To say that becoming a mother is a life-changing event is an understatement! While you probably suspected there would be some challenging days after your baby arrived, you may have been caught off guard with just how hard this time can be.
Those first weeks home with a newborn can feel like an endless cycle of feeding, sleeping and changing diapers made crazier by exhaustion, hormonal changes and new parent anxiety. You may be wondering if this is “normal” or if you’ll ever feel like yourself again. Take heart, you are not alone and you can do this, especially with some idea of what to expect.
This article will look at some of the more common challenges new moms face after having a baby, known as the postpartum period. Here are some tips to help you through.
What is the Postpartum Period and Why is it Important?
The time after your baby arrives through about 6-8 weeks is known as the “postpartum period” (not to be confused with postpartum depression). This time is also referred to as the “4th Trimester.” According to the World Health Organization the postpartum period is the most critical and yet the most neglected phase in the lives of mothers and babies. The more we can openly talk about common and important challenges mothers face after childbirth, the more prepared moms will be for this time.
Hormonal and Emotional Changes
During pregnancy your body produces 10 x the normal level of estrogen and progesterone. Within 3 days postpartum (around the time your milk comes in), your estrogen and progesterone drop back to pre-pregnancy levels. The drop in these 2 hormones make room for prolactin and oxytocin, the hormones that stimulate milk production.
Additionally, endorphins that rise during labor to help you be more alert and cope with the process of childbirth will peak at delivery and then decline in the first few days after birth.
These hormonal changes, combined with the stressors of new parenthood, can take a toll on your emotions in the first weeks postpartum. As you make emotional adjustments to the stresses of new parenthood it’s helpful to know what’s normal, and what’s not. It may bring relief to learn that 80% of women experience what is known as the baby blues.
The baby blues occur during the early weeks after birth, usually lasting a few days or up 1-2 weeks. If you have the baby blues you may have feelings of overwhelm, sadness, irritability, anxiousness or anger interspersed with feelings of happiness and contentment. The key is that your difficult emotions are interspersed with good emotions–that’s how you know it’s probably just blues.
If the above symptoms persist for longer than 2 weeks or are accompanied by intense feelings of sadness, anxiety, despair or if you have thoughts of harming yourself or your baby it’s important to seek evaluation for Postpartum Depression. Call your healthcare provider or the Postpartum Support International Hotline 1.800.944.4773.
Tips:
- Work to prioritize self-care. It’s healthy to shower, leave the house alone for a quick errand, prepare and eat food you enjoy, etc. and ask for help so that you have time to do those things. Parenthood is sacrificial, for sure, but that doesn’t mean your needs don’t exist anymore. For the next few years, you will have to inconvenience someone to get your own needs met, and that’s OK.
- This is a temporary season of life, and it will get less intense relatively quickly even if it feels like forever while you’re in it.
When your baby is born, circle the date on your calendar that represents three weeks postpartum. By then, you will feel physically and emotionally much better! Circle a date another three weeks out, and look forward to how different things will be by then, too. Mentally, this helps you not get lost in the days and see for yourself how quickly things change.
New-Parent Anxiety
It is completely normal to feel some amount of stress as you are learning to care for this new little one. Endless questions may be running through your head…Am I swaddling my baby correctly? How can I be sure my baby and I are bonding? Is my baby eating enough? What is skin-to-skin? Why is my baby crying so much? Why won’t my baby sleep long stretches? Is it “normal” to feel anxious after having a baby?
If you’re having racing or intrusive thoughts or irrational worries about what could happen to you or your baby there is such a thing as Postpartum Anxiety. If you are experiencing these symptoms, call your provider right away.
Tips:
- Accept that you’re learning a whole new role and how to balance it all, while caring for a tiny helpless human being and start being ok with doing it imperfectly. The way that you talk to yourself in your own mind has a huge impact on mental wellness. Celebrate small victories!
- Tell someone how you’re doing. If you find yourself feeling like you’re in over your head or you’re just not yourself anymore, tell someone. Sometimes it feels impossible to find the words, but just saying, “I’m not ok” to your spouse, a family member, or a friend is a step toward healing and preventing things from becoming worse.
Try to get out of the house each day. You may find it helps burn off some pent-up, anxious energy.
Exhaustion
Between frequent feedings and baby not sleeping long stretches, it’s completely natural to feel exhausted during the first few months. In fact, one survey found that 25% of women reported struggling with exhaustion at 6 months postpartum.
Tips:
- Try and rest whenever your baby naps (this could mean just putting your feet up, closing your eyes for a few moments, calling a friend or whatever helps you feel more human). This may mean leaving the dishes and laundry to pile up for a bit.
- Ask for/accept help when offered.
- Eat a nutrient-dense, balanced diet.
- Try and limit or spread out visitors. You are not in a position to be entertaining! Give yourself permission to take it easy and focus on you and your baby.
Talk with your partner about taking the night shift with the baby on the weekends or periodically.
