Written by Pamela Lim,  https://joyfulparenting.sg

There is really so much more to comprehend than just getting rid of the baby bump and getting back into your skinny jeans. During pregnancy organs were shifted, muscles are stretched, ligaments and connective tissue are softened from the increased hormones, progesterone and relaxin. Not to mention, it took 40 or so weeks to create a human. After which... they had to give birth. What a woman goes through to produce a baby is major!  

There is no doubt that being pregnant is life changing in so many ways. Your mind, body and soul are forever shifted. The type of labour and birth you had will influence how you adjust and your body recovers in the postpartum period. In general, it takes about 6 weeks for your body to return to its pre-pregnancy state. If there were pregnancy or birth complications, recovery may take longer. It is so important that postpartum moms learn how to safely get their core back, strengthen their pelvic floor etc.

Here are the two postpartum fears that moms confide in me the most:  

1) Fear of having sex again because they are afraid that it will be painful  

2) Fear that they will feel "different down there" during sex.

Pelvic floor health is very important.  

• Why is the pelvic floor so important? What are some exercises or things we should be doing to keep our pelvic floor strong and healthy? Should a pregnant woman start doing kegals during pregnancy and/or after?  When should she start? (vaginal birth - Caesarean) What is the proper way to do them?   (as an International Alliance Yoga Teacher, Doula and Clinical Hypnotherapist, I see some moms that have super tight pelvic floors that have a hard time “ letting go”.  I actually have to teach them how to let go... with visual skills and actually becoming aware of their pelvic floor, etc.)
• Exercise and pregnancy. A pregnant woman should exercise but also need to know what exercise to be aware and stay away from so she doesn’t injure herself.
• Diastasis recti. What is it?  What can a mama do about it?
• Lots of pregnant mamas complain about back pain during and after pregnancy.  What do we need to know about it?  How can we prevent back pain? 

During pregnancy, women have a tendency to gain weight. It’s not just because of the cravings. They also need to eat more for the baby that is inside their womb. But after giving birth, they find themselves with excess pounds that they are dying to get rid of.

Here are the 5 great ways to regain your shape after pregnancy:

1) Start a Post-Pregnancy Exercise Regimen
The BEST way to regain your figure after giving birth is by exercise. However, you need to plan a post-pregnancy regimen and gradually introduce exercises that are increasing in intensity since your body is still healing from childbirth. As early as 4 to 6 weeks post-partum, you can already perform light exercises like walking and stretching. Doctors say that you should be particularly mindful of a gap between your abdominal muscles after childbirth so that you need to be checked out by a physician before you start doing core exercises. Once your doctor determines that this gap is closed – usually around 4-8 weeks after delivery – you can commence with tummy exercises, such as pelvic tilts, bridges, and those that use an exercise ball. Yoga and Pilates are also recommended to improve muscle strength in the core and flexibility of the body overall.

2) Eat a Healthy Diet
Most doctors do not advise that you go on crash diets in order to lower your weight. Instead, it is better to be aware of the types of food that you are eating and the caloric quantity. This means if you have been eating foods with high calories to satisfy your cravings while pregnant, you need to cut back on these foods now. If you have been eating high calorie sweets and juices, you need to reduce your intake or find healthier low calorie replacements. For example, if you have developed a taste for orange juice, you can replace it with a healthier drink of honey and lime in water (which is not only low calorie, but is also a good natural weight loss drink). Nibbling on cookies while pregnant? Replace them with crunchy veggies like cucumbers and celery sticks. You can also add foods that aid in weight loss, such as green tea and apple cider vinegar which burn off fats.

3) Let Nature Help You Along
In itself, childbirth will enable you to lose 5 to 6 kg since much of the weight you are carrying is actually the baby. The best argument for breastfeeding is that it can help you lose weight since you lose up to 600 calories daily. Let’s not forget that carrying your baby and doing the activities that come with baby care will help you to lose more weight.

4) Join Other Mothers in Fun Activities
If you want to regain your pre-pregnancy figure, you will need a lot of encouragement and support. When exercising or doing other activities, you should be in the company of other moms who enjoy these same things. They will not only root for you as they see you gradually shedding those excess weight; they will also be glad to give you advice on weight loss based on their personal experiences. 

5) Get Lots of Rest
Here is something you are probably not aware of. When caring for your baby, you find your sleep being disturbed many times so that you are unable to get complete rest. However, because you need the extra energy to stay awake, you end up eating more than you should so that you gain more weight instead of losing them. Since it’s practically impossible to get a full night’s sleep, it is important that you take naps while your baby sleeps to make up for the sleep deficits. It is also recommended that you get a relative or a family member to take over so you can get enough sleep.

