What happens after natural or cesarean delivery

What happens after giving birth

The information you can find on pregnancy and childbirth is a lot, it comes from all over: mothers, aunts, complete strangers, the internet… everyone seems to know something and are eager to give you information about it. But once the baby is born? If we are not talking about breastfeeding, do we know what happens to the mother in the post-partum period? Today I want to focus on just that, give you some information about what happens after giving birth and what can happen to you, both during your hospital stay and when you return home.

Uterus after natural childbirth

As we all know the uterus it has a very important part of musculature that is able to relax for nine months while containing the baby. It is the same musculature that undergoes the rhythmic contractions of labor with the aim of "pushing" the baby towards birth. Muscle activity is stimulated by a hormone to which the uterus is particularly sensitive at term of pregnancy, that is oxytocin (attention, this hormone is also present outside of pregnancy and the cells of the uterus respond equally, simply not so vigorously), after the birth there is a moment in which the uterus is in total relaxation, it is said to be refractory.

It is a very short moment, on the order of one minute at the most. Immediately thereafter he begins to respond to oxytocin again, and the lees begin again contractions. You will say, again? For what? These contractions immediately after giving birth are not actually perceived by the mother very much, they serve to close the blood vessels and prevent a significant loss of blood that could turn into an emergency, putting the mother's life at risk. I would like to emphasize that during childbirth there is the possibility that there are very small lesions, I would say microscopic, of the cervix. These lacerations do not necessarily have to be repaired on the contrary, precisely because tiny ones tend to be left alone. The wonderful ability that our body has to quickly heal these small traumas will solve the problem.

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Pain after natural childbirth

Many times I happen to be asked if it is true that they feel gods pains after natural childbirth. Yes it is true, the intensity of these pains depends primarily on the individual pain threshold. If for me hitting the little toe against the corner of the door can hurt 10, for another woman it may only hurt 6. So even in this case the pain is very subjective. The reason you feel pain is that there are still some contractions occasionally induced by circulating oxytocin. For those who are breastfeeding, these pains will be felt right at the time of feeding, or when there is more oxytocin in the circulation.

These pains also exist for mothers who are bottle-feeding and have the sole purpose of helping the uterus to clean itself internally by expelling the remaining material (the losses we will discuss later are precisely this material). It is as if it were a blow with a broom that carries the remnants of pregnancy out of the uterus. There may also be different types of pain, for example if the birth was particularly difficult or long, if the baby was particularly large, the pain that can be felt is bone. That is, it is precisely the sore pelvis, the pubic bone in primis, but also the coccyx which in some cases can also dislocate itself (come out of its natural location) to widen the passage to a large child.

Uterus after caesarean section

A different case is instead the situation of the uterus after the caesarean section. First of all, we must remember that this obstetric operation is performed under epidural anesthesia (in most cases) or under general anesthesia (often used in case of urgency / emergency). The use of these drugs inhibits the ability of the uterus to react to the hormones of labor, also to allow doctors to operate in safety and in total control of a muscle that actually belongs to the class of smooth muscles, that is, the one that is contracts involuntarily. So during the surgery the uterus is cut, the baby is delivered, the placenta is removed and then closed again. From this moment on, the mother will be given a dose of the drug similar to thatendogenous oxytocin (or what we produce ourselves) with the same purpose for which it is produced after spontaneous birth: to prevent bleeding.

At this point we mothers who gave birth with the Caesarean section we find ourselves having a uterus that has a cut, a wound, which must heal. You have to imagine that the same condition that you find on the skin (therefore the stitches and the wound) you also have them internally on the uterus. The stitches in this case will be absorbable and will disappear by themselves, dissolved by the corpuscles that are involved in forming the scar. You can understand for yourself that the healing process of a surgical wound is slower in time than those small lacerations that can occur with a spontaneous birth. So for the first few days in the hospital you will be a little more controlled and "delicate" than women who have given birth spontaneously.

