Expecting twins or multiples

It seems like more people are expecting twins these days, and there are stories on the news about triplets, quads and more. What’s going on here? And what should moms know if they’re expecting multiples?

If you’re expecting more than one baby or think you might end up with multiples due to beginning fertility medication or treatment, you’ll want to listen in.

Jade Elliott is joined by Dr. Helen Feltovich, a maternal fetal medicine physician with Intermountain Healthcare who specializes in high-risk pregnancies  to answer common questions about expecting multiples.

Is the Number of Twins and Multiples Increasing?

Actually, the number of multiples being born has decreased slightly in recent years, probably due to responsible assisted reproductive technologies.

What Increases Your Chances of Having Twins or Multiples?

While fertility medication or in vitro fertilization may increase your chance for carrying multiples, there are other factors, like genetics or demographics that can come into play.

  • Family history of twins or multiples
  •  Over age 35
  • Previous pregnancy
  •  Taller than average
  • Obesity – Body mass index of 30 or higher
  • African American women are slightly more likely to have twins

If you have multiple factors, your odds of having multiples, multiplies!

Types of Twins

Identical twins is the common name for “monochorionic” twins, which means one placenta. These twins result from the fertilization of a single egg that splits in two. Identical twins share all of their genes and are of the same sex.

Fraternal twins is the common name for “dichorionic” twins, which means two placentas. These twins result from the fertilization of two separate eggs during the same pregnancy. They share genes just like any other siblings. Fraternal twins can be of the same or different sexes.

The only way to really know if your twins are identical is through genetic testing. In some very rare cases, there can be identical twins that are different in some important ways, like sex.

With Good Prenatal Care, Most Twin Pregnancies Result in Healthy Babies

Most twins are delivered past 36 weeks. The estimated due date is at 40 weeks of pregnancy, and 37 weeks is considered term. Half of twins are delivered after 36 weeks, and half before then, either because of spontaneous labor or because of a maternal or fetal problem that requires delivery. Multiples higher than twins often arrive earlier.

Risks of Carrying Multiples

  • Preterm labor
  • Pre-eclampsia (high blood pressure)
  • Gestational diabetes
  • Miscarriage
  • Placenta complications
  • Fetal growth concerns, especially for monochorionic (identical) twins
  • Increased risk for postpartum depression or anxiety due to complications

Prenatal Visits Are Even More Important If You’re Expecting Multiples

When you’re expecting twins or multiples, your doctor will likely want you to have more prenatal visits than for a singleton pregnancy due to a higher chance for complications. You’ll also likely need additional ultrasounds and fetal monitoring during pregnancy to check for any complications. That’s why it’s important to not skip prenatal appointments.

When to See a Maternal Fetal Medicine Specialist

If your doctor is not comfortable with managing or delivering twins, or if you have additional complications, you’ll probably be invited to see a maternal fetal medicine (MFM) specialist. This is especially true if your babies are monochorionic (identical). MFM specialists are trained in obstetrics and gynecology like general obstetricians, but then they do an additional three years of training specific to high risk pregnancies and deliveries. If you’re expecting three or more babies, it’s highly recommended you see an MFM specialist.

If there is not an MFM specialist in your area, ask your doctor about consulting with one through telehealth. We try to keep patients close to their home.

Things to Do at Home If You’re Expecting Multiples

  • Take prenatal vitamins as you would for a single pregnancy.
  • Drink plenty of water to stay hydrated
  • Eat well. Don’t focus on the number of pounds to gain. Your provider will watch the weight of your babies with growth ultrasounds.
  •  Get enough exercise

Bed rest is not recommended just because you’re expecting multiples.

Be Aware of the Signs of Preterm Labor

If you feel more pressure or have cramping, bleeding, or are leaking fluid, or have decreased fetal movement, call your doctor.

Prepare for the Postpartum Period

Set up social support for after the babies arrive. Your chances of having premature babies or a Caesarean delivery are higher when you are carrying multiples. If your babies are born prematurely, one or more of your babies may need to stay in a neonatal intensive care unit. You may want to think about how close you live to a hospital with a NICU or ask your provider if they have access to telehealth consultations for your baby.

