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Peeing After Birth - The Mama Coach

Be glad you won’t have to file this under “things they didn’t tell me before giving birth”.

If your reading this, your due date is probably fast approaching. Your bags are packed, nursery is set up, you are ready to go! But have you thought about what happens after baby is born? Yes, there’s skin to skin and the first feed. But after all that, you’re going to have to pee. And that first post-baby pee is important.

First lets start with a little lady-anatomy. Starting at the front is your urethra which connects to your bladder. Then in the middle you have your vagina, then at the back is your rectum. All three are in close proximity to each other and make up your Pelvic Floor, and each can be impacted during birth.

So why is going pee after giving birth so important?

1. Your birth healthcare professionals (OB, Midwife, and Nurse) need reassurance there was no trauma to your urethra and or bladder during the birth. Most often during a vaginal birth you may tear your perineum, the skin between your vulva and your rectum. Sometimes you tear upwards towards your labia, clitoris, and or urethra. These types of tears are not typical, but they can be difficult to repair and can be very painful after birth. If you pushed for a very long time, your genital area may be very swollen and that swelling may prevent you from peeing by closing off your urethra.
2. Trauma to the bladder is a risk of cesarean section because the uterus and bladder are actually attached together by the peritoneum, which is cut during the operation to access the uterus. Like with any abdominal surgery, injury to other organs is a risk.
3. And finally if you have a full bladder, your uterus cannot fully contract down after baby. After baby is born your uterus needs to clamp down to close off all those blood vessels that were attached to the placenta, like putting pressure on a wound. If your bladder is full, it pushes up against your uterus, preventing it from contracting properly and may increase your chances of bleeding more after birth.

What can you expect for your first pee after birth?

For a vaginal birth, you will mostly likely get up to the bathroom 1 – 2 hours after baby is born, once you are stable and your able to safely walk if you had an epidural. Your first pee will sting, especially if you tore or are swollen.

The hospital will most likely provide a squirt bottle for you to use. Fill this with warm water and squirt warm water on your vulva while you pee to help reduce the stinging. The next time you pee it should not be as painful.

If you cannot pee after a few hours, or if your bleeding increases because of your full bladder, you may need to have a catheter put in until the swelling goes down. You will be given Ibuprofen and ice pads to help.

For our cesarean mamas you will have a catheter in place for anywhere from 8 – 24 hours after birth depending on your medical situation and your doctors orders. Removing the catheter can be slightly uncomfortable, and after that you will be getting up to the bathroom independently. Like the vaginal birth, the first few trips to the bathroom might be uncomfortable from the catheter.

After Birth

After giving birth, you may continue to have some concerns with your bladder. According to Niagara based Pelvic Floor Physiotherapist Marie-Eve Nackers, symptoms like stress incontinence, urinating more then 8 times in a day, suddenly feeling like your bladder is smaller, or urge incontinence, may indicate you’re having some postpartum pelvic floor issues. But it’s not all about pee – painful intercourse, back and pelvic pain, or continuing sciatic symptoms may indicate pelvic floor issues as well. Marie-Eve goes on to add “Kegel exercises isn’t the magic cure that everyone think it is. Kegel exercises are only good if you have incontinence with sneezing, coughing, laughing, or jumping. If you have any other symptoms, like urge incontinence or any kind of pain, Kegel might make the symptoms worse”.

If you have any of these concerns for anywhere from 4 to 12 weeks postpartum, Marie-Eve recommends to seek out a physiotherapist who specializes in pelvic floor health.

For more information and to help prepare for your upcoming birth, contact your local Mama Coach for a private or group prenatal class.

The first days after childbirth

Pregnancy and childbirth is a serious burden for the body of any mother. After childbirth, significant changes occur in the body, but it must be said that restructuring cannot occur instantly. A woman will feel some changes right away, but quite significant changes will occur for several more weeks. What should change?

First days after childbirth (postnatal ward)

In the first days after childbirth, there may be hemorrhages in the eyes - red eyes, on the face - numerous bluish dots, similar to moles that appear during the second

childbirth. If a woman pushes incorrectly (holds her breath, screams, pushes “in the face”) or has features of the vascular wall, during attempts there is an increase in pressure in the vessels of the head, which can lead to rupture of blood vessels in and around the eyes . What to do with such red eyes?

