Reclaiming your body after childbirth isn't just about shifting those pregnancy pounds faster than a celeb mum can say 'Pilates'. We explain the healing process
Weight-loss postpartum is the most obvious indicator that your body is returning to its pre-pregnancy state. But it's by no means the only factor, or for that matter the most important one. If it's taken your body nine months to prepare for childbirth, then it's pretty reasonable to expect it to take a little time to recover from this momentous event.
'Too much emphasis is placed on new mums having to be superwoman,' says midwife Zita West. 'My advice is to stay in your pyjamas as long as possible. The minute you're dressed and at the supermarket, it's assumed you're back to normal.'
Remember to listen to your body - if you have no energy, it's telling you to take it easy. Use the links below to find out what to expect after giving birth, and how to care for your changing body.
Nine months after a vaginal birth
The first week: emotionally For three to seven days after giving birth, women find that they can quickly swing from being depressed to elated, to feeling depressed again. About 80 per cent of new mums experience this, and it's perfectly normal. On top of the hormones, you're also exhausted, and have just taken on the most important job of your life.
Physically The first six weeks The first six months Not enough women get the rest they need. Baby and sleep-deprivation alone can drive you mad, without the hormonal cocktail thrown into the mix. Four months after the birth is when a lot of women experience really bad times, emotionally - the novelty has worn off, they're exhausted, and not so many people are rallying round, as they now see you as an experienced mum. Don't be afraid to ask for help - you still need it.
'You can also expect your weight to stabilise after six months. This, however, depends a lot on the woman and how hard she works at it - every woman is different,' says Zita. 'Breastfeeding will help shift pounds, too. Don't diet, though - low carb diets can leave you feeling exhausted. Adopt a healthy eating plan and sensible exercise programme. Accept that it may take 18 months for the body to be back to its pre-pregnancy state.'
Recovering after a caesarean
The first week: physically Regardless of the type of anaesthesia you received, within 24 hours after surgery, you will be helped out of bed and asked to move around. This will help your circulation and greatly decrease the danger of getting blood clots. The longer you stay upright the faster you'll heal. Make sure to get adequate pain medication so that you can move around, sit, and feed your baby comfortably.
After 24 hours, you'll be relieved of your IV and urinary catheter and be able to eat very bland, mild foods. As you introduce solids, expect to feel some gas pains - a sign that your intestines are beginning to function again. The slower you introduce solids, the less gas and bloating you'll feel.
Within two to four days, your sutures, staples, or clamps will be removed, and you?ll probably be allowed to go home.
The first week: emotionally At home If heavy menstrual-type bleeding continues after the first week or recurs after slowing, call your healthcare provider. If you're saturating a sanitary pad within an hour or appear to be haemorrhaging even more blood, call your doctor immediately. This could be a sign that a piece of the placenta was left in the uterus or that the uterus isn't shrinking properly.
Within six weeks you'll be able to start exercising moderately - but wait until your caregiver gives you the go-ahead. It may be several months before you're back to your former fit self. Remember you've undergone major abdominal surgery. All the same, you'll be able to resume sexual intercourse within four to six weeks, with your medical practitioner's OK.
Call your doctor if:
When can I...
Have sex? 'The answer to this is, when you feel ready,' says Zita West. There is no pressure. Your midwife will check you after 6-8 weeks to make sure everything is back to normal. It's common for women to want to rush straight back into pre-pregnancy routines, but give yourself time, especially if you had an episiotomy - uncomfortable sex is very distressing, both physically and psychologically. 'Bear in mind that prolactin, the breast-feeding hormone, is nature's anti-aphrodisiac and, if you are feeding your baby, you may not fancy sex for 3 months or more,' adds Dr Sarah Brewer. This is perfectly normal. Less than 20 per cent of couples resume sexual activity in the first month, but 90 per cent do so by 4 months.
