Pregnancy brings a lot of changes to a woman's body, parts of her get bigger, she gets swollen from head to toe, and some of these changes bring pain. Soon after the birth of the baby, mom's body starts to change again. These changes that occur in the body during pregnancy are reversed as the body returns to norma, or the new normal.
This postpartum period begins soon after the delivery of the baby and generally takes 6 to 8 weeks to end. Like pregnancy, postpartum changes differ for every woman. Many new moms find they can deal with the changes brought about postpartum, while a few find it rather difficult to deal with both the emotional and physical changes.
Generally, it gets difficult because the postpartum period involves learning how to care for the newborn and function as a changed family unit. Meeting the constant need of a newborn involves time and energy and often new moms find no time to take care of themselves.
Some moms find the changes are for the better, like pigmentation or the dark line (linea nigra) disappears within a few weeks after the baby's birth, the stretch marks which too had developed during pregnancy will fade away (though not completely), and the chest will start feeling full of milk.
Since a woman's body has gone through an extensive process of pregnancy and labor, it requires some time to heal and recover. But there are some major physical as well as emotional changes to the postpartum body that women are quite unaware of or are not expecting at all. The list of these unexpected changes that happen to a new-mom's body is endless and individual:
15 Hormonal Imbalance
Bodies generally maintain a healthy balance of various hormones. Once a woman conceives, some of her reproductive hormones are replaced by pregnancy hormones that bring about a myriad of physical changes to her body. These changes affect the functioning of non-reproductive hormones. By the end of pregnancy, there'll be a sudden and vast change of hormone levels.
Many new moms might suffer from bouts of hyperthyroidism and hypothyroidism during the postpartum period. This condition, known as ‘adrenal hypersensitivity’ may soon cause our adrenal gland to work overtime, resulting in the depletion of energy levels, inefficiency, memory loss, etc. On the other hand, sustained high levels of cortisol tend to delay healing and could cause an inflammatory response in the body.
The hormone Leptin, which is responsible for appetite, can make us feel very hungry if it increases. High levels of estrogen can expand fat cells, making it easier to gain weight, causing stubborn fat to settle in for the long haul. Other nasty side effects of hormones include, hair loss, break outs, moods swings, weight gain, or the apparent inability to lose weight.
Exercising, limiting caffeine, diet change, proper sleep and reducing stress are all ways to battle the hormones that go haywire.
14 Involution Of The Uterine Wall
The uterus undergoes changes after childbirth referred to as ‘involution’. Involution begins immediately after the placenta's delivery by contractions of the uterine muscle fibers. These contractions control bleeding and cause the uterus to shrink in order to gradually regain its former size and contour.
Within a week after delivery, the weight of the uterus decreases to 1 lb, and at week 6 the uterus should weigh 2 to 3 oz, its pre-pregnancy weight. The uterus remains slightly larger than it was before pregnancy for women having their first child. Healing at the placental site is gradual and usually requires 6 weeks.
The height of the uterine fundus decreases by approximately 1 cm per day and is no longer palpable after 14 days. The regeneration of the uterine epithelial lining also begins soon after delivery. While the outer portion of the endometrial layer gets expelled with the placenta, regeneration of the endometrium starts 16 days after childbirth.
The enlarged muscle cells of the uterus undergo catabolic changes in protein cytoplasm causing a reduction in individual cell size, while the total number of cells remains unchanged. As the uterus continues to contract, moms may feel cramps known as 'afterpains.'
13 Afterpains And Separated Abdominal Muscles
It is not unusual to have sore muscles after birth. The ‘afterpains’ bring a lot of discomfort for many women the first few days postpartum. The sharpest pains usually ease off the 3rd day after childbirth. For first timers, afterpains can be almost nil to mild, but are more painful with each successive pregnancy, because of repeatedly stretching of the muscle fibers.
