4 Things You Should Know about Postpartum Recovery that People Don’t Talk About
Pregnancy glow is a thing. I know it because I’ve seen some women shine like a freshly minted penny with their sweet baby bump, vibrant locks, and dewy skin. But honey, that it is NOT ME.
Don’t get me wrong, my babies (and husband) are my greatest treasures… but if you think that I didn’t HATE every second of being pregnant, you are dead wrong. Both pregnancies were extremely difficult. I was sick the entire time and got so big that people often seemed both indignant and mildly disgusted when I told them the baby still had four months left to cook.
Then, each in turn, my sweet babes actually came. It was so wonderful to have them in my arms (especially instead of in this weird parasitic relationship), love on them, and gaze in awe at their soft faces. At the same time, it was a WILD adjustment filled with emotional rides, a body that felt like it had pushed out a little wrecking ball, and sleep deprivation.
During my postpartum journey, I learned four very valuable lessons (the hard way.) I’m sharing them here so that if you or any of the women in your life are facing similar challenges, you can know you’re not alone and find the resources you need for healing.
Postpartum Lesson #1: Pelvic Floor Physical Therapists are a Thing and They Can Help you Stop Peeing Every Time You Sneeze
After blasting a cannonball out of the most sensitive part of one’s body, it makes sense that there would be some pelvic floor issues. The pelvic floor is made up of all the muscles/tissues from your tailbone to your pubic bone. It supports several organs - including the bladder and bowels. Hence it is super important in helping you be and stay continent.
It’s pretty normal to need stitches after a vaginal birth due to a little ripping. (I’m wincing as I write this because I know how bad it sounds. And most women who have never given birth gasp when they hear this. Look, it’s usually not that bad… and if you have an epidural you likely won’t feel much if anything.) Although I recovered from my stitches more quickly after baby #2, my ability to handle any kind of impact (sneezing was the worst) without peeing my pants was almost zero. It got to the point where it was super disruptive to my life.
During my pregnancy, I had been working on a pre/postnatal certification and it had mentioned that a pelvic floor physical therapist could be a huge help. I had worked with physical therapists before but had no idea that some specialized in the pelvic floor arena. I tried finding one near me and had no luck. I talked to my OBY-GYN about my plumbing problems and she gave me a list of physical therapists I could call that specialized in pelvic floor problems. I have no clue why these physical therapists didn’t show up on my Google search but her list helped so much.
In light of this, I STRONGLY RECOMMEND that you ask your OB-GYN or doctor for a referral to a pelvic floor physical therapist. Be sure to check if your insurance covers your chosen physical therapist before going.
What to Expect from A Pelvic Floor Physical Therapist
In case you’re curious (because I sure as heck was), here is what you can likely expect from pelvic floor therapy.
The physical therapist will start with an evaluation of your pelvic floor, meaning they gotta get up in there in your lady parts to evaluate any damage. They may also do some massage techniques to evaluate tightness/weakness and help balance out the different muscles.
Next, they will probably teach you some pelvic floor strengthening exercises and stretches to get that pelvic floor relaxed. I was surprised to learn that my main issue involved a chronically tight pelvic floor, and that learning how to relax it was super important to my healing. It seemed counter-intuitive that I was peeing my pants because my pelvic floor was too tight rather than not tight enough, so I was grateful for that revelation.
Some recommendations/exercises/stretches my physical therapist included for my pelvic floor issues were:*
Kegels - note that when you do a Kegel, you need to contract (think of that pulling in sensation) on the exhale. This feels so counterintuitive so don’t be surprised if it takes you a while to get this down.
If I felt a sudden urge to pee, I was told to do some Kegels, take a few deep breaths, and then walk (not run lol) to the bathroom - strangely this helped a lot
My pelvic floor physical therapist was a woman and I was grateful for that, simply because it made the experience comfortable. It was also nice to have someone who could empathize. That being said, I have absolutely nothing against men pelvic floor therapists, I just preferred having a woman help me.
