Discharge Instructions for Self-Care Following a Loss of Pregnancy

Activity: 

Physical activity should be as you can tolerate and according to your healthcare provider's recommendation. No heavy lifting is advised. Allow for rest periods especially the first two weeks. If you would like to exercise - walking is recommended, jogging and swimming are usually okay after 6 weeks. Check with your health care provider about climbing stairs, or other strenuous activities. Do not return to full activity (aerobics, tennis, employment) until after your physician checkup. No sit-ups or weightlifting for the first four to six weeks if you had a cesarean section.

Driving:

Do not drive while you are taking Vicodin, Tylenol with Codeine, or any other narcotic medication.

Sleep:

Make sure to get enough rest. Napping is encouraged.

Diet:

A nutritious and balanced diet is essential for healing. If you have diabetes and your blood sugar level is too high or too low, this can put you at an increased risk for infection. Please discuss blood sugar goals and treatment with your health care provider.

Breast Care:

You may experience breast changes following the loss of a pregnancy for up to 14 weeks. Until your breasts return to normal, wear a tight bra (a jogging bra is best), even during the night. An Ace Wrap, instead of a bra may also be helpful. Do not express milk from your breasts or let hot water from the shower run over them for a long period of time. Stimulation of any kind can cause more milk production. If your breasts become painful and firm:

1. Apply an ice bag wrapped in a thin towel to the breasts.
2. Take pain medications as prescribed by your healthcare provider. 
3. Place cold raw cabbage leaves (not cooked) inside your bra directly onto your breasts. Change every two hours or when the leaves become limp.

Bowel Tips:

Drink at least six to eight glasses of water every day. Eat foods rich in fiber, such as fresh fruits and vegetables, whole grains and bran. Walk often. For hemorrhoids, use a sitz bath or sit in a tub with a few inches of warm water for 10 to 15 minutes. Report severe diarrhea or lack of bowel movement for three consecutive days to your health care provider.

Bladder Tips:

Turn on the faucet while you are on the toilet. Pour warm water over your bottom as you do with peri-care or urinate while you are taking a warm shower. Tell your health care provider if you experience frequent urination, difficulty urinating or a burning sensation when you urinate.

Vaginal Bleeding:

The appearance of your vaginal discharge will change during the days and weeks ahead. Typically, you will see: 

• Days one to three - Bright red discharge with small clots resembling a moderate to heavy menstrual period.
• Days three to seven - Pinkish to brownish discharge, less heavy bleeding.
• Weeks two to six - Creamy yellow to white color, less and less discharge. You should contact your health care provider if you return to a bright red or pinkish/brownish discharge appearance after the first week, soak more than one pad per hour, pass large clots or tissue, notice a foul odor, or have no discharge in the first two weeks.

Taking Care of Your Bottom:

You should pay special attention to cleaning your bottom as long as any discharge or bleeding (lochia) continues. If you had stitches to repair an episiotomy (vaginal incision) or a tear, they will dissolve by themselves and do not need to be removed. You may use medicated pads, sprays or sitz baths, as prescribed by your health care provider. A sitz bath is a small plastic basin you fill with water and position over your toilet, allowing you to submerge your bottom by sitting down. Wash your hands before and after you change your pad. Always wipe from front to back after urination and bowel movements. After using the toilet, fill the peri-bottle with plain warm water, rinse off your bottom, gently pat dry and then put on a clean sanitary pad. Do not use tampons or douches until your doctor advises that it is safe to do so.

Taking Care of your Cesarean Incision: 

Hygiene: 

Make sure you clean your hands often with soap and water or an alcohol-based hand sanitizer; especially before and after touching your wound. Remind your family and caregivers to wash their hands as well.

• DO NOT take soaking baths. Soaking in a bath, pool or hot tub within the first two to four weeks after surgery can break open your wound and cause infection.
• Shower daily or as directed by your doctor. Gently clean the wound with a mild soap and water. If you doctor has given you a special soap that helps kill germs, like the chlorhexidine gluconate (CGH) solution, follow those instructions carefully. After washing your wound, rinse off all the soap and dry.