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Postpartum changes are the physical and emotional changes that a mother goes through after giving birth to the baby.
These changes occur to bring back the mothers’ body to a pre-pregnancy state and sustain necessary activities such as breastfeeding. Some of these changes may get reversed coming back to the original state. Whereas, others might stay forever or complicate into a problem needing medical help.
Often the Immense joy of seeing your baby out of the womb is intermixed with these bitter and sweet changes.
Knowing what changes you may need to face and how they can be managed can help you a lot during this period.
The postpartum period is the period after the birth where the mother’s body tries to return to its original pre-pregnancy state. The phase starts after delivering the baby and the placenta and lasts till six months post-delivery.
It can be divided into 3 phases.
1. Acute postpartum phase: is the first phase that starts immediately and lasts up to 1 day. During this phase,the changes happen rapidly.
2. Early post-partum phase: is the 2nd phase, which lasts up to 1 week. The changes are relatively slower,and the problems are mostly self-identifiable.
3. Late post-partum phase: is the last phase that can last up to 6 weeks to 6 months. The changes happening are slow.
Even with a lot of changes, you may not be able to reach your pre-pregnancy physical function until after the six months.
Even after this period, the body is not fully ready to host a child again until after one to one and a half years post-pregnancy. It is necessary to maintain this period before conceiving again to avoid additional risk to both the child and the mother.
While the body faces a lot of changes, not all need extreme care and seem to return to normal eventually. Some of these changes are given below, and hopefully, they will help a new mother to manage them better.
Cause: here, the uterus tries to shed off the thickened inner lining along with some blood.This is somewhat similar to mensuration.
However, the discharge stays longer and changes its color from red to pale in color.
When and how it occurs:
• The first few days (1-4 days) will have a heavy and bright red discharge with a few clots, not very large.
• After this, from the 5th day till the 9th day, the discharge will become less heavy and will change the color from bright red to pink or light brown.
• From the 10th day to the 2-week mark, the discharge should become lighter in color, with only mucus.
Remedies for help:
• Sanitary Pads: It is advisable to carry extra pads as there can be increased flow during breastfeeding or while waking up. Use pads for the discharge.
• Do not use tampons: nothing should enter the vagina during this period.Always consider consulting a doctor before using it.
Time to heal: Lochia will subside eventually within 4-6 weeks after delivery.
Precaution: If there is extensive red discharge with large clots or foul smell even after 1 week of delivery, this could point towards an infection. You should consult the doctors immediately. The absence of lochia could also mean an infection.
One might think that the abdominal bulge developed during the pregnancy might get settled immediately after giving birth. This doesn’t happen soon. The uterus, which got enlarged in size to carry the baby during pregnancy,takes time to come back to its previous size.
This process is called the involution of the uterus, where it gradually reduces to its original size in about 6 weeks. This happens with the help of contractions where muscles of the uterus contract intermittently bringing its size down.
Uterus usually weighs 1000 grams initially and reduces to 500 grams after the 1st week. It then slowly reduces to 50 grams by the end of 6 weeks.
Health effects: These uterus contractions can also cause pain that can be very uncomfortable.
Remedy: you can discuss with your doctor who can suggest medicines to reduce the pain.
• Breast engorgement: After the delivery, breasts get enlarged due to the increased flow of blood in them.
• Nipple problems: Thenipples can also become swollen and cause pain due to cracks. Redness or irritation can mean there is an infection.
• Sagging breasts: Due to stretching of elastin and ligaments, breasts also tend to sag after pregnancy.
• Milk discharge: There can be discharge in between feeding or sometimes before the production of milk. This can stain your clothes, which may embarrass you in front of others.
Time: Milk production usually begins on the 3rd or 4th day after delivery.
Health Effects: A healthy mother produces about 500 to 800 ml of milk every day. To produce such a quantity of milk, the breast becomes engorged. This may cause heavy and tender breasts. Moreover, the milk may get accumulated inside the breasts forming small hard and painful lumps.
There are a number of ways to reduce the pain.
• Breastfeed the baby regularly, and don’t miss the feeding schedule. Frequent feeding will prevent swelling.
• Try expressing some milk with your fingers before feeding the baby or using the breast pump.
• Try to empty your breasts during a feed or by using a breast pump to avoid accumulation of the milk.
• In case, if one is not breastfeeding, pain-relieving medicine can be used.
• One can also use a sports or support bra when choosing not to breastfeed.
