Congrats, you just had a baby — now what?
New moms know to expect sleep deprivation, a sudden shift in hormones and a challenging physical recovery in the initial weeks after delivery.
The postpartum period can actually bring a wide range of temporary and long-lasting effects on the body — some are painful, others are bizarre and many are not discussed.
Here are 10 postpartum physical signs that women shouldn’t ignore — and some ways that you can manage them.
Postpartum preeclampsia
The potentially fatal blood pressure condition is becoming more common. It’s crucial to know the symptoms, which typically develop between 48 hours and six weeks after delivery.
Signs include severe headache, vision changes, right ribcage pain and sudden swelling of the face and hands. Seek medical care immediately.
Tearing with vaginal birth
Tearing of the tissue between the vagina and the anus can naturally occur during vaginal births. The key is knowing if the wound is healing properly.
Soreness in the early weeks is normal and can be managed with warm sitz baths, ice packs and over-the-counter pain relievers like acetaminophen or ibuprofen. Keep the area clean and dry and change pads frequently.
Most of the discomfort improves significantly in the first six weeks.
You should contact your doctor right away if you notice increasing pain, swelling, foul-smelling discharge or opening of the wound, which could be signs of infection or wound breakdown.
If scar tenderness or pain during sex continues beyond a few months, your doctor may recommend pelvic floor physical therapy, topical treatments or, in rare cases, a minor procedure to address scar tissue.
Painful C-section scars
Sensitive nerves in the abdominal wall may have become irritated during delivery. While usually temporary, persistent discomfort and drainage from the incision may indicate an infection.
You may need additional surgery to optimize care.
Vaginal dryness
Vaginal dryness is very common after having a baby, especially if you are breastfeeding.
Breastfeeding lowers estrogen levels, causing the vaginal lining to become thinner and drier. Itching, burning or painful friction, particularly during sex, is often the result.
Consider applying a vaginal moisturizer several times a week, using a lubricant during sex to reduce discomfort, trying hyaluronic acid-based vaginal gels and regularly inserting estrogen creams, tablets or suppositories into your vagina. Dryness typically improves once breastfeeding decreases or stops.
Prolonged bleeding
Vaginal bleeding is to be expected, no matter how you delivered.
However, bleeding that continues beyond six weeks may be a sign of retained products of conception, or RPOC, which occurs when a small amount of placental or pregnancy-related tissue remains in the uterus after childbirth. Left untreated, RPOC can lead to complications such as infection, persistent bleeding, and, in some cases, fertility problems. If bleeding is prolonged or becomes heavy, contact your doctor.
Urine leakage
Leaking a little urine after coughing or sneezing in the six months after delivery is quite common.
The pelvic floor muscles and perineal tissues undergo significant changes during pregnancy and childbirth. Weaker bladder support makes it harder to hold in urine.
Pelvic floor exercises (also called Kegels) are the most effective first step because they strengthen bladder muscles. Working with a pelvic floor physical therapist can be even more beneficial.
You may also want to consider over-the-counter continence devices that help support the neck of the bladder.
If your symptoms are severe and you’ve tried the basic measures, we’ve found injections of Bulkamid to work. Bulkamid is a soft, water-based gel that is injected around the urethra to add volume and cushioning and help prevent urine leakage. Mesh-based procedures are also available, and they shouldn’t affect future childbearing plans.
Pain during sex
This is arguably one of the most stressful experiences a new mother has postpartum, typically affecting up to 40% of new moms three months after delivery and 20% of moms at six months.
There are several explanations for this struggle — the tissues around the vagina may still be healing, particularly for those who suffered advanced tears; the vagina is dry; or the pelvic floor muscles are tight or tender.
Your doctor can check for scar tenderness and muscle tightness.
Using a water-based or silicone-based lubricant during sex can help, as can pelvic floor physical therapy.
Ab separation
Abdominal wraps — also known as belly binders — can relieve back pain, reduce swelling and support separated abdominal muscles.
Known as diastasis recti, ab separation occurs when the uterus expands and the abdominal walls stretch apart.
Dermatologic changes
Hair shedding and temporary skin conditions are driven by shifting hormones. These issues usually improve within six to 12 months postpartum.
Bigger feet
The body produces about 50% more blood and fluids to support the fetus. The fluid usually pools in the lower extremities, resulting in swollen feet and ankles.
The more you walk, the more the fluid recirculates and eventually evens out. If swelling does not improve, it could be a sign of cardiovascular disease.
Dr. Moiuri Siddique is a urogynecologist and director of female pelvic medicine at NYU Langone Hospital—Brooklyn, where she specializes in pelvic floor disorders, including pelvic organ prolapse, urinary incontinence and childbirth-related pelvic floor trauma. An assistant professor in the Departments of Obstetrics and Gynecology and Urology at NYU Grossman School of Medicine, Siddique is committed to providing compassionate, personalized patient care and advancing the field through clinical practice and research.
