10 Common Postpartum Body Changes After Birth
Having a baby was without a doubt one of the most incredible experiences in my life. I count myself lucky to have been guided by a group of wonderful doulas and childbirth educators who prepared me not only for giving birth, but also for getting through my postpartum journey.
Nonetheless, I was surprised by how much our bodies actually change after giving birth.
As postpartum doula, I witness firsthand that many families struggle with postpartum recovery... and many times, this is because they didn’t really know what can happen. The more families I support during their fourth trimester, the more I find myself noticing that many prepare extensively for birth but not nearly enough for postpartum. And this needs to change.
In fact, studies have shown that many new parents “do not feel prepared for the postpartum experience”.
That being said, what are some of the most common body changes that new parents experience after childbirth? What are some of the potential physical challenges we may expect? And what can we do about them?
In today’s article, I'm focusing on 10 common postpartum body changes that new parents may face after birth. Stay tuned for part 2 of this series, emphasizing on possible emotional changes during postpartum.
Constipation
Hormonal changes
Diastasis recti
Engorged breasts
Incontinence
Postpartum bleeding
Night sweats
Postpartum hair loss
Uterine cramping
Perineal sensitivity
Disclaimer: This list is not meant to be exhaustive and serves as general guidance only. If you are experiencing any of the challenges listed below or are concerned about extended symptoms, please ask for help and reach out to your trusted medical health care provider.
1. Constipation
Constipation is a very common aspect of early postpartum.
It is characterized by infrequent, difficult or painful bowel movements. We talk about constipation for less than three bowel movements a week, and/or considerably less bowel movements than what is normal for your body.
There are several reasons for postpartum constipation, including dehydration, weakened abdominal muscles, iron supplementation, effects of pregnancy hormones, damage to the pelvic floor muscles or perineal pain.
What to do:
It is important to stay very well hydrated with ample amounts of water, warming infusions and herbal teas. Drink at least 8-10 glasses of water every day, and always have some liquids next to your as you rest your body.
Try incorporating a variety of healthy fibers and fats into your diet to get your digestive system moving again. Here, think nourishing soups and stews, healthy fats like ghee, coconut oil and avocado, or slow-cooked bone broths if animal foods part of your diet.
In most cases, increasing your intake of fibers and liquids will already help improve your constipation systems. If problems persist, you may want to consider taking a laxative or consult your doctor.
Tip: If you need inspiration, the book “The First 40 Days: The Essential Art of Nourishing the New Mother” is one of my favorite recipe books for postpartum. Ask your family, friends or postpartum doula to whip up some of the tasty recipes to support your postpartum healing journey.
2. Hormonal Changes
Our bodies are incredibly well designed to adapt to pregnancy and postpartum. Hormones play a huge role in helping our bodies prepare for childbirth but also in ensuring our bodies recover from the strain of pregnancy and delivery.
A couple of hormones come together in incredible harmony during pregnancy, birth and postpartum:
Estrogen and Progesterone
The two hormones that have increased during pregnancy to support your growing baby and changing body, estrogen and progesterone, plummet considerably after childbirth.
Oxytocin
Also called the ‘love hormone’, oxytocin initiates the uterine contractions for delivery, helps release breastmilk when it’s time to nurse and facilitate a loving connection between the new parents and their baby.
Prolactin
Prolactin is responsible for stimulating milk production during the entirety of the mother’s breastfeeding journey. It can impact metabolism, fluid regulation, behavior and the immune system.
Relaxin
This hormone is heavily secreted by your reproductive organs during pregnancy. As its name indicates, it helps soften the cervix and vaginal opening as well as loosen pelvic ligaments in preparation for childbirth. If you choose to breastfeed, your body will also continue producing relaxin during the entire duration of your breastfeeding journey.
Thyroid Changes
In addition, thyroid hormone levels are prone to change after giving birth. Postpartum thyroiditis may cause: irritability, anxiety, increased sensitivity to heat/ cold, fatigue, insomnia, heart palpitations, weight gain/ loss or constipation.
What to do:
Remember that hormonal fluctuations are a normal and healthy part of postpartum.
Listen to your body. Notice changes. Learn about what is normal and healthy when it comes to the interplay of hormones during pregnancy and postpartum.
If in doubt, ask your trusted health care provider.
3. Diastasis Recti
Diastasis Recti (Source)
Diastasis recti is a partial or complete separation of the “six-pack” muscles (rectus abdominis) at the midline of your stomach.
As the uterus stretches to accommodate your growing baby during pregnancy, your abdominal muscles may separate. It’s a common condition for 60% of women.
Diastasis recti may happen because of:
stretched muscles and connective tissues,
increased pregnancy hormones (estrogen & relaxin),
and extensive pushing during labor.
