Mama and Baby Blog Series : Common Issues in the First Year

Mama and Baby Blog Series : Common Issues in the First Year

Mama and Baby Blog Series : Common Issues in the First Year

If you’re just joining in, I’m helping Mamas navigate the world of motherhood. It can be an overwhelming and exhausting journey, and … let’s be honest … the internet isn’t always filled with accurate information.

So far we’ve covered:

Mama and Baby Blog Series : Recovery from Birth
Mama and Baby Blog Series : Maternal and Postpartum Depression
Mama and Baby Blog Series : Breastfeeding

Today we’re going to dig deep into topics that women just don’t talk about. I’m a huge proponent of sharing stories and talking about what you’ve experienced to normalize every journey, but some things just kinda get swept under the carpet and never addressed. So let’s talk about some of those today!

Don’t forget – if there is anything that you’d like to see in this series – burning questions that you may have, experiences that you’ve learned from, whatever it may be – please leave a comment and I’ll be sure to address it!

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Urinary Incontinence

Muscles of the pelvic area require time to heal and as they heal urinary incontinence will often ease off. Urinary incontinence, the inability to hold urine, is common in many women postpartum.

The same muscles that are used to push your baby through the birth canal are used to stop urine from escaping the bladder during normal activity. For some women, coughing and laughing cause urine to leak. For others, simply walking from one room to the next involves a trip to the bathroom for an underwear change.

Muscles of the pelvic area require time to heal and as they heal urinary incontinence will often ease off. Some women also have problems with urinary incontinence due to having had a catheter if a C-Section was performed. It can take up to six months for urinary incontinence to stop and bladder control to return to normal.

Kegel exercises are suggested throughout pregnancy and postpartum for urinary continence and increasing the strength of birth muscles. After birth, losing pregnancy weight can ease up pressure on the bladder to increase urinary control as well.

Some of the same treatments used for urinary incontinence during pregnancy are used for postpartum control. Controlling constipation can also help prevent leaks after giving birth. Full bowels can put pressure on the bladder causing urine leakage from time to time. Constipation can be controlled with a diet filled with tons of vegetables, fruits and high fiber starchy vegetables and increased water intake.

Wearing protective pads can help you feel a bit more in control of wetness and odor that is associated with urinary incontinence.

Diastasis Recti

“Diastasis recti” means your belly sticks out because the space between your left and right belly muscles has widened. You might call it a “pooch.” Pregnancy puts so much pressure on the belly that sometimes the muscles in front can’t keep their shape. “Diastasis” means separation. “Recti” refers to your ab muscles called the “rectus abdominis.”

It’s very common among pregnant women. About two-thirds of pregnant women have it. Having more than one child makes this condition more likely, especially if they’re close in age. You’re also more likely to get it if you’re over 35 when pregnant, or if you’re having a heavy baby or twins, triplets, or more.

The condition can cause lower back pain, constipation, and urine leaking. It can even make it harder to breathe and to move normally. It’s rare, but in extreme cases, the tissue may tear, and organs may poke out of the opening – that’s called a hernia.

The muscle opening often shrinks after giving birth, but in some studies of women with diastasis recti, the muscle weren’t back to normal even a year later.

So here are the dos and don’ts:

Don’t strain. It can make matters worse. Constipation and lifting heavy things, including your kids, strain that connective tissue. Standing up and sitting down also count as heavy lifting in this case, because you’re lifting your body weight.

Do be careful with exercise. Some routine fitness moves, including crunches, sit-ups, pushups, and front planks make abdominal separation worse. So can swimming, some yoga poses (like downward dog), and doing anything on your hands and knees.

Do heal your belly. Physical therapists don’t have one standard guideline on what moves will bring the belly muscles back into line. When the connective tissue has healed, some core exercises may help you strengthen and rely more on your transverse (deep core) belly muscles instead of the outer ones. I highly recommend finding a trainer and/or studio that specializes in diastasis recti. Working with someone who doesn’t know the ins and outs of diastasis recti could cause more damage, instead of promoting healing. One of my besties – Brooke Cates, creator of The Bloom Method – has a great blog post on this: Three Mistakes Fitness Professionals Make that Permit or Even Cause Diastasis Recti.

If your abdominal separation is not too big, you may decide to live with it. But you should bring those muscles back together before you have another pregnancy. Your doctor can measure how far apart your muscles are using finger widths, a measuring tape or instrument, or ultrasound. Then she can see whether it’s getting better or worse.

Many women can close their belly gap by learning gentle movements to use while the abs are supported. Ask your doctor for advice. She may refer you to a physical therapist. If that rehab won’t work for you, maybe surgery will. An operation to correct diastasis may be called “abdominoplasty” or “a tummy tuck.” The surgeon folds and sews together the weak central ridge. It might be possible to get laparoscopy, which is surgery done with only small cuts instead of one large one. Scarring, infection, and other side effects are possible with any operation.

