What no one tells you about after the birth

Bleeding
After giving birth you will experience heavy bleeding. Invest in maternity pads as you should not use tampons. Kate Brintworth, matron for Community and Antenatal Services at King's College Hospital, says: 'In the first 24 to 48 hours you will bleed heavily and pass small clots. After a week it will settle down and become period-like, and should stop after four weeks. If you are still bleeding after four weeks, or have pain and a temperature at any time, tell your midwife who can check for signs of infection.

After-pains
After the birth, your uterus will shrink back to its normal size. You may get cramps, which can feel like period pains, or at worst mini contractions. This process, called involution, takes four to six weeks. Breastfeeding also brings on the pain because it releases a contraction-stimulating hormone called oxytocin. Kate says: 'The cramping will be most intense during the first 24 to 48 hours after giving birth, but it should taper off within two or three days. Take a paracetamol half an hour before you feed if the pain is severe.'

Constipation
It's normal not to feel the urge for a couple of days after birth. Kate says: 'There are good reasons for this. You are unlikely to have eaten or drunk much during labour. Eat some fruit and drink lots of water and your body should fix itself naturally. If you find it stings when you wee get a jug of water and pur it over the affected area as you urinate.'

Tears and episiotomy
It's not uncommon to tear delivering your first baby. A few women have an episiotomy, which is a cut made to make space to deliver the baby. Kate says: 'After birth, the perineum can be numb, so women can feel more discomfort on days two and three. But it should start to settle within a few days. A doctor may prescribe Voltarol tablets, a strong painkiller which won't interfere with breastfeeding. If the pain persists, ask your midwife to check for infection.

Nipple soreness
Kate says: 'Your baby's sucking action is surprisingly strong. Getting the latch right from the start can help you avoid a lot of potential problems, so if possible, ask for help every time your baby latches on in the early days. Pain that persists throughout a feed is not normal.' Rubbing breastmilk on your nipples or using Lansinoh can soothe and heal. If your breast feels lumpy and looks red you may have mastitis, a blockage of the milk duct. Place warm flannels over the tender area and feed regularly from that side to unblock it. And tell your midwife - if it becomes infected, you may need antibiotics.