NO TWO WOMEN

Surprising Things That Happen After Birth

You might never look at an ice cube the same way.

22/06/2017 7:18 AM AEST | Updated 22/06/2017 9:24 AM AEST

What happens during labour is something nearly every pregnant woman (particularly first-timers) will obsessively Google before their due date approaches.

Things like contractions, breaking waters, pain relief (Epidural! Epidural!) and breathing techniques will all be exhaustively researched right down to "best birthing playlists" and "how do I know when to push".

But what women often don't pay that much attention to is what happens in the days immediately after birth, which can be nearly as confronting in a whole number of ways.

It's something Royal Women's hospital staff obstetrician and senior clinical research fellow in the Pregnancy Research Centre, Penny Sheehan, sees all the time.

"I think everyone is so focused on labour and delivery in birth classes, when in reality the labour and delivery takes somewhere between 12 to 72 hours," she tells HuffPost Australia. "Whereas settling and breastfeeding, that's months. It's equally if not more important."

There are also changes in your body to be reckoned with, not to mention one hell of an emotional roller coaster ride.

So, pregnant ladies, prepare yourselves. This is what to expect after you're expecting.

All the emotions

You may have already heard the phrase 'the three-day blues' or 'baby blues' (note: completely different to postpartum depression) but you might not be expecting them to hit you with the force of an 18-wheeler truck. For an idea on what we're talking about, listen to Bec Judd relate her experience on the Mamamia podcast below.

Basically, the baby blues typically strike three to four days after birth, and usually coincide with your milk coming in (more on that later). Around this time you may also start coming down from the adrenaline high you experienced in the first couple of days after labour, and, on top of that, are feeling generally exhausted and probably more than a little overwhelmed.

In short, your hormones are flying around everywhere and it's not unusual to cry over spilled, excess, absent or even soy milk.

"In those first 48 hours somewhere most people do experience a drop," Sheehan tells says. "Partly it's about hormones decreasing, the placenta being delivered, and just those hormones slowly coming down.

"At the same time you have other hormones kicking in, those around breastfeeding, which tend to be hormones of the oxycontin/dopamine pathway, so are meant to be quite euphoric. But not right at the beginning, I don't think. There is a transition period there, so you are not getting the full effect of it at first, even though the pregnancy hormones are leaving your body."

LittleBee80 via Getty Images
Be prepared for all of the feels.

Insomnia

Speaking of hormones, those little buggers can also deny you much-needed sleep, in what surely has to be one of the cruelest jokes nature has ever made.

"Something that's quite common is that women are often exhausted after their delivery experience but can't sleep," Sheehan says. "It is quite common in the first 24 to 48 hours.

"It's a time of your hormones being really high, lots of cortisol, lots of estrogen, and I think that's what responsible for it. You've got through it all, you've delivered the baby, the baby is asleep, and you think, 'Awesome, that's great, I can rest,' and then you can't just get into a deep sleep.

"It's really common. I don't have any evidence of this but I wonder if it's part of the day three blues."

KatarzynaBialasiewicz
Cruel.

Let's talk about boobs

Engorged breasts

Thought your boobs were big during pregnancy? Ha. Welcome to the process of your milk coming in, which can see you up a couple of bra sizes literally overnight. (Prior to this, you would have still been feeding your baby, but your breasts would have been producing colostrum instead.)

"Often with your first baby, you can get an oversupply of milk when it comes in," Sheehan says. "Your breasts can become really engorged, you can go up a couple of sizes at least, overnight! It can be really confronting and terribly frightening."

It can also pose issues with breastfeeding, as your boobs might actually be too big for your baby's tiny mouth.

"Small babies and large breasts can be a bad fit. If your breasts are really engorged, it can mean your baby can't get a latch on, which in turn makes them even more engorged."

Nipple grazes

While it may come naturally to some, breastfeeding can be a challenge to plenty of new mums and bubs as they both learn how navigate the process. (Believe it or not, your baby doesn't know what it's doing either, and you have to learn together).

Not being able to get the baby to latch properly can prove especially challenging, and if not done properly, can result in painful nipple grazes.

IvanJekic via Getty Images
In the early days, breastfeeding can be a real challenge.

"It's very important women speak up and say if something hurts," Sheehan said. "If a baby is feeding and it's hurting, more than the odd sensation of tugging and stuff, you should take them off and detach them gently and try again.

"It's hard because if it's your first time you don't know what's normal and what's not. If it is actually sore, you should take them off and detach them gently."

While a nipple graze will usually respond to a bit of lanolin or breast milk, it's important to nip the problem in the bud before it becomes to painful to continue.