You may be at higher risk for postpartum depression or anxiety due to increased stress or complications.


Breastfeeding is best for babies, especially premature babies. It is possible to nurse multiples successfully. If breastfeeding is not working, there’s no shame in needing to supplement with formula.

For more information, here are some helpful links:





The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.

Take 2 – 19-year anniversary of 9/11, COVID-19 relief bill, high wind damage

The discussion on the weekly Take 2 podcast began with solemn commemoration of the 19 year anniversary of 9/11, a day when a series of four coordinated terrorist attacks by the Islamist terrorist group al-Qaeda against the United States included passenger airliners being hijacked and flown into the Twin Towers of the World Trade Center.

Podcast host Heidi Hatch, and former lawmakers Jim Dabakis (D) and Greg Hughes (R), recounted where they were Sept. 11, 2001, during the attacks.

The discussion then turned to current matters, such as the Senate Democrats walking away from the COVID-19 relief bill presented by the GOP. Is the deal dead until after the election – 53 day away?

Sen. Mitt Romney stated of the legislation:

We have an opportunity to either take steps to build on the important provisions we passed as a part of the CARES Act or we can do nothing. This targeted relief package, while not perfect, includes many important bipartisan provisions which would secure federal unemployment benefits, restart the Paycheck Protection Program, help parents with the expenses of childcare and homeschooling, and help our schools keep kids safe. Families, businesses, and communities in Utah need assistance now, not weeks or months down the road. I’m disappointed that my colleagues on the other side of the aisle would not at the very least vote to move forward with this legislation today so we could have a debate on the merits.

Sen. Mike Lee posted on Twitter that the bill wasn’t perfect but it is a start to “real reforms.”

Additional topics discussed are:

  • Trump knew it was worse than the flu. Does this change any minds?
  • Bob Woodward releases book “Rage.”
  • 5-15% undecided depending on poll.
  • Holy wind! Utah digging out from another mess. How are we doing at handling another crisis?
  • SLC schools push online start back a week with no power or WiFi.
  • Utah eliminates sexual assault backlog; 11,193 sexual assault kits tested, 5,025 DNA profiles entered into national database and 1,979 suspected identified through search of the DNA database. The turnaround time to process a kit is now 90 days instead of years
  • Western Wildfires: The left says climate change and the right says federal restrictions that don’t allow logging are to blame.
  • Real Housewives – Bravo releases the trailer. Who’s in to watch and is this good or bad for the great state of Utah?

Helping siblings adjust to a new baby

Having a first baby is exciting. Having a second baby and introducing them to the sibling brings its own set of stresses for some. How will the sibling respond? How best to introduce the baby to the family?

Jade Elliott spoke with Peter Lindgren, pediatrician, Intermountain Healthcare, to learn about the best ways to introduce a new baby to the family on this episode of hte Baby Your Baby Podcast.

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“It’s an adventure, and perfectly normal for parents to feel anxious about having another baby,” said Lindgren.. “My sister’s first response when I came home from the hospital was, ‘Send him back.’ But there also are many more stories of children who adore their new baby sibling, and often reflect the care and love that they have received.”

A new baby changes the family’s structure. Siblings might respond with feelings of betrayal or that they’ve been replaced or a regression in behavior. Mothers often experience a change in their relationship with an older child. Many fathers take on a more important role with older children, particularly as mothers feed a newborn.

There is no one recipe for how to introduce baby to his or her siblings. But here are some tips on how you can help children – and yourselves – through change:

Involve Siblings

– Before the baby is born, talk to your children about having a new sibling. For children under 2 years, it’s helpful to wait until the baby is closer to delivery (around 30 weeks of pregnancy).

– Read books together, such as “Peter’s Chair” by Ezra Jack Keats and “I’m a Big Brother/Sister” xx by Joanna Cole.

– Make caring for baby a team sport by including older siblings.

Reassure and teach

– Play it cool, but don’t be afraid to show your feelings. Children learn to navigate the world by watching their parents.

