Welcome to motherhood. Nothing that can be written will ever accurately describe the roller coaster of emotions, physical pain, or how one copes with each change to life as it all comes rushing forward. But women try because after every birth, no matter how many births a woman experiences, something is different. Something will catch her off guard and she will search for answers to know she is not alone.
This is the tribe of motherhood. No woman is completely alone in the chaos of messy hair that keeps falling out. The late nights watching travel shows because she wants to remind herself of the outside world, besides the fact her baby has finally fallen asleep in her tired arms and it is the first time in 6 hours the child has not cried. She becomes more than a little nocturnal, and steals naps like a robber at night. These are the moments in postpartum that feel normal but hard, and foggy but real. Every concern is valid. Every thought is valid. Here are some things even mom pros might have some questions about after having a baby.
Postpartum bleeding or lochia is basically one of the heaviest periods of a woman’s life. After going roughly 40 weeks without having a period the uterus expels all the blood and tissue it accumulated. For some women, it can last for the whole six weeks it is expected to take for recovery. During that time women are advised to use only pads to reduce the risk of a bacterial infection that can be caused by using tampons. It is the same reason they are advised against having sex for the first 6 weeks.
What a new mom can expect is heavy bleeding especially through the first 48 hours. Blood will go from bright red to dark red, then brown and maybe yellow in color as it ends. Blood clots about the size of golf balls are normal. This bleeding can gush intermittently or flow and taper gradually. Most women only have to deal with this bathroom horror scene for about 3 to 4 weeks. However, if a woman still experiences bright red blood after four days she should call her doctor. If she is having blood clots larger than a golf ball and she is bleeding through a sanitary pad every hour, this could be a sign of late hemorrhaging, and she should call her doctor. If she experiences fever and chills and foul smelling lochia, she should call her doctor. If the mother at any time begins to bleed so badly she feels faint, she should call 911.
For the last nine months, the uterus stretched to accommodate a full-sized baby. After it pushes the baby out the uterus will resemble a deflated balloon. So, now that it’s most important job is over, it needs to go back to being a nuisance every month. So, it does what every woman knows so well and cramps.
Postpartum uterine cramping may feel a little stronger than normal monthly period cramping. That statement is even more true for moms who have already given birth once before. Like a runner after a marathon, it is sore and tired and just wants to go rest. If the soreness seems too uncomfortable sometimes urinating can help. A full bladder can displace the uterus just enough to cause some pressure and discomfort. A breastfeeding mother may feel cramps while the baby is sucking. The hormones that produce breastmilk are the same that help the uterus contract. Think of it as a positive thing.
During pregnancy, the bladder takes a beating. From being pushed around by the uterus and kicked by the baby, the poor little balloon could have a little trouble recovering. For the first couple of days, especially while a mother is still under care, the provider may be monitoring her urine output. Some women have trouble with urine retention. With severe cases, the woman will have to be catheterized if she cannot pass urine on her own. Though, some women have the opposite problem. Postpartum incontinence is something many women know as a truth of life and make due the best they can. Do not be surprised to leak urine after childbirth. However, long after the postpartum period is over, panty liners have saved many moms during allergy season when sneezing happens. Urine leaking can happen when lifting heavy objects, running, squatting, and laughing. Women should keep their doctor updated on these issues and ask if certain medications may be able to help.
Just like with urinary issues, bowel issues show up very similarly. Right after the birth, it is normal to have trouble passing a bowel movement. The muscles that help guide all of that along are the same muscles that just pushed a baby out. Women are advised to eat a high fiber diet with a lot of water to help pass things along. Some women are given stool softener which can help a great deal, and should continue taking the pills for a few days after they have had their first successful bowel movement. However, some women are met with the opposite problem and experience incontinence especially if there was a perineum tear. This problem is usually not an enduring issue, but should still be discussed with a doctor.
The area between a woman’s vaginal opening and anus is called the perineum. During pregnancy, the weight of the baby puts pressure on the area. During delivery, the area is stretched. In some births, the area remains in tact but later it is swollen. If the baby come out too fast or the baby is a big baby the tissue from the vaginal opening can tear into the perineum. If the doctor preforms an episiotomy, an incision made to make more room for baby, this is the tissue that will be cut.