• Use ice packs if the pain is increasing.
• Use pads to prevent discharge from getting absorbed on the clothes.
• One can use cream or apply a little breast milk on the nipple after feeding to soothe the pain.
• Always consult a doctor or a lactation specialist to get more information on whether you’re breastfeeding correctly and if the baby is latching properly.
• One can also take a warm shower, but refrain from doing it, if it aggravates the pain.
During pregnancy, the body remains flooded with estrogen. This increased levels of estrogen support the hair longer and minimize its loss.
Postpartum: The levels of estrogen gradually drop back to normal, removing the protective effect. This causes the hair to step into its otherwise delayed breakage phase. Moreover, combined with the stress of delivery and disrupted routine adds up to the stress on hair. All of this brings a change in the hair texture and owes to an increased hair loss. This is experienced more during the 3rd or 4th month after delivery.
New mothers might feel stressed due to this excess hair loss and change in texture, which could result in a bad mood.
• Time: It is natural and will subside after the 6-month period.
• Eating healthy: protein and micronutrient-rich food and keeping hydrated, while avoiding smoking or unhealthy, are the right strategies to promote hair growth.
• Try following a healthy schedule as much as possible.
• Be gentle: when combing the hair and avoid tying the hair very tightly.
Swelling: Pregnant women gain over 10 kilograms during pregnancy and retain as much as 5 kg after delivery. Carrying this increased weight for more than 7 months can cause immense load on the feet and lead to swelling and pain.
Feet Arch: This extra load causes the arch on the feet to reduce, which can cause an increase in the shoe size due to elongation.
Relaxin: Another hormone called relaxin also plays a role in increasing the foot size. The hormone relaxes the muscles and the ligaments and helps the feet to spread.
Remedies: One should be prepared, and when this happens, it is time to switch to a larger shoe size and show off the new style.
Stretch marks: are common and occur due to weight gain and stretching of the skin during pregnancy. They can appear on your tummy,buttocks, and thighs. It might look disappointing, especially to a first-time mother. However, they are part and parcel of pregnancy, which can be managed to a certain extent by some of the treatments available.
Chloasma: Hyperpigmentation is faced by 85-90% of females during pregnancy. Some women also develop hyperpigmentation on the face called chloasma, which is also referred to as “the mask of pregnancy“. It is a dark colored (tan to brown) usually symmetrical patches seen on both sides of the face. Typical areas are cheeks, forehead, bridge of the nose, and chin.
Linea nigra: it is a thin dark vertical line that develops in the center of your belly. The line is about a centimetre wide and runs from the region of pubic hair to the belly button or some time to the top of the belly. It fades away over time as the melanin concentration reduces in the body.
Causes: Melasma and Linea nigra occur due to the increased synthesis of melanin. Melanin is the pigment that provides color to the skin and hair. The higher amount of estrogen, progesterone, and endorphins during the pregnancy results in these pigmentations.
• Stretch marks usually become lighter over time as the body returns to the normal shape. Some products like cream or oil available in the market can be applied best beforehand to prevent the stretch marks to a certain extent. Once these marks develop- some cosmetic treatments such as laser can be used. All the treatments can significantly reduce them but can’t completely remove them.
• Chloasma and the lineanigra usually disappear by 6-8 weeks. Sometimes chloasma persists for longer or even lifetime if ignored. This can be treated by a number of creams that may contain hydroxyquinone, tretinoin with steroids, or azelaic acid/kojic acid. If medicines don’t help, some procedures can be used, such as microdermabrasion, chemical peel, dermabrasion, laser treatment.
Precaution: Women who develop melasma should be careful when going out in the sun as it can deteriorate the condition and should consult a doctor for a remedy.
Causes: you gain weight during pregnancy by accumulating fat in the body. The accumulated fat is later used to provide energy for the production of milk. The body needs about 700 kcal energy every day to produce milk.
Time frame: Rapid weight loss is not a great idea and can lead to a lack of nutrition, causing lower production of breast milk. Weight loss of 1.5 pounds per week is apt and won’t hamper the lactation process.
• Eating healthy food: that contains lots of fiber and protein helps increase the metabolism, which in turn aids the process of fat loss.
• Breastfeeding requires extra calories: and doing it regularly will help burn more calories, thereby reducing the gained weight.
• Drinking plenty of water: staying hydrated is also important as it will increase the metabolic rate.
