September 11, 2008 by Daisy Rose
After nine months of pregnancy and hours of labour, it’s a relief to be able to hold your baby and think, “Finally!”
However, the real journey has only just begun, and the post-pregnancy period is an important transition to this journey. In the following three to six months, a woman may experience some changes and potential health problems. These problems are not serious though, and can be managed if a woman knows what to expect and takes good care of herself.
Each woman will have different reactions to the effects of pregnancy and childbirth. Some women may have been more tired at the end of their pregnancy, others may have been lacking in certain nutrients, while those who underwent a C-section or long labour may need more recovery time.
Here are some of the conditions that I commonly see in my patients after pregnancy.
All new mothers and even some seasoned mothers will find that their biggest problem is coping with the fatigue. Taking care of a baby 24/7 will take its toll on you, in just a matter of days.
Sleep deprivation can occur after merely seven to eight hours of missed sleep in a week. It’s not something to be brushed off lightly, as it can lead to depression.
One way to prevent fatigue is to ensure that you are not trying to be Supermom on your own. Preferably, plan ahead before the baby arrives to have someone around to help you out. Your mother, mother-in-law, relative, friend or maid can help you out with the household chores, taking care of your other children (if any), or baby-sitting while you have a break.
Make sure you get sufficient rest. As everyone will tell you, sleep when the baby sleeps! You may find that you will need two naps a day during the first few weeks so when baby starts to doze off, drop everything else that you’re doing and follow suit!
Finally, mental and emotional fatigue can hit you just as hard. Being with your baby is wonderful and rewarding, but sometimes you need some “me” time as well. Take 45 minutes or an hour each day to do something recreational, such as reading a book, having a walk or meeting friends, that doesn’t revolve around the baby. It doesn’t mean that you’re abandoning your child; you’re just having some time to yourself.
You can’t expect your body to immediately return to the way it was before pregnancy. The next six to eight weeks will be a time of healing, re-balancing and recovery.
For instance, you will find that the genital organs take between six weeks and two months to return to their original size and function. During this time, sexual intercourse may cause pain or discomfort, especially if you had a vaginal birth and had to have stitches. Get your doctor’s advice on how to have safe and comfortable sex life, and be sure to talk to your partner about taking things slowly.
Haemorrhoids and lower back pain (due to displacement of the coccyx) may also plague some women after a vaginal delivery. For women who had Caesarean sections, they may experience trapped gas in the digestive tract, as well as itching and burning of the scar for six to eight weeks.
Most women worry about suffering incontinence after delivery, especially after several births. This does occur in some women, who find urinary or anal leaking after a cough, sneeze or laugh, but it can be prevented in future pregnancies.
Closing up the pelvic floor is essential to prevent incontinence. During childbirth, the pelvic floor muscles (which hold up the reproductive and digestive organs) would have been stretched and distended, losing about 50% of its muscle tone. These pelvic floor muscles have to be restored to their original tone, so that the bladder and anal openings will not leak.
To do this, women should begin gentle pelvic floor exercises (also known as Kegel’s exercises) in the days immediately following childbirth. I have written about Kegel’s in this column before, as it can also be useful for women who have pelvic organ prolapse or incontinence due to ageing.
The Kegel exercises involve a series of simple contraction and relaxation techniques. For the exercises to be effective, you must get the technique right and do it regularly. Talk to your gynaecologist if you are not sure whether you are doing it right. It is very important that your pelvic floor recovers its tone before you embark on any other exercise programme!.
Other post-pregnancy complaints include varicose veins, bleeding gums and skin pigmentation that last several months. These are not serious or life-threatening problems, but they are inconvenient and terribly uncomfortable. You should get your doctor’s advice on how to manage them so that you can enjoy this period of getting to know your baby.
Finally, you may find that some aspects of your body may have changed forever, such as the way fat is redistributed in your body, the size of your feet and breasts, or the texture of your hair.
Periods, sex and contraceptives
If you are not breastfeeding, menstruation will resume about two months after childbirth. For breastfeeding mothers, this may be the case as well – but some women may find that their periods only resume after they stop breastfeeding.
Why do some people say that breastfeeding acts as a contraceptive? This is because the sensation of the baby sucking sends a message to the mother’s brain to suppress the hormone that stimulates ovulation (release of the eggs from the ovaries). So for breastfeeding to work as a good birth control method, the mother has to breastfeed the baby full-time, around the clock.
This means that other forms of contraceptives should be used when a woman decides to have sex again after childbirth. Barrier contraceptives like condoms and spermicide are appropriate for breastfeeding women. A diaphragm is only useful after two or three months post-delivery. IUDs (intra-uterine devices) should only be inserted after the uterus is fully healed.
Not all oral contraceptives are safe for breastfeeding mothers. The best one is the progesterone mini-pill, which does not interfere with ovulation, but prevents the egg from implanting to the uterus. However, this pill is not fail-proof, and can have side-effects, so you should talk to your doctor about whether it is suitable for you.
Finally, it is extremely important that you plan your next pregnancy carefully. If your pregnancies are not well-spaced, your body may not be strong enough to carry your next baby. Give your body a chance to recuperate, and your family enough time to prepare for the next child. This is the best way to welcome a newborn into the world!
By Dr. NOR ASHIKIN MOKTHAR (The Star)