Here's what to do when pregnancy makes its mark.
Your Post-Baby Body
Growing up, I had such straight hair that it took three trips to the beauty parlor for my permanent wave to take. Then, in my late 20s, I had my first child, and my hair went ballistic. Ten years and three kids later, I still struggle with hairdressers who remind me that I have to pick styles that work with my weirdly wavy hair. But I've suffered far more pregnancy fallout than just a few errant cowlicks. My feet are quite a bit bigger, and I have faint red lines running below my belly (not to mention some off-limits information about my private parts!). But I'm certainly not alone in this rather large boat of post-baby body mysteries. The older I get and the more women I meet, the more I realize that all of us wear one or many signs of pregnancy in some form or another.
Experts agree that most women's bodies will undergo some change -- from marks on the skin to fatter feet -- that crops up during pregnancy and sticks around long after baby goes off to preschool. The question is, what is it about pregnancy or childbirth that spurs these changes, and is there anything any of us can do about them? Here's what you need to know from head to toe.
Changes in Your Breasts
- The reality: For many women, post-baby breasts are smaller and saggier.
- The reason: The whole idea seems counterintuitive, because during pregnancy most of us have enviable cleavage. By the time the baby is born, your breasts might be twice as big as they were pre-pregnancy, thanks to the fact that your body is revving them up to produce milk. All that pressure causes the Cooper's ligaments, which run from the chest wall down to the nipples and provide support, to loosen. After birth, while your breasts are busy making milk, they'll expand even more. But as soon as the milk supply stops -- regardless of whether you breastfeed or not -- "the ligaments are left looser and further stretched out, causing the breasts to shrink and sag," says Gerald F. Joseph, MD, medical director for women's services at St. John's Regional Medical Center, in Springfield, Missouri. Some other contributing factors are weight gain and hormone fluctuations.
- The relief: There are a few cosmetic tricks you can try. To minimize sagginess, try exercises such as chest presses, which are aimed at strengthening the pectoralis muscles of the chest wall, and be sure to wear well-made supportive bras. If you're bent on having cute perky breasts again, though, plastic surgery may be the only way to go.
Changes in Your Skin
- The reality: About half of all pregnant women develop pink or reddish streaks called stretch marks or striae on the breasts, hips, or abdomen. Some women may end up with a thin brown line that runs from the belly button to the pubic bone or irregular brownish patches on the forehead, nose, upper lip, and cheeks. Moles may appear larger and darker; some women develop tiny, flesh-colored flaps of skin called skin tags on their neck and underarms.
- The reason: Stretch marks occur when the elastic fibers in skin stretch and rupture due to weight gain. If you already have some stretch marks from growing hips during puberty, you're probably in for more when you're expecting. And because pregnancy hormones increase the body's production of melanin, a pigment that tints the skin, some women may develop chloasma (also known as melasma or the mask of pregnancy) on their face and/or linea nigra, the darkening of the hard-to-see white line called linea alba, which runs down your midsection. Melanin is also responsible for your moles' altered appearance, and skin tags occur from extra skin growth that may happen during pregnancy.
- The relief: The good news? All of these marks, splotches, and lines fade, although for some women they may never completely disappear. Gaining weight slowly can reduce your chances of getting stretch marks, and liberal use of sunscreen can help minimize pigment changes. Moles should return to normal. If not, see your doctor, as some mole changes indicate skin cancer. Skin tags will disappear or can be easily removed by your doctor.
Changes in Your Veins
- The reality: By the end of pregnancy, your legs may look like a highly detailed roadmap of Minnesota. If you see big, blue, bulging veins (they'll look like rivers) on your legs, you probably have varicose veins. If you see little clusters of red, blue, or purple veins (these look more like secondary roads) that linger close to the surface of the thighs, calves, knees, and ankles, you have a case of spider veins. All told, both are pretty common phenomena. "Twenty percent of pregnant women develop varicose veins and 80 percent develop spider veins," says Luis Navarro, MD, director of the Vein Treatment Center, in New York City.
