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  • 1. Patient Medical History
  • 2. Patient Information
  • 3. Patient Authorization for Disclosure/Release of Medical Information
  • 4. Obstetrical Assessment
  • 5. Past Pregnancies
  • 6. Consent to Test for HIV Antibodies
  • 7. Obstetrical Care Guidelines
  • 8. Prenatal Testing
    • 8A. Screening for Chromosomal Abnormalities and Neural Tube Defects
    • 8B. Cystic Fibrosis Screening
    • 8C. Prenatal Testing Fee Schedule
  • 9. Bladder Diary and Urinary Evaluation
  • 10. Release of Medical Records to Outside Facility or Patient
  • 11. Release of Medical Records from Outside Facility to KCWC
  • 12. Meaningful Use Initiative Form
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  • Overland Park Regional Medical Center
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Patient Education

Post Partum Care

General Activities
For two weeks after your delivery it’s best not to do much more than what you did while in the hospital. Remember, you just had a baby.  Then gradually increase your activity as you feel able to. Taking care of a new baby is emotionally, as well as physically demanding, so don’t feel guilty about not getting other things done.  You may begin doing light housework such as preparing simple meals, doing dishes and making beds after two weeks.  Climbing stairs should be kept to a minimum for a few weeks, particularly after a Cesarean section.  If your house has upstairs bedrooms, use the handrail whenever possible.  It is best not to drive a car for a week or two.

Listen to your body. It will let you know when you have done enough.  When in doubt, underdo versus overdo. If you had a Cesarean section , lifting should be limited to 15 to 20 pounds for the first six weeks and you should wait two weeks to drive.

Bathing
To prevent infections, it is preferable for you to take a shower rather than a tub bath for two weeks after delivery.  If this is not possible, fill the tub with 3-4 inches of water, open the drain and leave the water running so you will have water running in and out.  This is called a sitz bath and may be continued as needed for comfort.

Episiotomy
Your episiotomy stitches should dissolve within 4-6 weeks. They do not have to be removed. The discomfort should improve daily. However, if any unusual pain develops, call your physician. Discomfort may be soothed by taking sitz baths as described above as well as taking over-the-counter or prescription pain medications.

Vaginal Bleeding
Normal bleeding after delivery is much like that of a heavy menstrual period and should decrease by the third or fourth day.  You may have bleeding or discharge up to 4-6 weeks.  You may notice an increase in bleeding your first or second day at home because your activity has increased.  You may even notice a few blood clots.  If your flow gets heavy and you begin cramping, this is an early sign of over-activity.  You will then need to decrease your activity and rest. If the bleeding and/or cramping continues (soaking a pad every hour for 2-3 hours), notify our office.

You can expect a menstrual period 5-12 weeks after delivery unless you are breastfeeding. Nursing may suppress periods, but not for everyone.  Remember:  Breastfeeding does not prevent a pregnancy.

Constipation
Try to maintain normal bowel habits after delivery to avoid constipation.  Extra fluids and a good high-fiber diet may help.  This includes flax/bran cereals, multigrain breads and fresh fruit and vegetables.

Your physician may also recommend a stool softener such as Colace or Surfak.  If a laxative is needed, Colace or Milk of Magnesia is acceptable even while nursing.  If you should continue to have problems, call the office for further instructions from your physician. If hemorrhoids are a problem, use the cream or suppositories you received in the hospital.  Sitz baths and/or lying on your side with your upper leg slightly bent may also relieve the discomfort of hemorrhoids.

Breasts
Nursing:  In the first few days of breastfeeding your nipples may be tender at the beginning of each nursing.  This is temporary and should decrease once let-down has occurred and should disappear within a few days. The key to avoiding sore nipples is correct latch-on and positioning of the baby at the breast. 

Hold the baby so that he is lying on his side and all of his body faces you.  His head should be lying in the bend of your arm.  Your forearm supports his back and your hand holds his bottom or thigh.  Throughout the nursing, all of the baby’s body should face you.  He should be lying horizontally across your body at the level of your breast. For comfort, use pillows to help support your arm and baby.  The baby’s mouth should cover one inch or more of your nipple and areola.  If your nipples become sore, you may express a few drops of breast milk on the nipples after nursing letting it air dry.  Holding the baby in different positions such as a football and cradle holds, always remembering to hold him closely to you, making sure that his mouth covers the entire areola, will also help keep the nipples from becoming sore.

If you notice cracked or bleeding nipples, keep your nipples clean and dry and let the nipples air dry after nursings.  Remember to change the nursing pads when they become moist and do not wear pads with plastic liners.

It is normal for your breasts not to appear as full about three or four weeks after delivery, however, this DOES NOT mean your milk supply has decreased. If you notice one area of your breast that is raised, hard, very tender, red and/or if you have fever >100º F, this is a sign of mastitis (an infection of breast tissue) and you should notify your doctor.  Please call our office if you have any questions.

