Discharge Information — Normal Vaginal Delivery

👶

After Your Normal Vaginal Delivery

Your guide to recovery and caring for yourself at home

Patient Name

Date of Delivery

Date of Discharge

Congratulations on the birth of your baby! Your body has been through something extraordinary. This guide will help you understand what to expect during your recovery and when to seek medical attention.

💊 Pain Management

Medication	Dose	Schedule
Paracetamol BF SAFE	1 g (2 tablets)	Every 6 hours (max 4 g/day)
Ibuprofen BF SAFE	400 mg	Every 6–8 hours with food

Take regularly for the first 2–3 days — don't wait for pain to build. Avoid codeine and tramadol while breastfeeding. Ibuprofen is especially effective for afterpains and perineal swelling.

Non-Medication Relief

Ice packs on perineum — 10–20 min, first 72 hours
Warm sitz baths — 10 min, 3× daily from day 2
Witch hazel pads on your sanitary pad
Warm compress for afterpains and backache

🩹 Perineal Care

Caring for Your Stitches

Use a peri-bottle with warm water during urination
Always wipe or rinse from front to back
Pat dry gently — never rub
Change pads every 3–4 hours
Stitches dissolve within 1–3 weeks
Support stitches with a pad when opening bowels

No tampons, intercourse, or douching for 6 weeks. Sexual activity may resume once bleeding has stopped and the perineum has healed. A water-based lubricant may help with dryness.

🩸 Bleeding (Lochia) — What's Normal

When	What to Expect
Days 1–3	Dark red, heavy flow. Small clots are normal.
Days 3–10	Pinkish-brown, lighter. May increase with activity or feeding.
Day 10–14	Yellowish-white. May briefly increase when placental scab separates.
Up to 6–8 weeks	Minimal, light discharge. Gradually stops completely.

🤱 Breastfeeding Tips

Getting Started

Begin within 1 hour — skin-to-skin contact
Feed 8–12 times in 24 hours to establish supply
Colostrum (first milk) provides critical immunity
Milk "comes in" on day 3–5 — engorgement is temporary
Monitor: 6+ wet nappies/day = baby getting enough

For engorgement: warm compress before feeds, cold compress between feeds, frequent feeding. Seek help for persistent pain during feeding, difficulty latching, or red/hot/painful breast area with fever (mastitis).

🍎 Diet & Bowel Care

Nutrition for Recovery

Extra ~500 calories/day if breastfeeding
Protein-rich foods for tissue repair
Iron-rich foods (red meat, leafy greens, legumes)
6–8 glasses of water daily
High-fibre foods to prevent constipation
Stool softener if needed (docusate 100 mg 1–2×/day)

🏃‍♀️ Recovery & Return to Activity

Timeframe	Activity Level
Days 1–3	Gentle walking. Rest when baby sleeps. Begin pelvic floor exercises.
Weeks 1–2	Short daily walks. Light stretching. No strenuous activity.
Weeks 4–6	Moderate exercise with clearance. Swimming once bleeding stops.
6+ weeks	Gradual return to higher-impact exercise. Assess pelvic floor first.

Contraception: You can conceive as early as 3 weeks postpartum. Discuss options before discharge or at your postnatal visit.

💪 Pelvic Floor Exercises

Start the Day After Delivery

Tighten the muscles around the vagina and anus as if stopping wind. Hold for as long as you can (work up to 10 seconds). Relax slowly, then repeat.

Work up to 10–15 repetitions, 3× daily
Continue these exercises for life
Over 25% of women experience urinary incontinence in the first year
Mention any leaking, heaviness, or pain at your 6-week check

🧠 Emotional Wellbeing

This is Normal — But Watch for Warning Signs

Baby blues affect up to 80% of mothers — mood swings, tearfulness, and irritability peaking around day 4 and resolving within 2 weeks.

Postpartum depression (10–20% of mothers) persists beyond 2 weeks with sustained sadness, hopelessness, difficulty bonding, or withdrawal. This is not your fault — help is available.

⚠️ Contact Us Urgently If You Experience

Heavy bleeding — soaking 1+ pad per hour for 2 consecutive hours, or clots larger than a plum
Fever ≥38°C with foul-smelling discharge or flu-like symptoms
Severe headache with visual disturbances, upper abdominal pain, or sudden swelling (possible pre-eclampsia — can occur up to 6 weeks after delivery)
Leg symptoms — pain, swelling, or redness in one leg (possible DVT)
Chest pain or sudden breathlessness (possible PE — call ambulance)
Red, hot, painful breast with fever (mastitis)
Unable to urinate or burning with urination
Wound infection — increasing redness, swelling, or discharge from perineal stitches
Thoughts of harming yourself or your baby — seek help immediately

📅 Follow-Up Schedule

Visit	Purpose
Day 3	Wound check, feeding assessment, baby check
Day 6	Recovery assessment, mood screening
6 Weeks	Full postnatal check — physical recovery, pelvic floor, contraception, emotional wellbeing

🌿 Recovery Reminders

Sleep when your baby sleeps — fatigue slows healing
Accept help from family and friends
Stay hydrated — keep water beside your feeding chair
Avoid lifting anything heavier than your baby for 2 weeks
Drive only when comfortable and not on sedating medication
Every recovery is different — be patient with yourself

📞 Practice Contact Numbers

Dr Nienaber's Rooms: +27 18 468 6214
Accounts: +27 18 468 6228 · accounts@drnienaber.co.za

🚨 Emergency Contact Numbers

Wilmed Park Hospital: +27 18 468 7700
Life Anncron Hospital: +27 18 468 0000
ER24: 084 124 | Netcare 911: 082 911
SADAG (mental health): 0800 567 567

Dr CS Nienaber