– Acting out is normal. Recognize the behaviors that you want to see.

– Jealousy can’t be avoided. Reassure, spend time with, hug, and make physical contact with older siblings.

– Keep your sense of humor!

More to think about

– Showering siblings with gifts is likely to make them feel like something really ominous is going on.

– Some wonder if the newborn should give a gift to the older sibling. Consider your older child’s personality before deciding.

Be Kind to Yourself

It’s okay to let your child respond in whatever way they are going to respond. Give them time to process their feelings, and yourself time to find your family’s new equilibrium. Remember that you get to do all of this in a sleep-deprived state, while recovering from a physically and emotionally intense experience. Above all, be kind to each other and yourselves.

For more information, please visit IntermoutainHealthcare.org.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.

Making it through morning sickness

So, you’re excited to be pregnant. You’re supposed to be glowing, but instead you look kind of green. If you feel nauseous or you just threw up, it’s probably morning sickness.

Jade Elliott spoke with  Hannele Laine, here an OB/Gyn from Intermountain Healthcare To help you know how to make it through morning sickness.

Morning sickness is common and may be under-treated

According to the American College of Obstetricians and Gynecologists, 50-80 percent of pregnant women experience nausea and 50 percent experience vomiting or retching.

Morning sickness may be undertreated. It often begins prior to the first appointment, so women sometimes wait for the appointment rather than asking for help. In addition, women may not seek treatment because they believe it is common and usually temporary or because they’re concerned about the safety of taking medications while pregnant.

What causes morning sickness?

The specific cause of vomiting during pregnancy is not known. One hypothesis is that it due to the change in hormones levels during pregnancy.

Common myths about morning sickness:

1. It only occurs in the morning. False: You can have morning sickness any time of day.

2. It’s resolves after the first trimester. False: A few women have it last into the second and sometimes even into the third trimester.

3. It harms the baby. False: Typical morning sickness does not harm the fetus.

What increases your risk of severe morning sickness?

Severe nausea and vomiting of pregnancy is called hyperemesis gravidarum. It is more likely to occur with these risk factors:

• A twin or triplet pregnancy.

• A previous pregnancy with nausea and vomiting.

• In women who have family members with nausea and vomiting of pregnancy.

• A history of motion sickness or migraines.

• Being pregnant with a female fetus.

Simple ways to help reduce morning sickness:

  • Eat small meals, every 1-2 hours to avoid a full stomach and to avoid hunger.
  • Eat bland, dry foods like crackers, cereal, toast or baked potatoes.
  • Eat some protein with every meal.
  • Avoid spicy or fatty foods.
  • Eat something before you get out of bed. Keep crackers on your nightstand.
  •  Take prenatal vitamins at night after a meal or switch to folic acid alone.
  • Avoid unpleasant smells as they may trigger nausea.
  • Try ginger capsules or candies, ginger ale or tea made with real ginger.
  • Wristbands that put pressure on or electrically stimulate a pressure point on the wrist may help.

How to prevent morning sickness from becoming severe:

  • Avoid getting dehydrated. Try taking little sips all day of something like Gatorade.
  •  Seek treatment early to prevent severe symptoms requiring hospitalization.
  •  Talk to your provider about how to manage your morning sickness and review possible medications that can help.
  •  Keep your prenatal visits and call if you are having trouble between visits.

When to call or see your provider:

• If nausea or vomiting is severe

• You pass only a small amount of urine or it’s dark in color

• You can’t keep liquids down

• You feel dizzy or faint when you stand up

• Your heart races or is pounding

• You’re losing weight

• If nausea or vomiting begins after nine weeks of pregnancy

Severe nausea and vomiting could be caused by something else:

Warning signs that your nausea and vomiting may be due to another cause:

• abdominal pain or tenderness

• fever

• headache

• thyroid enlargement or swelling on the front of the neck

• nausea and vomiting that occurs for the first time after nine weeks of pregnancy.

If you have severe nausea and vomiting, your provider may want to do additional tests to evaluate other causes of the symptoms. Some medical conditions can cause nausea and vomiting during pregnancy such as an ulcer, food-related illness, thyroid or gallbladder disease.

