In keeping with the philosophy of Family Centred Care, the hospital has adopted the practice of combined care. Combined Care means your nurse will care for both you and your baby together in your room. Having your baby in the room with you 24 hours a day provides you and your family with more time to get to know your baby, and for your nurse to teach and assist you with baby care. Although the nurses will always be available to assist you, you will do most of the care for your baby.
Please ask questions and request assistance whenever necessary. We are here to help you as much as possible.
Length of Stay
In most cases, mothers who give birth vaginally can expect to be discharged approximately 24-48 hours after the baby is born. If your baby is born by caesarean section, you can expect to be discharged approximately 2-3 days following the birth. Some mothers leave earlier at their request.
Occasionally, babies must remain in hospital longer than the mother. It is very difficult to leave without your baby, especially if you are trying to establish breastfeeding. In these cases, the nursing staff will arrange an appropriate place for you and your baby to stay.
After Birth
After the birth of your baby, your nurse will check your heart rate, breathing, blood pressure, temperature, uterus and vaginal flow. If you have a perineal tear, an episiotomy (a cut that has been sutured) or haemorrhoids, your nurse will offer suggestions to help reduce the swelling. As soon as you feel able and the effects of the epidural have worn off, you will be helped to the bathroom.
Please do not get out of bed for the first time on your own, as you may feel somewhat dizzy or weak.
The nurse will check on you and your baby at least every hour and assist you with care as needed. Please feel free to ask for assistance at any time!
Abdominal Cramping (after-pains)
After-pains are normal after delivery, but the discomfort will begin to lessen after a few days. If you have had other pregnancies or if you are breast-feeding, you may notice the cramps more. If this is the case, discuss pain relief options with your nurse.
Breast Health
Your breasts go through many changes during pregnancy and after birth. This section offers helpful information on what to expect postpartum, common breast health concerns, and when to seek support.
Whether you’re breastfeeding, pumping, or not lactating, this information is here to help you feel informed, comfortable, and confident as you care for yourself and your baby.
A blocked duct means there is a blockage in a milk duct. The duct cannot allow the milk from one area of the breast to flow towards the nipple. You may feel a lump of swelling in one area of your breast. The area may:
- Feel tender or painful
- Look red
- Feel warmer than the rest of your skin
The blockage needs to be cleared or it may develop into mastitis. In order to try and clear it:
- Begin all feedings on the breast with the blocked duct until the lump and pain are gone
- Gently, but firmly massage the breast just above the lump and towards the nipple before and while breastfeeding
- Apply a warm, moist compress to the area
- Take a warm shower or bath and massage the breast to help the flow of milk
Mastitis begins as inflammation in the breast tissue and may be caused by many reasons. If it is not treated quickly it can develop into an infection. It starts suddenly and usually occurs in one breast only.
Call your health care provider if you have signs and symptoms of mastitis.
Signs of Mastitis Include:
- Pain, redness and heat on your breast
- Red streaking on your breast
- Fever and flu like symptoms
- Feeling achy and run down or nauseated
You may continue to breastfeed if you have mastitis. Your antibodies will protect your baby from infection.
Engorgement is when your breast or areola becomes hard beginning 3-6 days after birth due to milk not coming out (not being expressed), causing swelling. Signs and symptoms are:
- Breasts that are hard
- Breast tightness and pain
- Breasts that appear red
- A low grade fever
How to manage engorgement:
- Breastfeed early and frequently
- Cold or Warm cloths for comfort depending on preference
- Ensure proper positioning, latch, suck and swallowing is established.
If you are choosing not to breastfeed, your body will still begin the process of breastmilk production on its own. There are several things you can do to ease any discomfort and stop milk production.
The main thing that impacts milk production is how fully and how often the breast tissue is emptied. When milk is removed from the chest/breast, it sends signals to your brain to produce more.
The goal is to have most of the milk stay in the breast tissue so your body knows to stop making more, without causing engorgement and/or mastitis. Removing small amounts (drops or a teaspoon worth) is okay. Do not drink less fluids – this will not slow down milk production, and can make you dehydrated.
