For my second, after I birthed the placenta, I started to hemorrhage. So I was given some herbs and a shot of pitocin in my leg. I was taken out of the birth pool and onto the floor where they massaged my uterus. It finally slowed when my baby was brought to my chest. They cleaned me up, and I started to nurse. The next day the soreness and pain settled in and I couldn't lay down for a couple of months without being in pain. For about 10 weeks I camped in the living room with my rocking chair. I never went out and smiled and said I was fine. I was really horribly depressed. If it wasn't for a visit to my house by an LC, I don't think I would have kept nursing. It took me till 6 months out to crawl out of my depression. I got a part time job. I wish I would have known about ppd and known to work to process this birth, which was more traumatic in some ways than my cesarean.
"I had a small tear that they stitched up, I didn't even know the placenta was born. Nursing went fine. The anesthesiologist came in and had me sit up to pull out the epidural. That felt weird. I thought I'd be staying in that room - with all the equipment and stuff. I was pleasantly surprised when they came in with a wheelchair a few hours after M was born and said we were moving rooms. I was also wary of my ability to get up. My butt felt like someone put a cue ball in it and my legs felt like velour. We got up though, and surprisingly I peed. My least favorite thing about postpartum was that I had a nurse, lactation consultant, doctor, nursery nurse, pediatrician, or food delivery person in my room every. single. hour. Literally, day or night, every hour, someone was coming in. I didn't sleep well until I got home." ~ Amili
"After birth I was not prepared for all the blood and the pressing on the uterus and the stitching up. I used ibuprofen for awhile after birth and went home about 4 hours after he was born. I had one 2nd degree tear and even with it being minor, it wasn't fun for those first weeks. I spent a lot of time preparing for birth but not postpartum recovery, so a lot of it was a shock to me. I was sleep deprived as well and was so grateful for the help of my parents. I did do herbal baths though to help with healing. But yeah, the whole soreness and bleeding and emotional roller coaster, no sleep, and constant breastfeeding was veerrrrryyyy shocking." ~ Chelsea
"It ends up he pooped while I was pushing and they wanted to suction him. When he was back in my arms, he started nursing right away. It hurt. Some observations: no one told me about your legs staying up in stirrups and 30 minutes of strangers staring at your vagina. No one told me about your free postpartum massage; Fundal Massage my ass. No one tells you that birthing your placenta feels like birthing an octopus. No one told me that your tailbone can hurt for a long time after. No one told me that you would feel like your vagina was just in a boxing match with Mike Tyson.... But, also no one told me that I might change my mind about an early discharge and want to stay the full two days so I had 24/7 help. No one told me that I might really need and appreciate the nursery nurse coming in so often to assess his latch (and diagnose a posterior tongue tie a few hours before we left the hospital). Final thoughts, never underestimate the power of sitz baths and boppy pillows to sit on." ~ Liv
Read the rest of Holly's story on her blog, including her postpartum blog post and her cord burning post~ Holly
"We stayed this way with Cole only slipping in to give us a blanket (our request) so we could hold him. Our midwife only slipped in to check his heart rate and his breathing. About 15 minutes later they helped us out of the tub and to the bed. On the way to the bed my placenta fell out. They knew it was coming (we didn't) and caught it in a bowl. They took our food order and did one more once over on baby and I. I appreciated that they didn't bother us. My midwife and doula helped me get him latched, my midwife checked my bottom out and helped me get cleaned up, but then they both left the room to make us breakfast and chart. The placenta stayed in the bowl beside us with a chux over it. A little while later, my midwife came in and helped us with the newborn assessments and asked if I was ok taking an after-birth smoothie to help with my contracting (I wasn't bleeding heavy, just a little more than what she wanted to see). We cut the cord and our doula made cubes out of the placenta for smoothies (and brought one to me right then). My doula did the dishes, cleaned up the birth pool, and did a load of laundry. We just hung out in the bedroom and, after breakfast, nodded off. When we woke, our doula was gone, my sister had arrived and my midwife was packing to leave. My mom came the next day (and my midwife to do the 24 hour assessment), and my postpartum doula came the third. I felt cared for and checked in on." ~ Trinity
"My doctor pushed on my fundus (holy owie) and pulled on my placenta to get it 'unstuck' (owie owie owie). He then gave me pitocin in my IV, cytotec in my bum, and methergine in my thigh. I bled a lot. Things finally settled down and he said I had a tiny tear that didn't need a stitch. The tech started washing me off but I told her I wanted to do that myself. My doula and nurse helped me to the shower and I rinsed off. Postpartum wasn't what I hoped for, they bothered me all the time and told me everything I did was wrong (breastfeeding, sleeping with babies cot right up against my bed and my hand on her, hubbies swaddling technique and diapering technique). We felt we were doing good, but they made us feel inept. That, along with the long line of well meaning visitors.. and we never slept or rested. We requested an early discharge and left 24 hours after baby was born. We did a follow up the day after at the hospital nursery." ~ Kelly
After baby is born, if your hospital does LDRP rooms (Labor, Delivery, Recovery, Postpartum combined), you won't need to worry about moving rooms. Common practice, though, is to have LD rooms and postpartum in another section.
