Hips – A consequence of pregnancy, childbirth and the hormone Relaxin, that loosens your body to prepare for childbirth, is hip pain, which many women experience for days or weeks postpartum. Pelvic/hip supports combined with ice or heat therapy and later physiotherapy will help relieve pain and regain normal function.
The uterus is truly where the magic happens. This small muscular organ lives inside of your pelvis with all the other organs that make up the female reproductive system. We’ll avoid giving you a high school health class crash course, (you probably know how babies are made at this point), but there’s so much about the uterus that happens during pregnancy and after delivery that are unknown to most women until a nurse is pushing on the fundus of your uterus to make it contract.
During pregnancy, that relatively small organ will stretch to about 40 cm around by the time you’re ready to deliver. Fortunately it doesn’t stay that size, and by your 6th week postpartum it should be relatively the size it was pre-pregnancy.
When you’re ready to deliver your uterus will start to contract, getting progressively more intense. This is because there are two layers of muscles, a horizontal inner layer that runs like hoops around the baby, and a vertical outer layer that runs up and over the uterus. This outer layer kicks off labor by contracting and pulling the cervix open, and then works in tandem with the inner layer that contract and relax. Here’s some uterine magic though, instead of going back to it’s regular shape like most muscles, the muscle fibers of the inner layer stay shorter and thicker as they work towards expelling your baby. Magic!
Once you’ve delivered it’s critical that the uterus continue to contract to expel the placenta. The placenta is attached to blood vessels at the fundus of the uterus, which sits at the top near your rib cage. Many bodies are too tired after labor to expel the placenta, leaving the blood vessels open and increasing the risk of hemorrhaging and infection. To help this process along a doctor, nurse or midwife will probably give your belly an intense massages to help it contract. If this doesn’t work, the placenta or any pieces left will need to be removed by hand. In rare cases an emergency D&C (dilation and curettage) surgery may be required.
Immediately breastfeeding your baby will continue the lovely oxytocin hormone and help your uterus contract for several days as it shrinks and gets rid of excess tissue. These after-pains will subside in time as well.
So as you can see, there’s a lot of vital stuff happening up there. Most of it critical to you and your baby’s life. It’s scary thinking that you won’t be able to control every situation you may encounter during labor, but being aware of how your uterus works on a fundamental level can help you interpret your body’s signs and give yourself that extra mental boost!
For many women there is an emotional weight behind how we view our breasts. They can come to represent things like femininity and desirability, and not recognizing how they look post-breastfeeding can be unexpected or even shocking. Knowing what to expect can help normalize your new gals. Remember, no four boobs are alike, and the degrees to which one woman might experience some changes vary widely.
Hormones (yay, your best friends) are genetic geniuses and are responsible for a lot of what happens to your breasts. They cause temporary things that seem unnecessary like the darkening of the nipples and areolas, and possible engorgement. But hormones also do clever things like enlarge the areolar glands, which secrete an oily substance that helps lubricate the nipple and provides olfactory stimulation for a newborn to more easily latch. How awesome is that?!
Some more permanent changes one can expect include a change in shape, and let’s face it, perkiness, due the rapid expansion and subsequent shrinking of the tissue. It’s not uncommon to find yourself buying a bra 4 sizes larger than you’re used to while pregnant and breastfeeding, and then going back to the old faithfuls when they return to your regular size. That’s a big shock to the skin.
If you are feeling dismayed by your new normal, there are a host of exercises that focus on strengthening the pectoral muscles. But it’s important to remember that you carried and fed another human using your own body, and staying positive about yourself and your body has lasting emotional impact on your mood. You’re amazing, and we’ll remind you of that every day.
During Pregnancy- Hormones estrogen and progesterone are now in full force and preparing your body for lactation by causing the milk ducts to become enlarged, which can lead to swelling and tenderness in the breasts and nipples. Other changes that may occur during pregnancy are:
- Darkening of nipples and areolas (the skin around your nipples) due to hormones that affect pigmentation of the skin
- Darkened veins along your breasts (due to increased blood supply to your breasts)
- Your breasts may start leaking a yellowish, thick substance known as colostrum
- Pronounced nipples, and the areolas and nipples will grow larger
- Small glands on the surface of the areolas called Montgomery’s tubercles become raised bumps
Some women experience all of these changes, some experience very few. The important thing to remember about changing breasts is that the occurrence of any of these, or lack there of, is normal.
Postpartum – Your breasts will change a lot within hours after delivery and more in the next few weeks until they get used to their new role as nutritional resources for your newborn.
