Your body after baby

Hair falling out? Boobs the size of basketballs? Still look pregnant even though your baby was born three months ago? Your body changed a great deal during pregnancy, but there's even more in store after your baby arrives. Katherine Granich takes an honest, no-holds-barred look at what to expect from your body post-pregnancy.

I have a photo of myself when my daughter was about six weeks old. It is Easter, and I am wearing a white top and a pink skirt. My hair, though washed and blow-dried, is lank and stringy. My tummy has this strange sort of pregnant-looking muffin-top that hangs over the waistband of my skirt, although it's clear from my posture that I'm trying to suck it in. You can clearly see the circles of my breast pads through my top, despite the fact I'm wearing a singlet under it. And my skin? Oy, vey. Let's just say that I thought acne would stop once puberty was over, and I was wrong.
     The changes to your body during pregnancy are pretty drastic. Weight gain, breast growth, feet going up a size, and even weirder things like an enhanced sense of smell and enlarged nipples can really throw you for a loop. But once your baby is born, everything should go back to normal - right?
The reality is, it can take a while, sometimes years, for certain physical aspects to return to their pre-pregnancy state. Some of the changes your body has undergone during pregnancy will never "go back to normal". Here's what you need to know.

Bleeding
I remember visiting a colleague who'd just had a baby. I was due a few months after her, and we were both first-time mums, so equally ignorant about childbirth and its aftermath. After cooing over her baby son, I asked her to tell me about her birth. But it wasn't the birth story she needed to unload. "Nobody told me how much you bleed afterward!" she half-whispered. "I'm telling you, it's carnage down there!"
     It is perfectly normal to have discharge for some weeks after your baby is born, even if you had a C-section. In the first 24 hours or so, you will experience somewhat heavy blood loss - like a very heavy period - as your body releases the remaining products of pregnancy and childbirth from your healing uterus.  This vaginal discharge is called lochia, and it can last anywhere from about three to six weeks post-partum.
     Lochia has three distinct phases. During the first stage (lochia rubra), which is usually at its heaviest for the first 24 hours after birth and gradually tapers off at around four to five days after birth, you'll experience a discharge that consists, at first, of bright red blood, mucus, and placental tissue. It reduces colour and texture by about the fourth day, when you'll move into the second stage of lochia (lochia serosa). At this point, you'll notice your discharge is a pink or brownish colour, as the lining of your uterus is shed. This ends at around 10 days to two weeks post-partum. In the last stage of lochia (lochia alba), your discharge will be yellowish or white. All of this usually ends by about six weeks post-partum.
     Your midwife or lead maternity caregiver (LMC) will want to know about your discharge, so don't be embarrassed to tell them what's going on down there. Also, in the first few days, pay attention to what's coming out - if you see large clots (like the size of a golf ball), tell your midwife immediately. Also, if you're still experiencing heavy blood loss at two weeks postpartum, or you notice that your lochia smells unusual or offensive, definitely let your LMC know and get it checked out.

Your cervix, vagina, and what happens with stitches
One of the most surprising things to most new mums who have given birth vaginally is what their vagina looks and feels like. Following a vaginal birth - where you have to push a watermelon out of a hole the size of a lemon - your vagina will feel very swollen and will look red and enlarged. It will also feel extremely sore. Your uterus had 40 weeks to stretch and grow to accommodate your baby, but your vagina only had the duration of your labour. No wonder giving birth hurts!
     The good news is that even if you feel like a baboon down there, your vagina will return to normal. Once the swelling reduces, which takes about a week, you'll need to work on getting your vaginal muscles - which were stretched during birth - back into shape. This means pelvic floor exercises are a must.
    Your cervix, which will also have stretched to full capacity, will also be sore following your baby's birth. Fortunately, it will return to its normal shape and size after a week or so.
     If you've had a tear or episiotomy, you will need to pay a little bit more attention as your vaginal area is healing. Your stitches will usually dissolve after about five days. Going to the toilet may be quite painful, particularly if you sit on the toilet seat. Try holding a warm, wet face cloth over the site of your stitches when you pass urine or faeces (especially urine, which is acidic and can aggravate the wound), so that you feel like you are supporting the area and not straining. Until your stitches fully heal, you may want to urinate standing up in the shower, or pour warm water over yourself as you pass urine. Keep this area as clean as possible. And if this area is still very tender several weeks following the birth, tell your LMC or GP - you may have excess scarring that needs to be taken care of.

Your uterus and when your period will return
After your baby is born, your uterus will be contracting and returning to its normal size. You may feel pains similar to Braxton Hicks contractions or period pains as this occurs. Break out the hot water bottle or soak in a warm bath, and rest assured that these pains should reduce fairly soon, especially if you're breastfeeding.
     Your period is a whole other issue. If you do not breastfeed, you can expect it to return within about six to eight weeks following the birth. If you breastfeed, it's anybody's guess. You could get your period back as early as two months and as far down the line as 18 months.
     Your first few periods following the birth of your baby may be different to what you were used to before pregnancy. Your hormones are still sorting themselves out, and it may take a few menstrual cycles before everything returns to normal.  But keep in mind that even if you haven't  got your period, you still need to take precautions - ovulation occurs before you have a period, so you can get pregnant even if you don't offcially have your period back yet!

