Postpartum issues such as urinary incontinence and loss of libido may not be the first topics brought up in group meetings with new moms, but rest assured, they are very common. Even if it feels awkward or embarrassing, sharing these problems with your doctor can help ensure your health and well-being during the postpartum recovery period.
“Patients should feel empowered and not embarrassed to ask their doctors about these postpartum symptoms,” says Anjali Goswami, MD, an obstetrician-gynecologist at NewYork-Presbyterian/Weill Cornell Medicine in Fresh Meadows, New York. “We are trained to provide these answers and to tell patients when a further evaluation is necessary.”
Here are some often-asked questions new moms have about awkward postpartum challenges.
I’ve Been Experiencing Leakage. Is This Common After Childbirth?
Urinary incontinence, or losing control of your bladder and leaking pee during certain activities, such as coughing, jumping, or laughing, is extremely common during the postpartum phase. In one review, an estimated one in three women had urinary incontinence immediately after giving birth — which persisted weeks and months after delivery.
Vaginal delivery and the weight of your baby during pregnancy stretches out and weakens the pelvic floor muscles, which support the organs in your pelvis and help control bodily functions such as urination and defecation. (Fecal incontinence, though much more rare, can also occur, especially if you’ve had severe tearing of the vagina and anal sphincter during delivery.)
“Just because it’s common doesn’t mean that urinary incontinence is not distressing,” says Dr. Goswami. It’s important to talk to your doctor about urinary incontinence. Without treatment, a weak pelvic floor can lead to pelvic floor dysfunction (when pelvic floor muscles don’t contract and loosen properly) and painful sex over time.
The good news: Your pelvic floor can be strengthened like any other muscle. Kegel exercises both before and after delivery help. And if incontinence interferes in your everyday life, your doctor may recommend a pelvic-floor physical therapist, who can assess the condition and recommend exercises.
To improve incontinence, Goswami suggests timing and limiting when you use the bathroom, as well as restricting alcohol, caffeine, and spicy or sugary foods, which can trigger bladder spasms.
Is It Common to Get Constipated After You Have a Baby?
One major culprit: pain-relieving medications you may receive after birth, which can temporarily slow bowel transit, says Goswami. “Good pain control during labor with an epidural can reduce the need for narcotic medications during delivery and postpartum,” she says.
Hormone changes in the first few weeks after birth can slow digestion, and episiotomy stitches and hemorrhoids can make bowel movements painful, which can add to constipation risk.
“The most common thing I see is that patients are afraid of the pain that comes with passing their bowel movements after delivery, usually related to injury to the perineum during childbirth,” says Goswami.
If you’re feeling backed up, ask your doctor about taking a stool softener. You can also ease constipation by adding more high-fiber foods (e.g., lots of fruits, veggies, nuts, and whole grains) to your diet. For pain or soreness, apply ice packs on the area or use oral and/or topical pain medication recommended by your doctor.
How Long Do I Have to Wait Before I Can Have Sex Again?
When you can resume sex depends on a lot of factors — including, importantly, if and when you feel up for it. If you’ve had a vaginal birth, there’s no set timeline for sex. Doctors typically recommend waiting a few weeks after delivery, but that can depend on your individual physical recovery and preference. But if you had to have stitches or a C-section, you may need to wait four to six weeks. “This allows for proper healing of the area and prevents infection,” says Goswami.
Talk to your doctor if you have any questions. And remember to use birth control, even if you still haven’t gotten your period or are breastfeeding. “Pregnancy is very possible immediately postpartum and during breastfeeding,” says Goswami, who recommends avoiding pregnancy for 18 months after delivery to allow for proper healing.
Is It Common to Have No Interest in Sex After Having a Baby?
There are plenty of reasons you might have a loss of libido after giving birth. You might be experiencing pain or soreness around your vagina or the C-section incision. Breastfeeding can cause vaginal dryness. And between being exhausted from caring for your little one, lack of sleep, and not having time to even shower, you simply might not have much desire for intimacy.
