A quick guide to post-pregnancy body changes

A HEALTHY PREGNANCY is 40 weeks, and the body continues to change even after the baby is born. The postpartum period, also known as the “fourth trimester,” constitutes the 12 weeks after delivery. This is an extremely critical time for both parent and baby as this closely linked relationship transitions into their new life together and the body starts to heal. Pregnancy can serve as a window to one’s future health. Optimizing health during this period can help improve long term outcomes for parent and baby.

During pregnancy, the body undergoes an abundance of anatomic and physiologic changes that support both the fetus and their gestational parent. Here are some of the most common physical changes you can expect post-pregnancy:

Hair loss

Patients commonly ask about hair loss during the postpartum period. While pregnant, your hair may grow faster and appear thicker due to hormone changes. After delivery, hair growth reverses to a resting phase. This can last one to five months, leading to the increased hair shedding/thinning that many people experience after giving birth. Thankfully, normal hair growth patterns typically return six months after delivery.

Bigger shoe size

You can expect your feet to get longer during pregnancy. There are two reasons for this. First, there is increased laxity of the muscles and ligaments due to hormonal changes. Second, the increased weight gain during pregnancy can flatten the arch of the foot. Unlike other bodily changes, this one is seen as permanent. Research has shown women’s feet may grow 2-10mm in length during and after pregnancy.

Urinary incontinence

Urinary incontinence is a common problem after delivery, affecting about one in three women. The decreased bladder control is due to weakness in the pelvic muscles, which stretch out during and after pregnancy. Kegel exercises are useful to strengthen this area and can help regain urinary control.

Decreased sex drive

After delivery, you can expect a temporary decrease in sexual desire. Estrogen and progesterone hormone levels drop after pregnancy, which means the vagina produces less lubrication and can make intercourse uncomfortable during the postpartum period.

Breast fluctuation

Breasts become engorged after delivery as the body prepares for breastfeeding. This results in breast fullness and firmness, which can cause pain and tenderness for some people. Breasts will revert back to a smaller size once breastfeeding is over. If you’re not breastfeeding, using a tight-fitting bra and avoiding breast stimulation will help suppress lactation in a majority of patients.

Skin changes

Stretch marks and varicose veins can appear on the skin due to weight gain and hormonal changes during pregnancy. There’s also evidence that family history and genetics are a factor. Although there are a variety of creams and lotions meant to reduce the risk for stretch marks, there is no strong evidence to confirm these products actually work. Stretch marks fade over time, and varicose veins typically go away 6-12 months after delivery.

Expert Guide to a Healthy Pregnancy: Answers to more of your questions

Mood

It’s very common to feel a variety of emotional changes in the weeks following delivery. It’s not unusual to feel an immense amount of love one minute and then start crying for no reason the next. “Baby blues” are commonly seen in up to 70% of pregnancies after delivery. These fluctuations usually resolve or stabilize within two weeks of delivery as hormone levels even out.

Some people, however, have more significant psychologic reactions after childbirth, including postpartum depression and postpartum psychosis. Risk factors for this can include a history of depression or other mood disorders in themselves or their family. It’s extremely important to speak up if these feelings become overwhelming, are lasting over two weeks, or if you have any thoughts of hurting yourself or your infant. In addition, your provider should be screening for this and talking to you about it at your visits as there are many options we can provide to help you through this time.

Although the body will eventually revert to a state similar to where it was prior to pregnancy, this process takes time. It’s reasonable to expect six months to a year for your body to return to its new normal, especially when it comes to weight loss after delivery. Things that can help expedite the recovery process include breastfeeding, physical activity, core-strengthening exercises, Kegel exercises, nutritious diets and of course self-care, though these aren’t the easiest things to accomplish in the postpartum period when balancing all the new responsibilities.

In the end, I try to remind all patients to give themselves grace. It took 40 weeks to create this new miracle, and it will take a similar amount of time for their body to return to normal.