by Alexandra Nicole Nuralam

Your Postpartum Body: These Are The Changes You Should Know

Image via @mariakragmann

If you’re a new mum or soon to be one, you likely have read several books on pregnancy and childbirth in preparation for your little one, but what about what your body would look like postpartum? During that first year, many people are underinformed about their own bodies, even as they learn so much more about their babies.

Your body will inevitably look different after giving birth—growing another human means your body can take much longer to heal—and it can be permanently changed in some ways.

Ahead, we speak to Singapore-based gynaecologist Dr Sheri Lim about what to expect when you’re done expecting. 

What are some of the biggest changes to our bodies after giving birth?

After giving birth, a woman undergoes huge adjustments. Your body shape may be more ‘womanly’ with a widening of the hips. This is due to the relaxation of the pelvic ligaments and increased fat deposition on the hips, upper thighs and back. Pelvic floor weakness or urinary incontinence risk is also increased by pregnancy and delivery.

What body changes can happen after a Caesarean section?

During a Caesarean section, an incision is made through the skin, nerves, fat, connecting tissue and muscle. As the various layers heal, the wound may feel sore or bruised. Anti-inflammatory and pain medications can help reduce the discomfort. Patches of numbness around the wound usually also improve with time. As the separation of the abdominal muscles is needed to gain access to the womb to deliver the baby, the core muscles needed for stability may be affected and take weeks or months to return to the way it was before.

Why do some people still look pregnant even after a month or so after giving birth?

Pregnancy triggers a physiological increase in weight to help carry the baby to term and prepare for breastfeeding.  Over nine months of pregnancy, the abdominal skin has stretched, the uterus and breasts have enlarged, and blood volume, extracellular fluid and adipose tissue have increased. This contributes to a pregnant appearance post-delivery. These changes can take up to 6 months to resolve.

When is it safe to start losing weight?

Although many women try to return to their pre-pregnancy weight, studies have shown that about 75% of women fail to do so in the first year post-delivery.  Women should aim to return to a BMI in the healthy range <25 and many suggest a healthy range is from 18.5 to 23 for Asian women. It is important to get adequate sleep, eat healthily and exercise regularly. Focusing on being healthy may be a more positive approach to weight loss. 

I would wait for your 4 to 6-week postnatal check before resuming an exercise program. After that, gentle exercise like walking the baby in a stroller, yoga, pilates and low-impact aerobics are safe. Pelvic floor exercises, however, can be started during pregnancy and any time after delivery. 

How long do postpartum hormones last?

The main pregnancy hormones progesterone and estrogen drastically decrease after delivery. The hormone oxytocin is raised exponentially to help contract the uterus and plays a role in bonding with the baby, as well as breastfeeding. Oxytocin levels drop about 6 months after when the infant starts taking more solid food and breastfeeding frequency decreases. Prolactin, a hormone responsible for milk production and breast gland development, remains elevated while breastfeeding.

When do you get your period again after pregnancy?

Everyone is different but if you are mixed feeding or not breastfeeding, your first period may be as early as 5 to 6 weeks after you give birth. For women who breastfeed, periods may not return until you stop breastfeeding or your baby has started taking solid foods.

What are some things we can do to ease these postpartum changes?

The extra weight you carry in pregnancy can lead to backache until your stretched abdominal muscles become strong again. Minimising excessive weight gain in pregnancy, keeping a good posture, using a support belt during and post-pregnancy, and gentle exercise can help minimise the backache. 

Recti divarication, otherwise known as abdominal separation, usually resolves in 4 to 8 weeks after delivery if it’s small. A progressive crunch-free exercise program focusing on rehabilitating strength stability in the early weeks can help stabilise the pelvis and reduce backache.

If you notice more hair shedding than usual, this is caused by a drop in estrogen levels. Using a volumising shampoo can help make your hair appear fuller. Avoid conditioning shampoos that weigh the hair down. Another tip is to try out a different hairstyle—it may just do the trick in making your hair look fuller. Thankfully hair loss usually returns to normal fullness when your baby turns one! If your hair loss continues, consider seeing your dermatologist.

Are post-pregnancy body changes permanent?

Some changes such as an increase in shoe size, breast shape, weakening of the pelvic floor and melasma are permanent. To reduce the risk of urinary incontinence, pelvic floor exercises and physiotherapy helps. 

As for treatment for skin issues like melasma, keep a lookout for skin-brightening ingredients safe for mums in your skincare products like niacinamide, azelaic acid and lactic acid. Using sufficient sunscreen and avoiding sun exposure by wearing a hat can also help lighten the dark spots.

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