You, after birth

Not many people talk to you about how you and your body will look and feel after your baby is born, so here is all you need to know – and what others don’t tell you

You’ll probably have all sorts of books and magazines that talk about your body and baby through every one of your 40 weeks of pregnancy. You’ll chat for hours about the birth options you’d like and what kind of care you want in labour. You’ll picture yourself reaching down for your baby and then feeding him or her for the first time.

Many of us stop there, like a freeze- frame in a film. Yet it pays to be educated about your body after the birth too, as there can be some surprises! If you want to be prepared and know how to cope, read on.

Time

This may sound strange but your concept of time seems to change. Many of us wish that someone had said at the time, that new mummy time is outside
of ‘normal’ time. It’s only when you look back on it that you will truly understand that each day, which seems to go on forever, is just a normal day. Problems like a tender tummy, soreness ‘down there’, aches and pains from labour, plus conditions like colic in your baby seem to be going on forever.

It helps to have perspective. Sleepless nights and new mummy worries will pass and you will soon be looking back on them. It helps to know, when you’re in the moment, that it won’t last forever – it just feels like it!

Your hormones and mood

Just before giving birth, you have a huge surge of hormones nurturing your baby. After the birth, the levels drop to a low. This can lead to your feeling irritable or sad (like a huge surge of pre-menstrual syndrome) and can be blamed for the ‘baby blues’ that a lot of women feel around a week after giving birth. It’s normal to feel like this; however, if the feelings continue, you could be suffering from postnatal depression and it’s important you get some help.

The hormone Oxytocin floods your body after the birth and it encourages bonding with our baby and helps us care for our tiny new human. What it also does, though, is make you prone to seeing everyday things that might cause danger or jeopardy to your baby – dirt and germs, illness and household accidents. While this is useful, it can make you anxious and postnatal anxiety can sometimes get out of control. Again, talk to someone if you feel like this.

You may find you cry about silly things during the post-partum period. Let the tears flow, it’s cathartic.

Lochia

After you have your baby, you will bleed from your vagina. Some women assume that it’s like a period but it’s really quite different and it’s worth being prepared for this, as many women are shocked by just how much they bleed. Mixed in with the blood is mucous and uterine tissue and clots that can be quite alarming!

Most of the blood comes from the area where the placenta was attached to your womb, though there may also be bleeding from any tears you may have incurred during the birth.

Remember you’ll need to stock up on maternity pads – and don’t think that your pre-pregnancy thin pads will do. You’ll also need sturdy knickers (or that God-send, disposable mesh pants) to hold them in place, so if you’re usually a thong or Brazilian kind of girl, think about investing in some larger pants!

Heavy bleeding at first is usually quite normal, though if you’re concerned, you should speak to your midwife and keep track of how many clots you’re passing. It usually lasts at least six weeks and gradually gets lighter, going from red through to pinkish and brown. Finally it will be a creamy colour and then stop, though you may have days when you bleed again and others when you bleed more heavily than others.

When you breastfeed, your womb contracts, so when you’re feeding, you will feel cramps and you will pass more lochia. Change your pad before feeding or have a towel to sit on just in case.

If you suddenly start to bleed heavily, it may be a postpartum haemorrhage (PPH). This can happen within 24 hours of birth and can be due to a retained placenta. Heavy bleeding between 24 hours and 12 days is called secondary PPH and may be due to an infection. If you are passing larger clots, speak to your midwife. You may be overdoing it.

Call a doctor or ambulance if you are soaking a pad in an hour, the blood is fresh and red, you feel faint or dizzy and are passing lots of clots. You may need medical treatment.

If you have pains in the abdomen, feel feverish and unwell and the lochia has an unpleasant smell, you may have an infection. Call your midwife for advice and urgent medical treatment.

How do I care for myself?

Hygiene is really important ‘down below’, especially if you have had stitches. Make sure you wash your hands before and after using the loo and changing your pads and keep things clean with a daily bath or shower. You should not use tampons nor moon cups.

The science and the myths

Some women who have had Caesareans are surprised that they have the same amount of bleeding as women who have vagina births.

