Real Talk—Here's What to Actually Expect Postpartum
Surprise! A new baby brings changes to your body, not just to your household. So what’s the real deal on your body’s transformation?
New and soon-to-be moms should know what to expect head to toe. Delivering the news is Gerilynn Vine, MD, OB/GYN at Memorial Hermann Medical Group Texas Medical Center Obstetrics and Gynecology.
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Just as babies grow out of diapers, new moms grow out of many changes to their bodies, Dr. Vine says.
"If you're concerned, it's always appropriate to ask your doctor whether its normal or not," she says. "You should feel no shame. Hormonal shifts are natural and often the cause."
Some people bounce back faster, and there’s nothing wrong with you if you don’t.
“Each person is different and goes through pregnancy differently—and they recover differently,” Dr. Vine says. “Some people bounce back faster, and there’s nothing wrong with you if you don’t.”
The Surprise: Your Shoe Size Goes Up
THE REALITY: Not only do feet swell during pregnancy, but often post-delivery, due to excess fluids within the body.
WHAT YOU SHOULD KNOW: “Your body gets used to not being pregnant and the fluid goes down on its own,” Dr. Vine says. But 60 to 70 percent of women go up in shoe size -- permanently.
HOW TO HANDLE IT: Prepare to say goodbye to those pre-baby Jimmy Choos. But your little one is worth it! Be concerned if one leg or foot is more swollen than the other. This may mean you've got a blood clot in your lower leg - which must be treated urgently, Dr. Vine says.
THE TIMELINE: Just as swelling varies with each individual, so does shrinkage.
The Surprise: You Still Look Pregnant
THE REALITY: Your uterus doesn’t shrink instantaneously at childbirth—therefore, neither does your belly.
WHAT YOU SHOULD KNOW: “Your body is healing and returning to what it was before baby,” Dr. Vine says. “If you’re super thin, the bulge may seem bigger.”
HOW TO HANDLE IT: "Embrace that voluptuousness,” she says. “It took a while to show you were pregnant. Afterward it will take time for your body and belly to go back to normal size.”
THE TIMELINE: Within four to six weeks, your uterus and belly usually contract. Pregnancy weight gain often takes six months to lose.
The Surprise: You Lose Hair
THE REALITY: Estrogen promotes wonderful hair and often wonderful skin during pregnancy, but after your baby arrives, “it’s very common for a significant amount of hair to fall out due to hormonal changes,” Dr. Vine says.
WHAT YOU SHOULD KNOW: Postpartum, you may lose strands, most noticeable when you run your hands through your hair while shampooing.
HOW TO HANDLE IT: There aren’t great treatments beyond patience and time.
THE TIMELINE: Hair loss may start between one to five months post delivery. “The comforting news: Hair definitely comes back,” Dr. Vine says, “usually within six to 12 months.”
The Surprise: Breastfeeding is Hard
THE REALITY: Most first-time moms struggle with breastfeeding. “The more pressure you feel, the more difficult it may become,” says Dr. Vine.
WHAT YOU SHOULD KNOW: The physical process of the baby latching onto the nipple correctly combined with your stress about providing enough breast milk can lead to your baby not gaining weight at the recommended rate.
HOW TO HANDLE IT: According to Dr. Vine, if your infant isn’t getting enough nutrition via your breast, supplement feeding with formula and consider a breast pump to allow you to express milk on your own schedule. “It’s OK if you feed with formula,” Dr. Vine says. “What matters is a healthy baby and a healthy mom, not how milk is delivered. Your baby will grow and develop fully—and you may get an emotional break by using formula.”
However, be concerned if your breast gets infected, known as mastitis. Signs include high fever, body aches, chills and a breast that is red, tender, warm to the touch or hardened. “If that occurs, seek medical attention,” says Dr. Vine.
THE TIMELINE: Breastfeeding may become easier with subsequent babies – and you may choose to supplement with solid food, at the advice of your pediatrician.
The Surprise: Your Breasts Swell
THE REALITY: Hormonal fluctuations may lead to enlarged breasts, as does breastfeeding. Skin stretches to accommodate larger mammaries, and may sag once breasts return to normal size.
WHAT YOU SHOULD KNOW: You may experience excess skin and a loss of fullness. “It depends on your natural skin and tissues,” Dr. Vine says.
HOW TO HANDLE IT: Enjoy your curves and focus on your wee one.
THE TIMELINE: Breast fullness starts during pregnancy and continues throughout breastfeeding. “Changes could be permanent,” she says. “Over time, breasts change and may not look the same as when you were younger.”
The Surprise: You May Have a Dark Line on Your Belly, Darker Nipples or Facial Patches
THE REALITY: Hormones secreted by the placenta and pregnancy may cause Linea Nigra (the darkening of a vertical line below your bellybutton), darker nipples and even facial patches, called melasma.
WHAT YOU SHOULD KNOW: These fade with time.
HOW TO HANDLE IT: Cocoa butter may help prevent stretch marks. Gels and creams may improve the color, texture and appearance of scars and stretch marks.
THE TIMELINE: Usually darkening and stretch marks fade over time, varying with each person.
The Surprise: Your Bladder Leaks
THE REALITY: The weight of your uterus during pregnancy places pressure on your bladder. Pelvic and hip muscles also relax during pregnancy, to accommodate your baby.
WHAT YOU SHOULD KNOW: The more babies you have, the higher your risk for urinary incontinence.
HOW TO HANDLE IT: As with any muscle, use it to not lose it. Your doctor can teach you how to do Kegel exercises, which are pelvic muscle contractions to strengthen the pelvic floor. You don’t have to wait until delivery to start Kegels.
THE TIMELINE: Most people’s leakage improves within six weeks of doing Kegels. “In general, with time, everything will go back to where it was before having the baby,” Dr. Vine says.
The Surprise: You May Feel Down
THE REALITY: At least 10 percent of women experience postpartum depression, but just one to two percent have extreme symptoms.
WHAT YOU SHOULD KNOW: Mothers may cry, be sad, lethargic, anxious or irritable, Dr. Vine says. They also may sleep poorly and gain or lose more weight than expected. Those with severe symptoms may not get out of bed to do what they need to do to care for themselves and the baby. In rare instances, some new moms can have thoughts of suicide or harming their baby.
HOW TO HANDLE IT: Get plenty of sleep and ask your family, friends or doctor for help. “Don’t let guilt keep you quiet,” she says.
And if your family expresses concern, listen. “I’m a big fan of using medication and therapy to get patients through rough moments,” Dr. Vine says. And fear not: According to Dr. Vine, many anti-depressants will not harm your baby if you breastfeed, including SSRIs (selective serotonin reuptake inhibitors) such as Prozac and SNRIs (serotonin and norepinephrine reuptake inhibitors) such as Zoloft.
THE TIMELINE: Symptoms can start two weeks after birth. In a third of cases during pregnancy, symptoms can last up to a year. “Sometimes depression can be a lifelong battle,” Dr. Vine says. “I usually recommend medication for six months to a year, depending on the situation and the patient.”
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