After giving birth, your body goes through a lot of changes and needs time to heal. So naturally, you may feel some discomfort and possibly experience any number of health concerns. But don’t worry; very few of these are serious. In fact, they can be a normal part of the baby’s development and your body’s healing process.

The following concerns may need extra care and attention from you or a health professional:

Mastitis

This is a painful inflammation of the breast tissue commonly affecting breastfeeding women. Symptoms include redness, hardness, and soreness of the breast. Breasts may feel hot and swollen, accompanied by flu-like symptoms. Research suggests that 10% of women experience mastitis within the first 3 months of giving birth, although it can happen within the first 2 years.

What causes mastitis?

Mastitis can be either infectious or non-infectious. Non-infection mastitis can develop due to a blocked milk duct, which causes milk to stagnate in the breast tissue. Infection happens if bacteria enter the blocked ducts and grow in the stagnant milk.

What can you do?

Keep breastfeeding; this will help the blocked milk. It also helps to massage the breast area under the arm (axilla) towards the nipple while feeding your baby. Expressing milk after a feed also helps. Rest, drink lots of fluids, and place a warm flannel on the breast to relieve pain. Paracetamol can also help with the pain. If you have an infection, you’ll most likely need antibiotics. If you have an abscess, this will need to be drained.

Bladder problems

Bladder problems are common after a vaginal birth, as it can be hard to control your bladder. Every time you cough, sneeze, or laugh, you may leak urine (known as stress incontinence) or you may find that you have a sudden urge to pass urine (also known as urge incontinence).

What causes bladder problems?

Both stress and urge incontinence are caused by a weakening of the pelvic floor muscles resulting from excess fluid from pregnancy. Bladder issues usually improve as the days and weeks pass after birth and the pelvic floor muscles start to tighten and tone up.

What can you do?

Pelvic floor exercises help to strengthen the pelvic floor muscles. If problems persist after a few weeks, speak to your doctor or midwife. If you have cloudy urine and feel pain when you pass urine, this could indicate an infection and require antibiotics.

Postnatal depression

This affects about 1 in 10 women and usually develops 4–6 weeks after birth, but can sometimes come on within a year. If left untreated, it could seriously affect a woman’s life. Emotional symptoms include anxiety, low mood, irritability, tearfulness, an inability to cope, a lack of interest in anything, difficulty concentrating, and not bonding with the baby. Feelings of guilt, inadequacy, and isolation are also common, as are headaches, stomach pains, a lack of appetite, and a loss of libido.

What causes postnatal depression?

The causes are unclear, but factors that increase the possibility of developing postnatal depression include having a history of depression or mental health problems or experiencing a traumatic birth. Relationship issues can also bring on postnatal depression.

What can you do?

In mild cases, emotional and practical support is enough to subside depression. In more severe cases, antidepressants, counselling, and therapy are usually offered.

Puerperal psychosis

This is a severe psychotic illness that is thankfully not that common. It affects about 1 in 500 women and usually develops within the first 2 weeks after birth. Symptoms include confusion, an inability to cope, neglect of appearance, and forgetting to take care of the baby. In some severe cases, a mother may have suicidal thoughts and want to harm the baby.

What can you do?

The mother will need to be treated by a psychiatrist and may need to be admitted to a specialised mother and baby unit for follow-up care.

Perineal problems

During a vaginal delivery, the area between the anus and vagina can stretch and feel sore. If you had an episiotomy or a tear that needed stitching, this can feel very painful. If, after stitches, the area becomes red and swollen and you have throbbing pain, you may have an infection.

What can you do?

Anti-inflammatory suppositories can help relieve discomfort. Warm baths with arnica oil added to the water can be very soothing. Pouring warm water over stitches can help ease the stinging while urinating. Paracetamol and anti-inflammatory painkillers such as ibuprofen are recommended for mild to moderate pain. Cooling gel pads also help to reduce swelling and bruising. An inflatable swimming ring is a great option to make sitting easier. If you show any signs of infection, you will be prescribed antibiotics and may be referred to a physiotherapist if you have prolonged perineal pain. Most maternity units now have a specific perineal clinic to deal with these problems on short notice.

Secondary postpartum haemorrhage

More than 24 hours of excessive bleeding up to 6 weeks after delivery happen to around 1% of pregnancies. The most common cause is an infection of retained tissues in the placenta. The bleeding is often accompanied by abdominal pain, fever, and feeling unwell. Infection is treated with antibiotics, and retained bits of the placenta are removed under anesthesia. If you have bleeding like this, you need to go back to the hospital as soon as possible.

What are some common maternal problems after birth (Part Two)?

Unii's Giving Birth Journey covers mastitis, depression and other postpartum issues.