For more information visit: https://intermountainhealthcare.org/services/women-newborn/

For additional information, click here.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.

Take 2 – Is there a ‘conspiracy of silence’ in Utah politics?

2News Anchor Heidi Hatch hosts guests Jim Dabakis (D) and Greg Hughes (R) – both former Utah lawmakers – for another episode of Take 2.

The former lawmakers discussed the “conspiracy of silence”  in Utah politics and other topics including:

  • State of Emergency: It’s time to get government working as its designed;
  • Race for the Governor’s seat: Does Chris Peterson have a shot?
  • The pandemic and businesses;
  • Addressing homelessness in Utah;
  • Policing: Lawlessness the fountainhead of addiction?
  • Salt Lake City moves to the “yellow” phase on Friday.

Take 2 – Conventions, sports boycotts and Huntsman as a write-in candidate

2News Anchor Heidi Hatch is joined by former Utah State Sen. Jim Dabakis (D) and former Republican Speaker of the House, Greg Hughes, for another episode of Take 2.

Was the Republican convention at the White House illegal? Dabakis says yes, Hughes says no. And that’s not all they disagree about.

They go head-to-head on Utah’s 4th District GOP nominee Burgess Owens with Dabakis saying he has filed bankruptcy three times and Hughes responding with how charitable he is with starting a mentoring program for youth. They also grappled over topics including:

  • Attorney General Sean Reyes speech at the RNC,
  • “China Virus” – Who’s at fault?
  • Upcoming general election – Will Jon Huntsman Jr. be a write-in candidate?

Newborn care: the first few days at home

Bringing home a new baby is an exciting time for everyone in the family, and often a time with many questions.

Jade Elliott talked down with Dr. Kaitlin Carpenter a pediatrician from Intermountain Healthcare, to help guide new parents through those first few days when you may feel excited, yet overwhelmed about caring for this tiny, new, helpless human.

You probably have a lot of expectations about motherhood, but the most important thing is to be flexible. Babies are unpredictable, and in the beginning it may feel like everything revolves around what the baby needs. Give yourself time to adapt to your new life and eventually, you’ll settle into a new routine.

Sleep Strategies

Grandma’s suggestion of “sleep when the baby sleeps” really is true. As much as you can, take advantage of these breaks by taking a nap yourself. Babies often have “day/night reversal” and will spend the first few weeks up all night and sleeping more during the day.

Babies are safest when they sleep on their backs in their own bassinet or crib. Avoid co-sleeping or falling asleep with a baby under six months old in your bed. Do not smoke, drink alcohol, use illegal drugs or misuse prescription drugs. Studies show these practices help lower the incidence of sudden infant death syndrome or sudden unexpected post-natal collapse.

Weigh the Pros and Cons of Visitors

There can be a lot of pressure to have visitors, but it’s okay to set boundaries or say “no” or ask visitors if they’ve been ill, or ask them to wear a mask, especially during the COVID-19 pandemic, or flu and respiratory virus season.

On the other hand, having a newborn is a time to ask for help. Think who in your life you can rely on to safely give you a break when you need it. Having someone come hold the baby while you nap can be a lifesaver!

How Often to Feed Your Baby

One of the most common questions I get asked is if a newborn is eating too often. It is normal for newborns to “cluster feed,” especially at night for the first few days and then again during growth spurts. During these times, the baby may want to eat every 30-45 minutes for several hours in a row and that is normal! Go with it. The baby is the boss. Breastfeeding works by supply and demand. The more frequently you feed the baby, the more breastmilk you will produce.

Grandmothers know a lot and are a great resource for all sorts of things. Some ask if the newborn can have water, which we do not recommend anymore.

Newborns can be very loud. Grunting, tooting, sneezing, and hiccupping are all normal baby sounds.

Diaper Duty

Be sure to keep baby clean and dry by changing wet and soiled diapers. This will help prevent diaper rash. Baby’s first few bowel movements are called meconium and are dark black and sticky. Then as they begin breastfeeding or drinking formula, bowel movements become more yellow and runny. When cleaning baby’s bottom, wipe down away from reproductive organs to keep germs from getting into those openings. If your baby is not producing frequent wet or dirty diapers, call your provider.

