Health, Women's Health

Postpartum Recovery

Covering Common Concerns

A woman’s body experiences remarkable changes during pregnancy, and it’s not uncommon to have questions, complications, or concerns in the weeks that follow giving birth. During this major adjustment, ongoing communication with a physician is key – The American College of Obstetrics and Gynecology recommends 12 weeks of follow-up care postpartum. Here, we cover common side effects that accompany postpartum recovery, as well as rare complications to look out for, and share insights from local specialists on the medical care that is available.

Postpartum Bleeding & Soreness

Vaginal bleeding after both vaginal delivery and C-section lasts for approximately six weeks. Similar to a heavy period, it will taper off and lighten in color over time. It is not uncommon for bleeding to become heavy again after week three when becoming more active. It is important to wear pads until your physician clears you to switch to tampons or a menstrual cup. After a vaginal birth, the perineum is also quite sore, particularly if you experienced a tear or an episiotomy. During your hospital stay, nurses will show you how to ice the area and use a warm water spray to keep the area clean while it heals. You can also use a sitz bath kit that fits on the toilet seat for soaking. Your uterus will also contract and cramp as it works to limit bleeding and make its way back to its original size. Medication or a heating pad can help alleviate these cramps.

Pelvic Floor Problems

A group of muscles that support the uterus, bladder, and rectum, the pelvic floor can be significantly impacted by pregnancy and childbirth. In the postpartum period, some women struggle with pelvic pain, incontinence, constipation, increased flatulence, pressure in the perineum, and lower back pain. Others leak urine or struggle to empty their bladder fully.

“For new moms, the physical impact of pregnancy and delivery can be a lot to navigate and know the best approach to healing. There are many symptoms postpartum, such as incontinence or pain with intercourse, that are often dismissed as common. While these are common symptoms, they are not normal for women to go through without any support or care. Pelvic floor physical therapists can help support and guide a new mom in this new phase of her life,” says Meagan Moyers, a pelvic floor therapist with Center for Sports Medicine & Orthopaedics.

While some women’s pelvic floor symptoms gradually alleviate with time, others may be referred to a physical therapist to learn exercises to relax or strengthen their pelvic floor as needed. “My approach is to come alongside moms and support the healing that their body is already doing,” says Moyers. “This could look like scar tissue massage, abdominal wall strengthening, breath work, pelvic floor assessment, functional strengthening, and return to a specific activity or sport.”

When pregnant, women can develop a routine that reduces the risk of pelvic floor problems after birth. These habits include avoiding heavy lifting, eating a high fiber diet to prevent constipation, and doing Kegel exercises.

The ‘baby blues’ only occur during the first two weeks postpartum and only last about two weeks. Anything that occurs after the first two weeks or lasts longer than two weeks is considered a PMAD.”

Maddie Storz

Mental Health

Pregnancy and birth involve a respective rise and sudden fall of hormone levels in a woman’s body, including progesterone, estrogen, cortisol, and thyroid hormone. Physicians agree that it is possible that such drastic shifts over such a short amount of time may make the postpartum period a challenge. While you may feel overwhelmed or sad as you adjust to life at home with a baby, these feelings should wane after two weeks.
A persistent low mood or feelings of helplessness, anger, and shame are signs of a perinatal mood and anxiety disorder (PMAD), which affect up to 1 in 5 pregnant or postpartum women.

“PMADs are mental health conditions such as anxiety, depression, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder, or psychosis that are activated during the perinatal period. Perinatal refers to the time around conception, pregnancy, birth, and one to three years postpartum,” explains Maddie Storz, a perinatal therapist at Healing Bonds Counseling Services.

“The advice I would give to someone going through PMADs is to not be afraid to reach out for help,” adds Storz. “The first one to three years postpartum can be difficult and you do not have to go through this alone. Perinatal therapists are trained in helping you build your community, grow your resources, and empower you as a mother.”

If you are in a crisis situation reach out to the Maternal Mental Health Hotline at 1-833-9-HELP4MOMS

Postpartum Stroke

Maternal stroke is a rare complication that can occur following birth, affecting 30 out of every 100,000 deliveries. Most maternal stroke occurs in the 12 weeks after delivery, and the risk is highest in the days after giving birth. “Having knowledge of your personal risk factors following delivery, and awareness of the signs and symptoms of a stroke is crucial to stroke prevention and stroke recovery,” says Jorden Watson, a physical therapist with Siskin Hospital for Physical Rehabilitation. “The majority of readmission rates for postpartum strokes occur within 10 to 11 days following delivery. Both chronic hypertension and hypertensive diseases of pregnancy have been shown to place women at a higher risk for a pregnancy-associated stroke. However, improved blood pressure management may reduce maternal risk of stroke in patients with hypertensive diseases of pregnancy.”

A rehabilitation center is often a woman’s best option for recovering from a postpartum stroke. “For patients who have been admitted following a pregnancy-associated stroke, we have equipment that simulates activities of daily life that a mother would be performing with her newborn child: walking and carrying a baby, placing a baby in a crib or stroller, dressing the child, and nursing. Goals are addressed through an interdisciplinary approach involving physical therapy, occupation therapy, speech therapy, neuro-psychology, and case management. As physical therapists, our job is to facilitate the greatest level of independence and help the patient maintain a close relationship with their newborn baby in a safe environment,” shares Watson.