<p> 这一段有很多网友在我的悄悄话信箱里询问：在美国医院生完孩子后能不能喝冰水？能不能坐冰袋消肿止痛？护士让马上洗澡行吗？能不能刷牙、洗头梳头？丈母娘或母亲签证不过，来不了美国帮忙时该怎么为妻子坐月子？妻子委屈地抱怨无家人帮助时怎么办？老美他们是怎么坐月子的？为什么她们不娇气、没有那么多的禁忌？难道中国人的体质就是弱吗？......</p>
<p>说实话，收到这些问题后，我沉默了好几天，一时不敢作答。我知道我的任何轻率的回答都可能被认为是对中国传统习俗的不忠不敬或称为挑战、反叛。若因此引起刚刚成为新爸爸新妈妈的夫妻的争吵，就更不妥了。所以我决定换个角度，说说美国医院给产妇们的护理和一些重要的出院指导（discharge instructions）。有无道理，大家自己判断吧。</p>
<p>医院的确给所有的产妇送来冰水---带冰块的真正的冰水。也送冰箱里的牛奶、Orange Juice，Apple Juice，Prune Juice等饮料给你喝。除了肉类蛋白质外，也搭配给你生菜沙拉（Salad）。最好的就算土豆泥了，是熟的、热的。没有开水、没有热鸡汤。这样的饮食供应的确使很多中国姐妹皱起了眉头。</p>
<br/><p> <strong>能喝冰水吗？</strong></strong></p>
<p>我喝了，因为我太渴了。护士递给我时我二话没说，一口气喝完后觉得人是那么地舒服。十三多个小时的艰苦产程，还一夜没睡，我不仅累还渴得要命。哪管它是冷的还是热的。你如果要遵守老祖宗的规矩不喝冰水，可以要求护士替你用微波炉热水。随着移民人数的增加，现在的很多医院都理解和尊重这种文化/传统习俗，都很好地训练着护士要尊重、满足各国移民的合理习俗和要求。</p>
<br/><p> <strong>可以用冰袋消肿止痛吗? </strong></strong></p>
<p>自然分娩的产妇都有不同程度的阴道/会阴撕裂（laceration或俗称tear）或婴儿太大而不得不做的会阴切开术（Episiotomy）。所以在你分娩后血氧等指标都稳定了被送到产后观察室（Postpartum Unit）时，那里的护士就会递给你一个冰袋（ice pack），指导你垫在会阴处消肿止痛。不能喝冰水，不能沾冷水，一切都用热水的中国习俗，使很多姐妹接受不了这冰袋的使用。但是请相信我，它的确能消肿止痛、帮助愈合，缩短你在医院的时间。有时候它比止痛药还管用。除了第一天（分娩后24小时内）的冰袋外，若是三度、四度的撕裂，加上严重痔疮的话，护士们还会教你用Sitz baths（温水坐浴盆坐浴）或加用 Witch Hazel compresses（一种草药温敷）和Tucks? medicated pads护垫来缓解伤口和痔疮（hemorrhoid）的不适。同样的，请相信我，它们的好处多过你的忧虑。</p>
<br/><p> <strong>能马上淋浴（shower）、洗头吗？</strong></strong></p>
<p>因人而异。若你的血压较低、失血多（护士会查看尿量和护垫，出血量大时会谨慎对待的！），护士不会让你洗澡的，就是上洗手间时也会指导你按铃，不能单独去，要让她看着（assist） 你以防你突然晕倒。但是一切正常时，及时清洗生产时身上的汗水和恶露(lochia)及以后溢出的奶水，保持身体清洁，可以避免细菌感染，有利伤口的愈合（水柱不要直接冲到剖腹产伤口处即可），也能减轻分娩的疲劳，睡个好觉。洗完头后用浴巾擦干、吹风机吹干。若一个月不洗头，汗水、灰尘、头皮屑等混在一起，头发该有多脏、多难闻啊，夏天时长头发结起团来都有可能。但如果你实在抗拒洗澡洗头，请使用护士发给你的peri-bottle，装满温水，每次如厕后冲洗会阴/肛门部位，保持清洁，防止细菌感染。</p>
<br/><p> <strong>能刷牙吗?</strong></strong></p>
<p>刷牙是必须的。饭后五分钟内刷牙/用牙线清牙是保持口腔卫生的好习惯。否则食物残渣留在牙缝中，在细菌的作用下发酵、产酸、会导致龋齿或牙周病、口腔溃疡等。</p>
<br/><p> <strong>能不能不吃青菜水果？我担心它会伤脾胃、寒牙齿。</strong></strong></p>
<p>我对各种蔬菜水果的寒、凉、热、毒性没有研究。只知道它们有各种不同的、人体需要的维他命、矿物质和纤维质等物。对产妇身体的恢复和奶水的成分有帮助。又能预防便秘。有进要有出嘛，再说会阴部位的伤口也不能因为便秘的用力而再度绷裂。所以吃不吃它们全由个人权衡利弊而决定。</p>
<br/><p> <strong>无家人帮助时丈夫怎样给自己的妻子坐月子？</strong></strong></p>
