What to expect when you're expecting (169 page)

Persistent pain in the perineal area, beyond the first few days

After the first 24 hours, a temperature of over 100°F for more than a day

Severe dizziness

Nausea and vomiting

Localized pain, swelling, redness, heat, and tenderness in a breast once engorgement has subsided, which could be signs of mastitis or breast infection. Begin home treatment (
page 446
) while waiting to reach your practitioner.

Localized swelling and/or redness, heat, and oozing at the site of a C-section incision

After the first 24 hours, difficult urination; excessive pain or burning when urinating; a frequent urge to urinate that yields little result; scanty and/or dark urine. Drink plenty of water while trying to reach your practitioner.

Sharp chest pain (not chest achiness, which is the usual result of strenuous pushing); rapid breath or heartbeat; blueness of fingertips or lips

Localized pain, tenderness, and warmth in your calf or thigh, with or without redness, swelling, and pain when you flex your foot. Rest, with your leg elevated, while you try to reach your practitioner.

Depression that affects your ability to cope or that doesn’t subside after a few days; feelings of anger toward your baby, particularly if those feelings are accompanied by violent urges. See
page 458
for more on postpartum depression.

If your perineum becomes very red, very painful, and swollen, or if you detect an unpleasant odor, you may have developed an infection. Call your practitioner.

“I look more like I’ve been in a boxing ring than in a birthing room. How come?”

Look and feel like you’ve taken a beating? That’s normal postpartum. After all, you probably worked harder birthing your child than most boxers work in the ring, even though you were only facing a 7- or 8-pounder. Thanks—or no thanks—to powerful contractions and strenuous pushing (especially if you were pushing with your face and chest instead of your lower body), you might be sporting a variety of unwelcome delivery souvenirs. These may include black or bloodshot eyes (dark glasses will do a cover-up job in public until your eyes return to normal, and cold compresses for 10 minutes several times a day may help speed that return) and bruises, ranging from tiny dots on the cheek to larger black-and-blue marks on the face or upper chest area. You may also be bringing home soreness in your chest and/or difficulty taking a deep breath, due to strained chest muscles (hot baths, showers, or a heating pad may ease it), pain and tenderness in the area of your tailbone (heat and massage may help), and/or general all-over achiness (again, heat may help).

“It’s been several hours since I gave birth, and I haven’t been able to pee.”

Peeing doesn’t come easily for most women during the first 24 postpartum hours. Some women feel no urge at all; others feel the urge but are unable to satisfy it. Still others manage to urinate, but with accompanying pain and burning. There are a host of reasons why basic bladder function often becomes too much like hard work after delivery:

The holding capacity of the bladder increases because it suddenly has more room to expand—thus your need to pee may be less frequent than it was during pregnancy.