Postpartum

This leads to better health for you and your baby, but it can come with challenges.

Does it hurt? It can be uncomfortable at times, but there are resources to help with technique to reduce this.

What if I do not produce enough? Unfortunately, this does happen to some people, and there is not a medication that will reliably increase your supply. But we do know that the more stimulation provided to the breast (with breastfeeding or pumping) the more the breast will produce.

When will my period come back? It varies for every person. Some people have their period come back even while they are still breastfeeding, and other times it will not come back until weeks after you stop breastfeeding.

Can I get pregnant while breastfeeding? The answer is yes. Breastfeeding is not reliable with preventing ovulation and pregnancy. You could actually still breastfeed during your next pregnancy, if they happen close enough. Once you are having intercourse, you should use protection, as you will ovulate before you have your period. 

Following are some resources that you might find helpful:

• Breastfeeding and lactation classes 
• Nursing Mothers of Raleigh 
• Triangle Breastfeeding Alliance
• North Carolina Breastfeeding Coalition 
• National Women’s Health Breastfeeding Helpline 1-800-994-9662

Postpartum blues refer to the feelings of anxiety, sadness, crying, and mood swings that can happen after delivery. It usually gets better after 2 weeks.

Postpartum depression is more serious. In addition to the above symptoms, there can be difficulty bonding with the baby, withdrawal from friends and family, sleeping too much or not at all, feeling hopeless, and thoughts of hurting yourself, or “what if I was not around.”

Anyone is at risk for postpartum depression, but the risk is higher for those that have had it before, or have a history of depression.

Sometimes counseling is needed, other times medication is added. If there is a concern about how you are feeling, please contact our office for an appointment.

If you have additional questions or would like to explore further, the American College of Obstetricians and Gynecologists provides helpful information.

Congratulations! You have just done one of the hardest things in your life, and it does not matter if it was a vaginal or Cesarean delivery, your body needs time to recover.

• Expect it to take about 6 weeks to feel better
• Don’t try to do too much
• Accept help

Even before you have your baby, you can start thinking about your options for planning your next one.

For most people, if you have a method that worked well in the past, you can return to that method.

Condoms can be used, if you are consistent, or there are hormonal options for birth control.

Things to consider that would affect your decision:

• With a new baby, will you be able to maintain an option that you have to do every day, every week, or every month? While the pills, the patch and the ring are great options, if you are not getting sleep, or have a fluctuating schedule, it could be hard to keep track of the days. There are long-term options that are progesterone only: the Depo shot, Nexplanon Implant, and the IUD in the uterus, and these can sometimes help with busy schedules.
• Are you Breastfeeding? The estrogen in the combined birth control options (pill, patch, ring) cannot be started prior to 6 weeks postpartum, as an earlier start can increase the risk of a blood clot. But there is also concern that the estrogen can decrease the amount of breast milk produced.
• How soon do you want to start birth control? We advise everyone to wait at least 6 weeks after delivery before resuming intercourse, and most hormonal birth control needs about 2 weeks to become effective. Most birth control can be started at your postpartum visit, but at this office we will wait 12 weeks to insert an IUD, to allow your uterus to return to its previous size.
• How soon do you want to become pregnant after stopping birth control? Most hormonal options will allow you to start having regular periods immediately after stopping, but the Depot shot can take up to 9 months to return to normal periods.

If you are done with pregnancy, and feel that your family is complete, there is the option for sterilization.

• This is a permanent procedure.
• Men can undergo sterilization as well, with a Vasectomy, that is performed by Urology, usually as an office procedure.
• Sterilization for females can be done at the time of delivery, either during a C-section, or the day after delivery for vaginal deliveries. We can also do it at a later time, as an outpatient surgery.
• Insurance usually covers these procedures, but you can verify with your specific coverage.

Circumcision is an elective procedure on newborn male infants to remove the foreskin–the skin that covers the head of the penis.

It is performed by one of our physicians (or certain pediatricians) prior to the baby leaving the hospital.

Circumcision takes only a few minutes. During the procedure, the baby is placed on a special table. Various surgical techniques are used, but they follow the same steps:

• The penis and foreskin are cleaned.
• A special clamp is attached to the penis and the foreskin is cut and removed.
• After the procedure, gauze with petroleum jelly is placed over the wound to protect it from rubbing against the diaper.

The American Academy of Pediatrics has found that the benefits of circumcision outweigh the risks, but the benefits are not great enough to recommend that all newborn boys have a circumcision.