Haemorrhoids, varicose veins and constipation are all made worse during pregnancy. In the postnatal period, the levels of progesterone fall and these problems usually diminish. Eating a well-balanced diet with adequate fibre and lots of fluid will help lessen the discomfort of haemorrhoids and reduce the symptoms of constipation.

Creams such as Anusol or Scheriproct may be advised and helpful, although you will need a prescription to obtain Scheriproct. Washing thoroughly after bowel movements is important to prevent inflammation and soreness. If you suffer from varicose veins make sure you take plenty of rest with your legs elevated.

If you have been wearing support tights in pregnancy you should continue wearing these in the postnatal period, making sure to put them on before you get out of bed in the morning. Leg exercises encourage blood flow through the legs and should be performed regularly especially if you are not yet completely mobile.

Following delivery of your baby it can happen that when you laugh, cough, sneeze or even when your bladder is very full you may pass some urine accidentally. Pelvic floor exercises are important and you need to pay particular attention to performing these in the postnatal period.

You may need a referral to a physiotherapist if the situation does not improve. Controlling weight and constipation can also help. It is important to drink fluids regularly and empty your bladder frequently.

Initially following a caesarean section, pain and itching in the wound are common during the healing process. However moving, stretching and lifting too soon can possibly cause a reopening of the wound. Bleeding from the wound, discoloured discharge, excessive/increasing pain or foul odours are all reasons to seek medical attention. Antibiotics can be used to treat a wound infection if caught early.

Rest is important after a caesarean section, eating meals slowly, increasing water intake, avoiding spicy or fatty foods as you will need to avoid bloating, wind or constipation. Do not over-stretch, lift heavy objects, or use a vacuum cleaner in the first 4-6 weeks. Use caution driving following a caesarean section. Some insurance policies may mandate a specific time but many don’t.

In this case you need to be sure you can do an emergency stop, so sit behind the wheel and brake hard and if you feel no pain then it is very reasonable to drive. This is usually about three to four weeks for most women.

After the first week following the birth of your baby, postnatal blood loss will diminish, becoming more brown or pink in colour. After the second or third week it should become lighter brown or clear, before completely stopping. Your next period may start again within the first 6 weeks if you are bottle-feeding, while if you are breast-feeding it will usually be delayed.

Although the majority of significant postpartum haemorrhage cases occur within the first 24 hours of giving birth, some women will experience delayed postpartum haemorrhage in the initial weeks following labour. It is important to monitor your postpartum bleeding for any changes and to contact your Doctor/Hospital if you notice any of the following:

• You soak a pad in less than an hour
• You notice a foul odour
• You have clots that are the size of golf balls or larger
• You feel faint or dizzy

A well balanced diet, lots of fresh fruit and vegetables, pasteurised dairy products, well cooked red meat, chicken and fish. Avoid soft cheeses, raw or lightly cooked eggs, raw meat, shellfish. No liver, game or cured meats. Try not to have more than 200mgs of caffeine a day (2 cups of instant coffee or four small bars of dark chocolate). Herbal teas are similar, no more than 2 a day. No alcohol or illegal drugs.

After the birth more than half of all mothers suffer a period of mild depression called the blues. This may last for a few hours or at most for a few days before disappearing. It may recur due to stress or lack of sleep during the first year. Rest, exercise and nutrition are very important to minimise depression symptoms. Having a good support system from family and friends is essential.

Family or partner support is crucial to giving the mother time for herself. Remember your partner’s needs too, as men experience the emotional stresses of parenthood just as strongly as mothers do. Talk to each other, make time for each other. Postnatal depression requires expert medical support. You will need advice, reassurance and support.

Patients can present with fatigue or loss of energy, diminished ability to think or concentrate, diminished interest or pleasure in almost all activities, significant weight loss or weight gain when not dieting, or a decrease or increase in appetite. Patients can also present with insomnia or excessive sleepiness throughout the day.

Other features suggestive of postnatal depression include agitation, feeling despondent, feeling anxious or fearful, panic attacks, feeling very sad and crying frequently. If you feel that you may have postnatal depression, call your Doctor to find out what treatment might be needed, which might sometimes mean referral to a psychiatrist or mental health support midwife.

It is important to realise that postnatal depression is a real illness which can be treated successfully with antidepressant drugs. These drugs are not addictive. They make the unpleasant symptoms fade until they go completely. It is important to remember that all mothers recover from postnatal depression.