There is some anecdotal evidence that women who have a more ‘natural’ birth have less bleeding, or it’s less prolonged, than those who have an actively managed third stage of labour. This is when the midwife will give an injection of syntocinon or syntometrine to help the placenta come away from the wall of the womb.

After pains

You’ve had your baby, you’re resting in bed and you figure it’s time to get to know each other – so why are you still having contraction-like pains? After pains are actually still contractions and are helping your womb contract back down. This is obviously quite handy in that it will help your insides get back to normal but it also helps to prevent bleeding from the womb. They can go on for a while, as long as 24 hours. They can also recur when feeding (see above).

Bonding isn’t always instant

Do you imagine that the first moment you see your baby, you’ll fall instantly in love and little bluebirds will fly over your flower- draped head? For some, that may be the case (though birds are frowned on in hospitals) but for many, bonding is slower. You’re suddenly presented with a tiny person, who has likes and dislikes and acts like a tiny dictator from day one and it takes some getting used to.

If you haven’t got friends and relations with babies, you may not know much about how to care for this tiny being. Don’t worry if you don’t instantly feel like Earth Mother – this parenting lark takes some getting used to.

Your stomach

Contrary to how it appears on Hollywood films, you don’t emerge from the delivery room with washboard abs, wearing your favourite pre-pregnancy jeans. In fact, you may wonder if you have given birth at all as you gaze down at your tummy after you’ve had your baby and feel cheated. I mean, all that came out – your baby, the placenta and all that fluid – so why is your stomach still so big?

Relax, this will take some time and gradually your insides and your tummy will shrink back down due to those after- pains and feeding contractions and you’ll start to look more like you did before your pregnancy. Of course for many of us, our stomachs will look a bit different to before we had kids – but each stretch mark is a badge of pride that we have carried our gorgeous babies and given birth to them.

Don’t expect to rush back into exercising but after your six week check- up, you can start to think about some gentle exercises (see panel) such as a walk in the fresh air or some stretches to tone your tummy. Most important, of course, are pelvic floor exercises! You should start these as soon as you can.

Your joints

During pregnancy, a hormone called relaxin floods into your body and makes your joints more flexible. This is to

allow your pelvis to open out during birth. Unfortunately, it means that you may damage your joints more easily during pregnancy and for a few months afterwards. That’s why it’s important that you find an exercise class where the teacher understands pregnant bodies but you should also bear it in mind when you start to exercise after the birth. Take it easy and don’t over-stretch or try to do too much too soon.

Your ‘bits’

OK, so this is an area that will probably change quite a bit after birth – at least temporarily. Your labia and vagina may look at little different, though will probably get back to ‘normal’ fairly soon. You’ll find that simple events like going to the loo suddenly become problematic. If you are sore or have had stitches, urine stings, buy a cheap plastic jug before the birth and when you pee, pour lukewarm water over yourself at the same time to stop it stinging. Having a poo can also be a big problem, especially the first one after giving birth and you’ll be worried about it, which makes it worse. Keep drinking water and if you need it, ask your midwife for a laxative suppository. If you tore and have stitches, you may worry about ‘popping’ them, so hold a clean sanitary pad over the stitches as you go – it will help you pass your poop with a little more confidence! You may find that you have a little urinary incontinence and pee when you sneeze or cough. This, again, will hopefully get better (keep up the pelvic floor exercises) but if, later on, it’s still an issue, ask your doctor about remedies.

Your hair

Pregnant hair is usually lush and fulsome, because those hormones stop normal hair loss. After you have had the baby, you may find that your hair starts to fall out. This can be a worry but it is normal. On those days when you brush your hair and come away with a full brush of shed hairs, you may start to panic. Rest assured that nobody else but you will notice. Interestingly, some women find that the texture of their hair changes and that they get changes to their skin too.

Here’s the good news

Don’t worry, all of this gets better and it’s important to keep that top of your mind. Your body will return to something like normal, your life will become more settled, you will sleep through the night, you will have sex again and you won’t break your baby. Try to relax and enjoy those early days with your little one, as they go by so very quickly.

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