Pregnant moms spend a lot of time learning what to expect from pregnancy and how to care for their newborns. But, while pregnancy anecdotes and birth stories take top billing at baby showers and get-togethers, girlfriends and family members tend to leave the challenging aspects of the “fourth trimester,” the first six weeks postpartum, left unsaid.
Changes that happen to a woman’s body during and after childbirth are not usually widely discussed with soon-to-be moms. There are so many exciting things to look forward to with a new baby. But pregnancy and childbirth can also have some less-than-desirable effects on a woman’s body, especially her pelvic floor. About 15 percent of new mothers need treatment for childbirth ailments such as urinary and fecal incontinence, complications from obstetrical tears, pelvic pain and other pelvic floor issues.
Navigating the fourth trimester
Know that help is out there. Whether it’s breastfeeding trouble or sleep deprivation, experts are ready to throw a lifeline when needed. Seek that help. Just having a lactation consultant watch a baby latch on can ease any fears of mom feeding baby incorrectly. It’s easier to make the decision to get help when you have that list of where to turn to for help ready before a baby arrives.
Focus on what works for you and your baby. From your pediatrician to the nurse at your OB-GYN’s office, everybody doles out different advice. Whose do you take? Try them all to find what works and keep your and your baby’s health in mind.
Consider if lanolin is right for you. Lanolin, a popular gift at baby showers, is a natural substance used to prevent nipples from cracking, blistering or drying out from breastfeeding. Pasque says Vaseline is tolerated easier. She has many new moms who come into the office with rashes because they are allergic to lanolin.
Stock up on healing supplies. Warm-water sitz baths, ice packs, doughnut pillows, peri bottles (i.e., squirt bottles to rinse with water instead of wiping after toileting for the first few weeks) and 100 percent cotton pads help heal the vaginal trauma caused by delivery.
Consider physical therapy or massage. If incontinence issues arise, see a physical therapist who specializes in pelvic floor exercises to strengthen the muscles that hold up the bladder and uterus. Therapists will ensure the exercises are done properly, and they have gadgets that monitor progress.
Moms who delivered by cesarean section also may benefit from a therapist massaging the incision scar. The tightness of the collagen fibers in the skin can make bending over painful, among other issues. Manipulating the tissue can promote blood flow and accelerate healing.
Avoid constipation. Chronic straining, especially if mom had a perineal tear, can put tension on the stitches and is hard on the pelvic floor muscles. Consider using a laxative like Miralax (rather than a stool softener) daily until the constipation subsides. It’s safe for breastfeeding moms as well.
Try walking. If it still hurts to walk nearly a month after giving birth, see a doctor. The spine could be out of alignment, or a pelvic bone may have broken during delivery.
Watch for postpartum depression. More intense than baby blues, which is marked by crying, sadness, anxiety and feeling overwhelmed, postpartum depression affects 13 percent of mothers and may appear a year after giving birth. Extreme irritability, insomnia and fear of the baby getting hurt in unusual ways are symptoms that are sometimes dismissed.