Looking after your body after having a baby:

What changes happen in my body after having a baby?

Every woman will have a unique recovery after having a baby. The type of labour and birth you had will influence how you adjust and your body recovers in the postpartum period. In general, it takes about 6 weeks for your body to return to its pre-pregnancy state. If there were pregnancy or birth complications, recovery may take longer.

Vaginal Bleeding
Most women experience heavy to moderate vaginal bleeding after having a baby. After the first few days, this often becomes a pinkish-brown colour rather than bright red, although it can vary between each person. It is recommended to use pads rather than tampons, and to change your pads regularly. It's also a good idea to observe the colour, volume and odour of your blood loss. If you notice any of the following, you should contact your maternity care provider:

• your blood loss becomes heavier
• you are soaking a pad every hour or 2
• you are passing clots bigger than a 50-cent piece
• the bleeding is smelly

Uterine cramps
Uterine cramps are also called ‘after birth’ pains. This is more common for second or subsequent births. It is caused by the release of oxytocin and may be more noticeable when your baby breastfeeds. You can take simple pain relief medication including paracetamol and use warm packs on your tummy to help ease discomfort.

Vaginal pain or discomfort
If you have had a vaginal birth, you may be sore for a few days. This may be particularly so if you have stitches due to a tear or episiotomy. In the first few days after birth, putting ice on the area can help to reduce pain and swelling. Pain relief medication, including paracetamol, may also help. You should bathe the area in warm water and pat it dry. In the first few days, remember to sit down gently and lie on your side rather than on your back whenever possible.

It’s a good idea to keep an eye on your perineum (skin between your vagina and bottom), particularly if you have had stitches. If the area becomes more painful or inflamed, or if you’ve had stitches and they look like they are coming apart, call your maternity care provider.

Caesarean section
If you have had a caesarean section, it may take a little longer for you to heal. It’s likely that your doctor may send you home with a prescription for stronger pain medication. It is recommended that you don’t drive or lift anything heavier than your baby for the first 6 weeks. This may mean you should ask for additional support from family and friends. Usually, your caesarean incision will have dissolvable stitches but not always. It is best to follow the advice from your care provider. Unless instructed otherwise, it is generally fine to bathe the area in warm water and pat dry. It is common for your scar to be tender for a few weeks. But if the area becomes more painful, inflamed (red) or oozing, or if the stitches look like they are coming apart, call your maternity care provider.

Back ache
Your centre of gravity has changed as a result of supporting your heavy uterus and hormonal changes during pregnancy. It will take some time for you to return to a normal posture and to regain your balance. Taking paracetamol in the early days may help to ease back pain. Some women find it useful to wear a supportive brace or compression underwear to protect their back in the early weeks after birth. Longer term, strengthening your core muscles will help to support your back. See a women’s health physiotherapist for more advice.

Abdominal muscle separation (DRAM)
Some women find their stomach muscles weaken and separate during and after pregnancy. This is known as abdominal separation, ‘diastasis recti’ or ‘recti divarication’. It is a common condition and often gets better in the first 8 weeks after having your baby. Avoid lifting anything heavier than your baby.

It is a good idea to roll onto your side when getting out of bed or sitting up, and to do gentle exercises (rather than intense ones) that strengthen the deeper stomach muscles. Wearing a supportive brace or compression underwear may also be helpful. If your muscle separation is quite large and if you are seeing no improvement after taking these steps, see a women’s health physiotherapist.

Breast discomfort
Heavy, full breasts and nipple tenderness is common, especially in the first 6 weeks when lactation is establishing. Many women find that warm and cold compresses on their breasts can help before and after a breastfeed, particularly if a breast become engorged. Some nipple tenderness is to be expected if breastfeeding, although pain or bleeding and cracked nipples is a sign that your baby may not be latching well to the breast.

Remember breastfeeding is learnt and can take time to do. If you are having any troubles breastfeeding, speak to your midwife or a lactation specialist to get support.

If you choose to formula feed or need to stop breastfeeding abruptly, you may find that your breasts become full and feel uncomfortable. The best thing to do is to wear a supportive bra and only express what you need to for comfort. Your milk supply will gradually decrease. Using cold packs and taking paracetamol can also help to relieve pain.

Breasts leaking
Many women leak breast milk as the breasts become fuller. This is particularly common if your baby is overdue for a feed. You may choose to wear absorbent breast pads in your bra. You may also find that your breast leak during sex. If this makes you or your partner feel uncomfortable you can try feeding your baby or expressing to decrease the amount of milk in your breasts. Wearing a supportive bra and breast pads is also an option.

