Having a baby is one of the most wonderful moments in a person’s life. But it leads to physical and emotional body changes that can cause anxiety for new parents.
‘Often, these changes are perfectly normal and are nothing to worry about,’ says Dr Elisabeth Rosen, a Livi specialist in women’s health. ‘But occasionally, you may need to seek further medical advice.’
Here’s our doctor’s guide on what to expect and what you can do at home to help — or, when to get a medical opinion.
1. Lower back pain
A condition known as symphysiolysis (sometimes called symphysis pubis dysfunction) can cause pain in your lower back after having a baby. ‘Symptoms usually start around week 18 of the pregnancy and anyone can suffer from it,’ says Dr Elisabeth Rosen. ‘It’s thought to be connected to the loosening of the ligaments and joints between the lower back and pelvis thanks to hormonal changes while pregnant.’
Self-help
If you’re suffering with severe pain in your lower back after having a baby, talk to your doctor. If you have general back pain after pregnancy, the NHS recommends:
- While feeding your baby, sit with your back well supported and straight. Put a small pillow or cushion behind your waist to support your lower back. Make sure your feet can reach the floor
- Kneel or squat (do not bend your back) to do tasks that are near the floor, like picking up toys or bathing your baby
- Change a nappy on a raised surface. You could kneel on the floor next to a sofa or bed. Never leave your baby unattended on a raised surface, in case they fall off
When to talk to a doctor
‘If you need painkillers regularly for more than 2 weeks, see your GP,’ says Dr Rosen. ‘They may suggest alternative painkillers, a TENS machine [which uses mild electrical current to relieve pain], acupuncture or a back belt which you can buy or sometimes borrow from your delivery ward to help support the lower back.’
Read more about lower back pain and how you can help manage it.
2. Pelvic floor problems
Most women who give birth vaginally will suffer some form of damage to their pelvic floor area such as a mild or moderate tear. This can lead to pain, discomfort, dyspareunia, incontinence and constipation for a couple of weeks postpartum but should slowly resolve.
Self-help
‘Immediately after the birth you can apply an ice pad or cold compress to help the blood vessels constrict and reduce the pain,’ says Dr Rosen. ‘Pain killers can also help and make sure you start your pelvic floor exercises from as early as possible.’
When to talk to a doctor
‘Usually the pain and discomfort will disappear in the first 2-6 weeks,’ says Dr Rosen. ‘Persisting problems should be taken up at your 6-week postpartum check-up. There, the midwife will be able to investigate your pelvic floor through a gynaecological examination and refer suspected persisting damage to your pelvic floor for further treatment’.
3. Episiotomy stitches
It’s common for women who have a vaginal birth to have some kind of natural tear or episiotomy (a cut made by a health professional). These are normally stitched up within an hour of the birth and should heal within a month.
Self-help
‘Shower each day rather than taking a bath for as long as you’re still bleeding as baths could let bacteria enter your uterus,’ says Dr Rosen. ‘Change your sanitary pads regularly and don’t have sex until you’ve stopped bleeding — usually around the 6-8 week mark.
It’s useful to examine your wound and stitches regularly using a mirror, just to check for any changes. Don’t worry if the wound feels itchy or irritated. This is actually a good sign that the wound is healing. Massaging baby oil into the area often helps.’
When to talk to a doctor
‘If you get a high temperature it could be a sign of infection, so see your midwife or a GP straight away,’ says Dr Rosen. ‘If the pain or swelling gets worse or there is a smelly discharge from the wound, also seek medical help.’
4. Bruising and infection after a C-section
Around 1.4 million C-sections are performed every year in Europe. ‘Like all major surgeries, a C-section risks infection through the cut as well as damage to the nerve and bruising is common,’ says Dr Rosen. ‘Most women will be able to take up light exercise within 2 weeks and normal exercise after 6 weeks but there may be decreased or a ‘tickling’ sensation as the nerves try to repair themselves.’
Self-help
‘Keep the scar clean and examine it regularly for any changes,’ says Dr Rosen. ‘Many women try to “be strong” and continue with daily life but if you need painkillers, take them for at least the first 2 weeks after the birth.
When to talk to a doctor
‘If you develop a high temperature or the scar becomes warm, there is an increase in pain, swelling or redness or you see any kind of liquid — apart from blood — oozing out, consult your doctor as it might be a sign of infection,’ says Dr Rosen. ‘If your pain is increasing rather than slowly decreasing you should also seek help.’
5. Piles
Haemorrhoids or piles, are swollen veins in or around your bottom and are common both in pregnancy and after giving birth. Up to 35% of pregnant women are thought to suffer from them. ‘Piles normally start during pregnancy due to the increased pressure from the baby on the abdominal wall,’ says Dr Rosen. ‘Many women don’t realise they have them until they experience itching or they spot blood on the toilet paper but they are usually very treatable.’
