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The body goes through a complete metamorphosis during pregnancy to make room for another life inside it. The final act of pushing the baby through the vagina is extremely painful and exerts a great deal of strain on the pelvic floor.
While the pain stops once the baby is delivered, the straining leaves the area around the anus and vagina (perineum) rather swollen, tender, and injured, which takes some time to heal. It is therefore important for the mother to get adequate rest and care for a few weeks after giving birth in order to make a complete recovery.
Signs That Qualify for Vaginal Delivery
One study showed that a cervical exam at 39 weeks can indicate a woman’s chance of a successful vaginal delivery. (1) A cervical exam can be done in the office by a healthcare provider, who will look at several measurements:
- Dilation – This refers to how many centimeters the cervix is dilated. The cervix is 10 cm dilated at the time of delivery. It is usually dilated between 0 and 4 cm before labor. (2)
- Effacement – This refers to the thinning of the cervix. 0% effacement means the cervix is still thick, and 100% effacement means the cervix is as thin as a sheet of paper. (3)
- Station – This is another measurement that refers to the baby’s presenting part (usually the head) at a certain level relative to the bony parts of the mom’s pelvis.
- A cervical exam often also measures how soft the cervix is and if the cervix is in a front or back position.
However, many factors come into play during labor that there is no one indicator that a woman will have vaginal delivery.
Recovery Period After a Normal Vaginal Delivery
Several factors play a role in recovery:
- Length of labor
- Length of the pushing phase of labor (called the second stage of active labor)
- Extent and type of vaginal tears
- Blood loss
- Mobility during and after delivery
- Baseline health
I hesitate to give an exact number because every woman is different and I don’t want them thinking something is wrong if they don’t fit into this timeline. However, most women are pretty uncomfortable for the first 2–7 days after delivery and then gradually feel better and better.
Tips to Promote Recovery After Vaginal Delivery
Bearing a child for 9 months and then birthing it through the vaginal canal are physically demanding processes that can leave the body extremely tired, drained, sore, and bruised.
Here are some simple healing measures that can help your body regain its full strength and energy after vaginal childbirth:
1. Do gentle exercises
Gentle movement is what I typically recommend. Stretching and short walks can be helpful. I usually recommend waiting until 4–6 weeks postpartum before returning to a normal exercise program.
2. Prevent hemorrhoids
Hemorrhoids are very common both during pregnancy and postpartum! (4)(5) After giving birth, avoiding constipation and straining on the toilet can help minimize them. There are topical treatments that can help as well. Sometimes simply ice or witch hazel can give some relief.
3. Take care of breast soreness
Breast soreness is common when first starting breastfeeding. The proper latch for the baby is critical in promoting ideal breastfeeding. Lactation consultants are often available in the hospital and for home visits to help (with latch and all parts of breastfeeding!).
Nipple care is also important. I usually recommend after breastfeeding or pumping to coat the nipple with a thin layer of the breast milk itself and then apply a nipple cream on top of that.
Breast milk has some healing properties for the nipple, and the nipple cream can help promote those healing properties and moisturize the sensitive skin. Mastitis is a concern if the breast is red, warm, or angry looking. Women often have a fever or feel like they have the flu too. Seeking medical care is important for any of these symptoms.
4. Be mindful of postpartum depression
Postpartum depression isn’t always obvious. A lot of women with postpartum depression don’t recognize it for what it is – instead, they attribute their symptoms to sleeplessness, hormones, or being new at caring for a newborn.
It’s important to acknowledge how you’re feeling postpartum to know if there are symptoms of postpartum depression present. Treatment does not have to be medication! Often therapy and counseling can help tremendously. For certain women, temporarily medication can be extremely helpful and lifesaving.
5. Keep a check on your diet
No special diet is usually necessary. Constipation is very common during pregnancy and postpartum, so avoiding constipating foods and increasing fresh vegetables and fruits can be helpful.
Staying hydrated is important. Discussing caffeine and alcohol intake with your doctor is important if you are breastfeeding.
6. Stock up on menstrual pads
You will experience heavy vaginal bleeding for about 4–6 weeks after childbirth. This form of bleeding is known as lochia, which is your body’s way of eliminating all the excess blood, tissue, and mucous from your womb that helped your baby grow.
You will require an extra pad cover to absorb this kind of copious discharge. One way is to place two pads side by side or overlap them from front to back to cover more space. You can also use a “padsicle” for relief, which is a pad and an ice pack in one.
