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Dr Sarah Temple
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A family doctor with more than 20 years experience working with children in both General Practice and Mental Health Services. Trained to run Emotion Coaching Parenting Courses. She has a special interest in the link between child and parental wellbeing.
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Birth and Labour

Changes to your body after birth

A summary of the changes you can expect in your body after your pregnancy and birth. Some welcome - some not so much!
Video Tutorial
In Short

There are many changes you can expect to happen to your body after your baby’s birth including:

Swollen feet.

Incontinence.

Breast engorgement.

Bleeding.

Hair loss.

Looseness and tears.

Haemorrhoids and piles.

Caesarian Scar.

Changes to your body after birth

Even if you’ve had a straightforward birth you can feel like your body isn’t back to ‘normal’ after the birth of your baby. Pregnancy, birth and an assisted delivery can leave you with various aches, pains and changes in your body. Some of these are temporary, some may require treatment and some may be permanent, for example, some women will go up a shoe size after their baby is born.

Swollen Feet

Some women can feel very swollen after birth. Swelling in the lower legs and feet, called oedema is totally normal. Any fluids resorbed by your uterus, as well as any IV fluids received during labour, can gather in your feet and extremities, such as your hands. The swelling should go down within a fortnight. Sometimes your shoe size will go up either temporarily or permanently after birth since your ligaments spread a little and your feet may spread.

Incontinence

Incontinence after birth is normal and usually temporary. The muscles inside the vagina have been stretched during a vaginal birth and you may find that you leak urine, especially if you laugh or cough unexpectedly.

If you are experiencing a lot of leaking wear a thick sanitary towel (which you will be wearing to soak up the bleeding called lochia after birth), go to the toilet frequently even if you don’t feel you need a week and tell your doctor at your postnatal check.

If it’s just a case of muscle tone you can strengthen your pelvic floor muscles with kegel or pelvic floor exercises (generally imagining you are weeing and stopping midflow) which you can do whenever you remember or often are part of postnatal yoga and pilates classes which focus on building core strength after birth.

Breast engorgement

Usually around 3 days after the birth, your breasts will swell and feel very full and heavy. This is a sign that your milk has come in. If your breasts become hard and painful they are engorged (which is not the same as your milk coming in) and you need to make sure that your baby is latching on properly and breastfeeding efficiently. Once your baby is emptying your breast of milk during a breastfeed the engorgement should pass. If your baby is unable to breastfeed, for example if they are in NICU and not able to suck effectively) you should start expressing your milk to ease engorgement and get milk production going so you can feed your baby your milk with a pipette, cup or bottle.

Bleeding

Postpartum vaginal discharge, known as lochia, is blood and cells from the lining of your uterus. This can go on for several weeks and will lighten gradually. It is better to use a thick sanitary pad rather than a tampon, which carries a risk of infection.

Whilst blood loss is normal after birth there are some symptoms that need medical attention from either your midwife or GP or in life threatening situations you need to call an ambulance and get emergency treatment.

If your bleeding is very heavy and bright red this might be a postpartum haemorrhage. A haemorrhage like this may happen within 24 hours of birth (although secondary haemorrhages can occur up to 3 months after birth). The causes can include retained placenta or when the uterus doesn’t contract back to its pregnancy size (afterpains are a sign that this happening).

Emergency symptoms accompanied by the blood loss include:

  • Increasingly bright red blood (especially if this is 4 days or more since the birth).
  • Using more than a pad each hour.
  • Blood contains clots bigger than a milk bottle top.
  • You feel faint and your heartbeat seems fast or irregular.

Call your midwife or doctor straight away if your blood loss lochia has an unpleasant smell, you feel feverish, bleeding stays bright red after 7 days, your abdomen feels tender.

Hair loss

During your pregnancy, your hair may have been your crowning glory as you have reduced hair loss. However, after your baby is born your oestrogen levels fall which means all this retained hair will start to fall out. This can be noticeable when your baby is about 12 weeks old but your hair should return to the pre-pregnancy condition in time.

Looseness and tears

The uterus, bladder and rectum can all fall a bit as a result of labour. Usually, this is a temporary thing that resolves as you resume normal activity.

Kegel exercises can help strengthen the pelvic floor muscles. Eat plenty of fruit and vegetables, and drink lots of water so you avoid straining with constipation.

The majority of women will tear a little bit during birth and about two-thirds of tears will need a few stitches (severe third-degree tears are rare and can reach to the muscles around the anus, they require stitching, often from a surgeon after the birth). Tears and stitches from tears and episiotomies can feel sore after birth and you can feel like your whole vaginal area is bruised.

To ease the pain of stitches and tears and aid recovery so makes sure you have a bath each day followed by about 5-10 minutes with a bare bottom to give the wound air. If it’s very painful a cold gel pack can ease the swelling and the pain and you can rent a valley cushion from the NCT which is like a doughnut that allows you to keep the pressure off the wound when you sit down.

Haemorrhoids or piles

Piles are swollen blood vessels in the rectum. They are common in pregnancy and women also develop them after birth from the pressure of pushing. They can be very itchy, sore and uncomfortable. Again, cold gel packs can relieve the discomfort but speak to your doctor if they haven’t gone. If you haven’t had these during pregnancy, you might still get them during the birth , owing to the huge pressure caused by pushing. You should keep the area clean and patted dry and you can gently push the piles back inside while you are in the shower. If you use a cream make sure that it is suitable for pregnancy or breastfeeding women.

Caesarian scar

It can be a shock to try and sit up after you’ve had a c-section as the muscles you use to sit up have been cut to deliver your baby. However, it’s important to get up and about as soon as you can after the birth but you may feel a little shaky the first time you wee, poo or have a shower.

At first, you will need to gentle support. Your scar when you do go to the loo or feel a sneeze coming on as it will hurt your scar.

Once the dressing has been removed (usually in the shower), you will need to keep the scar clean and dry (after showers) and look out for redness, puss or signs of infection.

Depending on the kind of stitches or staples your surgeon used your midwife may visit to remove them when you are back at home.

A caesarian section is major abdominal surgery so be gentle with yourself after the birth. No heavy lifting e.g. hovering and you may need a check-up before your car insurance allows you to drive again.

Postnatal pilates and yoga focus on rebuilding your core muscle strength which is particularly helpful after a c-section as those muscles have been cut during the delivery of your baby.

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DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.