Give yourself the space and time to recover fully. Although a waning sex drive can feel like just one more thing you have to worry about, the circumstances causing it will likely change with time, and your sex drive will return.
And remember, intimacy includes a lot more than intercourse. Talk to your partner about other ways you can connect, such as cuddling and kissing. If you experience additional symptoms, such as depression or a loss of interest in activities, including taking care of your baby, talk to your doctor right away.
Why Am I Sweating So Much?
The cocktail of hormones, including estrogen, human chorionic gonadotropin, and progesterone, produced during pregnancy drop precipitously in the days after giving birth, leading to symptoms such as mood swings and sweating, especially during the night.
If you’re breastfeeding, you might sweat a bit more, because prolactin (the hormone responsible for producing breastmilk) decreases estrogen levels, which increases sweating.
Sweating should subside within a week or two (or a bit longer if you’re nursing.) In the meantime, wear loose, comfortable, breathable (preferably cotton) clothes. Consider turning down the thermostat in your bedroom, too, so you can add or remove layers as necessary.
Why Is My Hair Falling Out So Much, and When Will It Stop?
Hair loss is another common postpartum symptom you can blame on hormones. Your hair is constantly cycling — growing, resting, and falling out. During pregnancy, hormones keep your hair in a growing state, so less of it falls out.
But after childbirth, those same hormones will drop, as will the luxurious locks you may have had during pregnancy. You’ll likely notice significant postpartum hair loss about three months after giving birth, and it lasts through about the first year postpartum.
If you’re breastfeeding, hair loss may be more gradual, and you may maintain more hair until you wean. Either way, you will likely notice more strands in your brush and possibly thinned-out spots (particularly if you naturally have fine hair or low hair volume). “Hair thinning is common for the first year postpartum. It is temporary, and it will resolve,” says Goswami.
In some cases, hair loss can be linked to other causes that may require treatment, such as thyroid disease, stress, a scalp infection, nutrition deficiencies, medications, and autoimmune disorders. If you continue to notice abnormal amounts of hair loss for more than a year after giving birth — or are bothered or worried about hair loss — check in with your doctor.
I’m Experiencing Mood Swings. Should I Be Worried?
All those hormone changes, combined with a lack of sleep and the stress and excitement of caring for a new baby, can make you feel like you’re having PMS on steroids the first few days after giving birth. You might feel overwhelmed by love for your new baby one moment and inexplicably tearful the next — and later, lash out at your partner for buying the wrong kind of onesie. “Dramatic hormonal changes postpartum can exacerbate anxiety and depression postpartum,” says Goswami.
Mood swings are very common, affecting most women at some point after pregnancy. The most important (and effective) step you can take to fight mood changes is to prioritize sleep, which is easier said than done when your baby needs to be fed every three hours. Whenever you can, try to rest when your baby’s napping (let the housework wait). If possible, ask your partner to take the night shift a couple of times per week, even if you’re breastfeeding. Five or six hours of uninterrupted sleep can make a huge difference. And nourish your body with healthy foods to allow it to repair itself.
But if your low mood is having a severe impact on your ability to take care of yourself or your baby — and lasts more than two weeks — talk to your doctor, and confide in a trusted loved one. Postpartum depression is relatively common, affecting about one in seven women, but it’s also treatable.
“In my experience, 95 percent of patients experience anxiety or depression symptoms at some point during their pregnancy or postpartum,” says Goswami. “Depression and anxiety are nothing to be ashamed of. Becoming a new parent can be overwhelming. Don’t hesitate to bring up these concerns with your ob-gyn, because we’re trained to guide you through these challenges.”
The Takeaway
- Although some postpartum symptoms can feel embarrassing, doctors emphasize that discussing them is important, because they are treatable and, if ignored, may lead to longer-term health problems.
- Open communication, self-care strategies, and support from doctors and loved ones can help most new mothers recover safely, with extra attention needed if symptoms are severe, persist, or interfere with daily life or caring for the baby.
- There are a lot changes after birth. Constipation, hair shedding, incontinence, libido shifts, mood swings, and sweating are common — even if people don’t talk about them — and often temporary.
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