What to expect in the postpartum period – a four-part series

How to care for your baby and you during each stage of pregnancy and beyond

According to Elizabeth Mlynarczyk, M.D., an OB/GYN who delivers at Northwest Community Hospital (NCH), the postpartum period begins at delivery and can last up to 12 weeks.

The American College of Obstetricians and Gynecologists (ACOG) states: “The weeks following birth are a critical period for the mother and her infant, setting the stage for long-term health and well-being.”

Dr. Mlynarczyk, who is accepting new patients, answers patients’ most commonly asked questions below.

What are some of the symptoms a woman experiences in the postpartum period?

It is normal to have light bleeding for up to eight weeks after delivery. Hormone levels drop after the birth of the baby and may take up to three months for them to return to normal. Hot flashes are normal during this time. If a mother exclusively breastfeeds, 40 percent of moms will not have a period for six months.

What will my breasts feel like in the postpartum period?

The mother’s breasts will become full and firm and feel tender or painful within 24-72 hours after the birth of her baby. A rise in temperature is normal, but if mom has a fever (temperature 100.5 degrees F or higher), she must call her doctor.

What will the healing process be like after delivery, episiotomy or C-section?

Pain in the uterus can occur when the mom is breastfeeding. These pains oftentimes go away after the baby is a week old. Also, if the mother had an episiotomy, she can take Tylenol or Motrin and use cold packs in the affected area. Mothers who had a Caesarean section can use stronger pain medications for the shortest period necessary to help relieve their pain. The medications prescribed by her OB/GYN are safe for breastfeeding.

One third of women will have a problem with hemorrhoids. It’s important to prevent or treat constipation. Drinking a lot of water, eating fiber and taking a stool softener can help.

When should I call the doctor?

Mothers should call their doctor if they experience the following:

• Bleeding that saturates a pad within an hour
• Fever
• Worsening vaginal or pelvic pain or pain with urination
• Severe breast pain or redness on the breast
• Chest pain or trouble breathing
• Leg pain or swelling
• Worrisome mood changes

When is a postpartum visit scheduled?

The timing of the first postpartum visit depends on the mother’s health. If she has any of the above-mentioned issues, she needs to be seen by her doctor immediately. If she had high blood pressure or other complications during delivery, she should be seen a few days after she is discharged from the hospital. Her doctor will advise when the new mom needs to come for a doctor’s visit.

How do I know if I’m experiencing moodiness from fatigue or if I have postpartum depression?

As far as mood changes, these can be normal for up to 60 to 80 percent of new mothers and can last for a few weeks after the baby is born. The mother may feel constantly tired or overwhelmed. She may cry for no apparent reason and worry about her baby. She may also experience mood swings, irritability or anxiety. This is called “Postpartum Blues.”

How can I combat this?

The new mom should take care of herself as well as her baby. Ways to help take care of mom include:

• Resting, which includes taking a nap when the baby is napping
• Eat healthy and exercise
• Ask family and friends for help, especially with chores, preparing meals and helping with other children
• Be open and honest with family and friends about feelings

How common is postpartum depression and how do you screen for it?

One out of seven women experiences postpartum depression. It is the most common complication during the postpartum period. The OB/GYN screens for depression during the postpartum visit, which is typically six weeks after delivery. The doctor may have the mom fill out a questionnaire. If the new mother is experiencing extreme sleeping or eating problems and feelings of sadness, hopelessness, guilt or worthlessness, she needs to tell her doctor. Also, she may experience panic, extreme anxiety or thoughts of hurting herself or her baby. The mother should tell her partner if she is experiencing any of the above-mentioned symptoms and see her doctor immediately.

Risk factors for postpartum depression include stress, history of depression, lack of support, domestic violence, lower income and education, smoking, traumatic birth experience, preterm birth/infant admission to NICU and breastfeeding problems.

The OB/GYN can help the patient by suggesting counseling, support groups, anti-depressant medication and access to resources.

What is the postpartum visit like?

The new mom should expect a thorough screening during her postpartum visit. This visit includes assessment of physical, social and psychological well-being. The OB/GYN will address health conditions, discuss contraception and perform a physical exam including a pap smear, if necessary.

Dr. Mlynarczyk is part of Gynecological & Obstetric Associates, S.C., located at 1614 W. Central Rd., Suite 205 in Arlington Heights. To make an appointment, call 847-392-9191.

From prenatal classes to postpartum services and breastfeeding support, NCH offers everything new mothers need to care for their babies. Learn more at www.nch.org/birthday.