4 Things Your Doctor Didn’t Tell You about Postpartum Health

Recently in my community I heard some shocking things coming from doctors-

“There’s no cure for stress incontinence. You can do surgery, but that usually doesn’t help. You’ll just have to deal with that for the rest of your life.” (As they denied her referral to a pelvic floor physio)

“Unless you had a C-section, by 6 months postpartum you should be perfectly fine. Any further symptoms are psychological. I’m giving you a referral to mental health.”

and…

“You have diastasis recti. The only thing we can do for that is surgery, and we only do that if your guts are falling out.

What????

Not true, ladies! Not true. And if these two women have heard this, how many more women are getting these discouraging answers from doctors?

I’m not trying to hate on doctors here, I promise. Doctors are amazing, and I think we can all agree we are grateful to have them. But the truth is, not all doctors are well educated on postpartum health- the issues we face when we aren’t sitting at the doctor’s office.
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The stats show that approximately 1.27 million C-sections are performed each year in the U.S. and women are seldom given proper information about how to care for their bodies afterwards, much less their incision sites! This leaves 6-18% of women who’ve had C-sections with chronic scar pain related to their surgery.

Thankfully, after a very long and painful labor, I did have a pretty easy recovery and no disastis recti, but I had very little support, either. As soon as I was cleared for exercise at my 6 week checkup, I spent the next two weeks killing myself in the gym at 5am. I was having a blast, but it was too much, too soon, and after that two weeks I was already exhausted, burned out, and totally discouraged. Even as someone completely passionate about fitness, I struggled to make myself work out over the next few months. I probably went to the gym once a week or less, and didn’t have any consistent routines. I knew I wasn’t going to put on any muscle with how inconsistent I was, which further discouraged me.

My own struggle is what led me to all the research and becoming a specialist within pregnancy and postpartum fitness. I didn’t have enough support in my time of need, but other women should! I started reading everything I could, and I was very surprised by how much information isn’t getting in the hands of the women who need it.

  1. Diastasis Recti isn’t a death-sentence; it’s repairable.
    If you’re not familiar, diastasis recti is the separation of the diastasis rectus abdominis. As your baby grows during the pregnancy, the abdominal wall will expand, stretching the skin, fascia, and linea alba, eventually leading to the separation of the ab muscles. All women will experience this and is perfectly normal, and in the postpartum period, some women’s will “heal” with no intervention. But even in this “healing,” it still won’t function properly, and that’s what is important to look at.Exercise can reduce the likelihood of diastasis recti, but specific exercises are what can heal it completely. Seeking guidance from a pelvic health physiotherapist (especially after a C-Section) can help you monitor how well your diastasis is healing so there’s no guesswork. I give my postpartum clients a specific protocol for diastasis recti.
  2. Pregnancy leads to postural changes.
    As you can imagine, your posture will change as that baby grows! To help accommodate the weight of the baby during pregnancy, your hips will tilt forward, increasing the curve in your lower back. In time, this can stiffen and shorten your lower back muscles, and also lengthen and weaken your glute and hamstring muscles. We already know the ab muscles stretch, and the rib cage flares upward while expanding the uterus, which limits the function of the diaphragm (this is why you may have seen shallow breathing during your pregnancy!).

    If you already had good posture before your pregnancy and worked to maintain good form during your pregnancy, yay! You’re ahead of the curve. But even if you weren’t very focused on this, it’s never too late to start improving your posture. In my program, we use specific movements to immediately help your posture. Focusing on good posture helps alleviate back pains, decrease risks of injury, and will help you feel more strong and stable as you recover.

    With my own postpartum journey, aside from some horse-related injuries that gave me back problems and poor posture and had to work through, I did have relatively good posture going into my pregnancy. After Grayson was born, I noticed that I was most comfortable carrying him on my right hip, and rarely could get myself to be ambidextrous on this. My hips ache SO MUCH if I get slack on stretching my hip flexors.

  3. Once you’ve had a baby, you are considered “post partum” forever!
    Things do NOT just simply go back to normal after you’ve had a baby. It is an incredible experience, but with that also comes an incredible range of emotions. While I think it is great that women get between 6-12 weeks of maternity leave on average, I want you to know that beyond this point, you are still healing. You’re still probably sleep deprived, you’re still learning, and you’re still emotional. You may be physically healed enough to return to your job, but that doesn’t mean you should have high expectations of yourself to have it all together. I say this lovingly! A lot of women will still feel sensitive, sad, easily startled/on edge, fearful, doubtful, or even angry, along with all the positive, wonderful emotions that come with having that sweet baby.

    No one warns you about this crazy range of emotions that you have. I remember feeling like “Mama Bear” on steroids. I got upset when FAMILY, people that I trusted, would take Grayson out of my sight so I could eat or heaven forbid, sleep. It was such a blur. I remember answering business-related questions at 2am while nursing, and thinking the next day “WHY did I say that?? That made no sense!” But I know it came from the mom brain and being so sleep deprived.

    Of course, it goes without saying that severe mood swings, any thoughts of suicide or self-inflicting pain, feelings of hopelessness should be addressed right away.

    As time goes on, things do start to feel more and more “normal” – or a new normal, I should say. But now, welcome to motherhood! From now on, every time you think you’ve figured out parenting, your child will change up his/her routine on you, go through a phase of not sleeping, and heaven only knows what else. You’ve just got to learn to roll with it! And seek advice from those you trust. (I’m sure you’ve figured out by now that EVERYBODY is ready and willing to offer plenty of unsolicited advice, too!)

  4. Nutrition plays a role in breastfeeding!
    As you could probably guess, what you eat will affect your quality of breastmilk that your child receives. A perfect example: we didn’t know it wayyyyy back when I was a baby, but my mom and I are both gluten-intolerant. She found out when she was having severe joint pain and felt like she was about to have a heart attack. I later discovered that gluten was the reason for the severe migraines I have had frequently since the age of 6. She didn’t know I was gluten intolerant, so she ate gluten while breastfeeding. The result? I was constantly sick from her milk. They diagnosed me as lactose intolerant (they said I grew out of it early as a child, and today I practically live off of dairy!).

    A digress to say this- if you eat something your baby’s body disagrees with, the breastmilk will transfer it to the baby. So it wasn’t that I was lactose intolerant, it was that my body disagreed with the foods my mom was eating.

    Likewise, there are certain foods that are GREAT for breastmilk supply, and foods that can lower your supply. Also, be aware of how much alcohol and caffeine you’re drinking. Of course, these are passed to the baby as well.

    One last thing to consider is how much you’re eating. On average, breastfeeding can burn around 500 calories a day. This should be noted because with the chaos of having a newborn, it can be hard for Mama to get all her meals in, and can sometimes under-eat.

    You can track your calories and macros each day to make sure you’re getting enough, but my opinion is that in the beginning, it really isn’t necessary. Try to eat until you’re satisfied, not stuffed, and generally just go on your hunger cues. Tracking macros can be very unhealthy if it becomes an obsession, and until life becomes a *little* more normal (ie, once your baby is sleeping more at night and YOU are sleeping more at night!), tracking can just be added stress.

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