Keeping Baby Safe

Remember that newborns cannot hold up their own head, so you’ll need to support their neck carefully when you’re holding your baby or handing your baby to someone else or placing your baby in an infant car seat, swing or stroller.

It is safe to take your baby on walks when you feel up to it. Getting outside for some fresh air and walking have positive physical and mental health benefits for the whole family. Make sure to secure your baby safely in a front pack or stroller. Try and keep your little one protected from the sun by keeping them in the shade. They are too young for sunscreen, so floppy hats and lightweight clothing can help.

Bath Time Bonding

Bath time is a great way for your partner to participate in baby’s care. You can use a baby bathtub to help make bathing easier and safer. Baby bath products and shampoo are designed for baby’s sensitive skin and to not irritate baby’s eyes. Be gentle and careful when bathing your baby. Babies are slippery when wet! Never leave your baby unattended in bathwater.

Some grandparents ask if alcohol swabs should be used to clean the belly button. We do not recommend that anymore. Just clean the area with soap and water. The remains of the umbilical cord will fall off naturally.

Newborn Skin Care

Most newborn skin peels a lot for the first few weeks. This is normal and nothing to worry about. You can apply baby lotion after their bath or put a little baby oil in their bathwater to help moisturize their skin.

Newborns get a lot of different kinds of rashes. Baby acne is common. Most rashes are not a big deal, but a few types may need treatment, such as herpes. If you are concerned about a rash, call your provider, ask about it at the baby’s well check-up or schedule a TeleHealth visit through Intermountain Connect Care.

Mom Self-Care

The newborn period is not as glamorous as many movies make it out to be. Embrace it! Your body has just gone through a huge transformation and will continue to change over the next months to years.

Remember to eat. Sometimes it’s hard to get in three meals every day. For breastfeeding moms, you are burning the same amount of calories breastfeeding as running a 5K every day, so don’t skimp on the calories!

Baby Blues and Postpartum Depression

Watch out for the baby blues. It’s normal for emotions to quickly go from up to down after having a baby, especially because of all of the hormonal changes and sleep deprivation. This should get better in a few weeks.

Post-partum depression or anxiety is something more serious and if these feelings persist, it’s important to talk to your doctor about them. If you find yourself spending more time being sad or anxious than being happy, or having a hard time feeling able to take care of yourself, or if you feel your emotions are keeping you from bonding with your baby, please reach out to your pediatrician or OB. We want to help, but it’s hard to know who is struggling unless you speak up.

Well Baby Check-Ups

Be sure to go to your baby’s well check-ups at your pediatrician’s office. These are normally recommended beginning at two weeks of age and then also at two months, four months, six months, 12 months, 15 months, 18 months and 24 months. Annual check-ups are recommended after age three. These check-ups help you know if your baby is gaining weight and growing and developing normally. This is also when your baby will receive important vaccines to prevent common childhood illnesses and important screenings are done for hearing and vision, etc.

Sibling Strategies

  • Older siblings can take some time to adjust to their new role. Make it a positive thing, saying “You get to be a big sister!” instead of “You aren’t the baby anymore.”
  • Expect some jealousy and maybe a developmental regression, especially if you have been working on potty training
  • As much as you can, let the older sibling help bring diapers or snacks to mom or have them “feed” their own baby doll during breastfeeding or bottle feeding.
  • A little one on one time with mom or dad goes a long way. Try to carve out time during the day to snuggle and give some undivided attention to your older child.

For more information visit: https://intermountainhealthcare.org/services/pediatrics/

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.

Take 2 – The Come Back Episode

2News Anchor Heidi Hatch reunites with former Utah State Sen. Jim Dabakis (D)and former Republican Speaker of the House, Greg Hughes.

The trio discusses topics that include what the former lawmakers have been up to since March and the current state of affairs amid a worldwide pandemic from the novel coronavirus. The conversation was lively and touched on the following:

Pandemic catch up:

What have you been doing since March?