It causes the loss of muscle tone and results in the repeated contractions and relaxation of the uterus. The afterpains can also be severe for women whose uterus has been over distended by a multiple pregnancy, a large baby, or if any blood clots were formed. Afterpains also become severe during breastfeeding, because it also stimulates strong contractions of the uterine muscles.
It's common for the two muscles that run down the middle of the abdomen to separate during pregnancy, known as ‘diastasis recti.’ This separation happens because the growing womb/uterus pushes the muscles apart, making them weak and long. The amount of separation varies for every woman.
The separation generally returns to being normal by the time the baby is 8 weeks old, but if the gap still looked obvious at 8 weeks, then the mom is at risk of back problems.
12 Chest Engorgement
Breast engorgement is due to an increased flow of blood to the breasts and will additionally make the bosoms feel full when the milk comes in or if a feeding is missed.
If they're engorged, the nipples are more painful and it can be difficult to breastfeed effectively. It's challenging for the baby to latch on deeply when the areola gets hard. Moreover, if the baby doesn’t get to nurse and mom is in pain, then her milk supply may decrease. Engorgement can also cause a mild fever.
For some women, the feeling of fullness can be mild, but others may find it painful and extremely uncomfortable. The best way to stop this situation is to get the baby to nurse, to pump, wear supportive bras and apply ice packs or take a warm shower.
The nipples may also become tender or sore during the first few days of breastfeeding, but as breastfeeding is established, the soreness will fade away. If the baby nursed or has latched onto one side more than the other, mom may also notice that one side will be bigger compared to the other.
The chances of having sagging breasts increase in women with a higher BMI, bigger cup/bra size, multiple pregnancies, older age and/or a history of smoking.
11 Lochia, The Red Run
Soon after childbirth, mom will have her first period accompanied by uterus contractions. Lochia is the vaginal discharge that starts after childbirth and contains a fair amount of blood, mucus, bacteria and uterine tissue. This discharge typically continues for 4 to 6 weeks after childbirth.
Since this blood sheds mucus and tissues of the placenta, mom may experience lumps or blood clots, and this is normal. This bright red discharge could come out sporadically in small bursts or as a heavy flow.
Within 3 to 4 days after childbirth, lochia becomes more watery and pinkish. Around the 10th day after delivery, a small amount of white or yellow-white discharge will start. The lochia contains mainly white blood cells and cells from the lining of the uterus at this point.
Lochia then lessens and gradually stops within 2 to 4 week's time, though a very small number of women may continue to have sporadic spotting for a few more weeks.
10 That Baby Bulge
It takes time for the belly/stomach to return to normal size after delivery. It generally takes about 6 to 8 weeks before the uterus returns to its pre-pregnancy size. Many women continue to look expectant after giving birth. And some never go back to normal. After delivery, the abdominal muscles become loose and the hormones direct fat behind the abdominal muscles around the intestines.
In addition, inactivity or lack of exercise after giving birth can contribute to an expectant looking belly. Most women experience a slow decrease in the tummy area. The Slow decrease is caused by the cells of the body releasing their fluids in the form of vaginal discharge, urine and/or sweat.
Additionally, the extra fat used to nourish the baby will gradually start to burn off, especially for breastfeeding mothers. Doctors recommend eating healthy and doing some light exercise. It generally takes at least a few weeks to show some noticeable results.
9 Postpartum Backache
Backache can continue even after childbirth. During pregnancy, the body releases relaxin to relax the ligaments and joints in the pelvis making it easier for the baby to pass through the birth canal, while the uterus expands and stretches, weakening the abdominal muscles.
Naturally a woman's posture gets altered, and instability increases the risk of joint misalignment and inflammation, putting ample strain on the back. In addition, putting on extra weight also overworks the muscles and joints due to the increased pressure on them.
Hormonal changes during pregnancy loosen joints and ligaments around the pelvic bones and over to the spine, which can cause mom to feel more wobbly and cause her pain as she walks, stands, or sits for long periods, bends or lifts things, rolls over in bed, gets out of a low chair or the tub. This pain doesn’t go away until the muscles regain their strength and the joints become less lax.
