Caring for Your Postpartum Body

Your baby isn't the only one who needs regular checkups.

Your Changing Body

For the better part of a year you looked after your health for the sake of your developing baby. But now that baby's here and you spend every waking (and not-so-awake) moment devoted to her care, what happens to you? It's all too common for new moms to pick up bad habits, such as skipping dental appointments and depending on junk food.

Avoid corner-cutting by rethinking your health choices. Here's how:

You think: "I'm having postpartum pain, but I'm sure it's normal."

Think instead: "It will only take a minute to ask my doctor if this is okay. I've got to take care of myself so I can take care of my baby."

The postpartum package comes with plenty of uncomfortable symptoms, but hemorrhoids, vaginal bleeding, and soreness from episiotomy or cesarean incisions should lessen as time goes by, says Elizabeth Mandell, MD, assistant professor of obstetrics and gynecology at the University of Virginia School of Medicine. If the pain does not go away or seems to get worse, call your doctor. New moms can suffer from uterine and urinary tract infections, reopening of incisions, and blood clots, and the sooner such problems are treated, the better. For less extreme postpartum pain, your doctor will suggest simple remedies. Keep your six-week postpartum checkup, even if you're feeling great, just to make sure you're healing correctly and so you can decide on a method of birth control.

You think: I've been seeing my ob-gyn so often -- farewell to my primary care physician for now."

Think instead: "I've been focused on gynecological health, so now's the time to get everything else checked."

If you have a chronic condition, such as diabetes, asthma, allergies, or hypertension, you're probably aware that you need to keep seeing your regular doctor. But even if you feel healthy, it's still important to get a physical that includes screenings for cholesterol, red blood cell count, and thyroid function, says Redonda Miller, MD, assistant professor of medicine and director of the Comprehensive Women's Health Program at Johns Hopkins University. Your primary care physician can also check any moles that may have grown during pregnancy, offer nutrition advice, talk about depression, and readjust any prescriptions. In addition, autumn is a good time for a flu shot. According to the Centers for Disease Control and Prevention, the vaccine is safe for nursing moms and their babies, as well as for any woman more than three months pregnant.

You think: "I'm nursing and haven't had my period, so I can't possibly get pregnant right now."

Think instead: "Better to be safe if I'm not ready to have another baby."

While you may not menstruate for seven to nine weeks, your ovaries can function soon after delivery, even if you're breastfeeding. Back-to-back pregnancy is a shock and does have risks. According to the American College of Obstetricians and Gynecologists, a baby conceived fewer than six months after a sibling is born is more likely to be born preterm, have a low birth weight, and be small for his gestational age, perhaps because his mother hasn't fully recovered and might even be anemic.

If an immediate pregnancy isn't in your plans, use contraception. Birth control pills can often be resumed six weeks after delivery, when the risk for blood clots has passed. (Back up birth control pills with condoms for added safety.) If you're nursing, consider switching to a progestin-only pill, which won't interfere with milk production. And of course there are plenty of other options, from natural family planning to condoms, IUDs, and even permanent birth control. Talk to your doctor.

Other Areas of Your Life

You think: "Everyone feels overwhelmed after having a baby, so I shouldn't complain."

Think instead: "If things don't get better soon, I'll talk to someone."

Surging hormones, physical stress from giving birth and starting to lactate, and the exhaustion that comes from fragmented sleep, all combined with round-the-clock baby care, put almost every new mom on edge emotionally. It's the so-called baby blues, making you feel a little sad and overwhelmed. However, the blues should begin to lift after two weeks, and most women are more or less themselves again by the six-week mark. If the stress doesn't fade and you're getting no joy from your baby, get help right away. You might be suffering from postpartum depression, which strikes as many as 10 to 20 percent of new moms. Either your ob-gyn or primary care physician can prescribe treatment and help you get support.

You think: "Getting my teeth cleaned is not on my priority list!"

Think instead: "It could save me from bigger problems later."

Pregnancy is hard on your teeth and gums. Gingivitis, an early form of gum disease, affects 50 to 70 percent of pregnant women. If left untreated, it can progress to periodontitis and result in receding gums, loose teeth, and even bone damage. As for cavities, ignoring them may lead to procedures such as a root canal. This is one area where an ounce of prevention can save you a pound of pain.

You think: "I skipped breakfast and barely ate lunch -- chips won't hurt."

Think instead: "If I don't have time to eat much, it had better be healthy."

With a new baby, time is skewed. You wake before dawn, and after a series of feedings and diaper changes, it's 2 PM and you're still in your robe, famished, with a "Welcome Baby" cake in front of you. But resist the urge to eat a pint of ice cream instead of a bowl of cereal. Most women come out of pregnancy with nutritional stores that are iffy at best, says nutritionist Elizabeth Somer, author of Nutrition for a Healthy Pregnancy (Owl). If you don't eat well now, you'll be cranky, susceptible to colds, and unable to sleep well or really enjoy this new chapter of your life.

Nursing moms need an extra 300 (healthy!) calories a day in order to maintain an optimum milk supply. Experts recommend eating six small meals over the course of the day so that you eat when you're comfortably hungry, not famished. Don't skip breakfast, because then you're likely to overeat and go for something sugary later, Somer advises. And drink plenty of fluids, since dehydration adds to fatigue. Eight glasses of water a day is a minimum, and nursing moms need even more.

You think: "Just carrying this baby is exercise -- and I'm losing weight."

Think instead: "I need a fitness program so I'll feel better."

Most new moms want to lose weight, but overall fitness is much more important, explains Lisa Callahan, MD, author of The Fitness Factor (Lyons Press). Weight is cosmetic, she says. Focusing on fitness will give you more energy, boost your immune system, reduce your risk for disease, combat depression, and help you lose weight. The key is making time for it. Think of it as being as important as brushing your teeth, says Dr. Callahan.

Two key areas to work on are cardiovascular fitness and strengthening your core -- the muscles of your back and abdomen, says Dr. Callahan. For cardiovascular health, any aerobic activity will do, such as walking, hiking, biking, or swimming. Activities that strengthen core muscles include yoga, Pilates, weight training, and old-fashioned crunches. Experts recommend exercising for at least 20 minutes, three to five days a week. You'll need that strength and energy, since your baby will only get bigger!

Reviewed 11/02 by Elizabeth Stein, CNM

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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