The most noticeable indicator for whether or not you have diastasis recti is a slight vertical pooch or bulge in the middle of your stomach, especially when you contract your muscles in that area. This gap can be up to 2.7 cm long.
What to do:
First of all, make sure you get enough rest immediately following childbirth. Your body has been through a lot, so please honor it.
Avoid any heavy lifting or abrupt movements that are hard on your abdominal muscles. When you get out of bed, roll to your side first, then support yourself with your arms to gently sit up (instead of sitting up straight from your back).
Try to focus on good posture and support your lower back with a pillow or towel behind you to avoid additional strain.
If your baby loves to be carried (as most of them do 😉), avoid carrying them on your hip but instead use an ergonomically friendly baby carrier or baby wrap to distribute the weight evenly.
Once your body has rested during the first few weeks after giving birth, consult with a pelvic floor physiotherapist, a physiotherapist specialized in postpartum care or a perinatal kinesiologist to put together a treatment plan for gently strengthening your abdominal muscles.
Tip: For those of you in Montreal, Quebec, I highly recommend ASK Physiothérapie for pelvic floor physiotherapy and Véronique Brouillette of Maman Active for perinatal kinesiology.
4. Engorged Breasts
As the mother starts producing breastmilk for her newborn baby, her body undergoes a set of changes. One of the most common changes for new mothers – regardless of whether they decide to breastfeed or not – is engorged breasts.
Breasts are engorged when they feel heavy, hard, tense and painful. This happens a few days after childbirth when the initial colostrum (also called “liquid gold”) is replaced by milk, and whenever the mother’s milk production is stimulated by her baby.
What to do:
The first step to relieving engorged breasts is ensuring a good latch and increasing the frequency of the feeds you offer to your baby.
Milk can also be expressed by hand or by a breast pump.
Massages and cold compresses can help offer some relief for sensitive breasts.
If pain persists, please consult a certified lactation consultant (IBCLC) for a custom treatment plan.
Related article: 7 Common Breastfeeding Challenges & How To Overcome Them
5. Incontinence
Although it is rarely talked about, urinary continence is very common in postpartum and affects almost 50% of all pregnant women.
As mentioned above, our pelvic floor muscles go through considerable strain during pregnancy and childbirth and sometimes no longer offer adequate support for our bladder in postpartum. Other reasons for postpartum incontinence include previous incontinence, multiple pregnancies, vaginal or difficult delivery (forceps/ vacuum) or being overweight.
Risks for Postpartum Incontinence (Source)
What to do:
If possible, reach out to a trusted pelvic floor physiotherapist as early as during your pregnancy to start strengthening your pelvic floor muscles with targeted, personalized exercises. If you have already given birth, schedule your first postnatal pelvic floor checkup as early as possible to look at underlying causes of your incontinence.
During pregnancy and in postpartum, integrate a gentle yoga practice into your routine (once you have honored an extended rest period after childbirth). Regular yoga sessions can help strengthen your core, bring awareness of particularly critical areas and foster your connection with your own body.
Similar to diastasis recti, avoid high-impact exercise and abrupt movements.
Tip: I attended prenatal and postnatal yoga classes through Naada Yoga, my personal favorite yoga studio in Montreal.
6. Postpartum Bleeding
Also called lochia, postpartum bleeding is a very natural part of the recovery process after childbirth. It refers to the discharge of blood, mucus and uterine tissue through the vagina.
Usually, postpartum bleeding lasts anywhere from 3 to 10 days after giving birth, which is when it should gradually transition to light bleeding and eventually spotting. Think about your menstrual flow, but heavier and with more mucus and tissue from your uterus. Lighter bleeding and spotting usually lasts for 4 to 6 weeks after delivery.
The color of postpartum vaginal discharge varies and changes with time.
The Lochia Color Code (Source)
What to do:
Although there’s really nothing that can be done to prevent or lessen the bleeding, there are a few considerations to keep in mind.
First, stock up on extra thick pads or postpartum diapers to absorb the unusually heavy flow. You will be bleeding a lot and need to make sure you are equipped. Look for postpartum or urinary incontinence pads here.
Then, invest in some large black underwear for extra comfort and less worries around staining your favorite underwear. Remember, postpartum is not the time for lingerie, but for comfort.
Do not use tampons or any other menstrual tool that is inserted vaginally.
If you experience prolonged bleeding or are concerned about the color/ texture of your discharge, please consult your doctor.
7. Night Sweats
As hormones fluctuate and change, it is very common for new mothers to experience hot flashes or so-called night sweats. They may wake up hot, dehydrated and drenched in sweat – especially during the first few weeks of postpartum.
