As a new mother, you may not know what to expect after your baby arrives. Focusing on the care of your latest arrival is naturally top priority. However, taking note of how your body may have changed physically and mentally is extremely important during your recovery process—for both you and your new bundle of joy. Here are the most common postpartum body changes you can experience after childbirth and how to handle potential issues safely.
Hormonal changes happen before and after giving birth. They play a major role in most of the physical changes the body goes through after childbirth. Here’s a breakdown of the key sex hormones.
Estrogen: The ovaries are the main location of estrogen production. The ovaries provide a suitable environment for implantation and fertilization during the menstrual cycle. Estrogen helps strengthen the vaginal walls and fallopian tubes. This hormone is secreted by the ovaries and is responsible for stimulating the luteinizing hormone, which assists in ovulation.
Progesterone: This hormone assists in preparing the body for potential pregnancy after ovulation. It triggers the lining of the fallopian tubes to thicken and accept a fertilized egg.
During pregnancy, estrogen levels slowly increase and reach their peak by the third trimester. Progesterone levels become extremely high. Side effects from these changes include loosening of ligaments and joints throughout the body.
Joint weakness during pregnancy is to be expected. It’s partially caused by progesterone, but mainly by a hormone called relaxin, which softens the cervix and pelvic floor. Regardless of the type of birth, vaginal or cesarean, your pelvic floor will be affected by labor due to relaxin.
The body needs this essential hormone to prepare the uterine lining for implantation and maintaining the lining of the uterus during early pregnancy. Throughout your pregnancy, the concentration of relaxin increases in the body. This improves flexibility in your tendons, ligaments, and joints. It also allows your belly to expand naturally while providing the necessary increased blood flow and nutrition to your growing bump.
In addition, relaxin encourages vasodilation (opening of your arteries) to increase cardiac output, which elevates your fitness level. “By your third trimester, the amount of relaxin in your system is high enough to soften your cervix and prepare your pelvis to open for childbirth,” says Dr. Jennifer Dour, chiropractor and owner of Garden State Spinal Care. “It’s important to acknowledge that relaxin is affecting your entire body, not just the pelvis and cervix. You may maintain the activity levels that you are used to, but you want to avoid over-stretching in your third trimester.”
Over-stretching can have adverse effects on your ligaments and tendons. Maintaining an exercise regimen is essential. Focus on strengthening in your first two trimesters to be able to maintain good form and avoid injury from over-flexible joints, ligaments, and tendons. A good tip is to concentrate on standing on your legs evenly. You want to avoid stress on the hip joints, so be mindful of shifting your weight to one side as this can cause hip ailments later in life.
In addition to the softening caused by relaxin, the pelvic floor experiences increased pressure during pregnancy. The pelvic floor muscles can also be stretched and damaged during childbirth. The relaxin hormone softens the muscles in this region to help prepare the body for delivery, and this can sometimes result in loss of bladder control, also known as incontinence. This is why exercising the pelvic floor is important during recovery. “One thing I suggest to my patients to start immediately after childbirth are Kegel exercises,” Dour says. Make sure you perform on an empty bladder, and either sit or lie down. Gently tighten your pelvic floor muscles, hold for a count of eight, and then relax the muscles for ten seconds. Do this sequence for ten repetitions, ideally three times a day.
Dour urges patients to start Kegel exercises as soon as possible, regardless of the type of delivery they had. It’s vital to regain strength and help reduce the chance of incontinence months or even years after the baby has been born.
Edema is general swelling throughout the body that usually starts before labor. The swelling is often more noticeable at the end of the day in the ankles, feet, hands, and fingers. “Normally, our bodies collect fluid from our extremities through muscle contraction. As muscles contract, the fluid is pumped back toward our heart,” Dour says. “There are valves that hold the fluid from going backward. When you are pregnant, you produce about 50 percent more fluid in your body than normal to meet the needs of your child. This fluid is also responsible for about 25 percent of the weight gained during pregnancy.” In cases where the swelling is excessive, you may require monitoring for preeclampsia. Signs of this condition include protein in the urine, high blood pressure, and swelling.