Cold tea compresses on the eyes (for 10 minutes) applied several times a day will have a calming effect and speed up recovery, which will occur in a maximum of 6-10 days. In about a week, the hemorrhages on the face will also pass. nine0003

Cramping abdominal pain worsens during breastfeeding associated with normal postpartum uterine contractions, which should shrink and return to pre-pregnancy size. Painful contractions of the uterus are more typical for repeated births and for twins. In primiparous women, such pains may not be present and uterine contraction is painless. Painful contractions may be more noticeable when breastfeeding, as suckling releases the hormone oxytocin, which stimulates uterine contractions. nine0003

After childbirth, in addition to reducing the size of the uterus, the mucous membrane of the uterus - the endometrium - should be restored. Therefore, immediately after childbirth, lochia appear from the genital tract - the discharge of blood, mucus and tissue residues from the uterus. In the first three days after childbirth, they are usually bloody and as plentiful (and sometimes more plentiful) as during menstruation. Increased discharge when standing up and other movements is a normal process.

Muscle pain in different parts of the body can also disturb a woman in the first days after childbirth. These pains are associated with the physical stress that a woman experiences during childbirth. These pains go away on their own within a few days. nine0003

Pain in the perineum and the discomfort associated with it - and this feeling is also normal, because it is unrealistic to expect a 3-3.5 kg child to pass through the perineum without any consequences. Even if you avoided tears during childbirth and did not have an episiotomy (an incision in the perineum), this area was still stretched and squeezed. The pain will go away in a few days.

In the case of an episiotomy, pain may increase, especially when laughing, coughing, sneezing, defecation. Like any wound, it does not heal immediately - it usually takes 5 to 7 days. At this time, the woman is forbidden to sit so that the seams do not come apart. At the same time, they are allowed to sit on the toilet, to perform regular sexual hygiene (after each visit to the toilet, it is necessary to wash the perineum with warm water, you can do it without soap, you should take a shower 2 times a day). While you are in the hospital, your midwife and doctor will examine your stitches for inflammation or other signs of infection. The stitches are usually removed on the 5th day. nine0003

In the first time after childbirth, only colostrum is excreted from the breast - a thick yellowish liquid, and milk appears on the 2-3rd day. By the 3rd day, the mammary glands often acquire hypersensitivity, sometimes bursting pain is felt in the chest , a feeling of compaction of the mammary glands may appear. With significant breast engorgement, it is necessary to limit the amount of fluid consumed (but not less than 1 liter per day), increase the frequency and duration of feeding the baby. To prevent nipple cracks and when they appear, you will need BEPANTEN, DEXPANTHENOL, SOLCOSERYL ointment. nine0003

During the first day after childbirth, there may be difficulties with urination . Some women do not have the urge to urinate; others feel the need but cannot empty their bladder. Despite all the difficulties, it is necessary that the bladder be emptied in the first 6-8 hours after childbirth. This is done so that the enlarged bladder does not interfere with the normal contraction of the uterus after childbirth. As a last resort, if you still cannot empty your bladder within 4 hours after giving birth, a woman may have a catheter placed. After giving birth, you need, regardless of desire, to urinate every 4 hours. Bladder function returns to normal after 3-7 days. nine0003

The causes of stool problems can be several factors, both physical and psychological. Getting your bowels back on track is rarely easy or quick, and takes a few days.

Include more fiber in your daily diet: fermented milk products, beets, high-fiber fruits, dried fruits. This will soften the stool, but make sure that there are no allergens among vegetables and fruits: remember that before the arrival of milk and the establishment of lactation, you should not drink a lot of liquid. Try to move more if your condition allows. And don't worry about your stitches coming apart - they won't. Since a woman is often given a cleansing enema before childbirth, there is usually no stool in the first 2-3 days. nine0003

Immediately after childbirth, you must not get out of bed on your own for 6 hours (only in the presence and with the help of a midwife), as there may be dizziness .

After childbirth the abdomen looks distended and somewhat pendulous and does not immediately return to its original shape, because the muscles and skin need time to contract. In order to quickly return to its former shape, you can use breathing exercises (traditional gymnastics can be performed only 6-8 weeks after childbirth). Breathing exercises are breathing with the stomach: while inhaling, inflate the stomach, while straining the muscles of the perineum, while exhaling, blow it off. Repeat 10-20 times, 4-5 times a day. nine0003

After a caesarean section: on the first day after the operation, it is only allowed to drink water up to 2-3 liters per day. But already on the second day, the mother is transferred to the postpartum department, where she immediately begins to lead an active lifestyle - she gets up and walks, feeds her baby, unsweetened bread, broth without meat are allowed. From the third day, after a cleansing enema, it is allowed to take boiled food (porridge, boiled meat, sour-milk products, cottage cheese, tea without sugar), butter cookies, buns, fresh fruits and vegetables are prohibited. nine0003