How is the state doing with unemployment (New #’s out Friday)?

Back-to-school – was too soon?

Mask mandates

GOP primary is over or is it?

Will Huntsman run as a write-in?

Should he?

75 days until the election


Congressional races

Special Session

Legislators did not want to renew the state of emergency but the governor did.

Legislators called themselves into session: Does it matter?

Why was a $123 million funding bill submitted an hour or two before a vote?


All virtual – awesome or boring?

Who had the best speech?

Obama raking Trump over the coals. Was this a good look? 1st for a former President.


Defund Police?


Sleep strategies for pregnant moms

If pregnancy can make you more tired, why is it sometimes so hard to get a good night’s sleep?

Jade Elliott spoke with Hannele Laine, an OB/Gyn from Intermountain Healthcare,  about the reasons many women experience sleep challenges during pregnancy and some strategies to help you get a better night’s sleep.

Sleep disturbances are common in pregnancy, especially in the third trimester as your baby grows larger and it’s harder to get comfortable. Common problems include difficulty falling asleep, increased waking at night, experiencing lighter sleep and shortened sleep intervals of deep sleep, which can all leave you feeling less rested.

This is likely due to a combination of factors including hormonal, physical and emotional changes as well as medical issues related to pregnancy.

According to the National Sleep Foundation’s 1998 Women and Sleep poll, 78 percent of women report more disturbed sleep during pregnancy, than at other times. Another study found that 97 percent of women had an average of three wakings per night in the third trimester. Lastly, there is some evidence that inadequate sleep – less than five to six hours, may negatively impact pregnancy and labor as well.

Physical causes of sleep problems during pregnancy:

  • Nausea
  • Heartburn/reflux
  • Difficulty in finding a comfortable position
  • Increased nighttime urination
  • Restless legs
  • Leg cramps
  • Low back pain
  • Sleep apnea

Emotional reasons sleep may be more difficult during pregnancy:

Many women worry about the birth, balancing motherhood and work, adding another child to the family, relationship changes and more. In addition, anxiety and depression are more common in pregnancy and the postpartum period and are frequently associated with sleep disturbances. And the current COVID-19 pandemic has added additional worries for pregnancy, delivery and motherhood.

But, there is hope! There are many things you can do to improve your sleep, including behavioral strategies, counseling and sometimes medication. Be sure to discuss sleep concerns with your doctor, especially if it’s impacting your normal functioning at work or with your partner or family. If you are having depression or anxiety, there is good evidence that treating it during pregnancy improves outcomes for women and their babies.

Tips for better sleep hygiene:

  • Keep a regular sleep schedule.
  • Create a relaxing bedtime routine – dim the lights, take a warm bath/shower, practice mind-quieting techniques.
  • Reduce stimuli – no screen time on TV, phone, or computer for two hours before bed.
  • Practice mindfulness or meditation.
  • Exercise for a minimum of 20 minutes per day, but not close to bedtime.
  • Avoid naps late in the day.
  • Avoid caffeine in the afternoon or evening.
  • Create a comfortable sleep position with extra pillows for cushioning (between legs, under your tummy or back).
  • Plan for 7-9 hours of sleep.

Tips for pregnant women to improve their sleep:

  • For increased nighttime urination – decrease fluid intake in the evenings.
  • For heartburn/GERD – avoid food that are spicy, acidic or fried. Take an over the counter antacid such as Tums.
  • For leg cramps – avoid soda/carbonated drinks. Add a calcium supplement likeTums.
  •  For restless legs – if your iron level is low, ask your doctor about an iron supplement.
  • For sleep apnea — if you snore three or more times per week or your partner reports you stop breathing during sleep, talk to your doctor about testing.
  •  Discuss any herbal supplements or over the counter medications with your doctor.
  • If sleep issues don’t resolve, talk to your doctor about when sleep medications such as Unisom, Benadryl, or melatonin can be used during pregnancy.