Leaks after childbirth

You can clearly imagine that there are losses after giving birth. And by leaks I mean leaks of bright red blood. Each woman has distinctive losses, so what you are told about them comes from personal experience. The loss of blood it is not due, as many believe, to the trauma of childbirth. This blood is caused by the fact that the placenta has created many connections with the blood vessels of the uterus so that once the uterus detaches from its seat, the vessels are forced to detach. But the blood flow does not stop and so here is the loss after delivery.

The quantity is given by the ability of our body to form the clot, or to stop bleeding, for some it is faster, for others less. You have to imagine postpartum discharge as a kind of intensive washing of the uterus. Obviously washing the inner wall, to take away everything that had belonged to the finished pregnancy. In this way it is possible to restore the normal cyclicality that the inner part of the uterus also has during the menstrual cycle. The losses therefore do not stop immediately after delivery, they continue for a few weeks, generally about 6 weeks, changing color and quantity.

At first it will seem like a pretty heavy period, so you will need to equip yourself with quite large pads both in the hospital and for the first few days at home. Slowly the quantity should decrease and after a couple of weeks or so it will also change color becoming darker. If this does not happen, if the blood continues to flow abundantly, contact the gynecologist immediately. It may be that there is a small piece of placenta left inside the uterus and if so it must be removed otherwise the connection and self-cleaning of the uterus will never end. After another week of loss similar to the 3rd day of the cycle the amount will continue to decrease, to come to resemble the typical brownish losses at the end of the cycle. Last step, last transformation is the transition from brown to yellowish, like a normal loss of vaginal fluid. Finally, about 6 weeks after the birth, the losses will have completely disappeared and the cyclical process of the uterine mucosa will be able to resume.

40 days after giving birth

If we count well those 6 weeks are about 40 days, the said period puerperium. After this period, the whole body slowly begins to regain the shape it had before pregnancy.

  • - organs internals displaced by the volume of the uterus begin to resume their natural position, the blood volume (increased in pregnancy) returns to normal, the same thing applies to breathing.
  • Even the pregnancy hormones they will have disappeared or in any case too low to influence bodily processes and therefore it is possible to resume cyclicality.

But be careful, it is not certain that at the precise expiry of the 40 day, once the losses have disappeared, everything is back to the way it was before the pregnancy. Let us remember that every body has its own times, it is held as a limit of 40 days because on average wound healing processes, losses and hormone levels have been seen to return to the situation before pregnancy.

  • Normally one is set 40 days after the birth gynecological examination di control, to evaluate the state of uterine involution, the possible presence of abnormal losses and to check the general well-being of the mother. It is a very important check, because it tells you what state your body is in but it also tells you if it is necessary to provide for the use of contraceptives because ovarian activity has started again and therefore a new pregnancy.
  • As you have read or heard the appearance of the first menstruation after childbirth it is highly variable and depends on several factors, including both hormones and breastfeeding. However, this does not ensure that ovarian activity has not resumed, perhaps the first menstruation has not yet arrived but the ovary has ovulated. So please ask everything about breastfeeding contraception.
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How long does it take for the uterus to return after childbirth

Just to clarify a few medical terms that are used and of which you may not know the meaning "Uterine involution”Means just that, the return of the uterus to its normal location. Let's dispel a myth, after a caesarean or natural birth, not even the supermodels you see on TV have a perfectly flat stomach. At least not immediately after giving birth.

Imagine a musculature that has stretched for 9 months reaching more than three times its normal size as it can suddenly return to its natural size. Try to keep a rubber band pulled for a day, you will see that it will be deformed. However, we have one thing more than elastic, an important ability of our muscle fibers to return to the initial position, obviously giving time to time.

In the first days after giving birth you will already see that the volume of the uterus has dropped below the navel, so it has already come a long way. In the following months the uterus will disappear again under the pubic bone and be 10-12 cm long. How long does this take? Here too I can report average data, let's say in about 5-6 months.

Do abdominal exercise, using the post-partum containing girdles does not help to decrease the volume of the uterus more quickly, because these methods act on the abdominal muscles not on the uterine one.

In conclusion, the 9 month journey is over, the birth has passed and now all attention is focused on this baby, its care and growth. It is absolutely normal, but I ask mothers not to forget about yourself, pay attention to your body, take care of it and you will see that even the days after birth will be a beautiful experience.

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