Some tips to help with any discomfort are to:
- Gently express tiny amounts of milk
- Apply cold compresses for 15 minutes at a time – you can repeat this every hour
- Avoid the use of heat on your breast tissue
- Take over the counter pain medication such as acetaminophen (Tylenol) or ibuprofen (Advil) as recommended on the label
- Wear comfortable bras and tops that are not too tight. Tight clothing can cause problems such as blocked ducts which can lead to mastitis.
Stopping milk production can take a few days to a few weeks. If you have any concerns or are worried you may have an infection, please contact your healthcare provider (OB, midwife or family doctor).
You may also reach out to Algoma Public Health for guidance and support from a lactation nurse.
Thrush is a fungus that can cause symptoms for the mother and the baby. Candida albicans (what causes both thrush and vaginal yeast infections) grows in moist dark places such as on the nipple, in the milk ducts, in the mother’s vagina and in the baby’s mouth and diaper area.
In the mother, possible symptoms of thrush include:
- Nipple or breast pain that occurs from birth, lasts throughout nursing, and is not improved with better latch-on and positioning
- Sudden onset of nipple and/or breast pain after the newborn period
- Nipples that are itchy or burning and appear pink or red, shiny, flaky, and/or have a rash with tiny blisters
- Cracked nipples
- Shooting pains in the breast during or after feedings
- Nipple and /or breast pain with correct use of an automatic electric breast pump
- Vaginal yeast (monilial) infections.
In the baby, possible symptoms of thrush include:
- Diaper rash
- Creamy white patches inside baby’s mouth, cheeks or tongue
- A whitish sheen to the saliva or the inside of the lips
- Baby pulling off the breast or refusing the breast (because his mouth is sore)
- Gassiness and fussiness
- Rarely, thrush is a contributing factor in slow weight gain
- The baby may also be without visible symptoms
If thrush is diagnosed in a breastfeeding baby or mother, both mother and baby will need to be treated simultaneously with medication prescribed by their health care providers.
Postpartum Nutrition
After delivery, it is important to get enough fluids and to choose foods that provide fibre, extra calcium and iron. To ensure you are getting enough calcium, choose milk, yogurt or cheese. To boost your iron intake, choose meats and alternatives such as lean red meat, beans and lentils, whole grain breads or dried fruits.
For more information you can visit the Government of Canada’s Food and Nutrition Guide linked below.
For Breastfeeding Mothers
Try to choose healthy meals and snacks recommended in “Eating Well with Canada’s Food Guide”. Remember that breastfeeding women need 2 to 3 extra Food Guide servings each day.
You can choose to continue taking your prenatal vitamins, or choose a multivitamin that has 0.4mg of folic acid in it.
Eat according to your appetite and pay attention to your feelings of hunger and thirst. It’s not a good idea to try to diet while you are breastfeeding as it can reduce your ability to make enough milk.
Drink plenty of fluids to keep your body well hydrated. Caffeine passes into breast milk and can keep your baby awake. It is best to limit your intake to no more than a total of 300 mg per day from all sources of caffeine. This includes beverages such as coffee, tea and cola soft drinks, as well as chocolate. Be aware that some herbal teas may have harmful effects and may have not been proven safe to drink while breastfeeding.
Discharge
Before being discharged from the hospital, your nurse will go over health teaching and discharge instructions with you and provide you with information for when both you and your baby will require follow up appointments.
Prior to leaving you will hand in your baby’s Health Card application, that will be submitted by the hospital on your behalf.
Ensure you ask for the name of the OB or Midwife that delivered your baby, as it will be required when you are applying for the baby’s Birth Certificate.
You will receive several resource materials (pamphlets and QR codes). It can be overwhelming at first, but once you are settled at home it is a good idea to review them.
