“It takes nine months to make changes and nine months to reverse them.” We’ve all heard it before. After the initial six weeks’ postpartum healing period, you’re left with a body that is familiar but not quite the way it was before. We’re here to tell you that some of these changes may be around to stay.
In collaboration with obstetrician and gynecologist (OBGYN) Dr. Edmund Hon, Healthy Matters brings you a guide to Post-Partum Changes, Part Two: Long Term Changes.
Appearance – Long term changes after pregnancy
- The extra weight gained during pregnancy can take a long time to lose. After the initial loss of the baby’s weight, amniotic fluid, increased plasma volume and water weight, many women will hold on to some of the weight they’ve gained during pregnancy. How much weight you retain in the long term is associated with how much weight you gained during pregnancy. Aiming to lose 0.5 – 1 kilogram per week over a longer period of time by incorporating movement is more realistic and sustainable than losing weight quickly. Try to make sure you practice healthy habits such as eating a balanced diet full of fruits and vegetables and exercising – even walking with your baby in the stroller will help. Think of these as lifelong habits to model for your little one.
- Speaking of weight gain, those extra 10-15 kilograms gained during pregnancy often flatten the arches in your feet and cause an increase foot size. The solution? New shoes!
- As a result of post-partum hormones settling back to normal, the full and shiny hair you had during pregnancy starts to fall out, peaking at around the 3-4-month post-partum mark. It can be alarming at first but it should even out within a year.
- After plumping up during pregnancy and breastfeeding (whether you actually breastfed or not), your breasts may change shape when you stop. Producing milk causes breast tissue to become more dense. When you finish breastfeeding, that fatty and connective tissue may shift. Some women may end up with breasts that are larger than pre-pregnancy, while others may have breasts that feel ‘empty’.
- Approximately 80-90% of women will get stretch marks at some point in their pregnancy. Some stretch marks may fade to a light, silvery colour, while others may remain dark and more red. Unfortunately, they are difficult to remove altogether without laser therapy or cosmetic surgery, however some women have found that applying a cream containing hyaluronic acid when stretch marks are red can help them fade.
- During pregnancy, some women develop a dark line, known as the linea nigra, going vertically down their bellies. The linea nigra takes up to several months to fade.
Sexual health – Long term changes after pregnancy
- Tiredness, a changing family life, increased life and work stress, and low estrogen levels can lead to a decreased sex drive in post-partum women. It may seem impossible now but most women are back to their normal levels within a year.
- Your fertility may decrease in the months post-partum as your hormones balance and you begin to ovulate again, but it is still possible to get pregnant in that time. Don’t forget that ovulation occurs before your period arrives so you may be fertile before your first period arrives. Birth control is still advised in the post-pregnancy period!
Physical health – Long term changes after pregnancy
- A weak pelvic floor can lead to longer term issues. During pregnancy and delivery, your pelvic floor muscles can become stretched, potentially causing long term incontinence, bowel control, uterine prolapse, and reduced sensation during sex. Strengthening your pelvic floor anytime in the pregnancy/post-partum period can help prevent and address these issues. If you are having trouble doing Kegel exercises or have a feeling of heaviness or pulling in your pelvis, experience pain during sex, or have a sense of rubbing against your underwear, please contact your physician.
- Key to getting back into or starting to exercise after a baby is ensuring your core muscles are strong enough to support your body. Women with uncomplicated vaginal births can begin gentle postnatal exercise a few days after giving birth; women who had a c-section birth should wait until they have their six-week check-up. The Hong Kong Family Health Services has a helpful guide to early postnatal exercise plan. Once the core is stable and you have no further concerns, you can ease into the exercise plan of your choice. Make sure you keep an eye on what feels comfortable and if vaginal bleeding increases, slow down and give your body more time to heal. Keep in mind that your body has worked hard over the last nine months and it make take some time to get back to the fitness levels you had pre-pregnancy.
- Finding time to fit exercise in is another big challenge for new (actually, all) parents. If you cannot leave your baby with someone during hours you actually want to be awake, there are lots of ways to fit in a bit of exercise here and there. Your baby will be captivated watching you do lunges, push-ups and star jumps all over the room! Or try taking your baby outside for a walk. Pushing them in a stroller or carrying them in a carrier will add a bit of resistance and expose them to the fascinating outside world.
Mental health – Long term changes after pregnancy
By now, you will have experienced the highs and lows of parenthood. Some days feel like you’re completely on top of this motherhood gig and other days, teething/sickness/a sleepless night hits and all of a sudden, everything you knew about this little bundle of joy goes out the window and you feel like you’ll never get a hang of being a parent.
Everyone needs support of one kind or another. As mentioned in Part One of this series, your support system can be made up of other parents with a baby of a similar age, someone who can watch your baby, and/or a partner who shares the load.
Knowing when you need a bit of extra support is key to taking charge of your mental health. In our book, The Hong Kong Maternity and Baby Book, psychologist Dr. Quratulain Zaidi describes the difference between baby blues and postpartum depression. With the baby blues you may feel emotionally fragile, anxious and overwhelmed but it only lasts for a few days and should be gone by two weeks postpartum. Postpartum depression is longer term and onset is anytime in the first year. Symptoms may include unexplained sadness, insomnia, feelings of worthlessness, disinterest in your baby, anxiousness, and a feeling of a loss of control. If you begin to feel like this, it’s important to contact your obstetrician, GP, or a psychologist as soon as possible. Early intervention is key to both you and your family’s well-being.
Additional information can be found through your doctor, the Hong Kong Family Health Service or NHS Choices.
Take home message
After all new parents go through in the first year, it’s a hard pill to swallow that having a baby will affect your appearance as well as physical, mental, and sexual health. It’s important to give yourself time to heal, discover what being a parent means to you and get to know your baby. Keep an eye on yourself and arm yourself with the resources you need.