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Pronunciations acetaminophen episiotomy perineum

Coping with some changes begins in the hospital, depending on how soon hospital discharge occurs, and then continues at home.

Discharge From the Vagina: New mothers have a discharge from the vagina. Staff members give them pads to absorb it. Staff members also check the amount and color of the discharge. Usually, it appears bloody for 3 or 4 days. Then it becomes pale brown for about 10 to 12 days, then yellowish white. The discharge may continue for up to about 6 weeks after delivery.

About a week or two after delivery, part of the remaining placenta may separate, causing vaginal bleeding of up to about a cup. Sanitary pads, changed frequently, may be used to absorb this discharge. Comfortably fitting tampons, changed frequently, can also be used unless they interfere with healing of an episiotomy incision or of tears in the area between the vaginal opening and the anus (perineum).

Drugs: Mothers who are not breastfeeding may safely take drugs to help them sleep or to relieve pain. For women who are breastfeeding, acetaminophen Some Trade Names
TYLENOL
and ibuprofen Some Trade Names
ADVILMOTRIN
are relatively safe pain relievers. Many other drugs appear in breast milk.

Genital Area: The area around the vaginal opening is usually sore, and the area may sting during urination. Tears in the perineum or episiotomy repairs can contribute to the soreness and cause swelling.

Immediately after delivery and for the first 24 hours, ice or cold packs may be used to relieve the pain and swelling. Anesthetics can be applied to the skin. Washing the area around the vagina with warm water 2 or 3 times a day helps reduce tenderness. Warm sitz baths can help relieve pain. Sitz baths are taken in a sitting position with water covering only the perineum and buttocks. Women should be careful when sitting down and, if sitting is painful, use a doughnut-shaped pillow.

Hemorrhoids: Pushing during delivery can cause or worsen hemorrhoids. Pain caused by hemorrhoids can by relieved by warm sitz baths and applying a gel containing a local anesthetic.

Breast Engorgement: The breasts may be enlarged, tight, and sore because they are engorged with milk. Engorgement occurs during the early stages of milk production (lactation)

For mothers who are not going to breastfeed, the following can help:

• Wearing a snug-fitting bra to elevate the breasts and thus help suppress milk production
• Applying ice packs and taking analgesics (such as acetaminophen Some Trade Names
  TYLENOL
  or ibuprofen Some Trade Names
  ADVILMOTRIN
  ) to help relieve discomfort until milk production stops on its own

For mothers who are breastfeeding, the following can help until milk production adjusts to the baby's needs:

• Feeding the baby regularly
• Wearing a comfortable nursing bra 24 hours a day
• If the breasts are swollen and very uncomfortable, expressing her milk by hand in a warm shower or using a breast pump between feedings (however, this measure tends to stimulate milk production and prolong engorgement)

If the breasts are very swollen, the mother may have to express her milk just before breastfeeding to enable the baby's mouth to fit around the areola (the pigmented area of skin around the nipple).

Mood: Sadness is common during the days after delivery. New mothers should not be too concerned unless sadness is extreme or lasts more than 2 weeks.

Last full review/revision November 2008 by Julie S. Moldenhauer, MD