<p>这个问题其实不需太多的指导。因为我自己的两个孩子在美国出生时也没有母亲的帮忙（当时父亲中风，我不敢要求母亲来。婆婆在我认识我先生之前早已过世）。我先生那时是学生，很忙。但他只好晚上时用高压锅/大锅大批量地煮好肉类鱼类（排骨汤猪蹄汤鱼汤红烧狮子头等等），第二天替我剔掉油、倒出我要吃的份量。自己起来捞些面，加些蔬菜，汤汤水水煮在一起吃了。其实很多新爸爸们都做得很好。尽心尽力地照顾着自己的妻子和新生儿，享受着初为人父的喜悦。美国公司也允许员工带薪请一到两星期的假照顾分娩后的妻子的。我在这里却要提醒各位姐妹，晚上尽量自己带孩子，辛苦些起来喂奶/换尿布/哄孩子，让先生们可以睡好睡足，第二天精神饱满地、平平安安地开车上学或上下班。</p>
<br/><p> <strong>什么是产褥期（"月子"）？</strong></strong></p>
<p>产褥期是指从分娩结束到产妇身体恢复至孕前状态的一段时间。在正常的妊娠过程中，胎儿及胎盘娩出后，子宫就会开始复位，胎盘剥离的创面的完全愈合大概需要六周的时间，因此把产褥期定到产后的六周，也就是说从胎儿娩出后到产后的六周这个时间叫做产褥期，民间俗称"月子"。美国也是相同的。若无伤口感染或出血或剧烈疼痛等症，指定六周后到产科医生复查，叫six-week postpartum visit。</p>
<br/><p> <strong>实际上，美国人也"坐月子"的。</strong></strong></p>
<p>从在医院开始，就让你多休息。如果你不希望电话或来访者的干扰，只要你一说明，电话就会在某一时段打不进来，来访者将被挡在门外。回家后也鼓励你多休息，将窗帘挂上，拔掉电话，搂着小宝宝甜甜地睡上一觉，保障精力充沛。（Remain in your bathrobe or lounge wear for the first week at home and rest whenever possible. New babies tend to be more awake at night than during the day for the first three weeks, so be prepared to rest when your baby sleeps. ）</p><p>找人帮忙：让家人或兄弟姐妹帮助买菜做饭清洁卫生等工作。让朋友或邻居帮助带宠物去散步，或带上大一点的孩子去公园等。（Let family members or others help with household chores, such as, laundry, cooking, shopping, cleaning, etc. When friends offer to help, let them! ） </p>
<p> 让配偶请二周的假或同时雇小时工帮忙。（If possible, arrange to have your partner take one to two weeks off after the baby arrives. If possible, hire outside help for a few hours during the first weeks, even if your partner will be off work and helping. You will both need some time to adjust and be with the baby. ） </p>
<p>尽量简化生活。用纸盘纸碗，叫外卖等。（Make life as simple as possible by using paper plates, take-out food and delivery services. Take it easy! ）</p>
<p>注意饮食搭配。（Review your diet to be sure you have enough protein, calcium and iron in your diet. For more information on calcium and iron, ask your health care provider about calcium and iron supplements.）</p>
<p>注重产后锻练。保健医生会指导剖腹产妇如何用特殊的姿势弯腰、下蹲和提重物，减少对肌肉韧带的损害及自然分娩的产妇要尽快地做凯格尔运动(Kegel exercises)，加快恢复，防止子宫下垂和以后的尿失禁。 </p>
<p> 不管是母乳还是用奶粉喂养，都有Support Group或Lactation Consultant或Lactation Hotline or Program交流和指导新妈妈如何处理乳头红肿、乳腺发炎和涨奶等常见问题及答疑，让新妈妈们更好地照顾自己和新生儿。</p>
<p>最后看两个出院指导（discharge instructions）。它们也强调休息和让身体恢复的重要，不是毫无禁忌的。</p>
<p> <br/><p> <strong>1. 自然分娩后何时恢复日常活动?