Night sweats are most commonly due to a sudden decrease in progesterone and estrogen levels during postpartum and lactation and due to your body getting rid of excess fluids that were stored during pregnancy.
As certain hormones decrease, one hormone increases: prolactin. Prolactin is the hormone responsible for breastmilk production and the growth of mammary tissue. Indeed, our body temperature increases by about 0.5 degrees after childbirth.
What to do:
Although postpartum night sweats will typically disappear after a few weeks, there’s a few things you can do.
Focus on moisture-absorbing clothing like cotton or natural fibers in general. Cooling pads or starting a fan could help bring some temporary relief.
Keep hydrated and always have a bottle of water handy to increase your water intake.
Avoid trigger foods such as alcohol, caffeine, excessively spicy food or too large portions.
Tip: I always put a change of clothes and a fresh towel next to my bed to make night sweats a little bit easier.
8. Postpartum Hair Loss
Many of us get to enjoy lusher, thicker, shinier hair during pregnancy. Then, postpartum hits and we end up using quite a chunk of it. Why is that?
Postpartum hair loss is a normal (and temporary) side effect of the fourth trimester and beyond.
Usually, most women will experience some sort of hair loss in their first year after giving birth, then get back to normal around the 12-month mark.
The biggest reason for postpartum hair loss is (you guessed it!) hormones. While natural hair loss slows down during pregnancy, our hormone levels drop in postpartum and cause increased hair loss. And because it is happening all at once, it seems extra shocking.
What to do:
Postpartum is not the time for extensive hair styling, drying or curling. Let your hair air dry as much as possible and avoid applying damaging styling products.
Make sure that you’re eating nutritious foods and incorporate a variety of fruits, vegetables and healthy proteins in your diet (dark leafy greens, sweet potatoes and carrots, eggs and fish).
Continue taking your prenatal vitamins throughout postpartum to replenish your vitamin and mineral levels. This is especially important for breastfeeding mamas out there.
Extra tip: If all else fails, get creative! Buy a new fancy headband, wear that hat that’s in the back of your closet or rock that mom bun! Postpartum hair loss is nothing to worry about and will usually get better around baby’s first birthday.
9. Uterine Cramping
Also known as “afterbirth pains”, uterine cramping refers to the uncomfortable or painful sensation caused by your contracting uterus after childbirth.
Just like our uterus expands to accommodate our growing baby, placenta, amniotic fluid and umbilical cord, our uterus also shrinks back to its regular size after we give birth. The entire shrinking process can last up to about 6 weeks, but severe cramping usually only lasts for a few days after delivery. Sometimes, it coincides with breastfeeding.
Once again, we have our hormones to thank. Oxytocin, the so-called “love hormone”, is linked to labor processing, breastfeeding and also to uterine cramping.
What to do:
Alternative pain management techniques such as meditation, breathing and visualizations can help offer some relief. If you have practiced meditation or hypnobirthing techniques in preparation for labor, make good use of them now!
You can also consider pain medication (that is compatible with breastfeeding, if applicable).
If pain becomes too strong or unmanageable, please consult your doctor.
10. Perineal Sensitivity
Perineal care is an important aspect of postpartum recovery, especially because the perineum becomes extra sensitive during and after childbirth.
You may experience discomfort, pain or swelling in this area due to extensive stretching or tearing during labor. If you have stitches, you will also need to take proper care of them to promote healing.
What to do:
Give your body rest.
One of the easiest and most effective methods to soothe perineal sensitivity is cooling. Use ice packs wrapped in natural cloths to relief your perineal discomfort.
Fill a peri bottle with warm water to gently cleanse your vulva, vaginal opening and perineum after peeing. Peri bottles are usually given in hospitals but can also be bought in pharmacies.
Enjoy a soothing sitz bath. Fill our bathtub with 5-7 cm of lukewarm water and allow your perineal area to soak for about 15 minutes in a seated position. There are also specific sitz bath tubs for parents who don’t have a bathtub. Feel free to add healing herbs to your warm water mixture for additional comfort and healing.
You can also prepare so-called “padsicles” (= frozen postpartum pads) ahead of time for your freezer. A couple of times per day, pull out a new padsicle from your freezer and put it in whatever underwear/ diaper you’re wearing. Make sure to change your padsicles every couple of hours.
Padsicles will provide pain relief, reduce inflammation, and soothe swollen tissue.
To make padsicles, you will need:
Maxi pads (buy the biggest/ most absorbent ones, usually overnight pads)
Witch hazel (for its anti-inflammatory properties)
Aloe (to soothe and promote healing after episiotomies)
Optional: healing herbs such as thyme, lavender or calendula.
A bag for freezing the padsicles.
For full instructions, I really recommend this padsicle article by Mama Natural.