Postpartum perineum is usually very swollen no matter if the tissue was cut, torn, or remained intact. Sutures may have been needed to stitch the area back together. To ease discomfort, wear lose fitting clothing, some women find comfort using witch hazel soak pads that they keep in their freezer, or sit on a pillow. There can be pain or uncomfortable pressure in that area if the new mom stands or walks for long periods of time. Though it is not always feasible, laying down and resting is always recommended whenever possible.
The painful truth is many women will get hemorrhoids during pregnancy or postpartum. The hormones released in the body cause veins to relax and blood to pool. Therefore, providers warn against blood clots, and hemorrhoids occur. Combine that with the pressure of carrying a baby and the trauma of pushing that baby out, hemorrhoids happen. Usually, a small grape-like mass can be felt and it will be painful to pass a bowel movement. Some rectal bleeding can occur especially when passing bowels.
Over the counter medications can be used to ease pain and discomfort. If a woman has had a tear or sutures she should contact her doctor first before introducing any cremes or suppositories to the area. Using an ice pack wrapped in a soft cloth can help bring down swelling. Over the counter pain medications like Tylenol and ibuprofen can help as well, women should avoid aspirin if they are breastfeeding. In some cases, surgical removal of the hemorrhoids will be necessary.
Whether of not a mother chooses to breastfeed, her breasts will still go through changes. If she chooses to breastfeed she will need to stay hydrated and well fed to produce enough milk. That is when she is really eating for two. She will need to either nurse or pump milk every couple of hours to keep supply up and to prevent clogged ducks and a possible infection called mastitis. If she elects not to breastfeed, or physically cannot breastfeed for many different individual reasons, she will need to still watch out for breast engorgement and mastitis. Again, keeping hydrated and eating good food is still so important.
Leaking is completely normal, especially at night. Many women report waking up in a puddle of milk. Leaking is normal if the new mom is feeling emotional. During these times a breastfeeding mother can take advantage of this and either feed her baby or express milk. Nursing during times of upset can actually make the mother feel better, since nursing releases oxytocin. If she does not feed her baby breast milk, then a warm compress and over the counter pain medicines can help relieve discomfort. One old wives’ tale that many women swear by still is using cabbage leaves in their bras to reduce engorgement.
Something that many women talk about during the postpartum period is hair loss. Stories of clogged drains and full hair brushes are on the lips of every woman who when through the worrisome period. They worry it will never end, that they will literally lose all their hair. So, it should be expected, no reason to worry, right? Well, yes and no.
Postpartum hair loss is usually at its most dramatic around three months but it can start and last anywhere between there and 6-12 months as well. Most of the time this is completely normal, though a troubling time in any new mom’s life and rightfully so. Obviously, women have strong attachments to their hair. So, when she starts losing fistfuls of hair she will worry something could be wrong. If hair loss is accompanied by fatigue, a painless throat goiter, or depression and anxiety she should consult her doctor about a possible postpartum thyroid problem. This condition effects an estimated 7% of all postpartum women.
In today’s world of women being super moms juggling work, school, kids, and home life, it is easy to forget that help can be a needed and welcome gift. Accepting help forms and strengthen bonds. Women who have strong relationships with friends and family are less likely to suffer from postpartum depression for a long time without intervention. Babies exposed to different people at a younger age can be less codependent on exclusively their mother.
Something surprising that happens to very independent mothers is learning to accept and ask for help. Get together with a friend or relative and create a call list. Create a schedule for friends and family to come by after the baby is born and help. They can hold the baby and mom can sleep for a little bit. Food and naps are always welcome. Never turn down a helping hand.
It is the most common theme in postpartum stories, sleep deprivation. Stories of a special needs baby, a high needs baby, a baby with colic, a baby that has acid reflux all riddle online forums with desperate parents asking one thing. How do we sleep? They drive out at 3 A.M. to sooth the crying baby, they do everything the books say, they try white noise, no noise, night light, complete dark, and still that baby cries.
Sleep deprivation can have some disturbing side effects. It is not advised to operate a vehicle if one has had little to no sleep. Sleep deprivation can lead to anxiousness and insomnia even if the parents do have the opportunity to rest. Some cases of sleep deprivation can lead to hallucinations. In others, the continuous interruption of sleep can lead to postpartum depression.
A mother worries all the time. Anytime she is not moving, she worries; about what would happen if she reached out for help. Would she be judged? Could someone take her baby? The answers to both of those questions, are no. Because luckily, many women have been reaching out for help, and PPD is a very real reality now.