You can prepare several padsicles by first wetting menstrual pads with aloe vera and witch hazel and then putting them in the freezer until ready to use.
7. Get adequate sleep and rest
Sleep is perhaps one of the most underrated components of good health. This is the period when the body can truly repair itself and regain its energy.
Thus, getting restful sleep daily helps the body recover faster from the trauma of childbirth. In fact, it has a major bearing on the physical, mental, and emotional well-being.
You may find it difficult to maintain a proper sleep schedule with a new baby on board, but the smartest thing to do is to align your own sleep hours with that of the baby. In other words, try to catch some shut-eye whenever your baby is sleeping. Also, you must prioritize your own health over attending to guests who come to see you and the baby.
Don’t compromise your own sleep just because there’s someone coming over. If possible, limit visitors to your home until you are feeling more stable.
8. Do Kegel exercises regularly
Vaginal childbirth can weaken your pelvic muscles to such an extent that you may lose some degree of bladder or bowel control. It is for this reason that doctors recommend a specialized form of exercise known as Kegel exercise, which is designed to strengthen the urethral and anal sphincter muscles. (6)(7)
9. Ask for pain relief
It is completely normal to experience postpartum cramping as your uterus shrinks back to its normal size, often while breastfeeding your baby. These cramps can be quite painful and discomforting, but they tend to subside on their own within a few days. However, if the pain becomes too frequent, unbearable, unusually prolonged, or progressively worse, you must see your doctor about it.
The doctor will conduct the necessary checkup to rule out any complications and recommend pain meds to manage your discomfort.
10. Ask for help if needed
New mothers often get so overwhelmed by the responsibility of looking after their baby that they completely neglect their own health.
Giving birth to a child takes a lot out of your body, which warrants that you take some time to heal before plunging yourself full-time into motherhood duties. After all, you need to be healthy yourself to care for your baby well enough.
So, there should be no misplaced guilt or shame in asking your partner, family, and friends to help until you are feeling better. They can help you in whatever capacity they can, such as in the kitchen, running errands, looking after your other kids, or tending to the newborn.
Having trusted people to fall back will give you some much-needed time to rest and relax.
The Safer Choice Between Vaginal Delivery and C-section
Both modes of delivery can be safe! Because a C-section is a surgery, it has slightly higher risks of potential complications, for both the C-section itself and risks for future pregnancies and future surgeries.
Risks Involved With Vaginal Delivery
One big risk of vaginal delivery is tearing of the vagina or perineum. Up to 80% of women have some sort of tearing during vaginal birth. (8) Most tears are easily repaired with sutures that dissolve all by themselves.
The chance of a large laceration (tear) that goes through the anal sphincter muscle or the rectum itself (called a third-degree or fourth-degree tear) is less than 3%, (1) which means a 97% chance that it won’t happen!
Another risk involves the need for operative vaginal delivery, such as a vacuum or forceps-assisted delivery. Your doctor will let you know if this is recommended at any point during labor.
Risks to consider for both vaginal deliveries and C-sections include bleeding, pain, anesthesia risks, and blood clots.
Plan Your Childbirth Before Delivery
Birth plans are popular. I remind women that no one can “plan” the way labor, delivery, and birth go. If you ask any experienced ob-gyn or midwife, they will say that surprises happen all the time!
I like expectant mothers to use the birth plan to think of their preferences – do they feel strongly about having music in the room or aromatherapy? What about delayed cord clamping and anesthesia? Who do they want in the room at the time of delivery?
Some of these ideas require a simple discussion with their health care provider and some require prep work for the family themselves.
Also, remember that not having a birth plan does not mean anything will be missed for the patient or their baby – hospitals, birth centers, and health care providers have recommendations for most of these questions, and they will let you know their preference if you don’t have one!
Having a healthy pregnancy is the best way to promote a healthy vaginal recovery. Staying active during pregnancy is important, as long as your doctor says it is safe. Eat healthy and avoid excessive weight gain. Optimizing medical conditions both before and during pregnancy can help too!
Stocking up on menstrual pads and potential medications for after delivery may be helpful (ask your doctor, but these medications can sometimes include ibuprofen, acetaminophen, and stool softeners).
Some women like to prep ice packs for perineal icing to decrease swelling, although the biggest benefit of these is in the immediate postpartum time frame, and hospital or birthing centers often supply them. Having healthy foods and snacks in the home can also help!