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As a mom of a five-month-old baby girl, I spent the last year of my life getting a lot of information and advice about pregnancy. Doctors, friends, and family members were all quick to tell me what was "normal" and what wasn't, and I felt very prepared for all things pregnancy-related that could come up, from morning sickness to insomnia and hip pain.
Labor was a big discussion, too. Would I have an epidural? If I went past my due date, was I open to being induced? How likely was a c-section? So many women were quick to tell me their birth stories, but that's where it ended. As soon as the baby was in their arms, the whole focus was on that tiny human and the intense love they felt.
I was lucky enough to have a pretty straightforward (albeit extremely painful!) delivery, with very minimal tearing. Afterward, the doctor told me I would heal "in no time." I was beyond relieved, especially because I'd heard horror stories of emergency c-sections after 24-hour labors, third degree tears, hemorrhages ... the list went on and on. The truth of my postpartum experience was a lot more complicated than "healing in no time," though. Here's what you should know about the months after giving birth, also known as the "fourth trimester."
You May Bleed... A Lot
I've had bad periods in my life, but nothing could compare to the bleeding that was the days and weeks after giving birth. The hospital sent me home with mesh underwear and enormous pads, and two days later I had to send my husband out to buy me adult diapers.
Bleeding aside, the doctor's promise that I would "heal in no time" kept running through my head on a loop. So much so that I tried to walk 20 blocks to my daughter's appointment with the pediatrician when she was three days old. PSA: Please don't try this.
"If you had a vaginal birth with no tearing or episiotomy, you are still in need of deep rest and recuperation," doula and pelvic health practitioner Kiana Reeves explains. "The massive and lengthy undertaking of building a human with your body’s resources, the process of birth itself, moving into care-taking mode 24 hours a day, and the nutritional requirements of breastfeeding are just part of why those first 40 days of rest and support are essential."
Meet the Expert
Kiana Reeves is a women’s health advocate, doula, somatic sex educator, and chief brand educator at Foria Wellness.
Your Pelvic Floor Muscles May Be Weak
I briefly worked with a trainer a few years ago, and she told me I had exceptionally strong pelvic floor muscles. It was a point of pride! After giving birth, my pelvic floor muscles were so weak that I peed involuntarily. All the time. On top of dealing with sore breasts and lots of bleeding, this wasn't exactly a welcome addition to my postpartum symptoms.
"Our pelvic floor muscles have been under strain from carrying the weight of the baby and need adequate time to recuperate," Reeves says. "For optimal postpartum recovery, try to include lots of nutritious and easy to digest food (that your community brings you so you don’t have to be up cooking all day), a lot of laying in bed and sleeping when the baby sleeps. That way, your hormones and body have a chance to regulate and get into restorative mode."
While there are exercises you can eventually do to strengthen those muscles, the main thing they need in those early days is rest — so prioritize that.
It May be Hard to Sit
In the first few days after giving birth, I dreaded everything that required any kind of movement. Standing up to hold my daughter? Ouch. Sitting back down? Also ouch. Using the bathroom? Forget it.
Especially if you had tearing, a sitz bath may be helpful. "Sitz baths are recommended for tears, as they bring heat and circulation to the tissue which can increase the speed of healing and reduce scar tissue," says Reeves. "Once you have stopped bleeding, full-body baths are beneficial as well, heat therapy for the pelvis through these and other modalities promote tissue health."
If you're struggling with bowel movements (yup, this is a thing), Reeves recommends loading up on omega 3s and magnesium. "This can soften stool and decrease colon transit time, meaning the stools won’t feel as firm and compacted."
If You Had a C-Section
Although they're incredibly common, a c-section is major abdominal surgery and typically take longer to recover from than a vaginal birth. So in addition to not pushing yourself too hard, it's important to pay close attention to your scar. "Once the wound has healed, massaging the scar with castor oil to help break down scar tissue can help prevent the scar tissue from continuing to grow," Reeves says. "Sometimes people who have c-sections will notice numbness on the scar itself and below, this numbness indicates scar tissue that is restricting nerve and proper blood flow to the area. Working with heat is beneficial, along with focusing on foods that support connective tissue growth like collagen."
How to Prepare
Unfortunately, there's so little emphasis on the mother in the weeks and months after giving birth—everything is about the baby. So if you find yourself sitting around wondering how to deal with everything from weird physical symptoms to anxiety and depression, it's important to remember you're not alone, and that you can always reach out to your doctor or a mental health professional for a little guidance.
And while it can be hard to fully prepare for the experience that is giving birth and taking care of a new baby, Tovah Haim, founder of the postpartum care company Bodily, suggests starting by stocking up on the essentials. "As adolescents, if we weren’t informed about our periods before we actually got them for the first time and didn’t have the basic products on hand, it would be disastrous and scary," she points out." That’s a preventable crisis and we have developed cultural norms to ensure that young women are largely prepared. The same type of prep needs to apply to birth and pregnancy recovery." (Side note: Bodily has some great products in their Care For Birth boxes.)
Haim adds that with a little education and prep work, the postpartum period can be a lot less scary, jarring and painful. "There’s always going to be discomfort, it is a major physical event! But it doesn’t need to be a crisis."