Non-nursing:  If you are not nursing, wear a good support bra at all times while your breasts are engorged.  You should expect some “leaking” of milk from the breasts. You may use ice packs under the arm pits and to the side of each breast during the first couple of days of engorgement and take Tylenol or Ibuprofen for discomfort. Do not be surprised if you have a slight elevation in temperature for a day or two while your breasts are engorged. 

Sexual Intercourse
Sexual intercourse is okay when it is comfortable for you, usually six weeks after the baby is born.  It is preferable to wait until your vaginal discharge is clear. Tampons should be avoided for the same amount of time.  Tenderness in the vagina may be eased by using a water soluble cream (K-Y Jelly), or a contraceptive foam or cream to lubricate the area (DO NOT USE VASELINE).

Before intercourse is resumed, thought should be given to the type of contraception used.  Condoms, foam or vaginal suppositories may be used without a prescription until you discuss contraception with your doctor at your checkup. Other contraceptive options that may be used while breastfeeding include the “mini-pill” and Depo-Provera injections.

Exercise
You may start some mild exercises such as walking after two weeks at home, depending on how you feel.  You should delay more strenuous exercise for four to six weeks. Begin with easier exercises and increase them gradually as long as you are comfortable and there is not any pain. If you had a Cesarean, do not begin an exercise program for at least six weeks after delivery and with your physician’s permission.

Cesarean Birth
Sometimes with the joy and excitement of having a baby, those who have had a Cesarean birth tend to forget they have also had major surgery.  Your recovery period will be longer and you should pay special attention to yourself during this time.  The information about going home after childbirth applies to you as well; however, you have a few other things to keep in mind: 
Observe your incision.  If any of the following should occur, call our office.

1. Red, hard, tender or hot area around your incision.
2. Separation and/or bleeding of incision.
3. Moderate or large amount of oozing or drainage.
4. Fever > 100º F.

A heating pad may help with incisional pain. 

Diet
Even with the demands of a new baby, it is still important that you take time for yourself and for your nutritional needs.  Just as you need a nutritious diet while pregnant, so do you need a nutritious diet after your baby is born.  The best advice is to get as much variety in your diet as possible. Select some foods from each of the four food groups each day.  If you are concerned about reducing, cut down on high fat and sugar foods and on alcohol, but don’t over-restrict breads and cereals or fruits and vegetables.  Take a look at the amount of food you are consuming as well if you wish to lose weight.  While you needed several hundred additional calories each day while pregnant, that need doesn’t continue after the baby is born unless you are nursing. Please continue your prenatal vitamins.  Follow this chart for the recommended number of servings from each of the four food groups.

Checkup
Your doctor will advise you when he/she would like to see you for your post partum checkup, usually 5-6 weeks.  Call the office before leaving the hospital or soon after going home to make an appointment.  This should assure a convenient appointment time for you.

Warning Signs
After leaving the hospital, call our office if you have any of the following:

• Heavy vaginal bleeding, soaking a pad every hour for three hours.
• Severe chills or fever over 100.4 degrees.
• Frequency or burning with urination (emptying your bladder).
• A red, hard, tender area on the breast.
• A red, hard, tender or hot area along the leg veins.
• Shortness of breath and/or chest pain.
• Any other unexplained signs or symptoms.

Baby Blues
Having a baby is a special time in your life.  You’ve spent nine months dreaming, preparing and anticipating this moment.  But, now that your baby is here, you may be having some unexpected feelings. This is completely normal.  It takes time to adjust to a new baby.  After all, the baby didn’t come with an instruction manual. 

At times it may seem frustrating and overwhelming. You may feel depressed. Don’t be unduly concerned. Depression, frustration and feelings of inadequacy are felt to some extent by almost all new mothers.

You just had a baby. Your body is trying to adjust to its post-pregnancy state; you’re probably tired and feeling isolated.  Take time to relax and enjoy your growing family.  This is a very precious time for all of you. If you are unable to get help with the baby, your other children or the house, try not to let it overwhelm you. Take time for those things that are most important – your health and your family – the dishes can wait.

There are several support groups in the area for new mothers.  If you feel your “baby blues” are impairing your ability to care for yourself or others in your family, call us and we can refer you to counselors who assist with depression.

A Note To The New Dad
Having a baby means many changes and adjustments for you as well.  You are now a father and you may be feeling many conflicting emotions.  While you are excited and proud of the new baby, you may also feel overwhelmed, depressed and even a little bit jealous. 

Become involved in the care of your newborn.  Help feed, dress, bathe and diaper the baby or older siblings.  Or, you and the baby just spend some time together getting to know each other. Take time to enjoy the new addition to your family.  Try not to let the new responsibilities you may feel you have get in your way of sharing this special time with your family.