Caring for Yourself
After Loss
1st Edition
Table of Contents
Introduction
We are here for you................................................... 2
Caring for Yourself
After delivery........................................................... 18
Perineal care............................................................. 18
What do I do Now?
Kegel exercises......................................................... 19
What happens to my baby?...................................... 4
Bladder...................................................................... 19
What choices do we have?
Bowels....................................................................... 19
What does the hospital do?
Swelling..................................................................... 19
What other options are there?
Sex.............................................................................. 19
Christiana Care Pastoral Services............................ 4
Birth control methods............................................. 20
Ask for help................................................................ 5
Breast care................................................................. 22
Friends and family
After cesarean surgery............................................ 22
Funeral/memorial information
Incision care.............................................................. 22
Clergy/spiritual leader
Bathing/personal hygiene..................................... 22
Medical providers
Diet............................................................................ 22
Creating memories.................................................... 6
Going home.............................................................. 22
Ways to remember your baby
Caring for Your Emotions
Coping with emotions.............................................. 8
What is grief?
What does grief feel like?
How long does grief take?
Responses to loss
Where to Find Help................................................... 9
Annual Memorial Service......................................... 9
The Tree of Remembrance........................................ 9
Going home.............................................................. 10
Recommended books.............................................. 10
Depression, anxiety and posttraumatic stress..... 11
Acute stress and posttraumatic stress.................. 11
How do children react to loss?.............................. 12
Age effects how children understand death........ 13
More tips for helping a child grieve..................... 14
Additional resources............................................... 15
Online resources...................................................... 15
Other important telephone numbers.................... 16
Caring For Yourself After Loss 1
Introduction
We are here for you
Grief is not a problem to be cured. It simply says that you have loved someone.
We wish to express our deepest sympathy and we want to support you and your family after the loss of
your baby.
We hope this booklet will help you by answering some of the questions you may have during this hard
time. Help is available if you feel you want or need it.
You and your family are part of the team. We are partners in your health and we want to make sure you
get the best possible care. We serve our neighbors as respectful, expert, caring partners in their health.
Please tell us who you want involved in your care while you are in the hospital. Our doctors and nurses
will talk with you clearly and help you every step of the way.
If you have questions, please ask.
Interpreter services are available upon request.
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What do I do Now?
What do I do Now?
What happens to my baby?
There are probably many hard questions going
through your mind. There are some decisions that you
may need to make depending on the length of your
pregnancy. This guide is to help you decide how you
would like to care for your baby.
What choices do we have?
Autopsy: Many parents say one of the most difficult
parts of losing a baby is not knowing why, and an
autopsy may help you find the answer. Please ask
to speak to your health care provider, chaplain, or
spiritual leader when making this decision.
If you choose to have an autopsy completed, the results
will not be available immediately and you will need to
make an appointment with your health care provider
after you have left the hospital to review these results.
Your provider will receive the results in 2-3 months.
You may take up to 24 hours to decide whether an
autopsy is right for your baby. If you are discharged
from the hospital and have not made a decision yet,
you will be given a card with instructions for how to
call the hospital once you have made a decision.
Funeral Arrangements: We understand that this is a
very hard time for you to have to make decisions about
your baby. The hospital can take care of your baby or
you may choose a private funeral home to assist you.
What does the hospital do?
You may not feel able to plan a funeral at this time.
If you choose to have the hospital take care of your
baby, your baby will be cremated; however the ashes
cannot be returned to you. There is no cost to you for
this service. Some parents feel this is a good choice
for them. Even with this choice, you can have a small,
private service for your child. A chaplain or social
worker is here to help you plan the best way for you to
honor your child’s memory.
What other options are there?
You may choose private burial or cremation. Burial
may be with another family member or in a children’s
section of a cemetery. If you choose cremation, some
parents bury the ashes and some keep them in a special
place. You may want to choose a funeral home to take
care of your baby. We have a list of funeral homes,
if needed. You can call them to ask about burial,
cremation, funerals and any questions about costs.
