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What to expect after pregnancy

Bryn Mawr Hospital June 20, 2018 Maternity

You just spent nine months growing a tiny human inside of you, which culminated in you bravely pushing through the intense physical demands of birth, regardless of which delivery method you experienced. You might feel like you just got all of the hard work out of the way, but life after pregnancy presents its own unique set of changes and challenges.

There’s a reason people say that having a baby is a life-changing event: From the moment of conception, your life takes on new shapes and priorities as you find yourself at the beck and call of your new baby.

We consulted with Catherine Bernardini, DO, chief of obstetrics and gynecology at Main Line Health, to figure out exactly what to expect after pregnancy.

Your body changes—a lot

Depending on factors like your age, fitness level, lifestyle, and perinatal weight gain, postpartum physical changes vary from mother to mother.

“Changes happen over days to weeks to months and are sometimes permanent,” says Dr. Bernardini.

Let’s start with the uterus, a.k.a. your baby’s home for the better part of the last year. About six months after giving birth, the uterus shrinks back to its pre-pregnancy state. Don’t be fooled, though—this doesn’t mean your belly is necessarily back to normal, too.

Because your abdominal wall stretched to accommodate pregnancy and make room for the baby’s exit, there may be hernias and rectus diastasis, which is a splitting of the rectus muscles. This is more common with larger babies or multiples, like twins or triplets. Some women can recover easily with physical therapy, while others will seek the help of a plastic surgeon to patch things up.

“Most women are cleared to exercise at their postpartum appointment, and with work, time, and diet, can get back to their pre-pregnancy state,” says Dr. Bernardini.

You still get cramps

As the uterus shrinks down, many women experience “after-birth cramps,” which can be quite painful. These contractions are caused by the distribution of prolactin, a hormone released from a gland in the brain.

If you’re a first-time mom, the cramps probably won’t bother you too much. However, each pregnancy is associated with more intense cramping, so if you’ve been through this rodeo a few times before, you’re likely to feel them more each time around. Fortunately, they only last for a few days and typically clear up on their own.

You can expect some bleeding

Post-pregnancy, you can expect some bleeding. New moms often see quite a bit of blood after giving birth, and if they don’t know to expect it, they can understandably be a little spooked.

“The first 24 hours or so [after pregnancy] can involve bleeding that is likely heavier than you’ve ever seen, but it then rapidly decreases and changes from bright red and clotty to pink to white and yellow over a period that can last as long as two months,” says Dr. Bernardini.

Don’t be alarmed, though: This bleeding is normal, and it originates from where the placenta separated from the uterine wall. Those after-birth cramps are nature’s way of decreasing your bleeding.

Your period will (eventually) come back

Though it may take a while, your period will be back in action before you know it. However, the timing of its return varies significantly between women.

While some women can menstruate as early as a month or two after giving birth, others (especially those who are breastfeeding) might not get their period until a year after delivery. Most commonly, breastfeeding mothers menstruate again about five to seven months after birth, when they’re no longer the primary food source for their baby.

On a related note, there’s a common myth that you can’t get pregnant while breastfeeding. According to Dr. Bernardini, however, you can absolutely get pregnant immediately after delivery.

“Women will ovulate before the first period comes,” she notes. “Don’t take chances unless you’re okay with the possibility of getting pregnant again.”

Your libido may decrease

Don’t be surprised if you experience a dip in your sex drive after delivery. This is totally normal since your hormonal drive to get pregnant more or less disappears during the postpartum period.

Breastfeeding lowers your body’s estrogen levels, and consequently, many breastfeeding women experience vaginal atrophy and dryness, which can cause sex to feel uncomfortable and even painful. If you have any vaginal tears, be sure to let them heal completely before engaging in sex. After giving birth, women should hold off on intercourse until they’ve had their first postpartum doctor’s appointment.

Your routine will change—a lot

“The biggest shock to many first-time parents is the complete lack of control. Your entire life just changes,” notes Dr. Bernardini.

Your main focus is now your baby. A lot of your old priorities will likely fall to the wayside as you are now tasked with learning and understanding all of your baby’s wants and needs. For the most part, it’s a guessing game—your baby doesn’t exactly tell you what they want, which can be exhausting and frustrating at times. You, your partner, your family, and your friends will have to support and cooperate with one another to work as a team and ensure a smooth transition into parenthood.

You might experience mood changes

Whether you experience mild mood swings or a more severe emotional issue like postpartum depression, most women experience some degree of mood changes after giving birth. Keep in mind that these conditions—which may cause frequent crying, irritability, or anxiety—aren’t something you can control or should be ashamed of. It’s completely normal to experience behavioral fluctuations that coincide with the release of hormones after delivery.

If you’re struggling or suffering, or have additional questions regarding what to expect post-pregnancy, it’s time to make an appointment with a trained perinatal mental health professional who can help you work through your pain and find relief.

While everything varies when it comes to what to expect after delivery, all new parents can expect life to change significantly after the baby arrives. By acknowledging and being aware of what to expect after pregnancy, you can begin preparing for all the physical and emotional changes you may experience throughout postpartum recovery.

Main Line Health serves patients at hospitals and health centers throughout the western suburbs of Philadelphia. To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (225.5654) or use our secure online appointment request form.