It may be difficult to think about anything other than your emotional reaction to what has happened. But our physical health can often impact on our mental health, and the other way around.
If you gave birth, your body has been through a challenging experience. It may help to understand what is happening physically as well as emotionally, so you can take care of yourself.
We have more information about coping with grief after a neonatal loss.
Changes to your breasts
Your breast milk will ‘come in’ a few days after you give birth. If your baby died within their first weeks of life and you are unable to feed them the milk you’re producing, this can be very distressing.
Your breasts may be swollen, firm and painful as they become full of milk. This is called engorgement, which may settle on its own. If you had started breastfeeding your baby, try not to stop producing milk abruptly. This may increase the risk of severe breast engorgement and mastitis (inflammation of the breast).
There are some things you can do to reduce engorgement and milk production, including:
- taking regular pain relief
- wearing a support bra all the time
- using breast pads to absorb leaking milk
- using cold compresses or gel packs on the breasts
- hand expressing a small amount of milk if your breasts feel very full
- applying washed and chilled dark green cabbage leaves to the breasts
- having a warm bath or shower to allow the breasts to leak naturally
- sleeping in a semi upright position to avoid pressure from heavy breasts.
It may help to hand express for relief. If you were expressing regularly for a premature or ill baby, it may help to increase the times between expressing. This will help to gradually reduce your milk supply.
Using milk suppressing medication
There are medications called dopamine agonists that you can take to reduce your milk production. These may help you feel better emotionally but they aren’t suitable if you have pre-eclampsia. Talk to the doctors or midwives caring for you in hospital about whether medication may be suitable for you. Your GP may also be able to help.
You do not have to take milk suppression medication if you don’t want to.
Donating breast milk
Not everybody wants to stop producing milk at this time. If you don’t, there is the option to donate your milk to the UK National Milk Bank.
It may comfort you to know that you are helping other mums and premature or sick babies.
Abdominal pain and cramps
It’s normal to feel pains in your tummy after giving birth. These may feel similar to contractions, cramp or strong period pains. This happens because your womb is contracting back to its normal size. You can take painkillers, such as paracetamol, to help with this.
Bleeding after birth
You’ll bleed from your vagina after giving birth vaginally or by c-section, which will be quite heavy at first. This will carry on for a few weeks and will gradually turn a brownish colour and decrease until it finally stops.
Use maternity pads for the first 6 weeks after birth. Do not use tampons as they can increase your chance of getting an infection.
Tell your midwife or health visitor if you’re losing blood in large clots or you need to change your maternity pads every hour or more. You may need some treatment.
You may have had stitches after tearing or an episiotomy (where the doctor or midwife makes a cut to make the opening of the vagina a bit wider) during the birth.
Find out more about recovering from a perineal tear.
Some women may leak urine (known as urinary incontinence) after having a baby. This is more likely if you had a vaginal birth, but some women who had a c-section may also experience this too.
You're more likely to have incontinence if you also had problems with controlling your bladder in pregnancy, if you had a long labour or an assisted birth.
It may help to:
- do some pelvic floor exercises
- cut down on caffeine
- avoid spicy and acidic foods
- drink 6 to 8 glasses of fluid a day but no more (many people with urinary incontinence avoid drinking fluids but this can actually make it worse)
- quit smoking
- avoid lifting heavy things.
Some women also have problems controlling their bowels (known as anal or bowel incontinence). This is more likely to happen after a third- or fourth-degree tear. Most women who have a third- or fourth-degree tear heal completely and have no lasting complications.
Don't be embarrassed to talk to your midwife, health visitor or GP about any incontinence problems. They can help you get the right care, such as bladder and bowel training, physiotherapy or surgery if needed.
If you are sore or itching around your anus or bleeding when you poo, you may have piles. These are lumpy veins inside and around your bottom (anus). Try to increase your fibre intake by eating fresh fruit and vegetables, and wholemeal or wholegrain breads and cereals. Also try to drink plenty of water – we recommend around 6 to 8 glasses a day. This will help avoid constipation and make it easier to go to the toilet.
Haemorrhoid cream may also help, which you can buy at supermarkets and pharmacists. Pelvic floor exercises may also help prevent haemorrhoids in the long term.
A pharmacist can suggest creams to ease the pain, itching and swelling.
Recovering from a c-section
It usually takes about 6 weeks to recover from your c-section, but everyone is different. Listen to your body and try not to overdo things.
Gentle exercise, such as walking, will help you recover from your c-section. Avoid anything more active until you have no pain and you feel ready. This includes:
- carrying anything heavy
- having sex.
Looking after your wound
Your wound will take about 6 weeks to heal. You will have a scar but this will fade over time.
You can look after your wound by:
- gently cleaning and drying the wound every day
- wearing loose, comfortable clothes and cotton underwear
- take a painkiller if the wound is sore.
Tell your midwife or GP straight away if you have any signs of infection, such as:
- a high temperature
- feeling generally unwell, for example, an upset stomach
- your wound becoming red, swollen, painful or having discharge.
Preventing blood clots
Keeping as active as possible and drinking plenty of fluids will help to lower your risk of a blood clot. Your midwife may have given you a blood-thinning medicine. While you’re in hospital, they will show you how to inject yourself daily.
Your next period and fertility
Everyone is different, so it can be hard to be exact about when your periods may start again. If you were not breastfeeding, it could start as soon as 5 to 6 weeks after you give birth.
But remember that you can get pregnant 3 weeks after you’ve given birth, even if your periods haven’t started again.
It’s important to use contraception every time you have sex, unless you want to get pregnant again. The decision about trying again is very personal. We have more information trying to get pregnant again after a neonatal loss, if it's something you want to think about.
How you may feel during these changes
Some people have told us that they had a very emotional response to the changes their body went through after giving birth and their baby died. This can be very difficult.
“I was very angry with my body for not recovering quickly enough, and felt quite revolted by my scar, and my excess skin and bruising and things as I had all these physical symptoms and no baby.”
Remember that you can speak to your bereavement midwife, community midwife or GP about any concerns you have about your physical or emotional health.
We’re also here to offer emotional and practical support to parents and families who are going through this experience. If you want to talk to a professional about how you’re feeling, our team of expert midwives are available for free on 0800 0147 800, Monday to Friday, 9am to 5pm. Or you can email them at [email protected]