After Baby Arrives, What’s Next for Mom’s Body

The first six weeks after giving birth can be exciting, exhilarating and exhausting all at once. With so much focus on your sweet bundle of joy, it’s easy for new moms to get overwhelmed and forget to take care of themselves. But since both pregnancy and childbirth take a toll on mom’s body, it’s best to understand what to expect in the weeks after delivery and know when you should check in with your doctor.

“Every woman has a different pregnancy, delivery and recovery experience,” says Erinn Myers, MD, a urogynecologist at Atrium Health Women’s Center for Pelvic Health – Mercy. Some women have minimal symptoms afterward, while others experience more significant issues. The more you know what to expect, the easier it is to manage this postpartum period.

OB/GYNs typically schedule follow-up appointments about six weeks after delivery to see how you’re feeling emotionally and physically, says Sasha Sabir, MD, an OB/GYN at Atrium Health Myers Park, a facility of Carolinas Medical Center. If all is well, they’ll likely clear you to return to exercise and sex. But before that appointment, here’s a top-down look at some things you might experience post-delivery.

Your Mind

In the first days after childbirth, some moms experience the baby blues – fleeting feelings of depression, anxiety or anger. These feelings are normal and typically subside in one to two weeks without treatment. On the other hand, postpartum depression involves more intense and debilitating feelings of sadness, anxiety or despair, which generally starts one to two weeks or longer after delivery.

If you experience these psychological symptoms and they persist two weeks after delivery or you have thoughts of hurting yourself or anyone else, Dr. Sabir advises contacting your OB/GYN right away. They can diagnose you, suggest resources, such as Atrium Health’s dedicated postpartum support group, and recommend treatment options, which may include anti-depressants or talk therapy. In addition, your OB/GYN can connect you with the Atrium Health Maternal Wellness Program, which is run by psychiatrists with specialized training in prenatal (before birth) and postpartum (after birth) mood disorders and anxiety.

Your Heart and Lungs

“Your body produces about a liter and a half of extra blood volume when you’re pregnant. That additional fluid eventually dissipates sometime after delivery, but before it does it can put more strain on your heart,” says Dr. Sabir. In addition, there’s a higher risk for blood clots while you’re pregnant and in the few months afterward, according to the Centers for Disease Control and Prevention.  

If you develop shortness of breath, chest pain, a racing heart or unexplained swelling or tenderness, especially in your lower limbs, that’s another reason to immediately call your doctor to rule out a blood clot or other serious issue with your heart or lungs.

Your Breasts

As your milk supply comes in a few days after you give birth, your breasts may become very swollen and painful. This is called breast engorgement and it can happen whether you’re breastfeeding or not. It typically subsides within a few days, but don’t hesitate to ask your doctor for ways to relieve the discomfort of this condition. If you’re breastfeeding and have questions or need help, you can also take advantage of the breastfeeding support offered through Atrium Health.

In addition, some women experience breast infections in the postpartum period, which is why Dr. Sabir encourages patient breast awareness so that you know what’s typical for your body and can report any breast changes, unusual lumps or discharge to your doctor.

Your Pelvic Area and Abdomen

Some vaginal deliveries and cesarean deliveries (C-sections) after long labors result in a tear in your perineum, the area between your vagina and anus. All but the smallest of perineal tears require stitches as do C-section incisions. Follow all discharge instructions for wound care and let your doctor know if you run a fever or have severe pain, increased swelling or foul-smelling discharge at the incision site as these might be signs of an infection.

After delivery, you may feel pelvic heaviness or pressure or experience urine or stool leakage. Some women also suffer from pelvic prolapse, which is when a weakened pelvic floor is unable to support the uterus, bladder or rectum, causing it to descend or press on the vagina. This can occur whether you have a vaginal delivery or a C-section.

For many women, these pelvic floor issues heal on their own or through Kegel exercises, according to Dr. Myers. If they persist after three to six months, Dr. Myers recommends following up with your OB/GYN to discuss further treatment options, which may include a referral to a physical therapist or a pelvic floor specialist/urogynecologist, who can offer advanced treatments or surgical care.

Atrium Health Women’s Center for Pelvic Health is also available to address pelvic floor disorders. It is home to nationally renowned physicians, who are pioneers in their field and are some of the only surgeons in the region to perform certain minimally invasive gynecologic surgeries.

Your Sex Life

At your follow-up visit, your doctor will check to see if you’ve healed enough to return to sex. Once you get the all-clear, Dr. Sabir says it's important to realize that between sleep deprivation, the stress of motherhood and hormonal changes, you may experience a change in sexual desire or arousal.  “Ask your partner for help in alleviating some of the stress you’re under. Given how overwhelming life is with an infant in the house, even scheduling time for sex can be helpful,” she suggests.

And whether you’ve had a vaginal delivery or C-section, Dr. Sabir recommends liberal use of lubrication during your first intimate encounters after childbirth. This will help to alleviate the discomfort you might experience due to still-healing vaginal tissue and the hormonal changes going on in your body.

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