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The first 48 hours after birth for mum

Your baby's finally here and the centre of all attention, but what's going on with mum?


Posted: 3 December 2009
by Maria Muennich

The first 48 hours after the birth of your baby can be demanding, exhilarating, uncomfortable, tiring, emotional and beautiful all at the same time. The main focus of these hours is getting to know your baby and recovering from the birth, or at least making a start on both. Unless you've had an unusually easy labour you'll probably be very tired as well as achey and sore for at least for the first couple of days. Thankfully you have a beautiful little baby to take your mind off it all.

Immediately after birth
The first few minutes after birth are a busy time. In amongst health checks, weighing, nose suctioning, cleaning and cord cutting, if all is well with baby she can be placed on your chest to feel the reassuring thump of your heartbeat. If you're planning on breastfeeding and all goes well, you'll probably want to nurse your baby within the first hour of the birth, and some babies will want to go more or less straight to the breast. New babies are usually quite alert for the first hour or so after birth, so you might want to make the most of it with some time for you, the baby and your partner. If you suffered any tears during the birth then you'll be stitched up now, so this might not be time alone though.

If you've had a hospital birth, when you've had a little chance to recover and get you both cleaned up it'll be time to leave the delivery room and go back to your room or ward. It can feel quite strange to be suddenly left alone with your new baby, particularly if it's the middle of the night on a quiet ward. Be assured that there are nurses, doctors and midwives around to give help if you need it though and don't think twice about asking if you have any questions or difficulties, such as difficulties getting your baby to latch on for feeding. If you have a home birth your midwife will probably stay with you for a while as you settle in with your baby.

Sleeping and visitors
In the first few hours you may be too exhilarated to sleep, even if you've had a long and exhausting labour, but very soon the need to sleep will catch up with you and it's important that you use this time to get as much rest as you can as well as bonding with your new baby. While grandparents and siblings may be keen to visit you and the new baby, it is sensible to limit visiting times to brief periods and don't feel bad about letting visitors know if it gets too much.

New babies who have spent time in the womb being awake and active when you have rested at night often take a while to change this sleep pattern and are consequently most alert during the night. In the first few days it's not uncommon for mum to be awake for much of the night with her baby, and so completely shattered during the day. This happened with our first baby: he took the sun coming up as his cue to finally close his eyes so that day-time visitors found an angelically sleeping baby and a mum who could barely keep her eyes open.

How do I look?
Most new mums will be too tired and too absorbed by their new baby to be bothered about what they look like, but there are a couple of things for which you should be prepared. First of all, your pregnancy belly does not disappear with birth, instead you're likely to look at least five months' pregnant and with a rather wobbly belly. If you give birth away from home you'll need to pack a going-home outfit that takes this into account.

If you were straining your facial muscles during contractions, as is quite common, then you may have popped a couple of blood vessels in your face and have a few red facial blotches as a result. These will clear up in about a week.

Even if you're not breastfeeding, it's usual for your breasts to leak milk until your supply settles down and breastpads worn inside your bra will help - you'll need to change them often to keep the nipples dry to help prevent soreness. Your breasts will also become engorged when your milk comes in, usually after a few days, but it's also common for them to become enlarged and sore in the first 48 hours.

And it's not just your breasts that may blow up like balloons, your feet and ankles may swell up for a few days too, particularly if you've had a long labour (personally, my feet looked uncannily like an elephant's for several days and there was no question of fitting into any shoes - I left hospital in soft slippers). This is usually the result of extra fluids in the body and nothing to worry about, but it's a good idea to tell your doctor or midwife, especially if the swelling is in only one leg or foot.

Afterpains and bleeding
Most mums feel what are called 'afterpains' as the uterus begins to contract back to its original size (which takes around six weeks). If you're breastfeeding then you'll probably feel these pains more strongly as you feed your baby as breastfeeding prompts the uterus to contract. Afterpains can vary considerably in intensity, from very mild to quite painful, and are usually stronger for women who've had more than one child.

You'll also experience vaginal bleeding after the birth as your uterus heals, this is called lochia and is usually quite heavy and dark red in the first 48 hours: You'll want to use special heavy-duty maternity pads (not tampons) to absorb the flow and it also makes sense to use either disposable or your washday knickers for the first few days as you'l probably want to change them every time you use the bathroom. Lochia usually continues for between two and twelve weeks and the flow may vary but will lighten off towards the end, it's nothing at all to worry about but if you should speak to your doctor right away if there are any clots in the blood.

If you've had a caesarian, the abdominal is usually at its worst for the first two days but you will be given some very effective pain killers to help you cope. You might find it strange to have to ask for your baby to be passed to you when you want to hold her and you will need a lot of help and support, particularly in these first couple of days. Make sure you read our tips for recovering after your c-section.

Going to the loo
Any mum who's had a vaginal birth knows that the thought of going to the loo for the first time after birth can be quite intimidating. This is because new mums are often a little bruised and raw in the nether regions, particularly if stitches were needed after labour. But don't worry, it really won't be as bad as you think. It's quite important to urinate within a few hours of birth, and this is likely to sting for the first few days at least. To lessen the stinging it helps to pour warm water over your vaginal area as you pee - a plastic spouted measuring cup, or similar, will help you direct the flow where it's needed. As your body loses the extra fluid from pregnancy you'll produce significantly more urine than usual in the first days after birth. Oddly enough, another impact of birth can be to make your bladder less sensitive, so you may not be aware of when you need to urinate: It's best to try to go to the toilet frequently, even if you don't feel the urge to do so, to avoid possible leaks and other bladder problems.

The idea of defecating may make you more anxious, but at some point in the few days after birth you will have to go. Even when you know that you won't rip any stitches when you open your bowels - which you won't - it may feel to you as though this may happen and this can be quite disconcerting. Try supporting the vaginal area with a clean sanitary pad and pressing gently upwards as you open your bowels.

Chills and sweats
It's quite common for women to experience feeling a chill straight after giving birth and this is perfectly normal unless accompanied by a fever. Extra blankets and a warm drink should help.

Sweating, meanwhile, is another way in which your body processes the extra fluids and waste products left over from pregnancy and it's common to sweat more than usual in the first few days, particularly at night-time.

Wind
Excess wind is quite common after birth, particularly if you had a caesarian. With abdominal surgery wind can become trapped in the body during the operation and takes a while to work its way out of the body. The wind may even be quite painful and may be felt in other areas of the body, for example, a caesarian is often followed by pain in the shoulder. If you have very painful wind you might want to use painkillers - talk to your doctor about what is safe if you are breastfeeding - and warm drinks such as peppermint tea can help (but if you're breastfeeding then don't overdo the peppermint tea s it can reduce milk supply).


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