If you are still not sure what to do, your nurse can
contact a hospital social worker or chaplain to assist
you in making any decisions.
Christiana Care Pastoral Services
Your priest, minister, rabbi, imam or other spiritual caregiver is welcome
to visit you. Christiana Care focuses on the whole person. The chaplain
focuses mainly on emotional and spiritual support of your care. Chaplains
from our Pastoral Services Department help support families with their
emotional and spiritual well-being in a variety of ways. A chaplain can
help through prayer, sacraments and other specific spiritual and/or
religious practices; help you deal with difficult issues; help you
think through decisions about the care of your baby; and to help
you renew strength and hope.
The Christiana Hospital Chapel is located on the first floor off
Christiana Hospital’s main lobby. The chapel is one place for
quiet thoughts, prayers and reflection.
Someone from Pastoral Services is available 24 hours a day. You may
also call the pastoral services office at 302-733-1280 for more information.
Roman Catholic Mass, Saturday - 4 p.m., Room 1100
Worship Service, Sunday - 9:30 a.m., Christiana Hospital Chapel
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Ask for help
One important decision is who should help guide you through the tasks which lie ahead. You may wish to call
some family members before you leave the hospital, or friend who may be able to think more clearly.
Friends and family
Name: ________________________________________________________ Telephone Number: ______________________
Name: ________________________________________________________ Telephone Number: ______________________
Name: ________________________________________________________ Telephone Number: ______________________
Funeral/memorial information
Funeral/memorial arrangements are often a special worry. After you choose the funeral home, the funeral director
will call the hospital. You do not need to make choices about the funeral while you are still at the hospital.
If you need assistance making funeral or memorial service arrangements please ask the hospital staff for help. Our
social workers can assist you with this process.
Funeral Home: ________________________________________________ Telephone Number: ______________________
Clergy/spiritual leader
You may wish to talk over the arrangements with your clergy/spiritual leader. Your funeral director will help you
find a clergy/spiritual leader if you do not have one.
Clergy or Spiritual Leader: _____________________________________ Telephone Number: ______________________
Medical providers
It can be overwhelming to process a lot of information right now. It is ok to follow up with your medical providers
and support team for clarification and additional information.
For your records make a list of who you talked with.
Doctor: _____________________________________________________ Telephone Number: _____________________
Nurse: ______________________________________________________ Telephone Number:_____________________
Chaplain: ___________________________________________________ Telephone Number:_____________________
Social Worker: _______________________________________________ Telephone Number:_____________________
Christiana Care Pastoral Services: 302-733-1280.
Christiana Care Patient Relations: 302-733-1340.
Christiana Care Social Worker/Case Management: 302-733-2222.
Caring For Yourself After Loss 5
What do I do Now?
Creating memories
While still at the hospital, if seeing and holding your baby feels right to you, staff members are here to help carry
out your wishes. Giving your baby a name is also meaningful and honors your baby. Think about whether you
would like photographs taken. Many who have lost a baby find comfort in these photos later on in their grief
process. A memory box is also something that can help. Some choose to get a lock of hair, hand and foot prints,
a hospital bracelet, your baby’s blanket or any other item that speaks to you in your time of grief.
Ways to remember your baby:
• Talk about your baby.
• Light a candle.
• Create a blog.
• Create music or a playlist.
• Celebrate birthdays and holidays in unique and
special ways.
• Attend a support group.
• Release butterflies.
• Plant a tree.
• Put a statue in a garden.
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• Hold on to mementos.
• Wear a reminder (necklace, pendant, ring).
• Start a foundation or fundraiser.
Caring for
Your Emotions
Caring for Your Emotions
Coping with emotions
Some people need to talk through their grief, while others feel the need to be silent and strong for their
partner or family.
What is grief?
Grief is a normal and natural response to loss. All people who have a loss, grieve, no matter your age,
gender, culture, ethnicity, or spiritual values.
What does grief feel like?
ANGER
GUILT
SHOCK
SADNESS
DEPRESSION
You may feel angry at
yourself, others, God,
the universe, or even
the person who died.