Self-help
Drink lots of fluid and eat plenty of fibre to keep your poo soft so you’re not straining. Keep your bottom dry and clean. Try to gently push the pile back inside the rectum using your finger. Use a haemorrhoid cream or suppository which you can buy from the pharmacist.
When to talk to a doctor
‘Most of the time you can treat piles successfully at home but if you’re really suffering over a long period of time and painkillers are not helping, or you keep bleeding from the rectum, see your doctor,’ says Dr Rosen.
6. Bleeding after birth (lochia)
It’s natural for women to bleed for around 2-6 weeks after giving birth either vaginally or via C-section. The bleeding is a mixture of mucous, blood and tissue shed after your birth as your womb lining is being replaced.
Self-help
‘Shower every day, keep changing your sanitary pads and don’t have sex until the bleeding has completely stopped,’ Dr Rosen advises.
When to talk to a doctor
‘If you suddenly start to bleed more or see clots in the blood you should seek medical attention,’ says Dr Rosen. ‘Sometimes there may be pieces of placenta or membrane left inside and you might need medication to help the cervix dilate again or – in rare cases – you may need surgery. If you have a high temperature after birth, also see a doctor as this could be a sign of infection.’
7. Sore and swollen labia and vulva
It’s natural for the vagina and the whole surrounding area to feel sore after giving birth vaginally, says Dr Rosen.
Self-help
‘You can use cold pads on the swelling as well as a local anaesthetic cream and take painkillers if you need them,’ says Dr Rosen. ‘I’d also suggest urinating in the shower to dilute the stinging sensation of the urine acid on this area.’ Follow the general advice above for pelvic floor problems too.
When to talk to a doctor
‘If you continue to have pain while urinating after a week it might be a sign of a urinary tract infection,’ says Dr Rosen. ‘A GP will be able to confirm this easily with a test and prescribe antibiotics.’
8. Separated stomach muscles (Diastasis Recti)
Around 60% of women will suffer from separated stomach muscles, or diastasis recti, during pregnancy. It’s caused by the muscles that run down the middle of your stomach separating as the baby puts more pressure on the abdomen during pregnancy. The amount of separation varies from woman to woman but most of the time, the stomach reverts back around 8 weeks after the birth.
Self-help
Gently exercise the stomach and core. Dr Rosen says, ‘Look for an app for new mums that provides exercises to help reduce the size of separation between the muscles.’
When to talk to a doctor
‘If you still have separation of more than 2cm after 2 months or it’s giving you pain, seek medical advice,’ says Dr Rosen. ‘The GP may refer you to a physiotherapist and in rare cases you may need surgery.’
9. Hair and skin changes
‘Hormonal changes during pregnancy can affect women in different ways and some report they have glowing skin while others say they have acne’ says Dr Rosen.
‘Some women report hair loss after giving birth but actually, this is down to their levels of oestrogen changing. While pregnant, the level of oestrogen is high which stops your hair falling out at the same rate as it would have if you weren’t pregnant. When that drops after birth, you shed the hair you would have normally shed that stayed in place thanks to your pregnancy.’
Self-help
‘It’s vital to maintain a nutritious, healthy diet, get as much sleep as possible and perhaps take a multivitamin for new mums,’ says Dr Rosen. ‘Iron tablets may also help, although these can cause constipation so be wary.’
When to talk to a doctor
If you’re losing your hair in just one place, rather than from all over the head, it’s a good idea to seek medical advice. Hair loss can be a sign of hyperthyroidism (an overactive thyroid) but that is unusual in postpartum women as doctors keep a close eye on thyroid levels during pregnancy.
10. Hormone changes
‘If you’re breastfeeding, you may have dryness in your vagina due to low oestrogen and it may be itchy or uncomfortable when you have sex,’ says Dr Rosen. ‘The onset of the baby blues is also down to hormone changes and tends to arrive around day 3 after giving birth.’
Self-help
Vaginal dryness can be helped with lubricants which can be bought over the counter. ‘Being aware that the baby blues can kick in around day 3 is important for both you and your partner as awareness is half the battle,’ says Dr Rosen. ‘Usually these feelings disappear after a couple of weeks.’
When to talk to a doctor
If you’re still feeling low after a couple of weeks you may be experiencing postnatal depression. ‘This is common and you shouldn’t be afraid of seeking medical help,’ says Dr Rosen. ‘You may need some kind of talking therapy such as CBT or we can prescribe antidepressants, even if you’re breastfeeding.’
This article has been medically approved by Dr Elisabeth Rosen, Kry/Livi doctor and women’s health specialist.