• Avoid alcohol: as it contains empty calories and can affect the baby if you are breastfeeding.
• Sleep well: Lack of sleep can cause eating disorders and depression.
• Take part in physical activity: Light to moderate activity, including walking or climbing stairs, will be enough.
Read more about: Post pregnancy weight loss
Hormone: Pregnancy leads to increased hormone secretion in the body, which can cause weak gums and teeth.
Vomiting: vomiting during pregnancy also exposes the teeth to stomach acid, which can damage the teeth.
Ignored oral hygiene: regular eating and ignoring oral hygiene can leave food lodged in the teeth, later, causing decay.
• Brush regularly and floss: to avoid food lodging in the mouth.
• Consult your dentist: regularly in case of pregnancy and let them know about it, also ask for advice to improve dental hygiene.
• Avoid brushing right after vomiting: as it can erode the enamel due to acid. Rinse the mouth thoroughly and use an alcohol-free mouthwash.
• Increase the intake of vitamin D and calcium to improve dental health.
• Gargle with salt water daily to reduce gum inflammation.
Damage: It is natural to lose sexual desire after delivery. Small tears, lacerations, constipation, blood discharge, and pain can all cause a negative impact on sexual desire.
Exhaustion: tiredness from taking care of the baby can be another reason for the reduced sex drive.
Oestrogen hormone levels: also drop considerably postpartum, and this can cause a reduced desire for sex.
• Sphincter laceration (a cut made for ease of delivery) is associated with a 270% increase in sexual pain after delivery.
• Intercourse problems can last up to 12 to 18 months, and about 35% of primiparous women complain of reduced sexual sensation while 24% complain of reduced sexual satisfaction.
Time: It is natural, and the women usually gain back their desire for sex after a few months (6-8).
Precaution: One should always ensure the use of contraceptives or protection as there are chances of conceiving after 6-8 weeks, even without menstruation.
Incontinence is the condition where one loses control of either urine or stool. The loss of bladder control is called urinary incontinence. Whereas, the loss of stool control is called stool incontinence.
Cause: This happens due to the extra pressure of delivery, which wears down the pelvic muscles, which in turn causes loss of control. Urinary incontinence can happen when one is laughing or coughing, causing strain.
Health Effects: Urination can also sometimes be painful, causing a burning sensation.
Incontinence in Women:
• Stress urinary incontinence is common and happens to 32% or primiparous women during pregnancy.
• Postpartum urinary incontinence is short term. If it lasts for more than 3 months postpartum,it causes a 92% chance of facing stress urinary incontinence at 5 years.
• According to a study, out of 72 women who had anal sphincter laceration, 4% faced stool incontinence 3 months postpartum, and it increased to 17%, 2-4 years later.
Kegel exercises or pelvic floor exercises: are beneficial in building the strength of the pelvic muscles, which will prevent incontinence.
Drink lots of water: stay well hydrated to prevent the burning sensation.
Soak: One can also soak in a hot water bath to reduce pain and ease the muscles.
Contact a doctor: in case the problem persists.
Another major concern post-delivery is difficulty in passing stool.This is common in females postpartum and can last for a few days. It might cause uneasiness and discomfort.
• Doctors can prescribe stool softeners if it becomes difficult or painful.
• Consume food rich in fiber, including a lot of fruits and vegetables. This will help in passing motions better.
• Make sure to drink plenty of water to ease the bowel movement.
Cause: Stomach muscles can get separated due to the expanding uterus and the body trying to accommodate the baby. It is natural and can be measured with hands,postpartum.
Steps for Measurement:
• Lie on the back with knees bent and feet flat on the ground.
• Raise your shoulder, like when performing an ab crunch, and check how many fingers can fit in the gap between the separated stomach muscles.
Precaution: The gap should reduce on its own as time passes. In case the muscles stay separated for more than 8 weeks, one should consult the doctor.
It is important to improve the strength of the pelvic muscles to prevent incontinence. This exercise is fairly very simple, doesn’t put much strain on the body, and can be done anywhere, sitting down, standing up, or even while lying down.
Steps to Follow:
• Squeeze the vagina and bladder like one is trying to stop urinating (peeing).
• Long Squeeze: Hold for as long as possible but not more than 10 seconds.
• Short Squeeze: Squeeze rapidly and let them go, do this until the muscle gets tired.
Repetition: Repeat the exercise at least 10 times for 3 times in a day.
Precaution: Make sure to breathe normally when performing them.
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