You may feel like
you should have
done more or not
done something.
You may feel
numb, or feel like
what has happened
is not real.
You may cry or feel
like you have no
energy.
You may feel pain,
loneliness, gloom
or lack of hope.
How long does grief take?
You can’t hurry grief. There is no time limit. Sometimes grief comes in waves. You may feel like you are
done grieving, and then you may become upset again.
Responses to loss
Below are just a few of the common responses to loss that you may go through. Your experience may be
different from others, but it is still normal for you.
Physical responses
Behavioral responses
• Drained of energy.
• Loss of appetite.
•Sleeplessness.
• Tightness in the throat or heavy feeling in the chest.
•Nausea.
• Changes in sleep.
• Changes in appetite.
•Crying.
• Social withdrawal.
•Overactivity.
Emotional responses
Spiritual responses
• Worry or fear.
•Loneliness.
•Shame.
•Relief.
•Feeling abandoned by God or religious
people or institutions.
•Anger at your higher power or religious
people or institutions.
• Loss of meaning and purpose.
• Hard time taking part in normal spiritual
practices.
• Stronger religious/spiritual activity.
Psychological responses
•Confusion.
•Preoccupation.
•Dreams.
• Not able to concentrate.
• Sense of presence.
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Suggestions:
• Allow yourself time for grieving.
• It is often helpful to cry. Crying heals.
• It is not the best time to make decisions.
• Continue eating a healthy diet and get a moderate amount of exercise.
• Be patient with yourself and your partner.
• Talk about your feelings with a friend or counselor.
• Understand that you will heal in time and try not to rush your healing process.
Where to find help
• Your Health Insurance Provider
If you have health insurance, your insurance card should have a toll free number for member services you can
call to ask for help in finding a behavioral health provider close to you.
• Your Employer
If your employer has an EAP (Employee Assistance Program), you may be able to receive additional help at
no cost to you. Contact the Human Resources Department at your place of employment to inquire about this
benefit and other possible resources.
• Your Faith Community
Your religious or spiritual leader may be able to support you while you cope with your loss.
• Christiana Care Center for Women’s Emotional Wellness
Licensed, highly skilled and caring specialists in behavioral health who provide outpatient counseling
and medication treatment for individuals affected by perinatal loss. Call 302-733-6662 or email cwew@
christianacare.org.
• Christiana Care Loving Arms Parent Support Group
Third Monday of every month, 6:15 – 7:45 p.m., Christiana Hospital, Conference room 1000.
Please join other parents who have also suffered a loss. The Loving Arms Parent Support Group is a self-help
group that provides time to ask questions, share thoughts or just listen. The support group is here to help
parents and families who have had an ectopic pregnancy, miscarriage, stillbirth or neonatal death.
You can come by yourself, with your spouse, partner, or bring a friend. You can come to talk, or just listen. To
confirm the date of the next Loving Arms Parent Support Group meeting and for more information about the
annual memorial service please call 302-733-4367.
Annual Memorial Service
Each year there is an interfaith memorial service where families and friends can come together with others who
have all suffered the loss of a baby.
The Tree of Remembrance
The Tree of Remembrance is located on the Christiana Hospital Campus near the pond by the Helen F. Graham
Cancer Center. There is a path leading down to the Bronze Tree near the white gazebo. There you will find the Tree
with names of babies, who have passed, engraved onto the leaves. For more information please call 302-733-4367.
Caring For Yourself After Loss 9
Caring for Your Emotions
Going home
Leaving the hospital can be very difficult. It is not uncommon
to feel distressed about leaving your baby behind.
It is also normal to feel uneasy about going home and seeing
baby items you may have for your baby. Some choose to have
someone else put baby items away until you feel ready to
deal with them. Still others choose to keep those baby items
out. Whatever you choose, it is important to let your wishes
be known.
Recommended books
Pregnancy and Infant Loss
• “Empty Arms: Coping with Miscarriage, Stillbirth,
and Infant Death”
Sherokee Ilse.
