Restoring the uterus after childbirth

The core logic of postpartum recovery of the uterus is to help the uterus, which has been expanded nearly 1,000 times by the fetus and whose weight has increased from 50g before pregnancy to 1,000g during delivery, gradually shrinks back to its pre-pregnancy size, removes lochia and residual tissue in the uterine cavity, and repairs the damaged endometrium and pelvic floor support structure. The golden recovery window is within 6 weeks after delivery. There is no "quick recovery recipe" that applies to everyone. The most effective is the rhythm that suits your own physical condition.

Last year, I met Xiaotang, who was born in 1995, at a postpartum rehabilitation clinic. After giving birth to a 7.5-pound baby boy, she saw an online tutorial on "retracting the pre-pregnancy uterus in 7 days" right after she was discharged. The corset cut into her ribs and caused pain. She also bought a home uterine repair device worth a thousand yuan and her stomach trembled every day. As a result, she suddenly developed a lot of bright red lochia on the 12th day after delivery. She was so scared that she went to the emergency room all night. After the B-ultrasound, hemorrhage was found in the uterine cavity, and the originally good rhythm of uterine contractions was abruptly disrupted.

In fact, regarding postpartum uterine recovery, there have always been subtle differences in the care ideas of Western medicine and traditional Chinese medicine. There is no need to ignore each other.

In the Western medicine system, to judge whether the uterus is recovering well, it first looks at the status of lochia, secondly looks at the B-ultrasound results of the 42-day postpartum review, and thirdly looks at whether there are signs of pelvic floor damage such as lower abdominal pain and urine leakage. The recovery methods they recommend most are actually very simple: get up early and walk slowly, and insist on breastfeeding. When the baby sucks the nipple, it will stimulate the mother's body to secrete oxytocin, which can naturally help the uterus contract. It is more reliable than any instrument. There are still many people who are confused about whether to do pelvic floor muscle electrical stimulation in the hospital. In fact, as long as the muscle strength does not reach the damage level after postpartum review, Kegel exercises at home are enough. If you already have mild prolapse or urinary leakage, just follow the doctor's instructions for treatment.

Traditional Chinese medicine’s nursing approach is more focused on “draining first and then replenishing”. It is believed that postpartum Qi and blood are deficient, and the recovery of the uterus is entirely supported by Qi and blood, so lochia must be eliminated first. You cannot drink tonic old hen soup or brown sugar water just after giving birth, which will easily block the lochia and prevent it from being discharged. There is a custom of drinking Shenghua soup in many places, but it is really not suitable for everyone - I have seen mothers with hot constitutions who drank Shenghua soup for three days in a row, and their nosebleeds came out, and the lochia increased. Now the obstetrics departments of regular traditional Chinese medicine hospitals will first look at your constitution before prescribing medicine, and will not let everyone drink the same prescription. Moxibustion on acupuncture points such as Guanyuan and Zusanli can also help uterine contractions, but the duration must be controlled to avoid burning yourself and getting angry.

Having said this, someone must have asked, are those popular "hand contractions" and "abdominal belt tightening" methods that are popular on the Internet useful? This matter is actually quite controversial. An old technician around me who has been doing obstetrics and gynecology for 10 years said that regular abdominal massage can indeed help the discharge of lochia, but it must be performed by a medically qualified person who knows the strength and position. The "technicians" from the Sanwu gynecology and health stores outside are trained to start work in 7 days. If they press your belly hard, the already fragile uterus can easily be pressed to bleed, and even the lochia can reflux and cause inflammation. As for the abdominal belt, mothers who have had a caesarean section can indeed relieve the pain of wound traction by using it for the first 3 days after the operation, but it should be tightened at the hip bone and not into the belly. Mothers who have had natural births really do not need to tighten it every day. The tightening will increase the abdominal pressure, but it is easy to push the uterus down, aggravating the risk of prolapse. The merchant's claim that "the uterus shrinks back as soon as it is tightened" is purely IQ tax. Oh, by the way, don’t listen to what people say, “Start running and jumping one week after giving birth to lose belly fat.” In the first 6 weeks, try to do as little exercise as possible that puts too much pressure on the abdomen. You have to wait until the 42-day review shows that core training is fine before slowly increasing it. Don’t hurt your uterus just to lose weight. It’s not worth the loss.

In fact, when you are raising a baby, you can easily do small things to restore the uterus. For example, when you are breastfeeding, you can rub your hands to warm them, and gently place them on your lower abdomen and rub them in clockwise circles. You don’t have to use force, just rub slowly according to the pain of contractions. The dull pain is similar to that when you are pregnant. It is normal. If it hurts so much that you break into a cold sweat, stop immediately. In the first two weeks after delivery, try not to stand or squat for long periods of time, let alone carry heavy objects. Think about it, your uterus is still like a soft bag of water, and your pelvic floor muscles are still too loose to support it. If you stand and carry heavy objects every day, wouldn’t it be easy for it to fall down?

Really, I have seen too many mothers who are anxious just after giving birth. Others’ uterus is completely healed after a 42-day re-examination, but I am extremely anxious when I still have some light brown discharge at 50 days. In fact, everyone’s body constitution is different. As long as there is no residue and no obvious symptoms of prolapse in the B-ultrasound re-examination, it is not a big deal if it is delayed for ten days and a half. Uterine recovery is a natural process. Don't force yourself to compete with the "perfect recovery standards" of Internet celebrities. It's better to put less IQ tax on it than anything else.