"Getting a really bad graze can be a downward spiral," Sheehan says.

Mastitis and nipple thrush

Problematic feeding can lead to blocked milk ducts and therefore areas of severe engorgement.

While Sheehan notes mastitis is not so much a concern in the first couple of days, it can become an issue in the early weeks after you head home and start breastfeeding unsupervised.

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Mastitis can occur any time, but is more likely once you have been discharged from hospital.

"If part of your breast is red and hot and you have expressed it out and there's nothing remaining in it, go straight to a doctor to get antibiotics," Sheehan says. "The breast abscesses that can develop as a result is just a disaster."

Nipple thrush is something else to look out for, and can be identified by a particular type of pain which Sheehan says is typically described as "a stabbing pain through to your back".

If you suspect you have nipple thrush, both you and your baby will need to undergo anti fungal treatment.

'Down there'

If you've had a natural birth, chances are, yes, you'll be a bit tender in your nether regions. Because you have just passed an entire human through your birth canal, you goose! Of course it's going to be sore!

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Very important note: your stomach will NOT look like this.

Pain

"If you had [perineal or vaginal] tears or episcopacy, you can be a little more uncomfortable. There might also be a little bit of grazing around the urethra, but this typically sorts itself out in 48 hours. It generally repairs itself really quickly," Sheehan says.

Those in discomfort may find relief from icing the affected area for ten minutes at a time, ensuring the ice is wrapped in dampened cloth, or putting an ice block in a sanitary pad. Alternatively, you can even make yourself a condom popsicle (yes, you read that right).

As for that first trip to the loo, Sheehan says: "Passing urine can sting a little bit initially but should settle down very quickly. Your first bowel action, however, may be a bit more of a challenge. You may have had some kind of opiate analgesia, maybe you were given Endone or Panadeine Forte, especially if you had a cesarean, and this can actually make the pregnancy constipation so much worse.

"So yes, that first bowel action can be really hard, because it's an area which is swollen and you might have an unspecified number of stitches. So that's something to consider. It's usually something that has settled down after the first week. It should be tender but not something you are aware of all the time."

Bleeding

"For the first week at least you can get really quite heavy period-like bleeding, potentially for two weeks," Sheehan says.

"There can be blood clots and occasionally little bits of membrane. After the woman delivers, the placenta is checked to make sure it's complete, but it is possible for little bits of membrane to sheer off. It's possible even to have a little bit of wall lining which didn't come out originally."

If this sounds like a horror story to you, don't worry, it's not forever.

"It should settle down pretty rapidly as the uterus shrinks down, but you can still have bleeding, a little bit, up to the full six weeks," Sheehan says.

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There will be blood.

Dryness

This happens a bit later down the track, but it's worth talking about as Sheehan says it's something many women don't anticipate.

"During pregnancy the vagina does increase its blood supply, the tissues get a bit more swollen and the extra estrogen makes it produce a lot more discharge," she says.

"Then all of that regresses because the hormones decrease. So, by the end of six weeks, the tissues around the vagina would have gone less plump and normal than their normal state, especially if breastfeeding.

"Estrogen is what makes vagina nice and moist and all those things. So lower levels of estrogen can mean vaginal dryness and irritation. I wanted to mention this because it can actually feed into depression, as vaginal dryness can be very unpleasant."

C-section recovery

Maybe you elected to have a c-section, or perhaps it was the result of an emergency or complication. The first thing to stress here is you did everything completely perfectly: your baby has arrived safe and sound, and that is by far and away the most important thing.

In saying that, many women can feel sadness, guilt or that they failed in some way. If this is the case, it's vital you seek emotional support from your partner and other loved ones, or, if you feel it could be contributing to a state of post-partum depression, to seek professional help.

Women who had a c-section may also feel groggy or nauseated in the first 48 hours, and could need ongoing pain relief to assist with the pain associated with the surgery.

For more details on what it's like the first few days after a c-section, read this mum's journal.

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There's no love like it.

In summary

There can be a lot of confronting changes that happen to your body and emotional state in those first few days and weeks after having a baby, but the important thing to remember is they are completely normal.

Sad because your tummy didn't go down as much as you thought? Take heart, neither did Kate Middleton's.

Struggling to breastfeed? Don't worry, so did Adele.

Freaked out by how your vagina looks? So was Kelly Rowland.

But at the end of the day, enjoy this time to bond with your beautiful little baby, who loves and depends on you more than anything else in the world. Oh, and get yourself some soft cheese and pâté, stat.

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