You've finalized every detail of your birthing plan, from choosing a playlist to help you relax to deciding whether you want an epidural to ease your pain. But have you thought about how you'll cope after your baby is born? "New moms often are surprised by how long it takes to heal and feel like themselves again," says Judy Chang, M.D., an assistant professor of obstetrics and gynecology at the University of Pittsburgh Medical Center. "I know I was."
But knowledge is power: Knowing what to expect when you're no longer pregnant and how to rev up your recovery will help you through this vulnerable--but mercifully temporary!--time. And once you're feeling more like your old self, it may be time to look like her too. That's where our gentle, progressive workout to strengthen and flatten your abdominal muscles comes in. Here's our guide to handling some of the most common postpartum body shocks, and, as a bonus, our super-effective ab routine to begin when you're ready.
1.Vaginal SorenessWhy it happensDuring delivery, the birth canal stretches, then stretches some more. As the baby emerges, your peri-neum--the area between the vagina and the anus--may tear or be cut by the doctor (an episiotomy) to facilitate delivery.
Feel-better adviceApply ice packs to reduce inflammation and swelling, says Amy Murtha, M.D., an assistant professor of obstetrics and gynecology at Duke University Hospital in Durham, N.C. Take a sitz bath (sit in a tub filled with a few inches of warm water) a few times a day, use refrigerated Tucks pads, and try anesthetic sprays containing a numbing agent such as benzocaine (often offered at the hospital and available at drugstores too). Taking pain relievers such as ibuprofen or acetaminophen also can ease discomfort. While urinating, squirt your perineum with warm water to lessen stinging. When sitting, using a "donut"--a round cushion with a hole in the middle--can take pressure off this sensitive area.
2.Vaginal BleedingWhy it happensThe uterine lining thickens enormously during pregnancy. After delivery, the lining is shed along with a bloody discharge, together known as lochia.
Feel-better adviceBleeding for several days to a few weeks is normal, explains Murtha, but it should stop by your six-week checkup. Wear pads, since tampons raise the risk of infection at this time. Consult your doctor if you are soaking a pad or more an hour; this may be a sign of postpartum hemorrhage. Also seek medical attention if the bleeding slows down a few weeks after delivery and then suddenly increases.
3.Cesarean-Section PainWhy it happensA C-section is major surgery that involves cutting through several layers of tissue in the abdomen and spreading the abdominal muscles apart.
Feel-better adviceTake your prescribed pain medication as directed at the first sign of discomfort--it's safe, even if you're nursing. "It is so much easier to prevent pain than it is to catch up with it," explains Chang. Minimizing discomfort also will encourage moving about, which can reduce your risk for developing blood clots and relieve post-surgery gas pains.
To get out of bed during the first couple of weeks: Place your legs over the edge, allowing gravity to help out; wait a few seconds, then use your arms to push yourself up. (You'll become familiar with this technique in your third trimester.) While the incision heals, keep it clean and dry, and report any bleeding, swelling or unusual redness to your doctor.
4.IncontinenceWhy it happensThe stress of pregnancy and pushing during delivery can weaken the pelvic floor, allowing urine to "leak."
Feel-better adviceRealize that incontinence is common, but also that it often resolves within six months to a year. If you leak a lot of urine, wear a pad. Avoid caffeine, and to keep your bladder from getting too full, head to the bathroom as soon as you feel the urge to go.
Kegel exercises can help prevent incontinence by strengthening the pelvic floor, notes certified Pilates instructor Jennifer Gianni, creator of the Fusion Pilates Post-Pregnancy & C-section Recovery DVD (fusionpilates.com). Contract the muscles around the vagina as if you're stopping the flow of urine; hold for 10 seconds, breathing normally, then slowly release. Aim to do 10 to 20 Kegels a few times a day. If incontinence lasts several months, consult your doctor.
5.ConstipationWhy it happensC-section surgery can temporarily slow the bowels, as can the use of narcotic pain relievers such as Vicodin. Women who've had vaginal deliveries may become constipated if they hold back during bowel movements out of fear of pain.
Feel-better adviceEat a fiber-rich diet and drink eight 8-ounce glasses of water a day to keep bowel movements regular. You also can ask your OB-GYN to prescribe stool softeners.
6.Hair LossWhy it happensWhen you're pregnant, your body is in growth mode, and that includes your hair. But those thick tresses will start shedding by six to 16 weeks after childbirth as your hormone levels fluctuate, says Andrea Cambio, M.D., a New York City dermatologist and a spokeswoman for the American Academy of Dermatology.
Feel-better adviceRest assured that your hair won't be clogging the shower drain forever; the shedding ends by six months after you give birth. In the meantime, adding layers or highlights can help your locks look fuller, Cambio says.
7.HemorrhoidsWhy it happensDuring pregnancy, constipation and pressure from the uterus on the rectum can cause varicose veins there. So can pushing during delivery.
Feel-better adviceTake a sitz or a tub bath to ease the itching and pain, advises Susan Harvey, M.D., an OB-GYN at Swedish Medical Center in Seattle. Cold compresses soaked in witch hazel can help decrease swelling and discomfort, as can anti-inflammatory hemorrhoid creams. Try to avoid constipation, since straining also can lead to hemorrhoids.
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