you talk with a 21y.o. G1P1 woman on postpartum day 3 over the phone after she h

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you talk with a 21y.o. G1P1 woman on postpartum day 3 over the phone after she had a normal pregnancy and birth. She is a little teary and overwhelmed. She states her bottom is sore, she is urinating a lot without any pain, her breasts are hard and full, and she can’t sleep longer than 3 hour stretches at night due to nursing her newborn. “When will my body be back to normal?”
Explain a typical timeline for postpartum recovery. Consider the first few weeks, few months, and a year.
How would you explain the reason for her current discomforts? What suggestions do you have for her during this period?
What are baby blues and how would you distinguish it from postpartum depression?
Postpartum Recovery Timeline:
1-3 Months:
Post-Pregnancy Body Changes
Postpartum Emotional Deluge
Sleep Deprivation
Increasing Milk Production
3-12 Months:
Post-Pregnancy Body Changes
Sleep Deprivation
Increasing Milk Production
Breast Size & Breastfeeding
Breastfeeding & Food
Itchy Nipples
How would you explain the reason for her current discomforts? What suggestions do you have for her during this period?
I would share with her and empathize that her bottom is sore from birth which is normal and expected. I would educate her on over the counter measures and homecares that could help. She could use a numbing spray, witch hazel pads (share how to make “padsicles” of these that can be frozen), use of Motrin, Tylenol prn, reminder of peri bottle use every time she uses the bathroom along with sitzs baths to help with the discomfort.
I would educate her that her breast are probably a bit engorged which is causing her discomfort and fullness as her milk has come in. I would encourage her to continue feeding her baby often and to give her body time to adjust to the feeding demand of her baby. She can do warm compresses to help with the discomfort. I would not encourage her to avoid over pumping and explain the sequence of supply and demand.
Would remind her that the increased urination is most likely due to her body experiencing postnatal diuresis. This can occur a few days after delivery. This happens because the body is trying to rid itself of the increase of fluids from pregnancy. I would also suggest minimizing a ton of fluid intake right before bed, to hopefully reduce the number of times she has to get up to use the bathroom. But emphasize it is important she continues to hydrate at the same time even during night time feedings since she is breastfeeding.
As far as the baby feeding every 3 hours, I would share with her that this is normal for this stage and would encourage that she continue to do so. I would suggest that she nap throughout the day when the baby naps so that she isn’t so exhausted at night. Also would encourage use of support systems available to her in the way of family, babysitters, doulas or others to give her a break for some much needed rest and recuperation. Remind her that its ok to ask for help and use that help! I would remind her that this is just a stage and it won’t last forever even though it seems the days and nights run into each other and are exhausting right now. Pause here to really listen to how she is feeling and provide a lot of reassurance and kindness.
What are baby blues and how would you distinguish it from postpartum depression?
Baby Blues
Often new moms will get the baby blues. These are hormonal changes that can cause anxiety, crying and restlessness that goes away within the first two weeks after giving birth. Baby blues are actually a mild and temporary form of depression that goes away once hormones level out. Almost every new mother, up to 85 percent of them will experience the postpartum blues. It can make you feel happy one minute and overwhelmed and crying the next.
Postpartum Depression
Postpartum depression is the most common complication of pregnancy. It can also be life-threatening. It has been found that postpartum depression is a factor in 20% of all maternal deaths, according to data in countries that track the incidence of the problem. Postpartum depression causes sadness, anxiety, depression, anger, irritability, difficulty sleeping and intrusive thoughts(thoughts that may involve harming the baby). This can last for months to years postpartum if left untreated. This may present later and does not resolve after two weeks time.

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