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- | February 25, 2021, 11:04 CST

The Facts About Postpartum Life
Life after giving birth can be overwhelming. Knowing what to expect can help you prepare.
Vita Eizans, D.O.

For many women, the weeks and months leading up to childbirth are exciting and filled with anticipation. Their focus is often on preparing for labor and the life-changing moment when they get to meet their baby for the first time. All too often, they don't give as much thought to what comes afterward.

A woman's body goes through many changes during and after pregnancy. There is physical change with the expansion of the uterus and belly, enlargement of the breasts and the effects of childbirth itself; there is mental change as the new mom adapts to the realization she is responsible for another human life; and there is hormonal change.

During pregnancy, a woman's body produces estrogen and progesterone in much greater amounts, but these levels drop rapidly in the 24 hours following childbirth. This dramatic change in hormone levels can have an impact on the way a new mother is feeling and also trigger symptoms of depression and anxiety. In some women, the level of thyroid hormones can drop, too, affecting the new mother's energy levels. This can have an impact on mood, sleep, concentration and weight gain.

The postpartum period generally lasts six to 12 weeks. It is recognized within many cultures as a much-needed period of recovery, and every woman experiences it differently. As well as the swift change in hormone levels, a woman's body has to contend with the aftermath of childbirth, whether she had a vaginal delivery or a C-section. And then there is the sometimes overwhelming task of learning how to breastfeed and overcoming any feeding-related challenges that might arise.

Physical health

The physical symptoms of childbirth are as varied as the women who go through it. Women who delivered a baby vaginally may experience pain around the perineum, and they may need to follow specific aftercare procedures if an episiotomy was performed or vaginal tears occurred during delivery. In some cases, stitches are needed to close the tears. There are ways you can reduce pain and support healing, including the use of cold compresses containing witch hazel. Women who delivered their baby by C-section may experience pain around the incision, and may be restricted to minimal movement while the muscle tissues repair and recover.

You may experience other physical symptoms following childbirth. Bleeding from the vagina will occur in both moms who have given birth vaginally or by C-section. The bleeding may be quite heavy and should continue for a few weeks, decreasing gradually until it stops. Don't use tampons during these postpartum weeks, to can avoid infection—opt for maternity pads instead.

If the bleeding seems to be excessive, you could be experiencing a postpartum hemorrhage. This can be caused by the uterus not contracting strongly enough; tears in cervical or vaginal tissues or blood vessels; blood clotting; or issues with the placenta. If you experience very heavy bleeding in the postpartum period, you should contact your healthcare provider.

Be kind and listen to what your body tells you.

You may also experience stomach cramps as the uterus contracts, and if you had a C-section, you may see some pink, watery discharge from the surgical incision. Take care to keep the incision clean and dry, and if the drainage continues, contact your healthcare provider. It is common to experience some difficulty with urination and bowel movements. If you had an epidural, you may not be able to feel when your bladder is full for several hours, and you will need time to recover from the use of a catheter.

Another common symptom is aching breasts and sore nipples. Your breasts will grow and become heavier as they accommodate milk production for breastfeeding, so make sure you wear a supportive bra postpartum. Ease sore nipples with topical creams specially designed for breastfeeding to reduce the pain while you and your baby learn to breastfeed.

Many women are anxious about their first bowel movement after childbirth. Don't let anxiety stop you from attempting a bowel movement; it's unlikely that your sutures will reopen. Drink plenty of water and eat fibrous foods to help move food through your system.

It is important to prioritize your own health, as well as that of your baby, during this period. Make sure you visit your OB-GYN regularly and continue to carry out any recommended aftercare tasks, such as perineal care. Wait until your perineum has healed and any bleeding or discharge has stopped or slowed before you have intercourse. Keep taking your vitamins and make healthy meal choices. Drink lots of water and avoid alcohol and caffeine, and try to get outside every day—the fresh air can help alleviate symptoms of fatigue and sleep deprivation.

Postpartum exercise

It is important to get plenty of rest in the weeks following childbirth before embarking on postpartum physical exercise. Of course, this timeline varies from woman to woman, so it's best to check with your doctor before returning to an exercise regimen. If you had a C-section, you may need to wait longer than a few weeks to allow your body to fully recover from the surgery.

