In this recurring guest column, Kate White, M.D., of Boston Medical Center, answers your questions on all things gynecology. As the author of the Mayo Clinic Press book Your Sexual Health, she’s ready to dole out wisdom on sex, periods, menopause and more. Submit a question here.
Q: I’m pregnant for the first time and am already struggling with some of the changes to my body. What can I expect after labor? What are the chances my body will go back to “normal”?
A: Let’s face it — your body will change after you have a baby. When you’ve just grown and birthed a whole human, there’s no other way around it — that’s going to lead to some changes.
While there’s a lot of information about what to expect with certain aspects pregnancy and childbirth, you may be less prepared for the other changes. You might get stretch marks over your breasts, belly, hips and thighs. Your belly may have a gap between your abs (diastasis recti), and a lower belly pooch. Vaginal dryness is common, due to a drop in hormone levels. And hemorrhoids (swollen veins in and around the anus) may make anal sex painful. Even your feet may change, becoming larger, and your mood may be all over the place for a few months. Sad truth—you can’t avoid post-pregnancy changes in your breasts by not breastfeeding. It’s the change in the weight of your breasts that makes them saggy.
Many pregnant people dread the thought of what giving birth will do to their vagina. They’ve heard horror stories about leaking urine (incontinence) and worse, the bulging of the walls of the vagina out the opening (prolapse). Some people worry so much about delivery that they request a cesarean section, thinking that it will protect their vagina from harm. But when it comes to your post-delivery vaginal health, it’s not just the delivery that influences how quickly your body heals. Carrying the weight of the baby in your body for nine months, with the baby’s head bearing down, creates the risk of loosening of your pelvic floor muscles, no matter how the baby is born.
Certainly, a C-section avoids additional trauma to your vagina, but it too has consequences. A post-C-section scarred uterus is never as strong as one without a scar, and you’ll have risks of placenta problems in future pregnancies, along with scar tissue formation in your pelvis outside the uterus. If your labor lets you deliver vaginally, it truly is the safest way to go for your body.
But the good news is that not all these changes to your body after birth are permanent. Vaginal dryness will likely resolve after you stop breastfeeding. Diastasis recti can be addressed with certain exercises or physical therapy. Your mood should stabilize after a few months or with the help of medication.
When it comes to permanent body changes, try to see them in a positive way: They’re evidence that your body did an amazing thing, a body that continues to protect and care for the baby you had. These changes are a sign of strength, and you should be proud of what you—and your body—have accomplished.
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