*Please note that this list is not a substitute for professional advice. My program was customized by a professional to meet my needs. Please be sure to consult your physical therapist or doctor to get a prescriptive program for your own needs.
Postpartum Lesson #2: Get Checked for Diastasis Recti and Treated if Needed
It’s normal to still look pregnant for quite some time after giving birth. It took 9 months to expand the uterus to be large enough to hold a full-term baby so obviously, it takes some time to bounce back. It can vary from woman to woman, but the uterus typically returns to its postpartum size after 6 weeks.
After 6 weeks, I noticed that I definitely still looked pregnant - not just with the weight I had gained (because it’s not like it only takes 6 weeks for THAT to melt off), but my stomach still looked like I had a baby bump. This can be a sign of Diastasis Recti which basically means that your superficial-most abdominals have separated.
I asked my physical therapist to check me for Diastasis Recti and she assessed that I indeed had it moderately severe. Through working with her, and a lot of deep and careful core work, I am happy to report that my core is once again strong and well.
The main signs that you may have Diastasis Recti are:
A stomach that bulges with a pooch similar to your baby bump >6 weeks postpartum
Core muscles that generally feel very weak
You can use this video to ask someone to assess you, or you can adapt the instructions to assess yourself. However, please do not use this as a substitute for medical advice. If you suspect you do have diastasis recti, definitely see a professional. It is so important to get treated because if you have DR and try to continue with normal life, and “push through the pain” in workouts, you could get seriously hurt and give yourself a hernia. Additionally, your physical therapist can assess you regularly for progress and let you know how strenuous you can make your workouts, as well as clear you for regular physical activity once they have determined that you have healed.
Some recommendations/exercises/stretches my physical therapist included for my Diastasis Recti issues were:*
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Progressed to Side Plank with Clamshell
Avoid front plank or push-ups or carrying more than 20lbs until sufficiently healed
*Please note that this list is not a substitute for professional advice. My program was customized by a professional to meet my needs. Please be sure to consult your physical therapist or doctor to get a prescriptive program for your own needs.
Postpartum Lesson #3: Chill Out About Breastfeeding
Before I dive into real life, let’s start with some positives. Breastfeeding is the gold standard of nutrition for babies. It is truly miraculous - a magic potion that adapts to the needs of the baby. It helps babies build their immunity, gives antibodies that adapt to the baby/mother’s environment, can be a wonderful bonding experience, and so much more.
Now for Ashlee’s reality. I dread, dread, dread breastfeeding.
With baby #1, breastfeeding was my number one challenge, no contest. I had what is called a “fast flow,” which basically means that in the first minute or two of sucking, I blast that poor little baby with the intensity of a mini, milky, firehose. As a result, my baby was terrified of breastfeeding. He would eat the minimum amount possible… which meant he was always hungry and hangry. Consequentially, Mama (ME) was a smelly, tired, stressed, hungry mess because I couldn’t meet my own needs while trying to take care of my constantly hungry little guy.
I really wanted to make breastfeeding work. I spoke with three different lactation consultants. The last one I saw put me in a crazy fancy recliner chair that I did not have at home, with a fancy expensive pillow (which I also did not have at home), and like two other pillows - one of which she was constantly positioning herself (I also did not have someone else with me at home except for in the evenings). Even with the intense set-up, breastfeeding was still a huge struggle and she had no answer for me when the baby kept screaming and tried to avoid eating. She sent me on my merry way with assurances and a stack of papers. I left with no real solution but a ton of motivation to keep the struggle going.
The internet was worse. Everything I read was basically like - here are 8 peer-reviewed pages about why you should breastfeed, but if you need to make formula work, okay I guess you’re not a terrible person but here are the risks, the end.
And so I pumped. And pumped and pumped and pumped. And it sucked (sorry, couldn’t help it) because although my husband could now get up with the baby to feed him, I still had to wake up to pump. So now both of us missed out on sleep. And still, my baby seemed to not be getting enough calories.