Postpartum Endometritis

Postpartum endometritis is a common cause of fever after childbirth. It is initially diagnosed when there is a fever (38C or 100.4F) after delivery on two separate occasions and there are usually other signs of uterine infections such as uterine pain or tenderness and/or abnormal uterine lochia. Postpartum endometritis is more common after cesarean delivery than after vaginal delivery.

Certain risk factors may help predict who is at an increased risk for developing postpartum endometritis:

  • prior infections
  • prolonged labor
  • prolonged rupture of membranes
  • cesarean section

There are several potential complications that may develop as a result of postpartum endometritis, including:

  • infections of the bloodstream (bacteremia)
  • infection and thrombosis of the pelvic blood vessels (septic pelvic vein thrombophlebitis)
  • pelvic abscess
  • septic shock

Prompt diagnosis and aggressive treatment of endometritis is essential to prevent these complications. The good news is that postpartum endometritis can usually be treated with broad-spectrum antibiotics.

Painful Postpartum Sex

Many women do not desire sex after childbirth because of pain, or fear of pain, during intercourse. The time it takes for a woman’s desire to return to previous levels depends largely on her birthing experience:

  • Women who deliver with the assistance of forceps tend to take longer to feel comfortable during sex.
  • The same goes for women who experience internal vaginal tears.
  • Women with swelling after childbirth and/or any breakdown of the perineum (the external region between the vulva and the anus that is made up of skin and muscle) also tend to take longer to feel comfortable during sex.

After delivery many obstetricians usually tell their patients “nothing in the vagina for six weeks”, or “no sex until the 6-week postpartum visit.”

There are several reasons for the recommendation for delaying postpartum intercourse:

  • allowing the woman’s genital tissues to heal, especially if there was an episiotomy or tearing
  • allowing a cesarean skin or uterine scar to heal
  • avoiding infection to the genitals and the uterus

Six weeks is usually when the uterus should have returned to its pre-pregnancy size – this is the last of the major physical postpartum changes .

Studies have shown that the average woman resumes sex after 6 weeks, with a median time of 3 months, other studies found that 1 in 5 first time mothers took 6 months to feel physically comfortable during sex, and another study found that over 50% of women were still having less frequent sex at 12 months after childbirth.

The bottom line? Postpartum sex can be awkward, uncomfortable, and potentially painful. Don’t feel pressure to have sex 6 weeks postpartum – wait until your body is ready, and you are both physically and mentally ready.

Hemorrhoids

Hemorrhoids are swollen, and sometimes inflamed blood vessels, veins in your anus and lower rectum. As many as half of all pregnant women get hemorrhoids during pregnancy, particularly during the third trimester. If you have had hemorrhoids prior to getting pregnant, you are more likely to develop them during pregnancy. Similarly, if you’ve had hemorrhoids during pregnancy, you are more likely to develop hemorrhoids after your pregnancy.

Hemorrhoids are bulging and swollen veins in the rectum. They can be internal hemorrhoids that are located inside the lower intestine or they can be external hemorrhoids, where they protrude out from the anus.

During pregnancy, an enlarged uterus puts pressure on these veins. Add the extra weight you are carrying, along with constipation and the straining and pushing you had during labor, and you might see yourself with a case of postpartum hemorrhoids.

The most common symptoms of hemorrhoids are discomfort, itching, bleeding, and pain. You may notice streaks of blood on the toilet paper after using the bathroom. Bleeding hemorrhoids may seep mucus that can leave your skin irritated. If your hemorrhoids are internal, it is not unusual to see blood in your stool. In some cases, you may feel a lump near your anus as a result of hemorrhoids.

Fortunately, there are a number of things you can do to get relief from postpartum hemorrhoids:

  • Place an ice pack to your hemorrhoidal area a few times a day. Ice is helpful to reduce your discomfort and decrease the swelling of your hemorrhoids.
  • Use a witch hazel cold compress.
  • Soak your bum in a warm sitz or tub bath.
  • Use pre-moistened wipes after each bowel movement instead of dry toilet paper. It is important to keep your rectum and anal area clean if you have postpartum hemorrhoids.
  • Drink plenty of water and eat foods, like fruits and vegetables, that are high in fiber. Doing so will help reduce constipation.
  • Speak to your healthcare provider about recommending a topical hemorrhoid-relief ointment or medicated suppository.

The important point to note is that hemorrhoids are common both during pregnancy and after. If the above tips don’t help improve your hemorrhoid symptoms or if they begin to bleed, contact your healthcare provider right away.

Postpartum Thyroiditis

The thyroid plays an important role in the development of the growing fetus. But proper thyroid hormone levels also help to minimize the chance of any thyroid complications after delivery.

