Pregnancy and childbirth really do a number on the female body (tell you something you don’t know, right?). Seriously, though – the medical establishment is only beginning to dig in and take a closer look at the seriousness of the changes that take place – and how they can affect women in the long term.
The idea that a woman should be back to normal and feeling great “down there” at six weeks postpartum is simply not true for all women. In fact, it’s hardly true for any women. It takes more time, patience and – sometimes – specialized pelvic floor physical therapy – before a woman feels more like her normal self.
It Can Take a Year or Two to Heal Completely
Recent research out of Salford University in the UK, led by Dr. Julie Wray, found it takes more like a year for the average woman to feel back to normal – both physically and emotionally – after giving birth. And, upon closer examination, the abdominal muscles can take as long as two years to return to a strong, healthy tone.
The length of time it takes for your body to heal depends on multiple factors, not the least of which include:
- The type of labor/delivery you had
- Whether or not you had an episiotomy
- How your body did (or didn’t) heal after an episiotomy or tearing
- Breastfeeding (breastfeeding helps to shrink the uterus and improve tone but it also increases your body’s production of relaxin, a hormone that relaxes ligaments and joints in the hips and pelvis, potentially causing more instability)
- Impact on pelvic organs that can lead to muscle weakening, bladder incontinence and organ prolapse without proper detection and therapy
One of the keys to your postpartum recovery is selecting a health care provider who understands that recovery doesn’t happen on a set, six-week schedule. You need a team who is willing to counsel, advise and help you find the support and assistance you need if you experience postpartum pain, discomfort or discontent that goes beyond the “six-week and all is well” checkup.
A Gentle Guide (and Timeline) to Healing From Childbirth
What does this mean for you…and your partner? It means, wipe the 6-week deadline off the calendar and, instead, plan to let your body and your psyche be your guide. In some cases, women are ready to get right down to life as usual – work, sex, play, travel – but their bodies are still experiencing pain, scar tissue, or shape changes that make it difficult.
In others, a body – including the vagina, clitoris, and perineum – might feel pretty great after six-weeks. However, exhaustion, stress and the demands of a new little baby can render you “unready,” causing guilt, anxiety and stress that takes its toll on you and your relationship.
Here is a more gentle, and realistic, guide and timeline for what your body needs after birth.
0-6 weeks. You could consider this period the “shock and awe” phase, and it will stretch into more like 10 to 12 weeks if you had a more traumatic delivery or if you had a C-section. In addition to the uterus returning to its normal shape (which often happens with contraction-like sensations or cramp-like feeling), the organs in your abdominal cavity are shifting back into their normal places – including your urethra, vagina and anus.
Lochia, the blood and fluid that evacuates the uterus during this period, will start out heavy, slow down and then fade away. If the flow becomes stronger again, it’s a sign that you are doing too much and that you need more rest. Sitz baths are a wonderful tool for healing your post-birth vaginal tissues, and can also be a nice relaxing time to spend with baby. You can make your own sitz bath or purchase pre-made baths from a health food store or from a local, certified herbalist.
YOUR MISSION: Take a “Babymoon”. Make sure your spouse, partner or mother/mother-in-law know the sign for “time for guests to leave” so well-meaning visitors are ushered out when you’re tuckered out. Get plenty of rest and DO take advantage of your friends’ offers to help with laundry, meal prep, house cleaning, grocery shopping and so on. The more rest you get during these first few weeks, the better off your body, mind and soul will be.
Breastfeeding to 4-months post-breastfeeding. You’ve heard all that great stuff about how breastfeeding women lose baby weight faster and all that jazz? Sometimes that’s true. Sometimes, in an effort to save your baby at all costs (read famine, drought, emergency migration), you may hold onto several extra pounds of fat that are not the enemy, but rather a food source for both you and your baby if times were leaner.
For about four months post-breastfeeding, your body will continue to make relaxin, and that extra layer may perpetuate a bit, until your body is 100% sure it won’t be needed to provide breast milk again. Joints and ligaments can be a little more elastic during this period of time so if you are a high impact exerciser, pair your routine with yoga, Pilates or some other form of exercise that works on strengthening the core.
YOUR MISSION: Try to make exercise a regular part of your routine, even if it’s as simple as brisk walks with baby in the stroller, or stretching on the floor to your favorite Yoga video if getting to a class is too complicated or expensive. The extra circulation will boost your endorphins and the gentle workouts will continue to improve abdominal tone while helping you to lose extra weight.
Up to one or two years. Your pelvic and abdominal muscles/organs are still on the mend. Pay attention to what your body is telling you. If you have scarring around or in your vagina, or you feel like sex is still painful or uncomfortable, this is a good time to check in with your OB and ask for a referral to a women’s health physical therapist (HRPT).
Remember when we mentioned that the medical establishment was only beginning to truly acknowledge and research post-partum recover at a deeper level? The field of women’s health physical therapy is one of the wonderful after-effects of this research. WHRT is designed to assist women with all manner of pelvic floor issues that can occur as a result of pregnancy and childbirth, including things like vaginal pain, urinary incontinence, rectal pain or issues with bowel movements, pain/discomfort during sex, symptoms of prolapse and so on.
YOUR MISSION: Don’t take a health care practitioners lack of education or understanding keep you back from having the body and sensations you deserve to have. If things don’t feel like they should, we bet a great HRPT can help. We’re lucky to have dozens of pelvic floor physical therapists throughout the state of Washington. Click Here for a list of resources.
Would you like to consult with an OB or midwife who goes beyond the typical six-week calendar to make sure you are happy, healthy and well? Schedule a consultation with us here at Overlake where compassionate care is always the priority.