Having sex
There is no rule on when you can start having sex again, it really comes down to personal preference. Although the general advice would be to wait until 4 to 6 weeks after having your baby. This allows your body time to heal and by this time you will have stopped bleeding. Hormonal changes may mean that your vagina isn’t as lubricated as usual. This usually improves after 10 weeks, but you can use lubricant and take it slow in the meantime. If sex is painful after 3 months, see your doctor.

Body temperature variation
Changing between feeling too warm or too cold is common in the postnatal adjustment period. This is due to hormonal changes in your body. If you have a temperature or are shivering, this is not normal, and you should see your doctor.

Urinary discomfort and leakage
Urine can sometimes cause stinging and burning if it comes into contact with a sore perineum. Making sure you are well hydrated and leaning forward when you are on the toilet can help to avoid this feeling.

Some women may also find that they leak some urine when they laugh or cough; this is called stress incontinence. It can take time to resume full bladder tone after pregnancy and birth. Doing pelvic floor exercises, once you feel able to do so comfortably, is a good way to strengthen these muscles. If you find you are still leaking urine, it’s important to speak to your maternity care provider at your 6-week check-up. There are many things that can be done to help improve or resolve this issue.

Constipation
Constipation is quite common for new mothers, but there are simple solutions to support you. The best place to start is by increasing your fibre and water intake and walking each day. If this doesn’t help, speak to your local pharmacist about gentle laxatives that may assist.

Haemorrhoids
Some women have pain in the anal area after the baby is born and this is commonly due to haemorrhoids. It's very important to avoid straining when you go to the toilet to prevent and support recovery from haemorrhoids. A warm bath can sooth the area and your local pharmacist may be able to provide a cream and other medications to help reduce the discomfort and support healing.

Baby blues
Don’t be surprised if you’re easily brought to tears or your mood changes easily. Hormones are to blame and crying is completely normal in the first few weeks after birth. Usually, the baby blues will pass but if you’re still feeling overwhelmed, anxious or depressed after 2 weeks it may be a sign of postnatal depression, in which case it’s important to seek help early. Speak to your GP or call Joyful Parenting at 6488 0286 to speak to a counsellor.

What are some tips to care for myself after having a baby?

Once you are discharged from hospital, it’s important not to do too much too soon. Focus on getting to know your new baby and allowing your body to rest and recover.

Try to rest and sleep when your baby sleeps. Eat healthy, nourishing food and drink plenty of water. Avoid skipping meals and prioritise yourself and your baby. Accept all reasonable offers of support including practical help with housework, meal preparation and caring for your baby.

If you are struggling emotionally, speak with your partner, friends, family or your GP. Your mental health is as important as your physical health. It can take some time to adjust to parenting. Many women experience disappointment or trauma relating to their baby’s birth — help is available through your GP or maternity care provider.

Be mindful of risk factors for developing postnatal anxiety or depression, which can affect many new parents. Aim to go for a gentle walk each day or do some other low-impact exercise, starting with a 5-minute walk around your home. Make some time for yourself each day, doing something you like and that gives some space for you.

Get your partner or support person to bathe and change your baby — it gives you a break and helps the baby get to know both parents. It takes time to recover from pregnancy, labour and childbirth and it’s important you don’t expect yourself to just 'bounce' back. Be patient as your body heals as you adjust to your new life with a baby.

Will my body ever go back to how it was before having a baby?

Everyone is different but many women find their body never quite returns to its pre-pregnancy state. It’s common to have stretch marks, loose skin on the tummy and even a different belly-button shape after pregnancy. Many women also find that their feet size may increase. This is because of the effects of the progesterone hormone.

Your breasts will also change shape, and your nipples will be bigger and darker because of breastfeeding. Hormonal influences during pregnancy will have prepared your breasts for breastfeeding. Even if you are bottle feeding, expect your breasts to produce some milk in the first few weeks after your baby’s birth.

When should I see my doctor after having a baby?

The general recommendation is for women to have a postnatal check 6 weeks after giving birth. Your doctor or maternity care provider will ask you for a thorough history and check your tummy and your perineum, or your incision line if you had a caesarean.

They will also ask how you’re feeling, if you’re having any problems feeding and how you’re adjusting after having your baby. It's important to share how you are really feeling and any discomforts you may be experiencing. In many cases, if things are picked up early this can improve the likelihood of resolving the issue.

Remember — If you’re worried about yourself or your baby before your 6-week postnatal check, see your GP or maternity care provider immediately.