• “A Silent Sorrow Pregnancy Loss: Guidance and
Support for You and Your Family”
Ingrid Kohn, MSW & Perry-Lynn Moffitt.
• “Empty Cradle, Broken Heart: Surviving the
Death of Your Baby”
Deborah L. Davis, Ph.D.
• “When Hello Means Goodbye”
Pat Schwiebert and Paul Kirk.
For Men
• “A Guide for Fathers when a Baby Dies”
Tim Nelson.
• “Fathers Feel Too: A Book for Men by Men on Coping with the Death of a Baby”
Andrew Don.
• “Strong and Tender: A Guide for the Father whose Baby has Died”
Pat Schwiebert, RN.
For Couples
• “Couple Communication After a Baby Dies: Differing Perspectives”
Sherokee Ilse & Tim Nelson.
• “For Better or Worse: For Couples whose Child has Died”
1992 The Centering Corporation.
For Siblings
• “No New Baby”
Marilyn Gryte.
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Depression, anxiety and posttraumatic stress
We know that patients who lose a baby are at greater risk for developing complex mental health disorders. It is
important that you know the signs and symptoms and where you can get help.
If you experience any of the following symptoms for more than two weeks, you should contact your doctor:
• Feeling down almost every day.
• Not keeping up with personal hygiene.
• Losing interest in the things you enjoy.
• Feeling restless and angry.
• Sleeping too much or too little.
• Feeling overtaken by anxiety and panic.
• Loss of appetite or eating too much.
• Having thoughts that are scary.
Acute stress and posttraumatic stress
It is not uncommon for individuals who experience the loss of a baby to develop acute stress symptoms. In most
cases, Acute Stress Disorder occurs in the first month after a traumatic event, like the loss of a baby. Initially, the
symptoms can be intense and quite difficult to experience. In most cases these symptoms will improve and taper
away over subsequent weeks after a traumatic event. If the symptoms persist for more than a month or you
develop symptoms well past a month after your loss, you should be evaluated for Posttraumatic Stress Disorder,
a more chronic condition that needs professional treatment. Below are common symptoms to monitor for:
• Feeling numb or sense of detachment from the
world or your body.
• Feeling like you are in daze.
• Finding yourself questioning whether certain
events really happened.
• Finding it difficult or impossible to experience any
pleasure and extreme guilt about moving on with
normal life tasks.
• Reliving both the emotional and physical stress
of your birth and/or your child’s death through
intrusive thoughts, feelings, nightmares or flashbacks (sudden, vivid memory that feels like it is
happening again).
• Avoiding people, places, activities or things that
remind you of the trauma of your loss.
We know that unresolved grief can lead to long-lasting effects on your health and well-being. Giving your self
permission to cry or verbalize your anger or confusion can be helpful in guarding against these effects. It is
important to find a way to communicate your feelings. If need be, there are professionals who can help you.
Caring For Yourself After Loss 11
Caring for Your Emotions
How do children react to loss?
Even small children feel grief.
Children may need extra support and love as they learn that death is a natural part of life.
Children may grieve as intensely as adults, but may express it in some other way. They may sometimes act out
their sadness and sometimes play happily.
12 Christiana Care Health System
Age effects how children understand death.
Infants and toddlers:
• May not understand death.
• May react to the feelings of adults.
• May react to disruptions in their daily routine.
• May become grouchy and cry more.
• May try to look for the person who is gone (at around 2 years of age).
What you can do:
– To help them feel more safe, try to stick to their usual routine and schedule.
– Staying physically close can help the child feel safe.
Children 3 to 5 or 6 years old:
• May think death is reversible.
• May think death is like sleeping.
• May feel they caused the death.
• May be sad one minute and playing the next.
What you can do::
– Assure the child that he or she did not cause the death.
– Do not use terms like “sleeping” or “lost” when you talk about death or the child may become fearful of sleep or being alone.
Children 6 to 9 years old:
• May start to see that death is forever.
