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 not true for all women. In fact, it’s hardly true for any woman. It takes more time, patience, and – sometimes – specialized pelvic floor physical therapy – before a woman feels more like her normal self.
The Postpartum Healing Timeline is Not the Same for Everyone
The length of time it takes for your body to heal depends on multiple factors, not the least of which include:
- Genetics
- 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 healthcare provider who understands that recovery doesn’t happen on a set schedule. You need a team willing to counsel, advise and help you find the support and assistance you need if you experience postpartum pain, discomfort, or discontent 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 wiping the 6-week deadline off the calendar and, instead, planning to let your body and your psyche be your guide. In some cases, women are ready to get back 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 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 the timeline for your body’s needs after birth.
0-6 weeks
You could consider this period the “shock and awe” phase, which will stretch into more like 10 to 12 weeks if you had a more traumatic delivery or 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 heavy, slow down and then fade away. If the flow becomes stronger again, it’s a sign that you are doing too much and need more rest. Sitz baths are an excellent tool for healing your post-birth vaginal tissues and can be a relaxing time to spend with the baby. You can make your own sitz bath or purchase pre-made baths from a health food store or a local, certified herbalist.
YOUR MISSION: Set boundaries and get some rest. Ensure your spouse, partner, family members, and friends know the sign for “it’s time for guests to leave” so well-meaning visitors leave 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 instead a food source for 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 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: 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 excess 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 feel like sex is still painful or uncomfortable, this is an excellent time to check in with your OB and ask for a referral to a women’s health physical therapist.
A women’s health physical therapist specializes in assisting 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 discount anything that doesn’t feel right. If things don’t feel like they should, reach out for 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 ensure you are happy, healthy, and well? Please schedule a consultation with us here at Overlake, where compassionate care is always the priority.