Sleep post-partum is also an issue:

  • Babies wake every three hours on average. So even though the sleep you get tends to be better quality, it is very disrupted and therefore easy to have inadequate sleep.
  • Continue to practice good sleep hygiene postpartum.
  •  Go to bed at the same time as your baby if possible.
  •  Consider a morning walk to help with day/night rhythm.
  • Sleep when the baby sleeps during the day.
  • Ask your partner, friend or family to help you prioritize sleep. (They could watch the baby, or do laundry, grocery shopping, meal preparation, etc.)
  • Contact your doctor if you note increased anxiety or depression.

For more information visit: https://intermountainhealthcare.org/services/women-newborn/

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.

Tips for a healthy postpartum recovery

Pregnant women have a lot to think about during the three trimesters of pregnancy. Their changing body, preparing for labor and delivery, planning for the arrival of their baby and then caring for their newborn afterward. It’s easy for women to forget about the “fourth” trimester, or the recovery period for women after childbirth. There’s so much focus on the new baby, they might forget to take care of themselves.

Many first-time moms don’t know the questions to ask about what recovery is like, because they’ve never experienced it.

Jade Elliott spoke with Hollie Wharton, DNP, CNM, WHNP, Nurse Practitioner and Certified Nurse Midwife, to discuss what new moms should expect the first few days after childbirth.

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Want to listen on another platform? Click here.

 Vaginal deliveries

For vaginal deliveries, as the adrenaline of birth or the epidural begins to wear off, they’ll begin to feel achy and sore. You’ll want to continue to use sanitary pads for bleeding and ice packs for the vaginal/rectal area to reduce swelling and alleviate discomfort. Witch hazel pads help keep the area clean and promote healing of the area and related stitches. Apply Dermoplast spray or Dibucaine gel to provide additional pain relief. All of these supplies are provided in the hospital and you’ll want to take them home with you, and continue to use for the first week or so.

The first week or two you shouldn’t be overly active. You’ll want to get out of bed or off the couch and walk around a bit, at least four times a day to help reduce chances of blood clot formation, as you are still at increased risk for this during the first six weeks postpartum.

You will have bleeding after a vaginal delivery that starts like a period and then gets lighter in color and flow. If it gets darker or brighter in color or heavier, you’re doing too much activity. So, adapt your physical activity based on your flow and listen to your body.

Ibuprofen (Advil/Motrin) and acetaminophen (Tylenol) help with swelling in the uterus and the vaginal/rectal area and can help with achy muscles in the back and shoulders due to using those muscles during labor and delivery.

 Caesarean deliveries

If you deliver via Caesarean section, keep in mind, that is a major abdominal surgery. Prepare yourself to have an incision with either staples or stitches. Staples are usually removed prior to discharge, but stitching, both internal and external, will dissolve over the next four to six weeks. I recommend no heavy lifting of over 20 pounds for six weeks. Make sure to take care of your incision site and watch for signs and symptoms of infection, including foul odor at site, excess bleeding, severe abdominal pain and fever.

Bathroom habits

Constipation is typical after delivery. Take a stool softener twice daily for 1-2 weeks, or until bowel movements are soft and easy to pass without straining. During pregnancy women urinate frequently as a result of a large uterus sitting on the bladder. After childbirth, you may need to retrain your brain and bladder that you don’t have to go as often. A few days after delivery, you will notice your urinary frequency will continue to be similar to pregnancy. This helps rid your body of the additional fluid that can cause edema in your limbs.

The first few weeks: When to call your provider

If you had a vaginal delivery and are experiencing heavy bleeding, defined as soaking through more than one pad in an hour, call your provider. Other reasons to talk to your provider include pain with urination, foul vaginal odor, severe abdominal pain or fever.

If you have shooting pains up either leg, headaches, chest pain or vision changes, it could be a sign of a blood clot. A caesarean puts you at even greater risk for blood clots due to more sedentary recovery. If you experience any of these symptoms, go to the emergency room right away for evaluation.

Baby blues are common during the first two weeks after delivery. After this transitional period, those symptoms should resolve. If they do not improve, or if you ever experience thoughts of self-harm, please contact your provider immediately. Your provider can provide resources for help with mental health concerns such as panic attacks, depression, excess anxiety about your baby or significant sleep problems.