- The reason: While the exact cause of vein problems is unknown, pregnancy is the biggest single accelerating factor. A pregnant woman has 20 percent more blood in her circulatory system to nourish her growing child; since 70 percent of circulating blood is stored in the venous system, this extra blood ups the amount of pressure applied to vein walls, which can cause them to bulge and darken. Plus, the growing uterus puts pressure on pelvic veins, which slows the flow of blood from the legs to the heart. This can damage the tiny valves that help direct blood flow in the veins, causing spider veins. Pregnancy hormones don't help either; they cause blood vessels to dilate, which also increases vein pressure and makes the whole road map worse. (And if your mom had them, you might too.)
- The relief: Fortunately, unsightly vein problems are treatable, but that largely depends on the extent and severity of the condition. Options include wearing support stockings with compression; sclerotherapy, which involves injecting veins with a solution that causes them to collapse and reabsorb into the body; and laser therapy, which seals in the vein.
Changes in Your Hips and Feet
- The reality: Many mothers wind up with wider hips.
- The reason: It's not your fault, but that's cold comfort when you look like a sausage in your swimsuit. During the third trimester, pregnancy hormones cause the ligaments holding the pelvic girdle together to soften, allowing the birth canal to widen during labor and delivery. Also, as the pregnancy progresses and you gain more weight, more fat collects on the outside of the hips.
- The relief: The redistribution of wealth around your waist can be controlled through diet and exercise. As for the looser ligaments, they will firm up over time, but your pelvis may never return to its exact pre-pregnancy shape. So if you went from a size 6 to an 8 in pants post-baby, you might have to grin and wear it.
- The reality: If you're convinced your feet grew during pregnancy, you're not crazy. They may be longer or wider -- or both -- postpartum.
- The reason: During pregnancy, your body retains fluid, swelling the soft tissue around your feet. In addition, the pregnancy hormone relaxin loosens the joints in your feet and causes them to spread out -- sometimes permanently.
- The relief: Although the swelling disappears after delivery, your feet may never return to their pre-pregnancy size. It's a great excuse to buy new shoes!
Changes in Your Bladder and Bowel
- The reality: "About half of all women delivering vaginally suffer temporary incontinence that persists for several months," says Guillermo Davila, MD, urogynecologist at the Cleveland Clinic Florida, in Naples and Weston. For some women, the news is even bleaker: About 25 percent of American women suffer long-term urinary and fecal incontinence and/or serious uterine prolapse (a loosening of the ligaments that elevate the uterus to the point where the uterus drops into the vagina).
- The reason: Most bladder-related problems are caused during vaginal deliveries, when the nerves and muscles of the pelvic floor, including the bladder and anus, are stretched and compressed. The result is nerve and muscle damage, which causes a leaky bladder or bowel.
- The relief: Start squeezing! Kegel exercises are a must during pregnancy and after delivery to help maintain good muscle tone in your pelvic floor.
If your urinary incontinence becomes problematic, a device called a pessary may be used to hold the bladder neck and reduce leakage. Similar to a diaphragm, this doughnut-shaped device is inserted in the vagina and removed as needed. It should not be left in place for longer than six weeks at a time and should be removed once or twice a week for cleaning. In extreme cases, medication or surgery to support the bladder may be needed. With fecal incontinence, the only truly effective options available are Kegels and surgery.
The Good News
Guess what? Not everyone complains about post-baby body changes. Here are some unexpected improvements you may be able to look forward to.
- Less body hair: Less shaving and waxing! Yay!
- Bigger breasts: It's happened before, and it could happen to you!
- Clearer skin: Bye-bye blemishes!
- Easier periods: For many new moms, their menstrual cycle doesn't cramp their style any more.
- A slimmer tush: Some breastfeeders report that they are actually slimmer post-baby from burning up all those milk-making calories.
Jennifer Lang is a freelance writer living in White Plains, New York.
Originally published in American Baby magazine, August 2005.
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 won health or the health of others.