You will lose a portion of the retained fluids during labor, but some will remain. This is a natural process of the body and it should not be painful. Fluids will gradually lower. You will sweat and urinate most of the excess fluid out within the first week after labor. There are two simple ways to reduce swelling in a speedier fashion. Dour suggests practicing ankle pumps after an intense workout. Sit or lay down with your feet elevated. Perform ankle pumps by moving your foot back and forth on each side for ten repetitions. This will help increase the blood flow back to your heart from your feet. The body will then begin to dispose of the extra fluid. Another basic rule is to drink plenty of water. Increasing your H2O intake will help increase the circulation in your system and improve the elimination of the extra swelling.
One of the earliest changes in the breasts during pregnancy is the increased tenderness. During the first trimester, progesterone reaches high levels throughout the body, causing a rapid engorgement of the breast tissue. This can cause a sore feeling in and around the breasts. Many women find that their breasts grow significantly in size during pregnancy. Progesterone is also responsible for the darkening of the areolas (skin around the nipples). After delivery, estrogen and progesterone levels take a sharp decline. Prolactin (the hormone that helps with the production of milk) levels rise to allow for lactation to occur. Oxytocin and prolactin, the main hormones responsible for lactation, are stimulated by the baby sucking on the nipples. Oxytocin helps with milk production, enhances the mother-child bond while breastfeeding, and offers a calming effect on the mother. As a mom breastfeeds, she may see and feel breasts decrease in size, but some women find that their breasts remain larger than their prenatal size.
The strength of your back can be compromised in several ways during and after pregnancy. These range from a lack of strength in the abdominal muscles to previous back pain or injury and/or inappropriate exercise during pregnancy. These scenarios can worsen if you don’t practice the proper care. “During pregnancy, you’re stressing your back by carrying additional weight,” says David Kirsch, director and curator of fitness and wellness programming at the CORE club. “That might continue through postpartum due to poor form when nursing or the way that you’re carrying the baby. Make sure that you are keeping your shoulders from folding in. And always tighten your core to stabilize your body.”
Many women experience pain in the mid-back area. Some of the most obvious reasons include breast enlargement, breastfeeding, and awkward sleep positions. It’s important to focus on the strength of your spine during pregnancy to reduce the stress and pain that can occur from postpartum body changes. “The constant leaning over can cause some to have headaches and muscle spasms,” Dour says. “Be cautious of your posture and wear a very supportive bra. For second-time mothers, their low back is what usually starts to give them more problems. With already having little ones to run after and bend for with a decreased strength in your core and lessened ‘me time,’ the low back gets a lot of stress. Focus on bending with your legs or going down onto one knee as much as possible before and after labor.”
Simple exercises such as pelvic tilts and concentrating on deep core exercises are gentle and effective ways to minimize any back pain you may feel.
Diastasis recti is the separation of the abdominals that most commonly happens during pregnancy. Most women will experience some degree of separation during pregnancy. But the extent depends on the growth of the uterus and the amount of pressure placed on the abdominal muscles. “Every woman should be checked by their doctor for the level of separation during their postpartum checkup,” Dour says. “If it is extreme, you should have a therapist review and exercise this area,” Dour says. Basic exercises such as alternating leg drops and opposite arm/opposite leg reaches are good ways to strengthen your core post-baby. Putting Kinesio tape on your stomach can help with healing the core by providing support, improving blood flow, and decompressing inflammation.
If you’re not sure you have diastasis recti, you can perform a self-assessment to monitor your progress over time. You may be eager to get back to your regular routine. However, it’s important to take your time with the healing process because giving birth places a lot of stress on the body. “I recommend my clients to go slowly in the beginning,” Kirsch says. “Diastasis recti or not, you should start with modified Kegels, belly breathing, and bridges to work your abs in a more low-impact way.”
Having a baby is strenuous on the body and can cause many postpartum body changes. Making sure you heal properly is the key to avoiding long-term ailments. It’s imperative not to ignore warning signs during and post pregnancy for a seamless recovery.