Your body after birth

Having a baby is the most beautiful and crazy thing that can happen in life. Your body also changes. He looks different, feels different, and may still be struggling with the rigors of pregnancy and childbirth. Your body will take a while to get back to normal – and most physical changes are nothing to worry about. Gynecologist Dr. Elisabeth Rosen explains how to deal with postpartum discomfort and when to see a doctor.

1. Your back needs a break

During pregnancy, your back will be under more strain than it was before. A condition known as symphysiolysis (aka: symphysis loosening) can cause lower back pain. "The symptoms usually start around 18. Weeks of pregnancy around and can affect any woman", according to Dr. Elisabeth Rosen. "It is believed that this condition is related to the loosening of the ligaments and joints between the lower back and the pelvis due to the hormonal changes during pregnancy."

Here’s what you can do: If you suffer from severe lower back pain after giving birth, you should talk to a health care provider. If you suffer from lower back pain in general, the following tips may help:

  • Sit up straight and make sure your back is supported while you breastfeed your baby. Put a small pillow behind your lumbar area to support your lower back. Make sure your feet hit the floor.
  • Kneel or squat down (without bending your back) to stay close to the floor while you z.B. Picking up toys or bathing your baby.
  • Always change your diaper on an elevated surface. For example, you could kneel on the floor next to the sofa or bed. Don’t leave your baby unattended while lying on an elevated surface.

When to see the doctor? "If you need regular pain medication for more than 2 weeks, you should seek medical advice," recommends Dr. Roses. "Your health care provider may prescribe other pain medications, a TENS unit (which uses mild electrical current to relieve pain), acupuncture, or a back belt to help stabilize you."

2. Your pelvic floor is recovering

Vaginal birth can leave marks on the pelvic floor area, such as a mild or moderate tear. This can cause pain, discomfort, pain during sex, incontinence and constipation for a few weeks after birth – but these symptoms should subside after 2 months at the latest.

What you can do: "Immediately after birth, you can apply a cooling pad or cold compress to help the blood vessels constrict and the pain subside," recommends Dr. Roses. "Painkillers can also help, plus you should start pelvic floor exercises as early as possible."

When to see a doctor? "Usually the pain and discomfort will go away in the first 2-6 weeks," says Dr. Roses. "Persistent problems should be addressed at postpartum checkup."Your doctor will examine your pelvic floor and treat you appropriately if pelvic floor damage is suspected.

3. Heal perineal tears and episiotomies

During childbirth, the tissue between the vulva and anus is greatly stretched. This can cause a perineal tear – or the midwife or doctor may need to make an episiotomy. These birth injuries are stitched and should heal within a month.

What you can do: "Shower instead of bathing while you’re still bleeding, as bathing could get bacteria into your uterus," says Dr. Roses.

"Change your pads regularly and refrain from sexual intercourse until the bleeding has stopped – this is usually after about 6-8 weeks. It’s a good idea to check the wound and sutures regularly with a mirror to check for changes. Don’t worry if the sore becomes itchy or irritated. This is actually a good sign that the wound is healing. Often, massaging baby oil into the skin in the affected area can help."

When to see a doctor? "If you get a high fever, it could be a sign of infection. In this case, go immediately to your midwife or family doctor," advises Dr. Roses. "If the pain or swelling gets worse or a foul-smelling discharge comes out of the wound, you should also get medical help."

4. After cesarean section

About 1.4 million cesarean sections are performed in Europe each year. In Germany, they are used at ca. 30% of births made. After a cesarean section, your body needs to recover, everything just takes a little longer. "As with all major surgeries, a cesarean section carries the risk of infection through the incision as well as damage to the nerve, bruising is also common," says Dr. Rosen.

You can do: "Keep the suture clean and examine it regularly for changes," recommends Dr. Roses. "Many women try to be strong and go about their daily lives as usual. However, if you need pain medication, you should take it for at least the first 2 weeks after birth."

When to see a doctor? "If you get a high fever or the scar gets warm, if the pain, swelling, or redness increases, or if you see any kind of fluid – other than blood – oozing out, you should see a doctor," says Dr. Roses.

5. Hemorrhoids can occur

Hemorrhoids are swollen veins in or around the buttock area. They can occur both during pregnancy and after birth. It’s believed that up to 35% of all pregnant women suffer from them. "Hemorrhoids usually develop during pregnancy due to the increased pressure the baby puts on the abdominal wall," says Dr. Roses. "Many women don’t realize they have hemorrhoids until they feel the itching or discover blood on the toilet paper. But hemorrhoids are usually very treatable."

