may use a laxative such as Ducolax or Senakot. If still no bowel movement, a Fleets enema may be effective.   To prevent a bladder infection, drink plenty of water, and urinate frequently. If you develop burning or pain with urination, call the office.   Medications: You may also continue to use the same medications used during your pregnancy. If you have any questions about medication, call your doctor.  Pain medications: Non-Prescription: Anti-inflammatory: (non-steroidal anti-inflammatory drug) such as Ibuprofen or Naprosyn. These are non-prescription pain relievers that reduce cramping, bleeding and discomfort.  The usual dose of Ibuprofen (Advil, Nuprin, Motrin) is 600 mg every 6 hours, not to exceed 2400 mg in 24 hours and Naprosyn (Aleve) is 220 mg, 2 initially, then 1 every 6-8 hours, not to exceed 1100 mg in 24 hours.  Tylenol is also useful for pain relief. Narcotic prescription: If you had a cesarean section, your physician will prescribe a narcotic like Vicodin, Darvocet or Tylenol #3.  Narcotics do not harm the infant, but may cause drowsiness, fatigue, nausea and constipation in the mother.  Ibuprofen and Naprosyn can make the narcotic work better so that you need less of it.  Use both according to your physician’s recommendation.  Stop using the narcotic before you stop the anti-inflammatory medication.  Post-partum depression After delivery, your body will undergo many changes. The demands of a new baby, and not enough sleep may lead to feelings of depression. For most women, these feelings may only last 4-7 days. Resting, maintaining a good diet, and planning time for yourself away from baby are important. If depression persists longer, or seems more severe, ask for help. Good Samaritan Hospital has an excellent support group (559-2508).  Please schedule an appointment with your doctor. Symptoms to report immediately:  Chills or fever over 100.4 degrees. Severe pain. Bleeding heavier than a period. Vaginal discharge with unpleasant odor. Severe depression. Breast infection - fever in association with red, painful breast. Bladder infection - frequency, urgency, or pain with urination.