How Your Body Changes After Birth
May 19, 2015
For nine (or ten) months, your body has been growing, expanding, and increasing. And we’re not just talking weight, bellies, and breasts. Feet are bigger, hair is fuller, and blood volume increases by 40-50%. At the time of delivery, the uterus has grown 15 times heavier since conception! The lining on the inside is thicker, too. And your hormones? There is an excess of those as well (since they are the culprits of all this growth). A woman produces more estrogen during one pregnancy than throughout her entire life when not pregnant!
But what goes up must (thankfully) come down! The changes to your body during pregnancy were pretty dramatic and obvious to the world. The body changes after birth are at least as dramatic but less obvious, and some happen mind-bogglingly fast. For example, you likely experienced your fastest weight-loss ever after giving birth: a 7-8 lb baby, a few pounds of blood, amniotic fluid, and placenta leaves most moms 12 lbs lighter. Why then will you likely still look pregnant? The uterus takes a little longer to adjust, as do other parts and systems of the body.
After baby comes out, your uterus has more work to do. The placenta has to be delivered as well. Your placenta has been the live-in nanny: regulating, filtering, and generally supporting the growth of your baby. It was also producing 250 mg of progesterone a day, increasing progesterone to 2000-1000% of their pre-pregnancy levels! Now that its job is done, out it comes and your body’s progesterone levels decrease rapidly to about a third of what they were at the end of pregnancy. (Remember that if you experience moods as dramatic as those changes!)
Such a fast drop in progesterone is a very good thing, too because all that progesterone has been keeping you from lactating and your uterus from contracting your entire pregnancy. Now your uterus can get on with contracting back to its normal size, felt by you as “after pains.” How painful these are can vary from woman to woman and pregnancy to pregnancy. I visualize that my uterus is at the gym and I’m “feeling the burn.” It’s an effective workout; in a week your uterus will have lost about half of its weight at delivery, at two weeks it’ll be down about two thirds, and by four weeks it’ll just about be its normal pre-pregnancy weight.
Your breasts will be going the other way, however, also thanks to new hormone levels. At birth, you’ll be able to give your baby the world’s best super-food: colostrum. Later your breasts will swell with milk, called engorgement. This happens so quickly it is usually uncomfortable at first, but should resolve quickly.
While your breasts go up in the first few days after birth, the fluid level in the rest of your body have to come down. Both the extra water in your cells and the extra blood in your pregnant body will be looking for any way out. You thought you peed a lot during pregnancy? You’ll be producing a crazy three quarts of urine a day in the first week after birth! It’s also common to sweat a lot, both day and night, and to feel almost feverish as your body temperature readjusts to new hormone levels.
Right after a vaginal delivery, the idea of anything coming out “down there” feels a little traumatic. Your entire pelvic area will experience some shock in the first few days, including the bladder. You likely will not be very sensitive to your urge to pee in the first few days. Go anyway. If your bladder gets too full, it can actually prevent urination. The upside is that after about a week of all this, most women have lost another 4-6 lbs in water weight.
Your vagina and perineum will likely be swollen, bruised, but also numb. The swelling will go down significantly in a few days and small tears heal surprisingly fast. Larger tears, stitches, and episiotomies will need time. Your bowels will need a bit of time as well. Many women don’t poop for a few days after birth. It is suggested to take a stool-softener to help go a little easier. At the hospital, they’ll provide you with some, but don’t forget to buy some for home too.
In the first few days after giving birth, expect to bleed like a heavy menstrual flow. The flow, called “lochia,” should change to a more pinkish and watery consistency towards the end of the first week postpartum. Although every woman is different, one sign that you are overdoing it can be an increase in your flow. From about 2 weeks to a month, your flow will look yellow to white as your body finishes the job of cleaning out the uterus.
Other changes you might experience are farther away from the action. Your hair has been delaying its normal shedding cycle because of the higher levels of estrogen. In the months to come, don’t be alarmed as your head makes up for lost time shedding hair. Your skin, as a result of hormones, fatigue, and stress, will likely experience some changes, too. Be patient, things usually normalize in a few months.
Of all the dramatic changes going on, the most intense and profound will likely be your feelings. Bonding with your baby happens at different rates for everyone, but expect your heart to be full to exploding with all kinds of emotions: joy, love, awe, concern, confusion, and even sadness or loss. Just as the incredible highs of meeting your new baby are completely normal, so are lower feelings of worry, anxiety, and overwhelm. Occurring a few days after birth, the “Baby Blues” are a natural result of the huge change in hormones and the stress your body has experienced. But Baby Blues only last a few days, but no more than a few weeks. If low feelings continue past that point, or you start feeling low at 10 days or later, you are experiencing postpartum depression. Unlike the baby blues, PPD doesn’t resolve on its own. Don’t delay in getting help, your body needs it.
Your body is amazing. Though it might not feel like it, it is gracefully handling so many huge changes at an incredible pace. Much of what is happening can’t be seen from the outside. So when you do look at yourself in the mirror, try to remember all that your body has had to deal with. Be grateful for all your body has done and patient with all it has yet to do. Finally, be gentle with yourself for the rest of the process.
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