Many women who have recently had a baby are surprised by the physical changes that happen to their body right after giving birth. A lot of that information wasn’t thoroughly covered if you didn’t know to ask about it. So we connected with Dr. Ashley Tovo, an OB/GYN at Medical City Dallas, about what you might want to know about your body after baby.
DFWChild: Can you detail some of the changes a new mom might experience with her body after baby and when they tend to present?
Dr. Ashley Tovo: Women will see many physical changes at the hospital and soon after going home. Many are surprised they may still look pregnant when they leave the hospital, which is completely normal. Bleeding may also last for several weeks, though it should be heavier in the hospital. Your nurses will monitor bleeding while you are hospitalized and may even utilize a technique called uterine massage or a fundal massage to help with contractions and decrease bleeding.
Another physical change is engorged breasts. Especially with the first baby, women will often leave the hospital before that happens. It may be up to a week before you get those sensations.
Hot flashes are also common since there are many hormonal changes happening in your body. Constipation can also be common with vaginal deliveries and C-sections. This is important to address with your physician. Hair loss can also [happen].
C: How long do some of these changes last?
AT: Many physical changes happen within the first month of delivering. One of the more long-term changes is “diastasis,” or the separation in your tummy muscles. Sometimes the muscle separation can persist, so some women may benefit from extra core strengthening exercises or seeing a specialized physical therapist or chiropractor. A woman’s pelvic floor muscles may also be weakened and require effort and strength to rebuild.
In terms of weight, everyone’s bodies are different, and some women need to gain a different amount of weight during their pregnancy. I think it’s important to be patient. A good lesson I have heard is that it takes 40 weeks to grow your baby and it will take 40 weeks to get back to your goal. All moms should show grace to themselves.
C: Are there certain postpartum symptoms that women should be concerned about if they last too long? AT: Several postpartum symptoms should be reported to and monitored by your OB, including persistent bleeding. If someone is still having heavy, bright red bleeding four to six weeks after delivery, they should call their provider to address this.
It is normal after delivery to have engorged breasts as milk is starting to come in—but in terms of infection, if one breast is really painful, red and hot, this can be concerning for mastitis. Additionally, severe headache and visual changes are important to watch for and report.
C: What about having that first period after baby?
AT: That varies if you are breastfeeding or not. If you’re not breastfeeding, that cycle may come more quickly. Typically, normal menstruation will come six to eight weeks after your delivery. These first few periods after childbirth can be heavier and involve more cramping.
C: We’ve all heard of the baby blues and postpartum depression. If a new mom thinks she might be battling the latter, when should she seek professional attention?
AT: Postpartum depression is a serious condition that should be addressed, and it has been challenging for women during the COVID-19 pandemic—with adding more isolation on top of being at home with a newborn.
Baby blues are milder mood changes [that are] experienced within the first two weeks after delivery. Feeling a little more emotional or fatigued is common. If your symptoms seem more concerning, such as suicidal or compulsive/obsessive thoughts, you should immediately call your provider to discuss.
Your physician should be providing checkpoints to monitor mild or more serious postpartum depression. At Medical City Dallas, we have questionnaires, and the care team starts screening for postpartum depression while you are still hospitalized.
If someone triggers a certain score on that scale, the care team will automatically call a social worker or counselor to come and talk with our patient. Additionally, this questionnaire is given when you come in for a postpartum check-up or bring your baby to the pediatrician.
C: And what about the ever-elusive rest? New moms should expect to be sleep deprived, but is rest important to their emotional recovery on top of physical?
AT: Yes. Take naps and let your partner help with feeding and diaper changing so you can get some sleep; it’s also important when it comes to managing postpartum depression. Having partners and family members be aware of postpartum depression signs is an excellent idea so they can provide support.
This article was originally published in December 2020.