Finally, I threw in the towel. My own mama looked me over with the bags under my eyes and my emotions constantly on the fritz and helped me realize that this just wasn’t working.
Once I started the baby on formula, life immediately got 300% better. Turns out baby boy had quite a happy disposition once he was fed.
As a result of the formula, the baby slept better, my husband and I slept better, and I could do things during the day besides sit in a chair and watch Netflix while dying inside. I was so relieved to know that my son was getting enough nutrients. I felt like an actual human again instead of a sickly dairy cow.
Soon after I stopped breastfeeding, the baby and I went to a check-up with the pediatrician. I shamefully told her that I had switched to formula. She was so kind and told me she had never breastfed any of her kids. She assured me that what mattered more was that I was connecting and present with my children. That resonated in my heart and gave me so much peace.
After talking with many other mothers, I found that several women who I absolutely respect also struggled with breastfeeding. Many had given it up to be in a better mental state and never looked back.
With baby #2, I was apprehensive about breastfeeding again but decided to try it out. I supplemented with formula from the get-go (it wasn’t the plan originally but was recommended to us in the hospital when the baby had an upset stomach). This time around, breastfeeding was smoother. Baby girl wasn’t terrified of the breast like her brother had been, and an awesome nurse had given me several helpful tips that made a huge difference.
However, I still struggled with breastfeeding emotionally. I didn’t know it at the time, but I was dealing with postpartum anxiety. Although breastfeeding was much easier, I found that every time the baby ate, I felt anxious and depressed. It was almost as if the feeding itself brought out the worst in me.
I decided to stop breastfeeding altogether and although I would still need to be treated for anxiety, it helped a lot.
Through these experiences, I learned that while breastmilk is the most nutritious food for a baby, fed is best. Additionally, a present mother who can connect and love on her baby is vitally more important than breastmilk. In the future, I will be extremely gentle with myself. I may not even breastfeed or may supplement from the beginning. If I decide to try it out again and need to stop, I will do so without shame. I will prioritize my mental well-being, and my baby’s need for enough calories.
Postpartum Lesson #4: Postpartum Anxiety is Real and Help is Available
I knew postpartum depression was something to look for after giving birth, but I had no clue postpartum anxiety was even a thing. After I stopped breastfeeding baby #1, my emotions evened out. It was a much different story after baby #2. Despite life going well, I was a labyrinth of chaos and angst on the inside. I literally did not know what was happening to me, and I couldn’t understand why. I am so grateful for a wonderful friend who helped me identify my postpartum anxiety and encouraged me to get help from my doctor My doctor helped me make some lifestyle adjustments and prescribed medication that has been life-changing.
Here are some signs that you may be dealing with anxiety:
Feeling anxious, nervous, or on edge
Not being able to stop or control worrying
Worrying too much about different things
Trouble relaxing
Being so restless that it is hard to sit still
Becoming easily annoyed or irritable (for me this manifested as high-strung impatience)
Feeling afraid, as if something awful might happen
These questions are taken from the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire
If you are feeling a bit out of sorts postpartum, you may want to take a minute to answer this questionnaire. It’s very possible that you may just be adjusting to newborn life/hormone adjustments. But something else could be going on as well. Speaking from experience, getting help was the best thing I did for myself and my family.
Because this topic is so close to my heart, I created a whole blog post about it. Please read if you or someone you love is struggling with anxiety.
In Sum
Birthing and raising children is so so hard. I hope these 4 lessons can help ease some of the toils in your own journey. Please take diligent care of yourself and get your body and mind checked by a professional if you suspect something is amiss. And for heaven’s sake, give yourself grace with the breastfeeding scene. Gift yourself some care, love, and sleep when you can manage it. Good luck, my friend. I’m over here sending all the mama-hood good vibes to you.