When to return to exercise and losing pre-pregnancy weight

You really need to rest for the first two weeks. Light walks are fine. Activity should increase as tolerated, while monitoring menstrual flow. Watch for physical symptoms to know your body is healing. At six weeks, you should be meeting with your health care provider for a checkup. We usually endorse regular exercise at this point as long you show appropriate signs of recovery. It takes nine months gain your pregnancy weight, so it is going to take at least nine months to lose that weight. Be patient with your healing.

Importance of self-care

New moms should continue to take their prenatal vitamins and focus on self-care and taking care of the baby. Let go of the housework and cleaning. Accept all offers of help. Let other household members help while you hold the baby.

Eating and drinking enough

If you are nursing, you’ll need an extra 500 calories per day. Drink two to three liters of water per day. This helps with fluid loss due to delivery, reduces swelling and is especially important if you are breastfeeding.

Sleep 8-10 hours per day

This can be a challenge with baby waking up at night. Take naps and sleep while baby is sleeping so you can get a collective 8 hours in a 24-hour period.


Be cautious about visitors. It’s ok to not have visitors until you feel ready and more rested. Make sure they have not had any symptoms of COVID-19, cold, flu, diarrhea, etc. Visitors should not have had any symptoms for three days. When you do have visitors, you can have them wear masks as a precaution, especially if you are indoors or cannot social distance.

Take a break

Take time for yourself. Go for a walk. Do something that helps you unwind. Get out and feel like a normal woman without your baby. It’s good for your partner to have bonding time with the baby.


In the hospital we have experienced nurses and lactation consultants that can help you with breastfeeding. You’ll be given a brochure of lactation consultants, listed by area that you can contact after you get home if needed. Your pediatrician could also provide this information.

You should call your provider or a lactation consultant if you have symptoms such as a fever or flu like symptoms. You may have a clogged milk duct or a breast infection called mastitis. You may have pain in one or both breasts. Red, tender hot spots are possible. You may need antibiotics.

Applying a hot compress before feeding can help. Putting the baby to breast is best. Try a different nursing position, such as the football hold. A cold compress afterward can help too. Ibuprofen or Tylenol will help. Avoid unnecessary stimulation of nipple.

To listen to the Baby Your Baby Podcast on breastfeeding, click here.

Postpartum check-ups

As midwives, we provide a two week check in by phone or video. We want to know how your recovery is going, how you’re doing physically and mentally, and answer any questions you or your partner may have. We also do an in-office check-up at six-weeks.

Birth Control

Breastfeeding is not considered an effective form of birth control. You ovulate before you have a period, therefore just because you don’t have a period, does not mean you cannot get pregnant. There are many forms of birth control that might an option for you. These include, options to start right after delivery, such as progesterone-only methods, and are safe with breastfeeding. You want to avoid estrogen in the first six weeks after delivery, as this can further increase risk of blood clot formation, but progesterone-only options are safe and effective. If you prefer an IUD, we don’t recommend placement until after six to eight weeks postpartum, so that your uterus can completely heal prior to insertion. This will reduce risk of complications.

To listen to the Baby Your Baby Podcast on birth control, click here.

Return to sexual intercourse

It is recommended to wait six weeks before intercourse to protect against unintended pregnancy and infection.

Changes to pelvic floor muscles

Kegel exercises and pelvic floor physical therapy can help those muscles that may be weakened after childbirth. Stress incontinence, or leaking urine when you cough, sneeze or exercise can occur after childbirth. It’s common, but it’s not normal. Exercises and therapy can make a big difference in improving symptoms and quality of life. Ask your provider about options if you are experiencing leakage of urine.

Abdominal muscle separation

Some women have abdominal separation (Diastasis Recti) that persists after six weeks postpartum. Your provider can examine your abdomen to determine and if you might benefit from therapy or treatment.

Settle into a routine

Even though the recovery period is not always easy and there are lots of adjustments, you’ll eventually settle into a new life and routine with your baby. Don’t be afraid during this time to reach out to your provider with questions and concerns.

For more information, click here.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.