When your breasts become overfull and uncomfortable, try applying heat. Hot baths or showers, or even a heating pad or warm gel pack can help the ducts open. Make sure you are feeding or pumping every 2-3 hours to avoid overfilling. If the breasts are so full that the nipples are flattening out, try gently expressing a small amount of milk after applying heat. Expressing before a feeding can relieve the pressure on the nipple and areola so the baby can latch.
Mastitis is an infection of the breast tissue that results in breast pain, swelling or “hardness”, warmth and redness. It may also cause flu like symptoms like fever and chills. Lactation mastitis generally occurs within the first six to 12 weeks postpartum, but it can happen after. The condition can cause you to feel run down, making it difficult to care for your baby. Sometimes mastitis leads a mother to stop breastfeeding before she initially intended to due to the discomfort, but continuing to breast-feed, even while taking an antibiotic for the mastitis, is better for you and your baby.
When you first detect the symptoms contact your doctor for treatment. Oral antibiotics are usually effective in treating this condition. If your signs and symptoms don’t improve after the first two days of taking antibiotics, see your doctor right away to make sure your condition isn’t the result of a more serious medical condition.
With mastitis, signs and symptoms can appear suddenly and may include:
- Breast tenderness or warmth to the touch
- Generally feeling ill possibly flu like
- Breast swelling/hardness
- Pain or a burning sensation continuously or while breast-feeding
- Skin redness, often in a wedge-shaped pattern
- Fever of 101 F (38.3 C) or greater
How to avoid mastitis:
- Proper latch will reduce sore and cracked nipples.
- Breastfeeding with your baby in multiple positions and fully draining your breasts at each feeding.
- Wear properly fitted (not too tight) bra and tops to allow for unrestricted milk flow.
- Proper nutrition and hydration.
Lactation Nutrition – The World Health Organization recommends exclusive breastfeeding for at least 6 months with your newborn. If you stick to this plan, there are some specific nutritional guidelines breastfeeding women should follow to ensure proper nutrition for baby, but to make sure mom’s nutritional needs are met.
Doctors suggest breastfeeding women should eat an additional 350 calories per day, and drink plenty of water, before you feel thirsty.
There are also certain vitamins and nutrients mom’s need a boost of, including: B vitamins, vitamin C, and vitamins D and K. Other vitamin groups that are important for a child’s development, though not solely relied upon breast milk are vitamins A and E, and these may require external supplementation for the baby through a shot or liquid form.
Because of the transference of nutrients from the mother’s diet to her baby’s, if she is not receiving enough of these nutrients in her own diet, she may be at risk for deficiencies that could cause severe health problems like anemia. Additionally, a vegetarian diet, malabsorptive stomach surgery, or other health conditions could exacerbate a deficiency. Blood work to determine these levels can be helpful in guiding a specific diet for a new mom.
Stretch marks may be more noticeable postpartum then while pregnant but should fade over time and may be aided with some topical creams but more effective are modern laser treatments.
Melasma, is brown to gray-brown patches on the face. Most people get it on their cheeks, bridge of their nose, forehead, chin, and above their upper lip. It can be triggered by hormones and the sun and usually fades after pregnancy.
Postpartum Acne, is a result of the hormone changes, stress and less than ideal skin care routines during postpartum. It can be improved with better facial hygiene and topical creams.
Facial Spider Veins, are visible on the surface of your skin tend to be on the face, below the eyes, or on the cheekbones. Other common places for them to show up include the neck, chest, hands, forearms, and ears.
Facial Spider veins often develop in pregnancy, particularly in the first trimester and second trimester. This is because they are linked to higher levels of the hormone estrogen circulating around your body.
About a quarter of us have one or more spider veins. They are harmless and aren’t usually a sign of illness, and only very rarely cause problems such as bleeding. They often clear up in about six months after your baby is born. In the meantime, you can cover them up with make-up and if the veins don’t get better after pregnancy, it’s possible to have laser surgery to remove them.
Dry and Flaky skin, is also caused by hormone changes and imbalanced hydration. It can appear as red-ish or leathery spots on the skin. Staying hydrated internally with water and externally with lotion should reduce the irritation.
Vision – Hormonal changes and water retention, can cause “refractive error” where your eyes have issues focusing. Previous eye conditions, such as glaucoma, high blood pressure, or diabetes, especially during pregnancy can alter your eyesight even more.