• May ask for details about the death.
• May feel alone and different from their classmates.
• May feel angry.
• May be fearful that other family members will die.
What you can do:
– Speak to teachers and counselors before the child returns to school.
– Encourage the child to ask questions about death, as they will likely face the questions of friends.
– Help the child work through anger, show them they are loved and reassure them they will still be cared for.
Children 9 to 12 years old:
• May feel helpless.
• May be easily hurt by remarks of others.
• May have a hard time in school.
• May try to take on the role of the person who died.
• May feel angry or guilty.
What you can do:
– Speak to teachers and counselors before the child goes back to school.
– Encourage the child to talk about the person who died and to express his or her feelings.
– Show your own feelings to help the child know it is OK to do so.
– Let them know it is OK to play and to be happy even though someone they love has died.
Caring For Yourself After Loss 13
Caring for Your Emotions
Teenagers:
• May try to hide their feelings.
• May act like they don’t want to talk about the death.
• May feel guilty or angry.
• May feel they need to protect other family members from their feelings.
• May try to take on the role of the person who died.
What you can do:
– Speak to teachers and youth leaders before the teenager goes back to school and other activities.
– Talk honestly about the death.
– Provide structure and support, even if the teen resists.
– Don’t encourage the teen to “take the place of” the person who has died; help them focus on their own needs and future.
– Allow teenagers to seek the support they need outside the family. Maintain family closeness, but respect the teen’s need
for privacy.
More tips for helping a child grieve.
Tell the truth. Use clear terms but don’t say the person “went to
sleep” or “God took him” as the child may fear they too will die
if they go to sleep or that God might take someone else.
Answer questions. Encourage the child to ask questions and
try to answer them clearly.
Help the child express feelings. Children may not know
how to express their feelings or may be afraid to do so.
Assure them that it is OK to cry or feel sad or angry. It
will help if they see adults expressing their feelings.
Pay attention to your child’s actions. Children often act out
their feelings rather than talk about them. They may start to
act younger than their age. This is common and will most
often pass. If behavioral problems persist or are severe, seek
the help of teachers or counselors at school or get advice from
the child’s doctor.
Be patient and understanding. Like adults, every
child will react to grief differently. Some may need
longer to adjust.
Give lots of hugs. Touch helps your child feel
safe and gives them a chance to ask questions.
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Additional Resources
Supporting KIDDS
1213 Old Lancaster Pike
Hockessin, DE 19707
302-235-5544
supportingkidds.org
Postpartum Support International 24-Hour Helpline
(Llamar la PSI Postpartum la depression)
800-944-4PPD
302-294-2365
If you are in crisis you can contact the following numbers:
CAPES, Christiana Care’s 24-Hour Crisis Line
302-320-2118
National Suicide Prevention Lifeline
800-273-TALK (English)
888-628-9454 (Español)
Online Resources
Bereaved Parents of the USA bereavedparentsusa.org
Compassionate Friends
A self-help organization for families who experience a death of a child
compassionatefriends.org
Hanks Hope A local resource for women, their families, and friends affected by pregnancy or infant loss
hankshope.org
Helping After Neonatal Death handonline.org
Honored Babies
A webite with several support groups, including one for Grandmothers
Hygeia Foundation International Stillbirth Alliance A coalition working to promote stillbirth research, education and awareness
March of Dimes Miscarriage Matters honoredbabies.org
drberman.org/hygeiafoundation
stillbirthalliance.org
marchofdimes.com/Baby/loss.html
mymiscarriagematters.com
Perinatal Hospice
Helps prepare families who know their baby will die, helps create birth plans,
and cares for baby while dying and afterwards
perinatalhospice.org
Solace for Mothers (Birth Trauma & Recovery)
solaceformothers.org
Caring For Yourself After Loss 15
Caring for Your Emotions
Other Important Telephone Numbers
Christiana Care Pastoral Services
302-733-1280
Christiana Care Patient Relations
302-733-1340
Christiana Care Health Information Management Services
302-733-1111
Christiana Care Pathology
302-733-3681 or 302-733-3625
Medical Examiner
302-577-3420
Christiana Care Billing Dept. (Patient Financial Services)
302-623-7440
Christiana Care Birth Records
302-733-2391
Parent Education Lactation Resource Center
302-733-3360
Christiana Care Center for Women’s Emotional Wellness 302-733-6662
Christiana Care Psychiatric Crisis Help Line 302-320-2118
Domestic Violence Hotline 302-762-6110
Notes
16 Christiana Care Health System
Caring for Yourself
Caring for Yourself
It typically takes four to six weeks after delivery for your body to return to normal, but for some
women it may take longer. The first six weeks after giving birth is called the postpartum period.