Breastfeeding Your Baby
If you have chosen to breastfeed, it helps to know that although breastfeeding is natural, it doesn’t guarantee that things will always feel natural about it. Breastfeeding, like other learned skills, can take time so it’s helpful to expect some challenges when you first begin.
Tips:
- Check that your baby has a good latch. Make sure your baby’s lips are fully out and his mouth is fish-faced while nursing. Usually, the cause of sore nipples is an imperfect latch. A lactation consultant can help you and baby learn better positioning.
- If breastfeeding hurts for more than 2 weeks, while the baby is nursing, between feedings, or if it hurts the whole time you’re feeding (not just on latch) find a Lactation Consultant right away. Try and find an IBCLC. Some Lactation Consultant’s are more helpful than others, so it’s worth trying a couple. The cost of a Lactation Consultant is much less than the cost of formula for a year.
Let your nipples dry between feedings. Leave a little extra milk on the nipple – breast milk has natural healing properties.
Here is an article offering more help and tips with breastfeeding.
Post-baby body
Many moms are surprised to find that they still look pregnant after their baby is born.
For most women, it can take between 6-8 weeks postpartum to return to what doctors refer to as non-pregnant anatomy and physiology – keep in mind this doesn’t necessarily mean you will “bounce back” to your pre-pregnancy body that soon.
Tips:
- Try not to focus on weight loss during the first 3-6 months after birth. During this time your body requires nutrients to recover from your pregnancy and childbirth.
- Be patient with yourself and your body – eat well, exercise when you are able and you should lose much of the weight over time. Small changes like taking the stairs, taking baby for a walk, cutting back on take-out can make a big difference.
- It may help to think of the amazing feat you just accomplished – your body grew and sustained life for 9 months so it’s unrealistic to expect it to quickly “bounce back”
If your baby likes to bounce, try doing squats while you’re holding your baby.
Returning to Intimacy
It is quite common to have some discomfort or pain the first few times you are intimate with your spouse after childbirth. In fact, a recent study found that 9 out of 10 women reported experiencing discomfort or pain the first time they had intercourse after childbirth. While it’s normal for intercourse to be uncomfortable initially, it should never be excruciatingly painful and it should not persist for longer than 1 month.
Tips:
- Hormonal changes lead to vaginal dryness, a personal lubricant may be helpful to reduce discomfort.
- Take it slow and talk to your spouse about how you’re feeling. True intimacy begins with good communication.
- Pain during intimacy may be due to pelvic floor dysfunction or scar pain from a tear or episiotomy. In this case, a Pelvic Physical Therapist can be very helpful.
Try sitting down with each other for a five-minute check-in each evening, or whenever your day allows. How are you doing? How are we doing? What do you need from me to help you feel more supported? Practice asking for what you need and expressing thankfulness for your partner.
Poor Bladder Control
Pregnancy puts a lot of stress on your pelvic floor muscles (a set of bowl-shaped muscles between your tailbone and pubic bone that stretch). These muscles stretch during delivery but afterward they may remain too loose or over-tighten in response.
One of the more common pelvic floor issues is leaking urine (stress incontinence) or frequently feeling the urge to pee (urge incontinence). You’ve probably heard ladies joke about peeing a little when they laugh or exercise. In fact, incontinence such a well-known post-childbirth symptom that it’s easy to assume it’s normal and can’t be remedied – but that isn’t the case! Even if you aren’t experiencing bladder control issues, a strong and coordinated pelvic floor may prevent incontinence down the road.
Tips:
- You’re not alone, don’t feel ashamed.
- If you continue to struggle with incontinence, seek out guidance from a Pelvic Floor Physical Therapist who will help you learn the correct exercises to strengthen and improve coordination of your pelvic floor muscles.
Start a bladder diary to become familiar with your toileting habits, discover trends over time and learn what foods and drinks trigger your incontinence.
As new mothers, it can sometimes feel like our emotional and physical health need to take a back seat to the time-consuming work of motherhood. We tell ourselves that we must simply power through so we can prove to ourselves that we are capable mothers. For some of us, we have waited so long for this child that we feel selfish to be anything other than thankful – it is ok to be thankful and yet overwhelmed. Remember your health and well-being are important and you are worth it!
Life After Baby Mini Course
This mini course addresses the challenges and physical changes many women experience after childbirth. Dr. Nicole Bringer, Pelvic Floor Physical Therapist and mom of 2, will take you through what’s normal, what’s abnormal after childbirth and help you begin solving these problems.
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Cited Research
March of Dimes. Baby Blues After Pregnancy. Retrieved on March 16, 2021 from https://www.marchofdimes.org/pregnancy/baby-blues-after-pregnancy.aspx
McDonald EA, Gartland D, Small R, Brown SJ. Dyspareunia and childbirth: a prospective cohort study. BJOG 2015: http://dx.doi.org/10.1111/1471-0528.13263
World Health Organization. WHO recommendations on postnatal care of the mother and newborn. Retrieved on March 16, 2021 from https://www.who.int/maternal_child_adolescent/documents/postnatal-care-recommendations/en/
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