Postpartum~The First 6 Weeks and Beyond

After spending so much time planning and anticipating for the arrival of your baby, rarely do mothers realize or understand what their body needs after birth. During the first weeks after giving birth, your body begins to heal and adjust to not being pregnant. This is called postpartum or the postpartum period. Your body goes through incredible changes to recover and heal from bringing life into the world and this can look and feel differently for everyone.

It can be challenging, as a mother often will be the recipient of so many tips and advice when pregnant, along with many tales of other mother’s birth stories. But little do you hear of the highs and lows of life with your new body and baby after the fact and it can be confusing and lonely without knowing what to expect.

• Soreness in your vaginal area

• Sore muscles in your neck, jaw or shoulders due to the exertion of labour

• If you had a c-section, soreness around your incision and in the muscles

• Contractions that feel like cramps as your uterus begins to return to a smaller size

• Bleeding which can be similar to a heavy period - this can last anywhere from 2 to 8 weeks

• Fatigue - you just brought a human into the world!

• Swelling in your belly and extremities

• Breast engorgement as your breast fill with milk. This can cause discomfort whether you are breastfeeding or not.

• Hemorrhoids and/or constipation

• Emotional intensity - hormonal fluctuations combined with excitement and lack of sleep can bring about tears, anxiety, joy, and frustration. This usually peaks around the 4th day post birth and should balance out within 2 weeks. If this continues past the first few weeks, talk to your doctor or occupational therapist as postpartum depression is real and more common than you might think

Parents expect to meet with their doctor for a checkup after birth, but did you know an Occupational Therapist who specializes in women’s pelvic health is a vital compliment to your health care plan?

Often women can experience symptoms of being postpartum much longer than 6 weeks after giving birth. Postpartum is truly forever; once you’ve given birth, you will always have a body that has been pregnant and/or given birth.

• Urine leakage called incontinence when coughing, laughing, running etc.

• Pain during sex

• Diastasis recti - (a separation of the abdominal muscles)

• Back, hip or pelvic pain

• Pelvic organ prolapse - when the pelvic organs such as the bladder, uterus or rectum shift in position

Women may think they should just find a way to tolerate these symptoms; however, doing so can have a profound effect on one’s physical, mental and social well being.

Your doctor should complete an internal exam to ensure your body is progressing in its journey through the postpartum period . This exam will also determine if any tears or cuts during childbirth are fully healed and would involve feeling inside the vaginal vault with gloved fingers. The use of a speculum for this check can artificially mask symptoms of prolapse and does not allow for a proper check of the pelvic floor structures.

Ideally, your doctor should ask about your mood to screen for signs of postpartum depression. Discussion may also include returning to normal activities like exercise and sex, along with birth control options. Many times I hear that all that was discussed was the ‘green light’ to return to sex and birth control. *** Know that just because you are given the ‘green light’ for exercise and sex, this does NOT equal return to full pre-pregnancy function. This needs to be slowly built up.

What your doctor may also miss is the signs and symptoms of pelvic floor dysfunction that can cause long term problems. These symptoms are the ones we listed above that one may think is just par for the course after having a baby.

• Urine leakage

• Pain with sexual activity or tampon insertion

• Lower back, hip or pelvic pain that doesn’t resolve

• Appropriate care of c-section and vaginal tearing scar tissue

Since the current standard of maternal care does not automatically include a referral to an Occupational Therapist who specializes in pelvic health, many women are left to find us on their own. Once they do, they’re understandably frustrated that our type of care exists and that they were not told about it.

Visiting an Occupational Therapist for a 6 week postpartum check up with focus on your pelvic health in relation to the entire post birth experience. This includes your emotional and mental wellness along with your physical. Your visit will include assessment, education and individualized strategies towards positive health.

Depending on the province in which your OT practices, and your specific comfort level, you may have an internal exam. In Alberta, OTs are trained and approved to perform these exams with their patient’s consent. This will allow for an accurate picture of the condition of the pelvic floor muscles and pelvic organ positioning.

Your OT will ask and have a candid discussion around your emotional and physical needs.

Education and strategies tailored to you will bring about positive outcomes such as:

• Improving and balancing your mood decreasing extreme fluctuations

• Reducing pain and discomfort

• Increasing awareness to maintain calm

• Strengthening and relaxing your body

• Improving postural alignment

• Being mindful of stress triggers

• Remaining present and connected with your baby, even in difficult moments

• Increasing body, mind and breath awareness and cultivating the ability to make a connection between these reactions and your actions

• Improving body image and self-acceptance

• How and when to ask for help

• Decreasing or elimination of physical symptoms such as leaking, prolapse or pain

It’s important to remind yourself that you’ve just experienced a life-changing event. Self-compassion, education and having the right health care professionals to support you will allow you to transition in a positive and empowering way.

Remember, once postpartum, always postpartum. If you didn’t get the chance to meet with an OT at the 6 week point, there is no time like the present! Please reach out to book an appointment with me at E-motion Therapy. I can do virtual appointments within Alberta as well if you aren’t located in Ponoka.

Also, if you are looking for resources to help yourself at home post birth, I highly recommend you check out Jessie Mundell’s Core + Restore for mom’s. Jessie is a registered Professional Kinesiologist and holds a Master's Degree in Kinesiology, with studies focused in prenatal and postnatal exercise.

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