Taking care of yourself is very important to remember at this time.
Please use the information in this booklet to help speed your recovery.
After delivery
You will bleed after delivery, similar to having your
period; this vaginal bleeding after you have a baby is
called lochia. You may notice more bleeding when you
stand up after you have been lying down. Sometime
after the first week, the bleeding will become thinner
and turn light red to dark pink. By the second week, it
will turn thicker and look yellow in color.
About four weeks after delivery the lochia will almost
disappear. Lochia has a slight smell but should never
smell foul or go back to a bright red color once it has
turned lighter. If this happens or if you bleed and
fill more than one pad an hour,­call your health care
provider. If you do too much activity, you may see
more bleeding.
Afterbirth pains happen when your uterus (womb)
begins to go back to its normal size after delivery.
18 Christiana Care Health System
It contracts (squeezes down) because it is a muscle.
This squeezing is sometimes called an afterbirth pain.
Some women say this pain feels like the cramping you
feel when you have your period. These pains typically
last no longer than two to three days. If this is not your
first delivery, these pains may be stronger than they
were the first time. These cramps are a sign that your
uterus is doing its job to keep the amount of bleeding
normal and return to its normal size.
Perineal care
The perineum is the area between your vagina and
rectum. You may have stitches and/or hemorrhoids in
this area after your delivery. Hemorrhoids are caused
by the weight of the baby’s head coming through the
birth canal. You can ease your discomfort and allow
faster healing from stitches or hemorrhoids by keeping
the perineum clean.
Wash the area with soap and water:
• First wash your hands.
• Fill the plastic bottle we have given you with warm
water.
• While sitting on the toilet, squeeze the warm water
over your perineum.
• Pat yourself dry starting in the front to your back
with clean toilet paper.
• Put on a clean pad.
• Wash your hands.
Sometimes we recommend using a sitz bath, which
is a basin filled with warm water. This can be used 24
hours after you give birth. Fill the basin 2/3 full with
warm water and sit, making sure that your perineum
is in the water for 15 to 20 minutes at a time. Do this at
least three times each day until the area feels healed.
Make sure you take your sitz bath home with you.
Use witch hazel pads to help soothe and clean the area.
Place a witch hazel pad on your perineum and rectum
after you clean your bottom and change your pad or
you may place the witch hazel pads on your sanitary
pad if this is easier for you.
A medicated spray to numb your perineum, can be
used for the first few days. Follow the directions on the
can. If there is an increase in swelling, pain and redness
around your stitches, call your health care provider.
Kegel exercises
Kegel exercises are important to build up the pelvic
floor muscles after delivery (tighten the muscles in
your perineum). These muscles stretch with pregnancy
and birth. Keeping these muscles strong helps stop or
lessen accidental loss of urine throughout your lifetime.
To do the exercise, tighten the same muscles that you
would use to stop the flow of urine midstream. Hold
these muscles tight for five to 10 seconds. Do this
exercise 10 times in a row, three different times each
day. This will give you benefits over your lifetime.
(You could try once to stop the flow of urine while you
are on the toilet but should not do this again and again
as you do not want to keep concentrated urine in your
bladder).
Bladder
You may see that you are emptying your bladder a lot
after delivery. This is how your body gets rid of extra
fluid. Refer to your discharge instructions for signs/
symptoms of a bladder infection.