If your postpartum unit is in another area of the hospital, generally you will recover in your LD room for around 2 hours. During that time, a number of things will be happening.
If you have a home birth, your midwife will normally stay for about 2-12 hours afterward, depending on your needs and birth experience, and will perform a lot of the following postpartum care practices. If you are at a birth center, generally you will stay there for 4-12 hours, again depending on the time or day, your needs, and your birth experience, before you head home.
PLACENTA
While you are bonding with your baby and getting to know them, generally your provider will bring
To minimize bleeding, they will most likely provide fundal pressure (aka massage or pushing on the top of your uterus). This helps your uterus to contract. This is very crampy and painful for some women. Other women, it is minimally crampy and painful, and more annoying. Some women feel it is less painful if they place their hand on top of the nurses' hands while they're doing it. Likewise, some women ask the nurse to show them how to do the massage to check their own uterus.
Most women in the hospital setting will receive postpartum pitocin or cytotec for the same reason unless they have a prior agreed upon arrangement with their provider. The postpartum pitocin can be administered via IV or through the muscle as a single shot. Postpartum cytotec is administered rectally. Midwives in most states can carry pitocin or cytotec for this same reason.
REPAIR
Some providers will begin any stitching that needs to be done before the placenta is birthed. Most prefer to start repairs after the placenta is born. If you haven't had an epidural, they will provide lidocaine, a local anesthetic, to the tissue through injection prior to any repairs being done. The stitches that they use are dissolvable. It's important to tell your provider if you have any sharp pain during the repair, although dull pressure is expected. Midwives at home and birth centers can provide lidocaine for repairs as well.
CLEAN UP
After repairs are done and your placenta is birthed, the tech will generally clean you off with warm water, soap, and a washcloth, change out your padding, change the sheets of the bed, and, if the bed was broken down for birth, they will put the bed back together. After you are able to move up in the bed and sit up, they will generally give you an ice pack for your bottom and help you change out your clothing/gown before covering you with blankets.
If you have a home or birth center birth - generally your midwife and/or doula will help you get cleaned up and take a shower or bath, clean up the birth pool and any bed messes, and get you into bed with a pad and soothing compresses.
RECOVERY MISC.
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- If you had an epidural for a vaginal birth, they will turn off the epidural and remove it.
- If you had an epidural and don't have a lot of feeling in your legs, they might empty your bladder with a straight catheter (one that doesn't stay in) once more before leaving for postpartum.
- If you had an unmedicated birth or have good mobility, they may have you use the restroom and try to empty your bladder before you head to postpartum. Your midwife at a homebirth would like to see you empty your bladder before she leaves as well.
- They will offer you something to drink (juice, water, ice) and sometimes a light meal. At home or the birth center, you can eat whatever you'd like. They normally encourage a high protein food and juice for energy.
- You will need to have someone (father, partner, doula, other support person) pack up your belongings for changing rooms if you are in the hospital.
- Sometime during this time, baby is normally taken to the warmer for any newborn procedures you have agreed to, such as eye erythromycin, vitamin K, and sometimes Hepatitis B. Baby will also be weighed, measured, have a physical assessment, and newborn reflexes checked. If you are at home or the birth center - these all happen in your room and in your presence, oftentimes at the end of your bed so that you and partner can take part in it.
