Who's body is this? The postpartum body - Changes you may not have expected
Recently I have been working with a lot of brand new mama’s, which is super exciting and also got me thinking about women’s bodies post labor and all the things big and small that go through changes. This also got me thinking about how it would have been nice to know what to expect. I mean no one told me how my sweat would turn into this awful foul smelling mess. I mean I have to wear deodorant now! Thanks kid. So lets dive in a touch on some of the lovely and not so lovely things to expect with your body once the little bundle has arrived.
Lets just start right out of the gate with the big one—-Vagina!
Vaginal Soreness-Ummm I know seems like a duh but seriously it doesn't really hit home till you get home and all things are quiet and you realize your crotch is an open wound and it hurts. The perineum-the area between the vagina and the rectum, will have gotten stretched and possibly torn. Yeah that is painful. Another very common occurrence is receiving an episiotomy, which is where the Dr. may have to make a small cut to widen the vagina to make more room. If this procedure is done then often there will have to be stitches to repair. So now you have been stretched and sewn-ouch!
Vaginal Discharge- Discharge and bleeding are part of the “cleaning” process after baby. In the next days and weeks after baby arrives your body is adjusting. The bleeding and discharge are your body cleaning itself out and getting rid of extra blood and tissue that was nourishing the baby. Initially the blood will be a bright red color and that will last for a few days. The color will change to pink or brown color and eventually transform into a kinda yellowish more creamy discharge and then be gone. Another common thing is passing clots and some of them can be as large as a plum!! That is huge and normal (no one told me that or maybe they did in my postpartum daze). This is different then bleeding. If you feeling like you are having to much bleeding postpartum reach out to your dr right away.
After Pains- After your baby is born your uterus will begin to reduce in size and return to its pre-pregnancy size, this process is called involution. By the end of labor it will have already reduced to the level of your bellybutton and after only one week it will be the level of your pubic bone. That is crazy to think about. What has taken nine months to stretch will have reduced back to normal size in only one week. After pains were a huge thing for me that no one told be about and I would have loved to have been given the heads up on. No one told me that I could have contractions for a few days after arrival!! They are no joke either, or at least they weren’t for me. My reading online after said, “you may have cramps like during your period.” Well ladies I am calling bull hockey on that one. Mine were full on contractions, which I would swear on my daughter's head, were worse than labor. (Not to scare you.) This is normal though. The pain is caused by your uterus shrinking down to its normal size. In a matter of a few weeks your uterus will go from about 2.5lb to only a few oz. The cramps for some moms can be worse during breastfeeding because this can trigger the release of oxytocin which helps stimulate the uterus to shrink.
Changes in Stool and Urination and Hemorrhoids- As if we don’t have enough going on downstairs, cuz we just had a baby, things get more interesting when you realize that you still have to pee and poop. One of two things is possible when poo is involved.
Constipation-Some moms will experience constipation. This is often common if you have or are using pain medications. This can be really challenging if you are struggling with hemorrhoids because straining is definitely not ideal. We will chat about what we can do to help this later on.
Diarrhea and leaking of gas can also be a challenge for some moms. This is due to stretched tissue of the rectum caused by the added pressure of having a baby. Over time it should get better as your muscles and body heal. Like with most things if it doesn’t improve see your dr.
Trouble with urination and incontinence are also very common after birth. One common problem is difficult urination because of the fear of it being painful and burning. It may also be due to the strain that was placed on the muscles of the pelvic floor. The other end of the spectrum is not being able to hold your urine or dribbling urine when you sneeze, cough, etc. Again this is related to the pelvic floor muscles and this can be strengthened and rebalanced.
Hair and Skin Changes -Hormones, Hormones, Hormones! As your body's hormone levels are figuring themselves out your hair and skin can change, heck why not everything else has!
Hair- it is very common for you to experience hair loss and thinning. Most of hair loss happens for the first 3-4 months and for most mammas it will slow down after that. Some people changes in their hair texture. My best friend, for example, has her curls relax! She ween from very tight heavy curls to post baby waves.
Skin changes- Some common conditions that moms may notice are
Hormonal acne-yes back to being a teenager. This was me. Never had acne as a teen and now my skin is like a thirteen year old.
Melasma which is hyperpigmentation- often caused by UV exposure, genetics and elevated estrogen and progesterone levels combine to create a darkening of skin on lighter-toned faces and lighter patches in the darker skinned.
Facial spider veins after pregnancy- caused by increased blood circulation and hormone levels highlight facial veins in a spider-like effect
Dry skin
Sweating- An increase in sweating at night is also a very common occurrence. This is often, once again a response to hormones adjusting. I personally experienced changes in my sweats odor. I never used to be a stinky person but, thanks kiddo, now I am a stinky mom. Like many of the changes we experience it is related to hormone changes.
Breast Changes- Common changes in the breasts
Increased in size, darkened areola, small bumps around the nipple and hardening of nipples
Asymmetrical breast size and/or stretch marks
Achy and tender breasts or engorged breasts-engorged breast can be really painful. Your breasts can get so full of milk that they feel like they are going to explode. I used to have to self express some milk just to relieve some of the pressure.
Blocked milk ducts- this can be really painful but the use of warm compresses and massage can usually take care of this.
Sore or cracked nipples
Mastitis- this is a condition that you will most likely need to see your dr about. Mastitis usually makes you feel really crappy and can need antibiotic sometimes.
Fatigue- Fatigue may seem like a no brainer in this situation but what I want you to remember is that your body just went through a trauma and trauma requires healing and healing takes energy. So keep in mind that not only do you have an amazing little baby to tend to but you have a healing body to tend to as well. Self care, Self care, self care. Rest at all possible moments. When that baby is asleep you should take a nap, bath, a v-steam.
Prolapse- Prolapse can occur when then pelvic floor muscles have been overstretched and weakened enough that they can no longer hold the organs in their rightful positions. According to the Mayo Clinic uterine prolapse occurs because of, “ the weakening of pelvic muscles and supportive tissues.” ) This is serious condition and you should consult with your dr about next steps. Depending on the severity of the prolapse you may just need physical therapy, acupuncture may be helpful or at the worst surgery.
Causes of weakened pelvic muscles and tissues include:
Pregnancy (Obviously)
Difficult labor and delivery or trauma during childbirth
Delivery of a large baby
Being overweight or obese
Lower estrogen level after menopause
Chronic constipation or straining with bowel movements
Chronic cough or bronchitis
Repeated heavy lifting
Gory details aside there are also some very important things to remember and look out for during your recovery time at home. The United States is the only developed country where the maternal mortality rate has actually increased. I personally think part is due to neglect on our healthcare systems, unrealistic expectations and lack of access to postpartum care and health care equity. This is crazy to me!
Listed below are some very important things to watch for.
Important things for you and your support people to watch for.
If any of these symptoms happen, call your doctor or go to the ER right away!
Fever over 100.4 Fahrenheit or chills
Foul smelling discharge, bright red bleeding that last for longer than 3 days after delivery, clots that are larger than a plum, if you have bleeding that you would need more than one pad in an hour
Increased pain in the perineum, swelling or difficulty with stitches
Blurry vision
Severe headaches or fainting
Any trouble with C-section incision, redness, discharge, pain, etc
Warmth, swelling, redness with any of your limbs
Warm, red or painful areas on breasts
Any trouble breathing
Any signs of postpartum depression such as: being unable to cope with everyday situations, thoughts of harming yourself or your baby, feeling anxious, panicked or scared most of the day.
Look at all the fun things you have to look forward to! Next time we will talk about emotional health post partum.
Good luck & don’t forget your acupuncture!