Bowels
It typically takes two to three days for your bowel
movements to return to normal. Some mothers have
short-term constipation and a full feeling or “gas.”
You can help yourself by:
• Drinking plenty of fluids - especially water. You
need to drink at least eight to 10 glasses of water
or fluid a day.
• Eating fruits, vegetables and high-fiber cereals.
• Emptying your bowels when you have the urge.
Do not take a stool softener or laxative without
asking your health care provider first. Call your
health care provider if you are unable to have a bowel
movement.
Swelling
You can anticipate that your body will hold some
fluid after your delivery. Your body carried extra fluid
during your pregnancy. You most likely had IV fluids
during your labor and birth as well. You may see some
swelling in your legs. It is important to move around
afterward and you should put your feet up whenever
you are sitting. Drinking enough water will help your
body to get rid of the extra fluid.
Sex
Having sex while you are bleeding raises your chances
of getting an infection. Remember, you will need to
use some type of birth control if you do not want to
become pregnant again (See chart on page 20 - 21).
Changes in your hormones after birth may cause you
to have vaginal dryness. A water-based lubricant can
be used for comfort.
For six weeks following delivery do not put anything
(no sex, no tampons, no douching) in the vagina and
use sanitary pads only.
Caring For Yourself After Loss 19
Birth Control
Methods
When can
you start it?
Sterilization
Permanent procedure to prevent any more pregnancies
1. Tubal ligation in operating room
2. Essure procedure
3. Vasectomy
Now
Intrauterine device (IUD)
What is it?
How is it used?
Within 10 minutes
after delivery or
6 weeks postpartum
Plastic device placed in the uterus:
1. Paragard (Copper IUD) – no hormones
2. Mirena
Nexplanon
Now
Plastic rod placed under the skin in your upper arm
Now
A shot in your arm
Now
A pill taken by mouth
6 weeks
postpartum
A pill taken by mouth
6 weeks
postpartum
A small patch placed on your skin
6 weeks
postpartum
A flexible ring you place in your vagina
Depo Provera (Depo shot)
Progestin-only pill (“the minipill”)
Combined oral contraception (“the pill”)
Ortho Evra (“the patch”)
Nuva Ring
Condom
Male condom
physical barrier you place over the penis before sex
Now
Female condom
physical barrier you place in your vagina before sex
Diaphragm
6 weeks
postpartum
20 Christiana Care Health System
Rubber cup (with spermicide) you place in your
vagina (it covers your cervix) before sex
*Shaded area above identifies birth control methods which contain hormones.
How often do you
need to take it?
How well
does it work?
Side
effects
Ok with
breastfeeding?
Only once,
it is permanent
Greater
than 99%
- Very difficult to reverse
- Possible regret
- Higher risk of pregnancy outside the uterus
(ectopic) IF you get pregnant
Yes
Greater
than 99%
- May change periods
Paragard – may led to heavier periods
Mirena – may led to little/no periods
- Small risk of coming out
Greater
than 99%
- May change periods – may increase
spotting between periods
Discuss with
doctor or lactation
consultant
Discuss with
doctor or lactation
consultant
Paragard
Can be used for up to 10 years
Mirena
Can be used for up to 5 years
Can be used for
up to 3 years
1. Yes
2. Discuss with
doctor or lactation
consultant
Every 3 months
94%
- May change periods
- Possible weight gain
- May decrease bone density with long
term use
Every day,
same time!