First week after birth

Continued vaginal discharge : within 1-2 weeks after birth the discharge gradually becomes watery pink, then brown and finally yellowish white. During this period, you should use sanitary pads (and not tampons: they can provoke inflammatory diseases of the uterus and appendages). Allocations may stop after two weeks, and may continue up to the 6-8th. If after the first week there is a profuse bloody discharge, or discharge with an unpleasant odor, or a fever, you should consult a doctor. In this case, hospitalization and possibly curettage of the uterus may be necessary. You should also see a doctor if brownish or yellowish lochia persists for more than 6 weeks, as this may be the result of an infection, especially if accompanied by fever or pain, and tenderness in the abdomen. nine0003

The suture area after episiotomy must be kept dry and clean. You can wash the external genitalia and perineum with a decoction of chamomile, calendula, eucalyptus. For the first 2 months after childbirth, get out of bed carefully, first turning on your side, bypassing a sitting position (this will reduce pressure on the muscles of the perineum), and feed the baby lying on your side or half-sitting; you can't lift weights.

The birth of a child is a very significant event for a woman, not only physically, but also psychologically. Firstly, childbirth itself exhausts the mother, and secondly, hormone production changes during and after childbirth. Therefore, it is natural that at this time comes period of mental instability .

The most typical feeling in the first days after childbirth is elation, but in the following days, and sometimes weeks, some women become sad, despondent, withdrawn and lethargic. It is worth noting that these are the usual emotions for the postpartum period associated with the normalization of hormonal levels. In this situation, close people (spouse, parents) should come to your aid to help you cope with negative emotions. nine0003

Within 7 days after the caesarean section (before removing the sutures), the nurse daily treats the postoperative suture with antiseptic solutions (for example, iodine, "potassium permanganate") and changes the bandage. The skin scar is formed approximately on the 5-7th day after the operation; already a week after the caesarean section, you can safely take a shower. Just do not rub the seam with a washcloth - this can be done in another week. Discharged from the maternity hospital in the absence of any complications on the 5-7th day after operative delivery. Since the pain in the scar area can persist for up to several weeks, it can be difficult for a woman to bend over, so it is easier to sit down, bending her legs at the knee and hip joints. nine0003

Remember that recovery after childbirth is usually about 6-8 weeks. However, the female body is individual. Therefore, each woman can feel the physical and emotional changes described above in her own way. Report any unusual or very severe symptoms to your nurses or your doctor.

Prepared by: Ass. obstetrics and gynecology Pavlyukova S.A. Head postpartum ward Dvornik E.V.0001

Bogomolova Marina Vadimovna

Embryologist

Clinic "Mother and Child" St. Petersburg

Immediately after childbirth

Immediately after the birth of the baby is placed on the mother's stomach , then the umbilical cord is cut and the baby is applied to the mother's breast. Then the skin of the newborn is cleaned, its length and weight, head and chest circumference are measured. The doctor examines the birth canal, if necessary, sews up tears in the soft tissues of the birth canal, assesses the tone of the postpartum uterus, and helps the woman empty her bladder. But even after all these standard manipulations, the mother is not transferred to the postpartum ward, another for two to three hours, the puerperal stays in the maternity block . Why? In the first two hours after childbirth, some complications are possible, primarily uterine bleeding or an increase in blood pressure. Therefore, during these two hours, the mother lies on a stretcher or a bed in the maternity ward, since doctors and midwives are constantly there, and the operating room, in which case, is also located nearby. The child at this time is usually taken to the children's department, where he most often sleeps. And only two hours later, if everything is fine, the mother is transferred to the postpartum ward. nine0003

How does a woman feel at this time? Chills may occur, abdominal pain may occur, especially in multiparas.

What should a woman do at this time? Relax and unwind. Take shelter so as not to freeze, especially if chills appear. Place an ice pack on the uterus. If possible, ask the midwife to bring hot tea.