Soreness in the back can continues due to a long or difficult labor. Many women are so reckless that they worsen their back problem by not using correct posturing during feeding time, while running around for errands, performing weight-bearing activities throughout the day and taking care of the newborn 24/7.
8 Embarrassing Postpartum Incontinence
Postpartum incontinence is quite common, though not every new mother experiences it. It’s both normal and temporary, but still embarrassing. This happens because, childbirth weakens the pelvic floor muscles causing an overactive bladder.
After childbirth the nerves that control the bladder, urethra and bladder movements become damaged during pregnancy and for some women, probably because of the episiotomy made in the pelvic floor muscle.
During labor, the baby’s head pushes alongside the vaginal wall making the nerves numb temporarily. This numbness can last beyond delivery, which means some women won't know when they need to go pee and they won't be able to hold it in. Some new mothers may also have a burning sensation during urination.
These nerves do regenerate quickly and the incontinence will disappear within weeks. Visiting the washroom when possible will help avoid accidents. Doing some ‘Kegel exercises’ helps, too. Talk to your obstetrician if the leaking doesn’t stop after a few weeks.
7 Constipation And Hemorrhoids
It's normal to be constipated for few days after birth due to feeling apprehensive about using the toilet after stitches and/or bruising.
Constipation can be caused by high levels of progesterone, a slowdown in the digestive system during labor, the use of pain relief during labor, or from consuming iron tablets. An episiotomy can also cause painful bowel movements. Hemorrhoids can occur during pregnancy and after childbirth because of constipation and the strain mom exerts to pass stool.
Increased blood flow to the pelvic area causes the veins in the rectal wall to swell during labor, and as mom pushes hard, the hemorrhoidal veins come under pressure. Hemorrhoids can be very painful, itchy and uncomfortable.
Hemorrhoids can bleed when mom strains or puts pressure during a bowel movement or when the anal fissure cracks in the skin of the anus caused by straining from constipation. The good news is that hemorrhoids do go away after a few days if they're properly treated.
A high fiber diet and plenty of water can help ease the pain during bowel movements. Sitting in a warm bath can also help. If you’re in excruciating pain, or you bleed from the hemorrhoids or if the hemorrhoids don’t disappear in a couple of weeks, consult your family doctor.
6 Swollen Extremities And Varicose Veins
Pregnancy can cause swelling. The feet may remain swollen even after childbirth because of a normal delivery. When mom pushes during labor, all the extra fluids in her body are carried to her face, arms and legs. If she's delivering by C-section, she'll receive IV fluids and her uterus squeezes additional blood into her body.
All this fluid and blood gets accumulated in the feet because there's no other place to go. The swelling should go down within a week or two after childbirth. Within days of delivering the baby, the kidneys become super active and mom will either pass all the fluids by urinating frequently or by sweating a lot.
Many women develop varicose veins/spider veins or find them getting worse during pregnancy. With the growing uterus, pressure is put on the inferior vena cava, a large vein on the right side of the body, which in turn puts increased pressure on the veins of the legs.
Varicose veins tend to improve generally within 3 to 4 months after childbirth and after postpartum weight loss. However, varicose veins are less likely to completely disappear if a woman had them before pregnancy, there's a family history of varicose veins, or if there's been multiple pregnancies, or mom has to stand for long hours.
5 Postpartum Hair Loss
New mothers experience hair loss between 3 and 6 months after delivery. In the normal cycle of hair growth, some hair is lost every day, but during pregnancy, increased levels of estrogen keeps the hair from falling out. After delivery, mom starts losing more hair than normal as the estrogen level falls. Hair stops growing and all the hair that was resting falls out all at once. Thankfully, this is only temporary.
Hair loss usually returns to normal within 6 to 12 months. In many cultures, it’s believed that a mother faces hair loss when her baby starts recognizing her as their mother.
