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Postpartum Problems

Postpartum Blues

WebMD Feature

You can't help but marvel at all your body has endured in the past nine months. Now that the pregnancy is (finally) over, you've been rewarded with a living, breathing wonder -- and a new title: Mom. Coming to terms with your new role, while learning how to care for your baby, can be overwhelming for any woman.

Like just about everything else in your life, your body faces significant changes in the weeks and months following your baby's birth. In this postpartum period, which begins immediately after delivery, your body will heal from childbirth, rebuild its strength and begin to regain its pre-pregnancy shape.

The more you know about what to expect, the better prepared you'll be to cope with the physical and emotional changes that come post-pregnancy.

Symptoms

Women may experience a wide range of postpartum problems, some more serious than others and each with its own symptoms. Some of the more common problems include:

  • Postpartum infections, (including uterine, bladder, or kidney infections)
  • Excessive bleeding after delivery
  • Pain in the perineal area (between the vagina and the rectum)
  • Vaginal discharge
  • Breast problems, such as swollen breasts, infection and clogged ducts
  • Stretch marks
  • Hemorrhoids and constipation
  • Urinary or fecal (stool) incontinence
  • Hair loss
  • Postpartum depression
  • Discomfort during sex
  • Difficulty regaining your pre-pregnancy shape

Causes and Treatment

Postpartum Hemorrhage

Although some bleeding is normal immediately after delivery, heavy bleeding or hemorrhage occurs in just 2% of births, most often after long labors, multiple births or when the uterus has become infected.

Postpartum hemorrhage is the third most common cause of maternal death in childbirth. It usually happens because the uterus fails to properly contract after the placenta has been delivered, or because of tears in the uterus, cervix or vagina. Soon after the baby and placenta have been delivered, you will be monitored to make sure the uterus is contracting as it should. If bleeding is severe, your midwife or doctor may massage your uterus to help it contract, or you may be given a synthetic hormone called oxytocin to help stimulate contractions. He or she will likely perform a pelvic exam to find the cause of the hemorrhage, and your blood may be tested for infection and anemia. If the blood loss is excessive, a blood transfusion may be recommended.

If hemorrhage begins a week or two after delivery, it may be caused by a piece of the placenta that has remained in the uterus. If so, the tissue will be removed surgically. Once you are home, report any heavy bleeding to your doctor immediately.

However, if you have a lump that does not respond quickly to home treatment, consult your doctor.

Uterine Infections

Normally, the placenta separates from the uterine wall during delivery and is expelled from the vagina within 20 minutes after giving birth. If pieces of the placenta remain in the uterus (called retained placenta), it can lead to infection.

An infection of the amniotic sac (the bag of water surrounding the baby) during labor may lead to a postpartum infection of the uterus. Flu-like symptoms accompanied by a high fever; rapid heart rate; abnormally high white blood-cell count; swollen, tender uterus; and foul-smelling discharge usually indicate uterine infection. When the tissues surrounding the uterus also are infected, pain and fever can be severe. Uterine infections usually can be treated with a course of intravenous antibiotics, which are used to prevent potentially dangerous complications such as toxic shock

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