The lochia has now changed color to a dark red or brown since the blood will now coagulate. This is a part of the healing process and is perfectly normal. Pay attention to any increase in bleeding, lower abdominal pain, fever or if the lochia has a strong/foul odor. These could be signs of infection. If you experience any symptoms of infection, contact your OB-GYN emergency room or an OB-GYN clinic. The midwife clinic that you went to can also tell you where you can get help, but you should get medical attention as soon as possible. For this reason, you will most likely be referred to the ER at a hospital.
If you overexert yourself, you may experience light bleeding or notice that the lochia becomes a bright red color. This is a fresh new bleed, and may be a sign that the wound from the placenta has started bleeding again. Although harmless, it is a sign that you need to take it a little easier. Remember to rest and gradually step up your activity level at a pace that feels good. If you’re uncertain, or if the bleeding does not stop, contact your healthcare provider. However, if the bleeding is heavy, you should get medical attention. You may require medication to help the uterus to shrink even more.
How are you?
Have your emotions stabilized now or does it feel worse than ever? Are you getting any sleep? Do you have someone you can talk with about what you’re going through and feeling? Feeling depressed or insufficient is something that many new parents go through.
You may find it difficult to put thoughts into words, but try to share them with those closest so that they can give you support. If you feel like things haven’t gotten easier, you may have a case of postpartum depression and for that, you need help.
Postpartum depression affects about 15% of all new mothers. If this is something that you’re going through, you may struggle to feel happy, you may have sleep issues, difficulty concentrating, feelings of guilt, hopelessness, mood swings, anxiety, concern, panic, an increase or decrease in appetite, worn out, a desire to isolate, and thoughts about hurting yourself or others. This is a psychiatric diagnosis and not something that you should try to, or can handle yourself. The condition requires professional help, and you can contact your healthcare clinic or your midwife clinic to get help and treatment.
When your baby is between three and five days old, it’s time for your baby’s first visit to the pediatrician. You will have the chance to join a mother’s group or come in contact with other new parents. The clinic can also help new mothers who feel low, so don’t hesitate to talk about how you’re feeling in order to get the help that you’re entitled to.
For women who had a vaginal delivery
If you had a tear, this will normally heal within two weeks. However, any stitches will last longer than that and if you feel a pulling or burning sensation, the stitches may be the cause. If they do not bother you, your body will dissolve the stitches and they will fall off by themselves after two to three weeks, depending on what material was used. If the suture material, the thread used to stitch any tears, is the type that needs to be removed, then this will be done about ten days later. However, it is uncommon to use such material today.
If the remaining stitches are bothering you, contact your midwife who can examine the tear, and even remove the stitches that are no longer needed.
For women who had a Cesarean delivery
After a Cesarean delivery, it takes about 10 days for the skin to heal, and you may hear different things about how long the scar should be taped. Remember that the new skin is weak and needs support to prevent it from stretching. It also needs protection from the sun so that it does not darken. Therefore, tape the scar if you feel like it feels comfortable. Use wide surgical tape and tape along the length of the scar. Change the tape when the edges loosen, and do so when you shower. If you soften the tape with water or shower oil before removing it, changing it will not be as unpleasant.
If the aesthetic is important to you, we recommend taping the scar for six weeks. Keep in mind that scar healing takes time, and it will be about six months before you know what the scar looks like.
For breastfeeding mothers
Breasts swell often between breastfeeding sessions or when it’s time to breastfeed again. It’s good to pay attention to any signs of clogged milk ducts. It can be difficult to know what’s what. The swelling in your breasts when your milk comes in goes away after nursing, but it does not when you have clogged milk ducts. Common symptoms of clogged milk ducts are redness, pain or warmth.
To reduce the risk of clogged milk ducts, we recommend feeding on your baby’s signals and pumping as needed. It’s a good idea not to pump too often, unless you want to stimulate milk production. The more you stimulate the breasts, the more milk you produce. Try instead to relieve the pressure if you feel that your breasts are always swollen and hurting.
Letting warm water flow over your breasts in the shower can release the tension. Another option is a technique called reverse pressure softening. Place your fingers around the nipple and press gently, maintaining pressure until the milk flows out. Do not move your fingers while you press to avoid stimulating the production of even more breast milk.
Avoid breastfeeding outdoors if it is cold, and avoid sitting in draughts or cold places. Dress so that your breasts are kept warm since the cold can both cause and worsen clogged milk ducts. You can also buy SPC flakes at the pharmacy. Sprinkle the flakes on your yoghurt to help reduce the risk of clogged milk ducts. If you have problems with this condition, contact your child health clinic or a breastfeeding clinic.
Source: - Janson, P.O. & Landgren, B. (red.) (2010). Gynekologi. (1. uppl.) Lund: Studentlitteratur. - Kaplan, A. (red.) (2009). Lärobok för barnmorskor. (3., omarb. uppl.) Lund: Studentlitteratur. - Myles, M.F., Marshall, J.E. & Raynor, M.D. (red.) (2014). Myles textbook for midwives. (16th edition). Edinburgh: Elsevier. - Savage S. J. (2020). A Fourth Trimetser Action Plan for Wellness. The Journal of Perinatal Education. Apr 1;29(2):103-112. DOI: 10.1891/J-PE-D-18-00034 - Stewart E. D. & Vigod N. S. (2019). Postpartum Depression: Pathophysiology, Treatment, and Emerging Therapeutics. Annu Rev Med. Jan 27;70:183-196. DOI: 10.1146/annurev-med-041217-011106