Some women's hair may not grow back, it’ll remain thin, but eventually the hair will stop falling out. The texture of the hair will never be the same. It may look straight or wavy, more dry or oily than it was before pregnancy. All this happens probably due to the hormonal fluctuations women go through during and after pregnancy.
Exhaustion and physical stress due to the entire birthing process are other contributing factors for hair loss.
Avoid stress, eat a well-balanced diet and treat your hair gently.
4 A Loose And Dry Downstairs
The vagina changes naturally after giving birth and might feel wider, stretched, dry, sore and tender because of multiple small lacerations. Some women might feel some discomfort after the delivery because their perineum might be cut (episiotomy).
Loosening also depends on the size of the baby and the number of children a Woman has had. Very few vaginal folds remain and the hymen is also torn permanently, but it heals gradually.
The swelling and openness starts to reduce after a few days, although 6 to 10 weeks are needed for the complete involution of the vagina to gain the same size and shape it had before pregnancy. Apply cold packs to the area and avoid lifting heavy things. Attempt doing Kegel exercises to help strengthen the pelvic floor muscles.
Vaginal mucosa reduces in size and the vaginal walls do not regain their thickness. The production estrogen can't be reestablished immediately due to breastfeeding, which is why some moms experience vaginal dryness. This makes intercourse very uncomfortable, couples should use of a cold lubricant to help ease dryness. Talk to your family doctor if you are in too much discomfort after 6 to 8 weeks.
3 Intimacy After Childbirth
Intimacy can continue after childbirth, but because of vaginal soreness and fatigue, it can take a toll on the mood or mom's drive. Her body needs time to heal after giving birth to her baby whether it was a natural birth or a C-section. Waiting for over 4 to 6 weeks after childbirth for intimacy helps the cervix to close, for any tears or small lacerations to heal and for postpartum bleeding to stop.
Hormonal changes can leave things feeling dry and tender, especially for breastfeeding moms. Some women experience some pain during intimacy if they're still healing from an episiotomy or perineal tears.
Many new moms experience a drop in their drive because they're focused on the newborn, fatigued, lack self-esteem or have the postpartum blues. Most women have little or no time for themselves or for that matter knockin' the boots. The abrupt fall in estrogen levels after childbirth lowers intimacy drive for some time.
It could be quite possible that a woman's body isn’t ready for getting physical, or mom may want to do it with her partner after a few weeks after childbirth. Each woman should do what's best for her and think twice before doing it if she doesn’t want to be expecting again.
2 Postpartum Depression
It's natural for new moms to have mixed feelings, from joy and excitement to fear, apprehension and anxiety. This coupled with hormonal changes can cause crying spells, mood swings, making mom feel confused. These feelings are sometimes known as ‘baby blues’, and often go away after having given birth.
Some moms may experience a deep and ongoing depression that lasts much longer. This is called postpartum depression. A mother with postpartum depression may not enjoy her baby and may have frequent thoughts that she is a bad parent. She may also have scary thoughts around harming herself or her baby.
Postpartum depression is caused by different factors, including: family history, biology, personality, life experiences and the environment (especially sleep deprivation). These may fade gradually and if they don’t, getting treatment to help manage symptoms and getting proper care and support helps the recovery process.
1 Random Physical Changes
Weird and random physical changes occur to a woman's body after childbirth. Soon after birth the body sees a number of changes in hormones which can affect the amount of fluid in the body and can cause some common physical changes like night sweats. Some women reported after giving birth they could wear contact lenses for a long periods without discomfort.
Some moms discover that they need to wear a slightly larger shoe size than they did before, or the taste for certain foods has changed. For a few less fortunate moms, they deal with bleeding gums and wobbly teeth after birth. Childbirth and breastfeeding absorb a lot of calcium from new mothers. Because breastfeeding uses so much calcium, moms need to keep their calcium levels high.
Lack of sunshine causes some moms' vitamin D levels to fall low, for these women it may become necessary to take vitamin D supplements. Other women may have increased their fertility and also their chances of becoming expectant again.