As a new mom, I found my postpartum body went through just as many unexpected changes as my pregnant body did. And just like during pregnancy, some of these changes took place quickly while others happened over a span of months. Most of these postpartum changes left me wondering if I missed a chapter in my “What to Expect When Expecting” book.
Years later, as a postpartum doula, I found many of my clients asking me about the same things I once was surprised by. To help my clients—and you, reader—to be more prepared than I was, I’ve created a list of some common postpartum changes any pregnant person should be prepared for:
Breasts: During pregnancy, you may have noticed your breasts change in size, shape, and/or sensitivity. After childbirth, your breast will likely continue to change and grow. During the first few days (up to 10 days) many women find their breasts change dramatically as they begin to produce milk for the baby. Breasts may become heavy, swollen and engorged. This is often uncomfortable and may even be painful—nursing frequently will help. Hormones play a role in the color of the areola which may darken after giving birth. Your nipples may become sore or painful; if this happens, seek support from a lactation consultant as soon as possible. We recommend holding off on buying any expensive nursing bras until your body adjusts to nourishing your baby. At about six weeks, your milk supply (and breast size) starts to regulate. This is a good time to splurge on nice nursing bras.
Sex: You will likely be cleared to have sex at your six-week postpartum check-up. You might find, though, that your sex drive isn’t what it used to be. Or maybe it is, but sex itself isn’t what it used to be. Hormonal changes might leave your vagina dry and tender, especially if you’re breast-feeding. You might also experience some pain during sex. If you tore or experienced any lacerations during birth this can be a part of why you might experience pain. Working with a pelvic floor therapist can help make postpartum sex enjoyable. Using plenty of body-safe lubricant may also help.
Hair: As your estrogen levels drop off and return to normal, you may start to shed a lot more hair than you did during pregnancy. Hair shedding takes place around 3-6 months postpartum and can last up to 12 months. During this time, it can feel like you are losing all of your hair. You may see it come out in clumps when showing or brushing your hair. Losing your hair in large quantities can be scary and sad, especially if you experienced months of thick, shiny locks during pregnancy. Rest assured, though, that this is a normal part of postpartum and most mothers can expect normal hair growth to return around 12 months postpartum.
Night sweats: Do you find yourself waking up in a puddle of sweat? You’re not alone—this is a common postpartum symptom. So what is the cause for this rather annoying postpartum change? Because estrogen increases during pregnancy and drops again after giving birth, low levels of estrogen can prompt night sweats during the first few weeks postpartum. Another culprit is excess fluid in the body. During pregnancy, the body takes on 50% more blood and fluids. The body no longer needs this fluid after giving birth, however, so it secretes it through sweating and urine. Night sweats generally peak at about two weeks postpartum and then begin to taper off.
Hemorrhoids: May women get hemorrhoids after delivery due to the immense amount of pressure pushing puts on the anus and rectum. Discomfort around the rectum, itching, burning and pain—especially after a bowel movement—are all possible signs of hemorrhoids. Talk with your provider if you’re experiencing any of these symptoms as—there are many options for relief and healing.
Postpartum bleeding: Stock up on the mesh panties and over-sized pads! Vaginal postpartum bleeding is known as lochia. Lochia is often times heavier and longer-lasting than menstrual bleeding. It also may look different than your period. The components of lochia consist of mucus and tissues from your uterus. The heaviest flow lasts up to 10 -14 days postpartum and then starts to taper off. Bleeding can last 4-6 weeks total. Tip: If your postpartum bleeding slows but then increases with activity, this is a sign you are over doing it.
Stomach: It can be a shock to wake up on day two postpartum to find a belly that looks like it did at six months pregnant. Instead of a firm baby bump, though, you’ll likely find a soft and squishy belly instead. Be kind to yourself and know this won’t last forever; you just spent nine months growing a baby, and that extra room your body created doesn’t disappear overnight. It will take roughly six to nine weeks post-birth for your uterus to shrink back down to its pre-pregnancy state.
Diastasis Recti: During pregnancy, your stomach muscles separate to accommodate your growing baby. After you have given birth, this gap does not always close. This common postpartum abdominal condition is called diastasis recti. The gap is usually 1 to 2 inches wide and can be a big reason for that “mommy pooch.” Certain exercises can exacerbate the gap, so it is best to speak with your provider to get a referral to a physical therapist.