Start with gentle movements and slowly increase the amount of exercise. Embark on only one physical activity at a time, such as walking, before moving on to a light run or another aerobic exercise. It is possible that if you exercised regularly before and during your pregnancy, you may find it easier to return to a more active lifestyle. But remember, your body has experienced a huge change. Be kind and listen to what your body tells you.

Mental health

It is just as important in the postpartum period to manage mental health as well as physical health. The combined experiences of pregnancy, childbirth and new parental responsibilities can be a lot for the mind to comprehend. And that's without factoring in the rapid drop in hormones following delivery.

It is important to understand the difference between baby blues and postpartum depression, as early intervention can help reduce symptoms over the long term.

It is normal for a woman to experience swings in her emotions after giving birth, as well as a low mood often termed the "baby blues." In the days after childbirth, a woman can experience feelings of disappointment, a desire to cry for no reason, impatience and irritability, anxiety and restlessness. These symptoms may disappear without the need for treatment, but for some women, these feelings can linger and sometimes worsen. This is known as postpartum depression or postpartum anxiety.

It is important to understand the difference between baby blues and postpartum depression, as early intervention can help reduce symptoms over the long term. Talk to a doctor if your symptoms don't ease after two weeks or they get noticeably worse; if you find yourself unable to care for yourself or your baby; if you find it hard to get through the day; or if you begin to have thoughts about harming yourself or your baby.

The main red flags for identifying postpartum depression include difficulties bonding with your baby or a desire to withdraw from your partner, anxiety that prevents you from sleeping or eating appropriately, and feelings of extreme guilt or worthlessness.

The causes or risk factors for postpartum depression include hormonal changes, such as the sharp drop in estrogen, progesterone and thyroid levels; physical changes, including pain, lingering baby weight and an inability to carry out everyday tasks; and stress caused by the adjustment to having a baby and worries about being able to provide proper care.

You might be at greater risk of developing postpartum depression if you or your family have a history of depression, or you have little emotional support, an abusive relationship or financial uncertainty.

Some healthcare professionals use the Edinburgh scale to help diagnose postpartum depression. Once the condition has been diagnosed, treatment can include at-home, self-help strategies, such as building a support network and talking about your feelings, practicing mindfulness, eating healthy foods and getting fresh air every day. Your healthcare professional might also suggest therapy or counseling, or prescribe antidepressant medication.

In rarer cases, some women can experience postpartum psychosis. This illness occurs in just 1 or 2 women per 1,000 deliveries, according to Postpartum Support International. The onset is usually sudden, most often within the first two weeks postpartum.

Symptoms include delusional or strange beliefs, hallucinations, hyperactivity, irritability and rapid mood swings, paranoia and an inability to sleep. If you experience any of these symptoms, it is imperative to seek medical attention immediately.

Breastfeeding

Breastfeeding is very beneficial for your baby. Breast milk contains the right mix and balance of nutrients to help your baby grow and develop. It is easy to digest and contains antibodies that boost your baby's immune system. Breastfeeding is good for you, too. It reduces your risk of future certain cancers, cardiovascular disease and diabetes. It is also much more affordable than formula.

Make sure you prioritize your comfort when attempting to breastfeed.

That's the good news. The bad news is it's not always easy to do, and not every woman is able to breastfeed. Some women may prefer not to breastfeed, and that's fine, too.

It's helpful to understand as much as you can about breastfeeding before you begin, so you can prepare for the possible challenges. When you begin, don't be afraid to ask people for help—your healthcare provider should be able to advise you on how to hold the baby, how to position the breast and nipple, and how to encourage the baby to latch on to the nipple. Lactation consultants can also advise you, if necessary.

Make sure you prioritize your comfort when attempting to breastfeed. The stress of discomfort can prohibit the hormones needed to release, or let down, your milk. Plus, the baby may be a slow eater, so you could be sitting in one position for a while.

Have the baby sleep nearby so you don't have to move too far to breastfeed during the night. Make the situation as easy for yourself as possible. And don't forget to look after yourself by eating healthy, nutritious meals and looking after your breasts while they perform this new task of nurturing your baby.

Resources

Postpartum life can be challenging, but you don't have to go through it alone. Take care of yourself and be honest about your needs. Build your support network. Seek out support groups, online or in person, made up of women who understand exactly what you are going through. Communicate with your partner, family and friends, and lean on them when you need help. You got this, mama.

Vita Eizans, D.O.

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