Use tampons? 'I'm not a big fan of tampons, postpartum or otherwise - I don't think it's healthy to stop the flow of blood,' says Zita West. 'Ideally, you should let your blood flow get back to normal. I would advise sanitary towels in the months after giving birth, but if you do use tampons make sure they're organic.'
Wear a g-string? Good news for those of us who never liked them anyway, Zita recommends 'big pants' for at least the first six weeks. 'G-strings can increase the chance of recurrent infection or irritate the healing process if there is an episiotomy scar. The same goes for tight jeans or trousers,' she advises.
Eat my favourite food again? 'You can eat most of your favourite foods again after giving birth,' says Zita, 'But be cautious if breastfeeding - peanuts might not be a good idea, for instance, as you don't want to trigger an allergy. Check with your healthcare practitioner.'
Use scented bath products? Zita recommends caution. 'These can irritate any scar tissue and lead to infection in an area that's pretty battered and bruised anyway,' she says. 'Ideally, wait until everything's healed up properly.'
For more information on the Zita West Clinic, which offers pre-conception, pregnancy and postnatal care, call 020 7224 6091. For Zita West products (all the essentials before, during and after pregnancy) call 0870 1668899 or visit www.zitawest.com
'The hormones oestrogen and progesterone increase when a women is pregnant but, after giving birth, they're gradually withdrawn over a six week period,' explains Janet Fyle, midwifery advisor at the Royal College of Midwives. Post-delivery, these hormones stimulate the production of breast milk. However, because the body is already striving to get back to its pre-pregnant state, this can cause mood swings as hormone levels fluctuate.
The placenta is removed straight after the birth, and the uterus immediately begins to contract back to its original size. This causes after-pains. Your midwife will keep an eye on this (failure to contract might indicate an infection). It will take six weeks for it to revert back to normal, becoming a pelvic rather than abdominal organ, again. The cervix also begins to shrink immediately after giving birth, and will likewise make a full recovery in six weeks. Start doing those pelvic floor exercises now!
Experiencing any or all of the following is entirely normal within the first
six weeks after giving birth:
'The main physical healing takes place over the first six weeks; the emotional over about six months,' says Zita West. 'The big factor in re-balancing hormones is how well rested and prepared for labour a woman was. I advise my patients to give up work at 32 weeks. So often they work until the last possible date, and give birth a week or so later, when they're still exhausted and unprepared.'
If you had general anaesthesia, you'll feel groggy and possibly nauseated as you come round. The nausea can be relieved with medication, but may not subside completely until the anaesthesia wears off, which takes approximately 48 hours. You'll also be shown how to cough or do breathing exercises on a regular basis, to expand your lungs and clear them of any accumulated fluid, which decreases the risk of pneumonia. Be sure to use your hands or a pillow to support your incision when you cough (ditto sneezing and laughing).
Your hormones will be rebalancing, as if you'd had a vaginal birth, so expect to experience the same gamut of emotion as your fellow new mums. However, mums who've had C-sections often have to contend with feelings of guilt, inadequacy, frustration or resentment, if you had your heart set on a vaginal birth and feel you were cheated out of it. These feelings can be hard to dismiss, especially when everyone keeps telling you how irrational you're being. If you feel this way, remind yourself that giving birth is just one part of the pregnancy process. You did a fantastic job of nurturing and protecting your unborn baby - the outcome being a healthy mum and baby. Also remember that many women find their babies' births, whether vaginal or C-section, bear only scant resemblance to what they actually expected.
Accept you'll need help. Ask for support from your partner, parents, in-laws, and friends or, if you can afford it, hire paid help. You may need prescription painkillers for up to a week after surgery, gradually changing to over-the-counter pain relievers. Just as you would if you'd had a vaginal birth, you'll experience a discharge called lochia, which originates from the site where the placenta was attached to the uterine wall. For the first week or so it will be bright red; it gradually turns pink and then yellow-white, and may last up to six weeks.