91%
- Less bleeding, cramping, PMS with periods
- Possible headaches, acne, breast tenderness,
mood swings (less than with “the pill”)
Discuss with
doctor or lactation
consultant
Every day
91%
- Less bleeding, cramping, PMS with periods
- Possible headaches, acne, breast tenderness,
mood swings
Discuss with
doctor or lactation
consultant
Every week
91%
- Less bleeding, cramping, PMS with periods
- Possible headaches, acne, breast tenderness,
mood swings
- May be less effective if you weigh more than
198 pounds
- May cause skin irritation
Discuss with
doctor or lactation
consultant
Every month
91%
- Less bleeding, cramping, PMS with periods
- Possible headaches, acne, breast tenderness,
mood swings, change in vaginal discharge
Discuss with
doctor or lactation
consultant
80%
- Protects against sexually transmitted diseases
- May have vaginal irritation to latex (nonlatex condom does not protect against STD)
- May be uncomfortable
Yes
88%
- May have vaginal irritation to latex or
spermacide
- Not recommended for use during your period
- May get more urinary tract infections
Yes
With every act of
sexual intercourse.
With every act of sexual
intercourse; can be placed up
to 6 hours before, must leave
in vagina for 6 hours after sex
*Shaded area above identifies birth control methods which contain hormones.
Caring For Yourself After Loss 21
Caring for Yourself
Breast care
Depending on the length of your pregnancy, you may
make breast milk 2-5 days after giving birth. Here are
some tips on how to make you more comfortable and
prevent production of breast milk.
• Do not pump your breast or stimulate your
nipples, this will only raise your milk supply.
• Wear a well-fitting support bra, i.e. sport bra,
during the day and at night.
• You may wrap a towel around your chest and
have help pinning it tightly over your bra for
more comfort and support.
• Put ice packs or bags of frozen vegetables (wrapped
in a towel) over your breasts. You may do this for
20 minutes at a time 4-5 times each day.
• If ice packs do not stop the pain, talk with your
Health Care Provider about taking pain medicine.
If you have Steri-Strips, they may be removed if they
are falling off. You should remove them after one
week if they have not come off on their own. The skin
around your incision may feel numb and itch as it
heals. This is normal.
Incision care
• Wash gently with warm, soapy water. Rinse and
pat dry every day.
• Let your incision get air at least three to four times
a day.
• Look at your incision with a hand mirror. It should
look dry and closed.
Call your health care provider if you notice any
of the following:
• Redness, swelling and/or notice the skin is warmer
around the incision than other parts of your belly.
• You have a fever.
• When you shower, turn your back to the water
spray. The spray of water on your breasts can
cause you to make more milk.
• More pain or tenderness around the area.
• Call your Health Care Provider if you have or feel:
n A fever higher than 100.2 degrees,
taken by mouth.
• Opening of the incision.
nChills.
n Flu type feelings- aches, pain.
n Red painful lump(s) in your breast
that do not go away in 1-2 days.
Many women try other natural cures to help lower
their breast milk. Check with your health care provider
or a lactation consultant for more information. Call
Parent Education/Lactation Resource Center 302-7333360 for help.
• Severe pain in your belly.
• Any drainage from the incision.
Bathing/personal hygiene
You should use showers during your recovery period,
or you may also soak in a clean tub of warm, clear
water, no bubble baths. Do not douche. Do not use
tampons.
Diet
After you go home you should stay on your usual
nutritious diet.
After Cesarean surgery
Going home
After your Cesarean surgery (delivery of the baby via
an incision in your belly and uterus), you will have an
incision (a cut) in the lower part of your belly. Some
health care providers use staples to close the incision,
others use stitches. If you have staples, make sure to
call your health care provider for an appointment to
have the staples taken out soon after you go home.
If your health care provider used stitches, they will
go away on their own. Sometimes small narrow strips
of tape, Steri-Strips, may be put on the incision.
It is important to get rest so that your body can heal.
If possible, have someone to help you when you return
home. Your health care provider will tell you if you
have limits to your activity.
22 Christiana Care Health System
Please call your health care provider to make a follow
up appointment after your delivery.
Notes
Caring For Yourself After Loss 23
Notes
24 Christiana Care Health System
Scan this QR code to access
an online version.
P.O. Box 1668
Wilmington, DE 19899
302-733-1000
christianacare.org
Christiana Care is a private, not-for-profit regional health care system that relies
in part on the generosity of individuals, foundations and corporations to fulfill its
mission. To learn more about our mission, please visit christianacare.org/donors.
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