Any positive results from your baby’s Newborn Screen bloodwork will be communicated to you from your baby’s doctor or midwife
Pain Management
To help control your pain after birth, there are options available to you that will be discussed by your nurse. If you undergo a caesarean birth, a variety of pain medications are available after your surgery. Discussions with your doctor/midwife and nurse will help decide what is best for you. Often a self-medication package including Tylenol, Advil and a stool softener is ordered and kept at the bedside. Your nurse will provide more instructions and answer any questions you may have.
Constipation and Bowel Movements
Constipation is a common problem after having a baby. Here are some suggestions to help:
- Choose whole grain/ whole wheat/ bran breads and cereals
- Eat more vegetables and fruit throughout the day
- Drink at least 8 glasses of fluid a day (water, milk, juice)
- Include light activity in your daily routine such as walking
A stool softener, Colace, is included in your self med kit. It is recommended that you take 2 tablets every morning to help prevent constipation
Haemorrhoids
Haemorrhoids are swollen veins around the rectum. A sitz bath, ice packs or “Tucks” medicated cooling pads can help reduce discomfort. To relieve burning or itch, you can use a cream or suppository that your doctor has ordered, which is better absorbed following a warm sitz bath. Your nurse will gladly help you decide what works best for you.
Avoid sitting or standing for long periods. Keep bowel movements soft by eating a high fibre diet and drinking lots of fluids (6-8 glasses per day). Your nurse will offer you a laxative or suppository ordered by your doctor if you need it. Haemorrhoids usually disappear a few weeks after birth, if you just developed them during your pregnancy.
Vaginal Bleeding
After the birth of your baby, you will have vaginal bleeding which may continue for 2 to 6 weeks. At first, the bleeding (called lochia), will be dark red like a heavy period. The colour and amount will change in a few hours to a moderate dark red. After a few days it will turn to a pinkish colour, and then to a scant brownish discharge. If you are breastfeeding, it is normal to experience an increase in flow of brighter red blood following a feeding, which should decrease over time. If your flow (lochia) increases because of too much activity, more frequent rest periods may be needed.
In hospital, please let your nurse know if …
- your bleeding increases
- you pass any clots (jelly-like blood) and show these to your nurse
- your vaginal discharge (lochia) has a foul odour
- you feel feverish
Once you are at home, call your physician/midwife or report to the nearest emergency department if …
- you have bright red bleeding that continues after resting
- you soak through one perineal pad in one hour or less
- you pass large clots the size of a plum or golf ball (after the first 24-48 hours)
Pelvic Health and Recovery
Your body goes through incredible changes during pregnancy and birth, and pelvic health is an important part of your recovery. This section shares information on what’s normal after giving birth, common pelvic health concerns, and ways to support healing and strength as your body recovers. Taking time to care for your pelvic health can help you feel more comfortable, confident, and supported as you move through the postpartum period.
Lochia (vaginal discharge) that transitions from bright red to pink/brown, and eventually becomes white by week 6.
If you had a tear or episiotomy, stitches usually dissolve within 1-2 weeks. Mild soreness is expected.
You may feel a decreased urge to empty your bladder or experience minor leaking (incontinence) as nerves recover.
- You may begin gentle pelvic floor exercises (Kegels) and deep core breathing. It is normal to feel a gap between your abdominal muscles. In most cases, this will narrow naturally, but functional strength is more important.
You may feel ready to return to running or jumping. It is recommended to gradually return to usual strenuous activities to ensure the pelvic floor can handle the pressure.
If you are breastfeeding, lower estrogen levels can cause vaginal dryness and may make pelvic tissue feel thinner or more sensitive.
Pelvic Floor Contraction Exercise (Kegel)
Kegel exercise aids in healing of episiotomy and haemorrhoids, helps to restore bladder tone and strengthens pelvic floor muscles. You can start kegel exercises any time after delivery.
It also helps to prevent prolapse or slipping of the uterus in later life and may add sexual enjoyment during intercourse.
Lying on your back with your legs crossed at the ankles, squeeze knees, thighs and buttocks together as if preventing yourself from urinating. Hold and count to five. Relax. Repeat. Gradually, this exercise can be done without ankles crossed and can be done anytime, sitting or standing.