For most women, their eyesight settles back to normal along with their hormones–so a few months postpartum, your eyesight should go back to normal. But, if you’re nursing, sometimes it can take even longer.
A much more rare condition occurring in about one to two per 1,000 women. Onset is usually in the first several weeks following childbirth and symptoms are the same as PPMD, but far more severe and intense. Women with postpartum psychosis may exhibit frantic, excessive activity, are unable to eat, are incoherent or very confused, and make irrational statements. They may have hallucinations, believe people or others that do not exist are talking to them or directing their behavior. Loss of memory and thoughts of harming themselves, their baby, or others are immediate signs of postpartum psychosis and must be treated immediately by a physician specializing in treating this type of psychosis. Call your doctor or midwife or 911 for help.
Postpartum Mood Disorders/Depression (PPMD)
PPMD is less common than the baby blues but not uncommon as it is estimated that 20 to 40 percent of women experience PPMD at some point during the first year after childbirth. Symptoms are similar to a mood disorder but more intense and longer lasting. Common Symptoms of PPMD:
– feel inadequate, despondent
– unable to cope with everyday life
– very anxious or have panic attacks
– obsessed with getting things into order
– fears about your health and your baby’s health
– sleep difficulties
– under or over eating
– social withdrawal or not wanting to be alone
A difficult or unexpected childbirth experience, having a premature baby or special needs baby increases the likelihood of PPMD. You should contact your physician or midwife if these symptoms occur frequently and cause you to be unable to care for your baby and/or yourself.
Women commonly feel exhilarated and have difficulty resting or sleeping in the first few days following childbirth. You may find yourself reliving the birth experience and trying to understand the sequence of events leading up to your baby’s birth especially if you feel it did not happen according to your expectations. When alone at home, the 24-hour-a-day responsibility of caring for a baby may make you feel overwhelmed which can trigger strong emotions like irritability, crying easily or anxiety. These symptoms characterize a mood disorder often called the “Baby Blues.” Over 80% of women experience these symptoms to some degree:
- Mood swings
- Feeling overwhelmed
- Reduced concentration
- Appetite problems
- Trouble sleeping
These symptoms should be acknowledged as real and valid but thankfully they are temporary and may last anywhere from few days to a few weeks and set in at some point during the first 6 weeks. Often easier said than done, but getting sleep and rest, reducing household or work demands, concentrating only on self and baby care, and getting help with infant feeding, if needed, all help diminish your stress level.
Emotions – The first weeks and months after childbirth is a time of emotional upheaval. Intense feelings like– joy, exhaustion, fatigue, confusion, loneliness, disappointment, anger, fear, and happiness are all common.
Settling into your new role as a mother is a normal “life crisis.” You redefine who you are and the new responsibility of caring for a totally dependent infant can feel like a very heavy a burden. It’s not unusual to feel that your life has changed too radically and all that’s left is feeding, changing, and soothing an infant. But, try to keep perspective and remember that you are not alone, not the first or the last that has successfully mastered this transition. You will get into your new routine. Be patient with yourself and remove unrealistic expectations.
You will have less time for your loved ones and yourself. The depth of your feelings are related to hormonal changes, fatigue and lack of sleep, and to the pain of incisions, swollen breasts or sore nipples. It may also be related to the level of support you have at home, your feelings about your childbirth experience, and the individual needs of your baby. Know that all moms need help and the more you can ask for and receive the better for you and your family.
Unmanaged pain has been shown to decrease mood and your ability to connect with your loved ones and baby. Make sure you are taking the appropriate measures to manage your pain at this critical time.
Hemorrhoids are blood vessels that have become unusually swollen in the rectal area. Hemorrhoids typically range from the size of a raisin to the size of a grape. They can be itchy to painful, and sometimes they can even cause rectal bleeding especially during a bowel movement.
Hemorrhoids are relatively common during pregnancy and get worse with vaginal delivery but ultimately go away during postpartum. Here are some simple measures to use immediately after birth to help you relieve the pain and swelling associated with hemorrhoids.
- Apply a soft ice pack to the affected area several times a day.
- Soak your bottom in warm water, in a shallow tub or a sitz bath a few times a day for about ten minutes at a time.
- After each bowel movement, clean the affected area, using a peri-bottle and pat dry.
- Ask your healthcare practitioner to recommend a safe topical anesthetic or medicated suppository.
- Take the pressure off your rectal veins to relieve the pain. Avoid sitting or standing for long stretches of time and try a donut shaped pillow when sitting. Lie down when you can – when you’re nursing, reading, or watching TV, for example.