1st day after delivery

Shortly after the woman is transferred to the postpartum ward, 9 will come to her0089 postnatal midwife . She will tell you about the arrangement of the department (where the shower, toilet, dining room are), about the daily routine (the time for visiting doctors, eating) and will help the young mother, if necessary, to empty the bladder using a catheter. If a woman lies together with the baby, then immediately after the transfer to the postpartum ward, the child will be brought to her. The midwife will help the mother to properly attach the baby to the breast and start breastfeeding. Then come pediatric nurse : She will show you how to swaddle your baby and explain how to take care of him. Do not be afraid that after childbirth there will not be enough strength for the child: most newborns sleep most of the day and wake up only for feeding. In addition, in the maternity hospital, the child is usually washed and dressed by nurses, so that the woman will have enough time to relax. If there is no joint stay of mother and child in the maternity hospital, then every three hours they will bring him to the ward for feeding, and then take him back to the children's department. Over time, the woman herself will pick up and carry the child. nine0003

How does a woman feel at this time? On the first day after giving birth, women feel differently. Some experience an incredible elation (this is due to the release of endorphins into the blood - the hormones of pleasure), while others, on the contrary, feel very tired. Some want to call all their friends and announce the birth of a child, they are inspired, full of energy and ready to take care of the baby on their own. Other mothers want to be alone and come to their senses, they still do not have the strength to constantly be with the child. nine0003

What should a woman do at this time? In any case, immediately after childbirth, as after any heavy load, you need to restore strength: first eat, and then go to bed or just relax. By the way, the following situation is possible: the birth occurred in the evening or at night, and dinner time has already expired; therefore, in order not to starve, you need to bring something light for a snack (cookies, bread rolls) with you to the hospital in advance.

6 hours after birth, the mother can usually get out of bed. nine0003

In general, if the birth went without complications, then you should start getting up as early as possible, first with the help of a midwife, and then on your own.

It helps to improve blood circulation, normalize the functioning of the urinary system and intestines, and accelerate healing processes. In addition, very soon the baby will require more attention.

Important point: After childbirth, the tone of the bladder decreases, so the urge to urinate may be absent or it may become painful and frequent. However, you should go to the toilet at least four times a day. Urination can be caused reflexively by opening a tap with water, this helps many people a lot. In the absence of the desired effect, urine is removed by a catheter. Most often there is no stool on the first day after birth. nine0003

Next days

Every day the mother will be examined by an obstetrician-gynecologist : he will evaluate the contraction of the uterus, the condition of the sutures and the amount of discharge, see if colostrum is secreted. The midwife will regularly measure the temperature, pulse, blood pressure and treat the external stitches with disinfectant solutions several times a day. Also, every day the baby will be watched by a pediatrician, after which he will tell his mother about the condition of the child. After a normal birth, a woman, as a rule, is discharged on the 3rd-4th day (after a caesarean section - on the 5th-6th). nine0003

How does a woman feel at this time?

After childbirth, a woman may experience pain in the abdomen due to uterine contractions, as well as slight muscle pain in different parts of the body. On the face and on the whites of the eyes, a “rash” may appear - pinpoint hemorrhages that appear due to the fact that small capillaries burst during attempts from tension. Blood pressure can be lowered, so dizziness is possible (to avoid it, you should get up smoothly, without sudden movements). There may be pain in the perineum, even if there were no tears and its incision (pain appears because the perineum was severely stretched during childbirth). If the perineum is sutured, then it will not be possible to sit for at least the first two weeks. Sometimes after childbirth, varicose veins appear in the anus (hemorrhoids), which means discomfort in this place. nine0003

What should a woman do at this time? Mom needs to continue to rest and gain strength. And you should also follow the rules of personal hygiene: often change postpartum pads, do air baths for seams (if any), take a shower daily, wash yourself every time after a bowel movement. Well, the most important thing is to establish breastfeeding and learn how to take care of the baby in practice.

Time in the maternity hospital flies very quickly. Try to spend it usefully - restore your strength and acquire useful skills: at home, all this will be very useful to you! nine0136

REMINDER

Things to do at the maternity hospital

1. Have a good rest: sleep all your free time and eat well.
2. Get complete information about your child's condition: so ask your pediatrician all your questions.
3. Establish contact with the child: therefore, spend as much time with the baby as possible, ideally - be with him all the time. Take the baby in your arms, unfold the diapers, carefully examine the baby without clothes. nine0170
4. Learn how to care for your baby: so ask your baby nurse to show you how to wash your baby, how to change clothes, swaddle, change diapers, clean ears and nose, cut nails.
5. Establish breastfeeding: To do this, feed your baby on demand. Ask the midwife to show you how to properly hold the baby at the breast, how to give and take away the breast.

Make an appointment

to the doctor - Bogomolova Marina Vadimovna

Clinic "Mother and Child" St. Petersburg

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