Your tummy and weight
We've all heard of pregnant women who packed their pre-pregnancy jeans in their hospital bag, determined to wear them home after delivery. The reality is, after your baby is born, you may still look pregnant for several weeks while your body gradually sheds the extra weight that you needed to gain to nurture your developing baby.
     Your uterus, which has expanded dramatically during pregnancy to accommodate your baby, takes several weeks to return to its pre-pregnancy size. In the meantime, your stomach may be flabby, soft, and wobbly. This is because your stomach muscles are stretched and need time to contract as well. If you are desperate to get things back in order as soon as possible, don't just start punishing yourself with crunches - see a physio with a speciality in working with post-natal women, so you can make sure you are doing things correctly and not further injuring those tender muscles.
     Losing the baby weight depends on many factors. Breastfeeding will help (although it may not be as dramatic as some people say it is - you'll probably lose some weight through breastfeeding, but not all of it). Eating sensibly and healthily will also help. Exercise makes a difference too. But don't start any diet regimes or drastic weight-loss programmes without advice from your GP. It can take several months to return to your pre-pregnancy size, and many women find that parts of their bodies have changed too much to fit into their old clothes - expanded hips might never get back into those skinny-waisted jeans. Be kind to yourself, and wait until your body has healed from the pregnancy - at least six weeks - before you even think about your weight.

Your hair
Eight weeks after my daughter's birth, I finally made it in to see my hairdresser for a root touch-up. "Is your hair falling out yet?" she asked me casually as she foiled me up. My horrified expression didn't faze her. "I get new mums in here all the time concerned because they're losing their hair," she explained. "So if it happens to you, don't worry. It's normal."
     When you're pregnant, hormonal changes mean that your body "hangs on" to your hair - which is why many pregnant women find that their hair feels thicker and more lustrous during pregnancy. After the birth, the levels of estrogen in your body drop, and along with this go all of the hair your body refused to let go when you were pregnant. Most commonly, hair loss occurs between two and six months following delivery. You may notice more hair in the shower or on your hairbrush, but your hair should not be noticeably thinner-looking, and you won't get any bald patches! Post-pregnancy hair loss is a temporary situation, so hang in there.

Your skin
Pregnancy, with its accompanying hormones, can have unexpected effects on your skin. Your skin may have experienced that glow associated with the second and third trimesters, or you may have had an acne breakout the likes of which teenagers run screaming from. Chances are, your skin behaved in an unusual way during pregnancy, whether it was positive or negative. And post-pregnancy, as the ramped-up hormones you've been building over 40 weeks start to leave your body, your skin will likely misbehave again.
     Freckles, moles, and pigmentation sometimes get darker during pregnancy but fade afterwards, and if you experienced chloasma facei, also called "pregnancy mask", on your face, you can expect this to start to fade within about six months. You may have experienced small growths of skin called skin tags, which are harmless but can be easily removed by your GP if they bother you. And if you've had a linea nigra - the dark line of pigmentation which runs from your navel to your bikini line - it will start to fade as well.
     If you gained stretch marks during pregnancy, make friends with them, because no matter what you try to do, they won't ever go away completely.  While they may be very obvious immediately following delivery, they will eventually fade to skin-coloured or silvery-white lines - but it could take a year, so don't despair.

Your breasts
Did your breasts grow during pregnancy? Well, watch out, because when your milk first comes in, you might be shocked at how large they can become. Their size should settle down after a few weeks, but they will usually remain larger than before you were pregnant, especially if you are breastfeeding. Your nipples may also be enlarged and darker in colour, but they should fade somewhat within a few months post-delivery. Research indicates that pregnancy has the greatest effect on our breasts' appearance, not breastfeeding, so if you are concerned that breastfeeding is going to "ruin" your previously perky boobs, don't be. During breastfeeding, your breasts will be continually producing milk, filling up with milk, emptying, and filling up again. They will feel tender at first, and your nipples will be sensitive to touch. Many women can't even stand the sensation of going bra-less, so wear a maternity bra at all times. After you stop breastfeeding, your breasts may feel empty and saggy, and have stretch marks from pregnancy which were not as evident when your breasts were full of milk. It may take around six months post-weaning for your breasts to return to their pre-pregnancy appearance, so don't panic. Wear a good, supportive bra and be patient.

The good stuff
There are positive health benefits associated with pregnancy, besides that gorgeous bundle of joy who makes you smile every time you look into the bassinette. Some positives that occur post-pregnancy are:

Katherine Granich is the former editor of OHbaby! Magazine and has still not lost her baby weight, four-and-a-half years later. But she's fInally doing something about it.

As seen in OHbaby! magazine Issue 11: 2010

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• Having more than one child decreases your chances of developing breast cancer and uterine cancer.
• After pregnancy, breastfeeding for a long period of time (for example, a year or longer) further reduces breast cancer risk by a small amount.
• Women who have been pregnant have a lesser risk of developing ovarian cancer, and breastfeeding also reduces the risk of ovarian cancer.

Two new studies from University of California-Berkeley researchers found that pre-birth maternity leave and longer post-birth maternity leave are associated with better health for both infants and women. So don't skimp on your time off work!
Most of the post-pregnancy body changes mentioned above, though somewhat of a shock when you're experiencing all of them at once, do resolve themselves. It may take months, but your body will feel "normal" again.