Monmouth County's Ask the Doctor

When Does Your Body Go Back to ‘Normal’ After Pregnancy? By Margaret Dufreney, MD

While there are many resources for women on what to ex- pect when you are expecting a baby, patients often ask me what to expect after delivery, when a woman’s body continues to experience a myriad of changes. Until I had my own baby recently, I had told my patients to expect their bodies to go back to “normal” functioning in six to eight weeks. Physiologically, many of the body’s systems have returned to baseline within this time frame. However, I can tell you from personal experience that every woman’s body is different. In general, here’s what you can expect to experience after having a baby: • Your uterus, which enlarged as your baby grew, will take about six to eight weeks to contract back to normal size. During this process, you may experience cramping, bleeding, a heavier-than-normal period, and/or vaginal discharge.

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• Your abdominal wall muscles will slowly regain their muscle tone over time. In some cases, the muscles sepa- rate, causing a condition called diastasis recti. This caus- es the belly to protrude or bulge. It can be treated with physical therapy.

• Your body will still be surging with fluctuating hormones after delivery. You may experience “baby blues” or post- partum depression, which is common. Sleep deprivation and fatigue may make symptoms worse. Postpartum blues usually resolve within two weeks, whereas postpartum depression persists. If you still feel depressed, anxious, or frustrated after two weeks, contact your doctor. • If you choose to breastfeed, you may experience breast engorgement, pain, discomfort, clogged milk ducts, or mastitis, an infection of the breast duct. Breastfeeding can be a challenging, painful process. It may take a while for your baby to learn to latch on to your nipple, and it’s easy to become frustrated. However, there are breastfeeding specialists who can help you and your baby master this new skill. • You may find that you lose a lot of hair after delivery. This is due to the hormonal changes that occur during preg- nancy. Hair loss can continue for six months after delivery. However, don’t panic – new hair will grow in its place, usually within six to 15 months. • You may have urinary issues, including urine leakage or incontinence. This condition is more common among women who have delivered vaginally since pushing can weaken your pelvic floor muscles and delivery may damage the nerves in that area. It’s normal to have some leakage, and it should improve in a few months. Ask your doctor about exercises that can help tighten your muscles. Pelvic floor therapy with a trained physical therapist can help as well. • If all the symptoms above weren’t uncomfortable enough, you also may develop hemorrhoids during or after preg- nancy. As your baby grows and your body carries more weight, you can become constipated, causing you to strain during bowel movements. Then, during delivery, pushing can further inflame and irritate your rectum. They typi- cally get better over time, or you can use cream or stool softeners to treat the condition. Getting Physical Again In general, you should wait six to eight weeks after delivery before exercising or having sex. You may not feel up to get- ting physical even after eight weeks, so it’s important to talk with your partner about your feelings. You may begin ovulating again three to four weeks after having your baby, so consider using birth control if you’re not ready to become pregnant again. While breastfeeding may suppress ovulation, it’s important to note that you can get pregnant while breastfeeding. Avoid birth control methods that use estrogen during the first 30 days after delivery due to increased risk of blood clots. If you are breastfeeding, avoid estrogen because it may reduce milk production. You will notice a variety of physical changes during and after pregnancy. Odds are that what you are experiencing is normal. While everyone is different, you can expect to feel “normal” again in about six months. Dr. Margaret Dufreney, MD, is a board-certified obstetrician-gynecologist on staff at CentraState Medical Center. She can be reached by calling 866-CENTRA7.

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ASK THE DOCTOR

SUMMER 2020