Postpartum Challenges: What New Mothers Need to Know

By Mallory Campoli on October 10, 2019 - Fact checked by Dumb Little Man

by Mallory Campoli October 10, 2019

Postpartum is frequently thought of as the first six weeks after giving birth. Six weeks is when many women have their last medical appointment with their doctor. However, those of us that have had a baby or who have treated women postpartum know otherwise.

In 2018, The American College of Obstetricians and Gynecologists (ACOG) recognized that there was a fourth trimester of pregnancy, which lasts for 13 weeks postpartum. This was a big step in the right direction.

Postpartum is forever

The changes that occur during pregnancy and postpartum can last for weeks, months, years or even the rest of a woman’s life. However, just because the body has changed means that it is any better or worse — just different.

Outlined below are many of the challenges women face postpartum and what to do about them.

Urinary incontinence

Just because you had a baby does not mean you will leak forever. If you have any urinary leakage, then you would benefit from getting help from a pelvic health or women’s health physical therapist. You may be pleasantly surprised to know that you may only need a few visits to prevent a lifetime of discomfort and embarrassment.

The pelvic floor is made up of muscles and can be treated. Many hip, back, and lower extremity injuries that occur years later could be avoided by taking care of the pelvic floor early in the postpartum period.

I often recommend that my patients have a check up with a pelvic health therapist six to eight weeks postpartum. If this is not a possibility in your area, there are many online resources for postpartum women.

Diastasis recti abdominis (DRA)

A split in the abdominal wall is also common in up to two thirds of women during pregnancy and postpartum. It should slowly improve on its own.

However, if the split does not resolve, then there are many nonsurgical options to improve it. A great place to start is diaphragmatic breathing, deep core stability, and Pilates with someone who is well-versed in DRA. If the DRA persists, reach out to a physical therapist.

Postpartum depression

Exercising postpartum decreases the risk for postpartum depression. So, begin exercising as soon as you feel comfortable. You can begin with gentle breathing and deep core exercises and slowly transition to Pilates, yoga, and walking.

When returning to moderate or intense exercise, wait until the postpartum bleeding has stopped or slowed down significantly. If you begin exercising and the bleeding increases, you are doing too much too soon.

Always walk before you run. You are not the same person you were prior to having a baby. Take it slowly and you will save yourself a lot of anguish later.

Overtraining injuries and stress fractures

This is because stress is stress and your body cannot differentiate between emotional, mental or physical stress. The stress of having a new baby, not sleeping, healing from birth and much more does contribute to injuries.

Additionally, if you are breastfeeding, the calcium is pulled from your bones to create your milk supply. This is not to say you cannot exercise while breastfeeding — you can!

Should you decide to exercise, make sure you are not doing too much too soon. Always listen to your body.

Lastly, be kind to yourself

This is a period of change and growth for you and your family. Remember that despite what the media says, your body is still healing for a long time after giving birth. The better you treat it now, the better it will perform for you later.

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Author: Mallory Campoli

Kate Mihevc Edwards PT, DPT, OCS, author of Go Ahead Stop and Pee: Running During Pregnancy and Postpartum, is a doctor of physical therapy, board certified orthopedic specialist and owner of Precision Performance and Physical Therapy in Atlanta Georgia that specializes in the treatment of runners and triathletes’.