Common Pelvic Health Conditions
- Accidental leakage of urine with coughing, sneezing, laughing or exercise
- Pain in the pelvic region
- Pelvic organ prolapse
- Diastasis recti (separation of your abdominal muscles)
- Scar tissue concerns
- Painful intercourse
- Constipation
- Hip, low back or tailbone pain
If you are experiencing any of these conditions, and they are becoming concerning to you, you may be interested in seeking out a Pelvic Health Physiotherapist.
Some options in Sault Ste. Marie and the surrounding area are:
If you are a Group Health Centre (GHC) patient, GHC offers pelvic floor physiotherapy services. Please ask your care provider for a referral.
Sexual Health
The decision to resume intercourse is a personal one and the right time for you will be when both of you are comfortable.
Many couples may not be prepared for the impact having a baby has on their sexual relations, interests and responses. Both parents should make adjustments. You should try to speak honestly to each other about how parenting is affecting your sexual response, feelings and needs.
Once your stitches have healed, bleeding has stopped (usually 2-6 weeks) and you are comfortable, intercourse can resume. If you are unsure, you can consult with your health care provider.
After 2 to 3 months, sexual responses gradually return to what they were before pregnancy. Most women who breastfeed will experience milk leaking from their breasts during orgasm.
The physical and hormonal changes that could occur after having a baby that affect your sexual relationship include:
- Shorter and weaker orgasm (due to weaker vaginal muscles)
- Less lubrication in the vagina
- Longer arousal time
- Fear of another pregnancy
- Fatigue for both mom and dad
- Baby’s crying
- Discomfort during intercourse
- Fear of hurting the incision with caesarean delivery
The following suggestions may help you deal with these temporary changes:
- Daily repetitions of Kegel and pelvic exercises to help restore pelvic and vaginal muscle tone.
- Use of a water based lubricant (example: K-Y jelly) can be very helpful if your perineal area is feeling sensitive. It may also help with the vaginal dryness many women experience at this time. The use of Vaseline is not recommended.
- Use of various positions will lessen the pressure on the tender areas in the vaginal area, the abdomen and the breasts.
- Try placing a pillow under your hips to decrease pressure during intercourse.
- If you had a caesarean delivery, you might try a side lying position where the woman can control penile penetration and avoid pressure on her incision.
- To avoid pressure or discomfort, you may want to position yourself on top so that you can control the entrance of the penis.
Birth Control
You may become pregnant, even if your menses (period) has not returned.
If you decide to have intercourse before you see your health care provider, be sure to use an effective method of birth control. Some of the common choices are condoms, oral contraceptive pills, Evra patch, Nuva ring and lactational amenorrhea method (LAM). We encourage you to discuss with your partner which method of birth control you will use. Using the method chosen as your health care provider advises is extremely important. Remember, there is no grace period after a pregnancy – it is possible to become pregnant again almost immediately after giving birth.
For further birth control information, talk with your health care provider at your next check-up. For more information, call the Sexual Health Department at Algoma Public Health.
Exercise
It is natural to want to get back in shape after your baby is born. Allow yourself time to recover, and then begin exercising gradually. You may find that a little exercise can be refreshing and a great stress reliever. Walking is also a great way to keep fit; however, avoid long tiring sessions. Exercise slowly and smoothly, and avoid holding your breath. Vigorous exercises such as jogging and skipping should wait until after your 6-week postpartum check-up and approval from your physician.
If you feel pain, stop exercising. Begin again only after the pain has stopped.
Your Mental Health Matters
The postpartum period brings many changes—physically, emotionally, and mentally. While welcoming your baby can be filled with joy, it can also feel overwhelming at times.
However you’re feeling, your mental health is important and deserving of care. If you’re struggling, feeling low, anxious, or simply not like yourself, support is available.
Click the link below to explore mental health information, resources, and services designed to support you during this season of recovery and adjustment.