<br/>
</strong>
<p>Resuming Usual Activities Following Your Vaginal Birth:
</strong></p>
<table cellspacing="1" cellpadding="1" border="1">
<tbody>
<tr>
<td width="150"><p>Baths<br />
(泡澡)</p></td>
<td><p align="left">Two weeks — this allows time for healing to occur, although sitz baths are OK immediately after delivery.</td>
</tr>
<tr>
<td><p>Showers<br />
(淋浴)</p></td>
<td><p align="left">Immediately</td>
</tr>
<tr>
<td><p>Lifting<br />
(>15 pounds)<br />
(提15磅以上的重物)</p></td>
<td><p>One week, give yourself permission to rest and recuperate from the “work effort” of labor. Do not try to do too much too soon.</td>
</tr>
<tr>
<td><p>Walking<br />
(走)</p></td>
<td><p>Immediately</td>
</tr>
<tr>
<td><p>Climbing stairs<br />
(上楼梯)</p></td>
<td><p>Immediately</td>
</tr>
<tr>
<td><p>Sexual intercourse<br />
(性生活)</p></td>
<td><p>After six-week postpartum visit/instructions. Remember, you can become pregnant even if you are breastfeeding. We recommend that you wait until after you see your obstetric care provider.</td>
</tr>
<tr>
<td><p>Home activities <br />
(家务活)</p></td>
<td>Give yourself permission to rest and recuperate. <br />
Wait two weeks before you resume strenuous cleaning activities.</td>
</tr>
<tr>
<td><p>Driving/travel (local)<br />
(短途开车/旅行)</p></td>
<td><p>Immediately, if you can walk without discomfort and are not dizzy or bleeding excessively, the short drives will do no harm. On the other hand, having a friend or relative drive you around may be preferable.</td>
</tr>
<tr>
<td><p>Driving/travel <br />
(long distance)<br />
(长途开车/旅行) </p></td>
<td><p>After six-week postpartum visit/instructions.<br /></td>
</tr>
<tr>
<td><p>Back to Work<br />
(回去上班)</p></td>
<td><p>After six-week postpartum visit/instructions.</td>
</tr>
</tbody>
</table>
<br/><p> <strong>2. 剖腹产后何时恢复日常活动?</strong></strong></p>
Resuming Usual Activities Following Your Cesarean Birth:<br />
<br />
<table cellspacing="1" cellpadding="1" border="1">
<tbody>
<tr>
<td width="100"><p>Baths<br />
(泡澡)</p></td>
<td><p>Two weeks — this allows time for healing to occur.</td>
</tr>
<tr>
<td><p>Showers<br />
(淋浴)</p></td>
<td><p>Immediately, but allow water to run gently over your incision, not hit it directly.</td>
</tr>
<tr>
<td width="150"><p>Lifting<br />
(>15 pounds)<br />
(提15磅以上的重物)</p></td>
<td><p>After postpartum visit/instructions — although your abdomen looks well healed, your inner tissues and muscles require at least six to eight weeks to resume their usual strength. Do not risk injuring these healing structures by exerting yourself.</td>
</tr>
<tr>
<td><p>Walking (short distance)<br />
(短距离走路)</p></td>
<td><p>Immediately, but pace yourself and do not allow yourself to become fatigued or overly tired.</td>
</tr>
<tr>
<td><p>Climbing Stairs<br />
(上楼梯) </p></td>
<td><p>One week, except when obviously necessary.</td>
</tr>
<tr>
<td><p>Sexual Intercourse <br />
(性生活)</p></td>
<td><p>After six-week postpartum visit/instructions. Remember, you can become pregnant even if you are breastfeeding. We recommend that you wait until after you see your obstetric care provider.</td>
</tr>
<tr>
<td><p>Home Activities <br />
(家务活)</p></td>
<td><p>Give yourself permission to<br />
NOT do housework — four weeks at least!</td>
</tr>
<tr>
<td><p>Driving (local)<br />
(短途开车)
</p>
</p></td>
<td><p>Three weeks — you must be able to apply the brakes without experiencing ANY hesitation due to abdominal pain or pain from your incision. Practice this in the car before actually going out for a drive. You must be able to react rapidly to any automobile emergency. Do not take any chances. Let someone else drive.</td>
</tr>
<tr>
<td><p>Driving (long distance) <br />
(长途开车)</p></td>
<td><p>After six-week postpartum visit/instructions.</td>
</tr>
<tr>
<td><p>Travel (local) <br />
(短途旅行)</p></td>
<td><p>Two weeks, let others come to you.</p></td>
</tr>
<tr>
<td><p>Travel (long distance)<br />
(长途旅行)</p></td>
<td><p>After six-week postpartum visit/instructions.</td>
</tr>
<tr>
<td><p>Back to Work<br />
(回去上班)</p></td>
<td><p>After six-week postpartum visit/instructions.</td>
</tr>
</tbody>
</table>
<p>美国产妇在月子期间也是有禁忌的。我的美国护士同事们是严格遵守上面的规矩（discharge instructions）在家休息的。六星期后看完医生（six-week postpartum visit </strong>）回来上班或继续休两星期的假。你在超市里看到的刚生完孩子就拎着Infant Carrier里红红脸蛋的Baby一起Shopping的年轻产妇还是少数的。我们不学她们！
<p> 好好休息、尽早下床适当活动、做轻微的家务、照顾好自己和宝宝、尽快恢复。 |
北美产妇的月子
