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Surviving birth: What to expect when you’re postpartum

January 25, 2020 • read

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Surviving birth: What to expect when you’re postpartum

Your baby isn’t the only lasting legacy from your pregnancy. From hair loss to newfound incontinence, carrying a baby can change your body in so many ways. Growing a baby takes a herculean effort, and giving birth doesn’t mean your body’s finished changing. Most new moms know to look out for mood changes that might signal postpartum depression, but there’s a lot more to your postpartum recovery. Let’s take a look at all the ways your body changes after giving birth.

Your uterus after pregnancy

During pregnancy, your uterus grows to accommodate your baby. So it follows that after your baby is born, your uterus will be larger than normal. This is part of the reason you’ll still look pregnant for a while after you give birth. For the first few days postpartum, you’ll feel small contractions or cramping, especially while breastfeeding (if you are). These cramps are actually your uterus shrinking back to its pre-pregnancy size. The uterus starts shrinking within minutes of giving birth, but it takes about six weeks to fully return to its previous size. If you’re concerned that your uterus is not shrinking after pregnancy or you still look pregnant after the two-month mark, speak to your doctor or your local pelvic floor physiotherapist. You may have diastasis recti — a common post-pregnancy condition in which a gap appears between the two sides of the abdominal muscles.

Bleeding and perineum care

Whether you deliver vaginally or have a c-section, you’ll experience bleeding after giving birth, otherwise known as lochia. This bleeding is how your postpartum body gets rid of any extra tissue and blood left over from pregnancy. Lochia is bright red, but turns brown and eventually yellow after a few days or weeks. You may also pass clots during the initial phase — this is completely normal as long as they are smaller than a golf ball. But if you find that clots are larger than that or that you soak through a pad in under an hour, contact your doctor — this might mean there’s another issue. Also, you shouldn’t use tampons for lochia — it can introduce harmful bacteria into the vagina as well as irritate the area.

Vaginal deliveries can cause tearing (in some cases you may have had an episiotomy). Either of these will make your perineum (the area between your vagina and your anus) quite tender as it heals. You can use ice packs or frozen pads in your underwear to soothe the area. Upgrade your padsicles with witch hazel and aloe to help speed up healing.

Postpartum body

While you may be anxious to lose your pregnancy weight, wait for your doctor or midwife’s go ahead before you start exercising. Pregnancy causes significant changes in your body and beginning an exercise regime too soon after delivery can cause more problems than it solves. Counter intuitively, abdominal exercises like crunches are the most damaging and can actually worsen conditions like diastasis recti. Try not to focus on post-pregnancy weight loss. It took nine months to put the weight on, so give yourself at least that much time to lose it. And stay away from restrictive dieting if you’re breastfeeding: not only will it affect your mood and energy levels, but you need all the nutrients you can get to stay healthy and feed your baby, too. 

Giving birth is physically strenuous, which means you’ll want to avoid doing certain things until you’re cleared by your doctor or midwife at your six-week appointment:

  • Lifting anything heavier than your baby;
  • Crunches, sit-ups, or other abdominal exercises;
  • Strenuous exercise;
  • Restrictive dieting (even after your check up);
  • Having sex; and
  • Inserting anything into the vagina, including tampons or douches.

Breast changes

Your body begins producing colostrum (the first thick, nutrient-dense milk newborns eat) before your baby is even born. Colostrum becomes milk three to five days after delivery, and your breasts will feel more full as your milk comes in. You may sometimes feel engorged as your postpartum body figures out how much milk your baby actually needs. While engorgement usually gets better on its own after a day or two, it can be quite painful while it lasts. Ice packs and ibuprofen can help, as can applying heat and hand expressing some milk to relieve the pressure. But be warned — your body will replace any expressed milk. So pumping or expressing milk can ultimately prolong engorgement. And prolonged engorgement can lead to clogs and mastitis, which can be extremely painful. For more info on common breastfeeding issues, check out our blog on the topic

Mood changes and postpartum depression

Your hormones will fluctuate in the days after you give birth. These fluctuations kick off a number of physical changes from getting your uterus to contract and shrink to producing breast milk for your baby. They can also affect your mood.

There isn’t one single cause of postpartum depression, but the physical and hormonal changes along with sleep deprivation and the intense feelings that come with having a baby, can trigger it. Postpartum depression is similar to regular depression, but the feelings tend to center around being a parent and concern for your newborn. Postpartum depression can strike anytime within the first year after your baby is born. Symptoms of postpartum depression can include:

  • Severe anger and irritability
  • Bouts of crying/feelings of extreme sadness
  • Difficulty or lack of bonding with child
  • Brain fog, difficulty concentrating, or thinking clearly
  • Feelings of hopelessness
  • Feelings of inadequacy as a parent
  • Thoughts of self-harm or suicide
  • Thoughts of harming your baby

Many new moms experience “the baby blues,” a period of emotional intensity in the weeks following the birth of their child. This is totally normal, and can include feeling more teary, angry, irritable, or sensitive than usual. Unlike postpartum depression though, the baby blues usually resolves within a few weeks. If these feelings don’t go away within a few months, it may be postpartum depression. Without intervention, symptoms of postpartum depression can become more severe and recur chronically. Getting help for postpartum depression can include counselling, medication, and support from family and friends.

The long-term outlook

The long-term effects of pregnancy on the body are varied and even weird. Everything from bigger feet to increased hair shedding (which is temporary, thank goodness). If you delivered your baby preterm (before 37 weeks), long-term effects also mean you’re at greater risk of heart problems. Your pelvic floor can also suffer long-term consequences, which can lead to urinary incontinence and pain during sex. But the long-term effects of pregnancy aren’t all bad: if you breastfeed, for every 12 months you nurse your baby, you cut your risk of developing breast cancer by four percent. And each full-term pregnancy that a woman carries reduces her risk of developing ovarian and endometrial cancer. Plus, there are pelvic floor physiotherapists and interventions for many issues that crop up.

Having a baby puts your body through a lot! You grow another human being inside your body, deliver it, and make food for it. And you do most of that on little to no sleep. Your body works overtime to do this, and how you care for your postpartum body should reflect that. So let those dishes pile up and feel free to leave those emails unanswered for a while. Having a baby is hard work, your first priority is taking care of them and yourself.

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