Something to understand about postpartum depression is it can come in many different forms. Anxiety, OCD, insomnia, rage, and feeling like she is in a fog are all some signs of postpartum depression but not all. Postpartum depression, if left untreated, can last years. It does not just go away on its own. It is a chemical imbalance and therapy and medication can help. Medication can save a mom’s life, and it doesn't have to be a long term treatment. If a new mom doesn’t feel right, she should talk with her doctor, even her OBGYN who will specialize in a range of women’s health issues.
Postpartum psychosis is a lot like depression. However, the symptoms usually show up between 1 and 3 months after childbirth. Women who experience postpartum psychosis completely lose their grasp on reality. Auditory hallucinations are common. These women will live in a fairy land like state. The new mother may talk back to the voices she hears. She will begin to become delusional and see her life happening in very different ways than it actually is happening. Some visual hallucinations happen, though they are not as common. Other symptoms include insomnia, rage, and overwhelming guilt.
For these new mothers, it is extremely important that she has a support system. She will need help in the form of a good partner, family members, and friends. Postpartum psychosis almost always requires medication and in some cases hospitalization until she is well enough to go home. Just like when looking out for a sign of depression, it is so important for a woman to be aware of herself and her own thoughts and body. Early intervention and reaching out for help from a friend, relative, but mostly to a doctor is so important.
While pregnant, preeclampsia is a medical condition that is continually looked for in pregnant women. They are coached to watch for vision changes, headaches, and swelling. But in rare conditions postpartum eclampsia exists. Usually symptoms happen within the first 48 hours after birth. Even less common are the cases that happen around the 6 week mark.
Postpartum eclampsia symptoms are seizures, fatigue, muscle pain, reduced urination, and swelling. Changes in vision can occur like seeing spots, double vision, and headaches. Most mothers are monitored for a while at a health care facility after the baby is born. But if these symptoms occur, one should call a doctor immediately.
Something some women will face after pregnancy is gallbladder pain. This happens when gallstones form in the gallbladder and slide in and out of the bile duct. Gallstones are formed by a buildup of cholesterol. During pregnancy, the gallbladder becomes slower like everything else in the GI tract and does not empty out entirely. Increasing the risk of stone formation. It is not uncommon for women who are freshly postpartum to end up in the emergency room with a gallbladder attack.
Symptoms include intense shooting pain in the right upper quadrant of the abdomen. Some women state the pain wraps around the body from front to back creating a C shape and ends under the right shoulder blade. Other symptoms are shortness of breath, chills, and vomiting. Attacks usually happen at night which is usually followed by the heaviest meal of the day, dinner. Seek medical treatment immediately.
Postpartum weight is something many women worry about immediately after birth. Exhausted and depleted of nutrients they will start to worry about the number on the scale. For all new mothers, a healthy lifestyle is more important than ever. There’s a new baby to care for, so that makes self care even more important. Follow a nutritious and complete diet, avoid fads and look at the food pyramid. Eat until satisfied and absolutely no food deprivation, keep healthy satisfying snacks all around. Hydration is especially important.
Mothers should hit the gym when they are ready. Light cardio and resistance will help boost mood and stamina. No reason to push the body to transform into anything that belongs in a magazine just yet. It took 40 weeks to make a baby and the body to transform into the beautiful birthing machine that it is. So, it will take about that long to gain even some resemblance to what it looked like before baby. Many women are forever physically changed after birth, and that in itself is a beautiful sight
It is suggested to wait 6 weeks, after delivering a baby or having a C-section, to have intercourse again. Physically, this reduces the risk of exposing your body to bacteria and protect the woman from injury. Emotionally, the new mother, and her partner may not be ready for sex. After going through one of the most transformative experiences of their lives, combined with the lack of sleep, sex may be the last thing on their mind. Then again, some may feel ready earlier rather than later.
Regardless, take this time to enjoy one another and rediscover the relationship. Sex will most likely be uncomfortable the first time for women. If she had a vaginal delivery she may still feel very tender. If she had a C-Section any pressure on her abdomen could cause pain. Each partner needs to be practicing clear communication. Sometimes, instead of intercourse, kisses and caresses are a great way to start becoming intimate again. Take things slow and enjoy feeling a little more like an individual again.
Sources: WhatToExpect.com, VeryWell.com, Postpartum-Living.com, PostpartumProgress.com, MedicineNet.com