5 Things You Should Expect Post-Partum

Contrary to the slick advertising campaigns, the hours after you give birth will not consist of you rocking in a glider wearing a gossamer white gown while filtered sunlight bathes you and your little cherubic newborn in a hazy glow of rosy light. (Sorry.)

And please, in the name of all that is holy, don’t compare yourself to the celebrities proclaiming they got their pre-pregnancy bodies back before their baby’s umbilical cord was cut. I’ve seen thousands of post-partum women, and, trust me; it’s all lies and Photoshop. Want the truth about what to expect post-partum? Here goes…

1. Your Belly. Hopefully, you won’t have some nimrod (or your Uncle Joe, who thinks he’s hilarious) asking, “When is your baby due?”, as you’re carrying your brand-new bundle of joy out of the Family Birth Center. But steel yourself. I’ve seen this happen more than once, because after you’ve had the baby, you’re still going to look pregnant. Your once firm, baby-filled belly will now feel like Santa’s bowl full of you know what. Without the baby to hide the truth, you’ll be introduced to the full extent of your stretch marks, and if you had a dark line down the middle, called the linea nigra, it might seem much darker and wider. The stretch marks will fade to silvery/white in time, and it can take up to a year for linea nigra to disappear.

2. Your Uterus. Your uterus is a large sack of muscle. After ejecting its precious contents, it should contract, and stay contracted. What? You thought you were done having contractions? Nope. And here’s why: Where the placenta was once adhered is now a placenta-sized wound on the inside wall of your uterus. Post-partum contractions control post-partum blood loss by pinching off the large, juicy blood vessels that fed the placenta. After delivery, your uterus should naturally contract, becoming hard as a rock, and about the size of a large grapefruit. The top of your uterus, called the fundus, will sit at about the level of your belly button.

In the minutes after your baby is born, just when you thought the agony of childbirth was all over, some mean nurse will come along and rub your fundus. This will not make you happy one little bit, and you will want to grab your nurse’s hand and break every single one of her fingers. Please don’t. Your nurse is not a sadist; she’s trying to keep you from hemorrhaging. Sometimes the uterus is tired after delivery and won’t contract properly. Massaging your fundus helps the uterus contract, preventing excessive blood loss.

If you insist on bleeding despite vigorous (and let me warn you that vigorous might mean your nurse is practically standing on the bed and driving her fist into your belly with all of her might) you may be given a variety of medications to help your uterus contract. If massage and medication don’t stop the bleeding, the doctor or midwife might put their hand inside your vagina to explore the uterus further for retained pieces of placenta which can keep the uterus from contracting. You could also find yourself heading back to the operating room for an emergency D&C. None of this is any fun, but might be necessary to save your life.

3. Your Vagina. What can I say? A baby just came out of you. It’s not going to be pretty down there. So don’t look. Don’t let dad look, either. Seriously. Remember it as it was. It’ll be okay again someday. I promise.

Routine episiotomies—a surgical incision made between the vagina and the anus–are falling out of favor. This is because studies have shown that tears or lacerations are usually not as deep, and they heal faster. Vaginal injuries are officially measured by the degree, or depth of the wound into the vaginal wall; not by the number of stitches needed to repair it.

1st Degree: Involves tears in the skin around the vaginal opening.

2nd Degree: Tears in the vaginal tissue and into perineal muscle. 3rd Degree: Tears through the perineal muscle and into the anal sphincter. 4th Degree: Tears through the anal sphincter and into the lining of the rectum. (OUCHIE!)

Most repairs take 5-15 minutes, but serious 3rd or 4th degree tears might extensive repair, or even a trip back to the operating room (very rarely). You’ll be given a little plastic spray bottle and shown by the nurse how to use it to keep your vagina clean. After delivery, keep your legs together as much as possible until your follow-up appointment which is usually scheduled with your care provider at about 6 weeks. Let your vagina heal.

4. Your Nipples. People used to believe that if the baby was latched properly you wouldn’t have any nipple soreness. But studies now show that “80-90% of new breastfeeding moms experience nipple soreness, with 26% progressing to cracking or extreme nipple pain”. It’s true that correct positioning and latch are critically important to preventing true nipple damage, but isn’t always enough.

Lanolin helps. Most hospitals will provide you with a small sample to get you started. You can purchase more at your local drug store. Smear it on and leave it on. You don’t need to wipe it off before feeding the baby. This stuff is greasy, so buy some breast pads to protect your pretty, new nursing bras. (Extreme nipple pain requires a lactation consult.)

5. You. You are still you; not the collection of body parts I’ve just described. You are a human being who now just happens to be a mother too. You have just been through a monumental physical and emotional experience. Give yourself a fucking break!

You don’t owe anyone anything after giving birth. You don’t have to put your make-up on. You don’t have to get back into those skinny jeans. You aren’t competing with the latest celebrity who supposedly “Got Her Pre-Baby Body Back!” five minutes after she had her baby.

Just take care of yourself and your baby. That’s more than enough.

Everybody else can just go suck it.

Related post: 4 Truths About Our Post-Baby Bodies