- Normally your blood pressure cuff, whether you had an epidural or not, will go off around every 15-30 minutes. Also, you may have a pulse ox on your finger. In home and birth center births, they will check your blood pressure and listen to your respiration before they leave to make sure you are doing well.
- Some hospitals remove the saline/hep-lock prior to moving to recovery - others remove it after 12-24 hours in postpartum.
POSTPARTUM (24-72 HOURS)
Once you are moved to your postpartum room, your hospital will expect you to stay anywhere from 24 - 72 hours after birth. If you would like to be considered for early discharge, let your provider and nursery staff know that.
When you arrive at postpartum, normally your postpartum nurse will assess you for her own records (another set of vitals, another fundal massage, etc.) and your babies nursery nurse will do another set of vitals on baby (usually in the warmer, but many women request it be done with baby in their arms). If you're at home or a birth center - your midwife will continue to monitor you intermittently before leaving/sending you home. They will provide a list of things to be looking for, what to expect, and when to call them.
Around the time that you arrive in your postpartum room, your baby will probably be getting very sleepy. This is usually babies longest nap for the coming weeks. Pro Tip: consider not having any visitors until you have taken advantage of babies first nap and napped yourself at the same time.
If you haven't yet been offered food or to use the restroom, this is usually when they would offer or ask that of you. Pro Tip: since you don't know when you'll birth, consider packing an actual microwaveable meal - otherwise you might get whatever is in the fridge - which is oftentimes cold cut sandwiches. Your nurse should also help you become familiar with any/all of these items that your hospital might have handy:
- Peri bottle - this is your bathroom time best friend. Spraying warm water (and sometimes witch hazel) from this bottle onto your bottom before you start to urinate helps dilute the urine, making it less stingy on your stitches, and confuses the tissue in your bottom/urethra, making it easier to 'convince' your body to relax and allow you to urinate. Pro Tip: put a Tucks pad in the peri bottle with the warm water and shake it up. Also, a few drops of peppermint in the toilet bowl can help stimulate the first pee.
- Witch Hazel/Tucks pads - these are wonderful to stuff in your pad to help sooth your bottom and bring down swelling/hemorrhoids.
- PADS - the pads at the hospital are thick, bulky, and leaky and are kept in place with strange undergarments. They're free, and you go through a lot of them usually - so that's a bonus... Pro Tip: consider using Depends - which are just as absorbent but don't leak nearly as bad - and they keep those soothing cold packs in place better.
- COLD PACKS - some hospitals offer ice in a glove, others have the perineal cold packs. Just like with other times icing, it's best to do 20 minutes of cold, then a break. Thankfully the perineal cold packs only stay cold for 20 minutes. Pro Tip: have someone make you some padsicles for when you get home
- Medicine and Stool Softeners - your nurse will tell you what pain medication options you have on your chart, but your provider should order ibuprofen or other light pain medication for your discomfort. Also, the stool softeners are to help you with your first bowel movements; and labor makes the system reset, which, in turns means a more difficult time with the first bowel movement most of the time.
After you've settled into your postpartum room, you will normally have a nurse check on you every 2-3 hours and on baby every 2-3 hours. They also, usually, stagger this care - which results in someone coming into your room every 1-1.5 hours, day and night. Pro Tip: see if they can coordinate both coming in at the same time so that you can rest more without interruption.
Pro Tip: while at the hospital, take advantage of the nurse staff... when you change diapers, swaddle, bath, or nurse baby - ask for confirmation everything is ok and right. More confident parents from reinforcement means easier adjustment when you get home.
You should expect your bleeding to taper off dramatically during your stay. Take your time adjusting to baby and nursing and call for help with nursing if/whenever it's pinchy painful. Discharge takes time and is a great opportunity for partner to pack everything in the car so that the only thing left to take out to the car is you and baby.
I hope this overview of what to expect in every stage has been helpful for women choosing to birth in the hospital. What did your hospital stay include that you weren't expecting/prepared for? What were you glad for? What worked and what didn't?
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