What you can do: Drink plenty of fluids and eat a high-fiber diet to keep your stool soft and prevent heavy pushing. Keep your buttocks clean and dry at all times. Try gently pushing hemorrhoids back into the rectum with your finger. Use a hemorrhoid cream or suppositories available at the pharmacy.

When to see a doctor? " Most of the time hemorrhoids can be treated well by yourself. But if you suffer from it for a long period of time and painkillers don’t help or you continue to bleed from the rectum, you should see a doctor," says Dr. Roses.

6. The uterine lining renews itself

It is normal for women to have bleeding for about 2-6 weeks after a vaginal delivery or cesarean section. The weekly bleeding (lochia) is a mixture of mucus, blood and tissue that is shed after birth, as the lining of the uterus is renewed.

Here’s what you can do: "Shower daily, change your pads regularly, and abstain from sexual intercourse until bleeding has stopped completely," recommends Dr. Roses.

When to see the doctor? "If you suddenly start bleeding more or observe blood clots, you should see a doctor," says Dr. Roses. "Sometimes parts of the placenta or mucosa can remain after birth, and you may need medication to re-expand the cervix – in rare cases, surgery may also be needed. If you get a high fever after giving birth, you should also see a doctor, as a fever could indicate an infection."

7. The vagina becomes dry and sore

"It’s quite normal for the vagina and the entire surrounding area to feel sore after delivery," says Dr. Roses. Also, due to low estrogen levels, the vagina can become very dry, which can cause pain during sex.

You can do: "You can put cooling pads on the swelling, apply a local numbing cream and take painkillers if needed", says Dr. Roses. "I would also suggest urinating in the shower to alleviate the stinging sensation of uric acid in that area." Also stick to the general tips above for pelvic floor issues.

When to go to the doctor? "If you still have pain when urinating after a week, it may be an indication of a urinary tract infection," says Dr. Roses. "A family doctor can easily confirm this with a test and prescribe you antibiotics."

8. Gap between the abdominal muscles

In about 60% of women, a gap forms between the straight abdominal muscles (rectus diastasis) during pregnancy. The cause is a splitting of the muscles that run in the middle of the abdomen, because the baby exerts more pressure on the abdomen during pregnancy. The width of the cleft varies from woman to woman. In most cases, the abdomen regresses about 8 weeks after birth.

You can do: Begin with a gentle workout for the abdominals and core. Ask your midwife for appropriate exercises to reduce the gap between muscles.

When to go to the doctor? "If after 2 months you still have a gap that is wider than 2 cm or causes you pain, you should see a doctor," explains Dr. Roses. "Your doctor can prescribe physical therapy for you."

9. Skin and hair changes

"The hormonal changes during pregnancy can have very different effects. Some women report having glowing skin, while others suffer from acne," says Dr. Roses. "Some women report hair loss after childbirth, but this is actually due to fluctuating estrogen levels."

"During pregnancy, estrogen levels are high, which means that hair does not fall out as quickly as it would without pregnancy. When estrogen levels drop again after childbirth, you then lose the hair that would normally have fallen out anyway, but that stayed on your head even longer because of your pregnancy."

What you can do: "It’s important to eat a nutritious, healthy diet and make sure you get as much sleep as possible, and new moms should also eat if necessary. take a multivitamin," explains Dr. Roses. "Iron tablets can also help. You should be careful with this, however, as it can cause constipation."

When to see a doctor? If you lose hair only in one place and not on the whole head, you should see a doctor. Hair loss can be a sign of hyperthyroidism. This is unusual in postpartum women, however, as doctors keep a close eye on thyroid levels during pregnancy.

10. Your mood swings

"Mood lows are due to the hormonal change. The baby blues occur around the third day after birth," says Dr. Roses.

Here’s what you can do: " It is important for both you and your partner to be aware that around the third day after birth, the baby blues can set in. This awareness is already half the battle," explains Dr. Rosen. "Usually these feelings disappear by themselves after a few weeks."

When to see a doctor? If your mood hasn’t improved after a few weeks, you could be suffering from postpartum depression. "This one is not so rare and you should not be afraid to seek medical help," recommends Dr. Rosen. "In many cases, behavioral therapy helps, sometimes antidepressants are also prescribed."

If the body remains like this?

The biggest changes happen in the first few weeks after birth, as mom’s body recovers and restores itself. The uterus regresses, injuries heal, hormone balance returns to normal. This regression process continues even after the first few weeks. Give your body time and get medical advice if you have complaints or if you are worried about a physical change.

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