One particular postpartum complication is postpartum thyroiditis – a condition characterized by an inflamed thyroid gland. Postpartum thyroiditis is not a typical infection; however, the gland does become inflamed due to a response to an injury of the gland, of which the cause is unknown.

Postpartum thyroiditis is a postpartum condition that results in temporary hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid). Postpartum thyroiditis is fairly common. In fact, 5-7% of women worldwide develop the disease after giving birth.

Certain risk factors may help predict who is at an increased risk for developing postpartum thyroiditis:

  • a prior history of thyroiditis
  • blood content that includes anti-thyroid antibodies – those antibodies that have developed against the thyroid in response to the injury (Researchers know that women are four times more likely than men to have thyroid antibodies in their blood, indicating thyroiditis. The levels of antibodies increase with age, often leading to hypothyroidism later in life.)
  • a history of postpartum thyroiditis after other pregnancies

When the thyroid becomes inflamed, it will first emit large quantities of thyroid hormone into the bloodstream (hyperthyroidism). During this phase, most women are unaware of any symptoms, which are often mild and short-lived. However, once this initial phase passes, a woman either recovers completely or has sustained damage to her thyroid. If the thyroid gland was damaged, this damage, together with a depleted reservoir of thyroid hormones, can lead to hypothyroidism (underactive thyroid). This condition, too, may also clear up or result in further damage and complications.

The following are the most common symptoms of hyperthyroidism or hypothyroidism that accompany postpartum thyroiditis. However, each women may experience symptoms differently. Symptoms may include:

Hyperthyroidism (overactive thyroid):

  • weight loss
  • feeling warm
  • experiencing muscle weakness
  • feeling tremulous
  • experiencing anxieties
  • rapid heartbeat
  • loss of concentration

Hypothyroidism (underactive thyroid):

  • weight gain
  • feeling tired
  • constipation
  • loss of memory
  • cannot tolerate cold weather
  • cramps in the muscles
  • feeling weak

Postpartum thyroiditis symptoms usually do not appear until three to eight months after childbirth. The symptoms are also often mistaken for normal signs of recovery from childbirth or other medical conditions, so make sure to see your healthcare provider if you have experienced any of the above symptoms.

If the postpartum thyroiditis is in the hyperthyroidism (or initial) phase, treatment is usually not necessary. However, if the condition progresses and symptoms of hypothyroidism become evident, thyroid hormone replacement therapy may be considered.

Hair Loss

You have just given birth to your wonderful new bundle of joy, and now all the sudden, after dealing with all the other “joys” of pregnancy, you’re losing all your hair!

At any time, 90% of your hair is growing, and 10% of your hair is in what is known as the resting phase. The drop in hormones as your body returns to normal after delivery will likely cause you to lose some of your hair. This hair loss should not be enough to produce any bald spots, or create any issues with appearance. Even when not pregnant or postpartum, we lose a lot of hair as a normal part of life.

The hair loss you experience postpartum should decrease and return to normal within three to four months, when your body resumes a normal hormone cycle. A large portion of this hair loss is the hair you would normally lose during your pregnancy (that your body is holding on to as a result of the hormones). After pregnancy, your hair may fall out all at once as the hormones work to return to their normal levels. This is one of the main reasons pregnant women usually have great looking hair!

In the meantime, if you’re having trouble coping with the hair loss, keep these things in mind:

  • A diet with plenty of high quality protein and lots of fruits and vegetables full of vitamins and minerals will promote hair growth and healthy follicles. The high fiber and antioxidants will encourage and promote hair growth.
  • Supplement your diet with good vitamins like A, B6, B12, and zinc to promote the health of the hair follicle.
  • Use shampoos and conditioners that contain ingredients like biotin and silica to strengthen your hair.

The most important thing to remember is that all of this is normal, and there is really not much you can do about it, other than taking care of yourself. Hair loss, like all the other things you dealt with during pregnancy, will pass too :).

In a Nutshell

1. YOU ARE NOT ALONE. You’ve got this, Mama. Hang in there, ask for help, and know that you’re going to make it through this tough first year.

2. Talk about your journey! You aren’t the only woman experiencing these (and other!) postpartum issues, so let’s normalize this process and help each other out :).

3. Just like every other symptom you experienced in pregnancy, this too shall pass. It might take weeks, months, or even years, but you created a life – the hardest part is over.

Let’s Talk!

I’d love to use this space as a forum of sorts, providing inspiration and community among my readers, so … I want to hear from you!

What postpartum issues did you experience that no one talked about?

What tips and tricks do you have for new Mamas when it comes to navigating this crazy hectic journey?

Spread some Postpartum Issues lovin’! Sharing is caring, and I bet you have some friends who would love to read this too :).

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