The period following childbirth, known as the postpartum phase, can present a wide array of physical changes for new mothers. While some effects are temporary and expected, others can be painful, unusual, or go unaddressed. Dr. Moiuri Siddique, a urogynecologist and director of female pelvic medicine at NYU Langone Hospital—Brooklyn, highlights 10 postpartum physical issues that women should not overlook and offers guidance on managing them.
Postpartum Preeclampsia
Postpartum preeclampsia is a serious blood pressure condition that can develop between 48 hours and six weeks after delivery. Symptoms include severe headaches, changes in vision, pain in the upper right ribcage, and sudden swelling of the face and hands. Immediate medical attention is crucial if these signs appear.
Tearing and Wound Healing
Tearing of the tissue between the vagina and the anus can occur during vaginal births. While soreness is normal in the initial weeks and can be managed with sitz baths, ice packs, and over-the-counter pain relievers, persistent or increasing pain, swelling, foul-smelling discharge, or wound opening could indicate infection or breakdown. Proper hygiene, including keeping the area clean and dry and changing pads frequently, is essential. For lingering scar tenderness or pain during intercourse beyond a few months, a doctor might suggest pelvic floor physical therapy, topical treatments, or, in rare cases, a minor procedure.
C-Section Scar Pain
Sensitive nerves near the abdominal incision can become irritated during a C-section. While discomfort is often temporary, persistent pain or drainage from the incision may signal an infection, potentially requiring further surgical intervention.
Vaginal Dryness
Vaginal dryness is common postpartum, particularly for those who are breastfeeding, due to lower estrogen levels. This can lead to itching, burning, or painful intercourse. Options for relief include vaginal moisturizers, lubricants during sex, hyaluronic acid-based vaginal gels, and estrogen creams, tablets, or suppositories. Symptoms typically improve as breastfeeding decreases.
Prolonged Bleeding
While some vaginal bleeding is expected after birth, bleeding that continues beyond six weeks may suggest retained products of conception (RPOC). This occurs when small amounts of placental tissue remain in the uterus. Untreated RPOC can lead to infection, persistent bleeding, and potential fertility issues. Contacting a doctor is recommended for prolonged or heavy bleeding.
Urinary Leakage
Experiencing minor urine leakage when coughing or sneezing in the six months after delivery is common due to changes in pelvic floor muscles and bladder support. Pelvic floor exercises, such as Kegels, are the primary recommendation for strengthening bladder muscles. Physical therapy for the pelvic floor can also be beneficial. In some cases, injections like Bulkamid or mesh-based procedures might be considered for more severe symptoms.
Pain During Sex
Pain during intercourse can affect a significant percentage of new mothers. This can be due to healing tissues, particularly after tears, vaginal dryness, or tight or tender pelvic floor muscles. A doctor can assess for scar tenderness and muscle tightness. Lubricants and pelvic floor physical therapy are common recommendations.
Abdominal Separation
Diastasis recti, or abdominal muscle separation, occurs when the uterine expansion stretches the abdominal walls. Abdominal wraps can help relieve back pain, reduce swelling, and support separated muscles.
Dermatologic Changes
Hormonal shifts can lead to temporary skin conditions and increased hair shedding. These dermatologic changes typically resolve within six to 12 months postpartum.
Swollen Feet
Increased blood and fluid volume during pregnancy can cause swelling in the feet and ankles. Increased walking can help recirculate fluid. Persistent swelling may warrant medical evaluation for potential cardiovascular issues.