Your post-natal health

It is common for women to experience a separation in their abdominal muscles after giving birth, or in some instances, during pregnancy. This separation occurs as the hormones soften the abdominal muscles to allow space as the baby grows. The separation will usually improve on its own over the first 6-8 weeks and beyond after birth. Sometimes the gap in the muscles may not go away completely. A gap of 2 fingers or less is normal.

• To learn more about recovery please see: Abdominal muscle separation..

A healthy diet is always important, but it’s especially important if you are breastfeeding. Breastfeeding uses a lot of energy and nutrients. It is important that your diet supplies the nutrients you need during breastfeeding, such as protein, calcium, iron and vitamins. You need these nutrients for your own health and wellbeing. Try to eat regularly and include a wide variety of healthy foods.

For more information, visit the Better Health Channel.

As a new mother your sleep will probably be interrupted and exhaustion is common. You will no longer have control over when and how long you sleep. Your sleep will depend on your babies sleep patterns. During the first three months most babies will wake several times a night and even at one year will wake once or twice a night.

More than missing sleep

If you are experiencing physical and emotional difficulties after birth they will compound the tiredness that you already feel. If you are having problems with feeding, back pain, perineal pain, haemorrhoids, sexual or relationship problems it is advisable that you seek help. Your MCHN or family doctor may suggest ways to help you through this time. Depression after birth and exhaustion are often linked.

Some suggestions by women for women to help you get through

• Talk about how you feel
• Have time out from your baby
• Share the housework
• Accept any help that is offered
• Join a new mothers group and find out that you are not on your own.

Between 10-30% of women experience some degree of stress incontinence after birth. This could be to lose a few drops of urine when the laugh, cough, sneeze or jogging. It is also possible to have a sense of urgency to get to the toilet. Discussing these problems is difficult however it is important to be able to so that you can access help.

What causes incontinence?
During birth the muscles that support the bladder, uterus, lower bowel and surround the openings of the vagina, urethra and anus are stretched and may be damaged. These muscles make up the pelvic floor. Forceps, birthing a large baby, a long second stage of labour, having more than one baby and being overweight all make the pelvic floor vulnerable to being weakened.

Will it go away?
It may improve in time however that is not guaranteed. There are some things that you can do to improve your pelvic floor

• Talk to a physiotherapist.
• Learn how to perform pelvic floor exercises effectively.
• Discuss the problem with your doctor. Your doctor may wish to test your urine to ensure that the incontinence or urgency is not related to a urinary tract infection.
• Discuss with your doctor measures to reduce your weight if you believe that your weight is contributing to your bladder problems.

Some people may refer to haemorrhoids as piles, they are swollen veins around the anus. Haemorrhoids may begin in pregnancy or appear after labour and birth. Haemorrhoids are made worse by constipation and straining and are painful. Generally they will settle in a few weeks after your birth.

There are some things that you can do to help

• When feeling pain do pelvic floor exercises
• Do not strain to have your bowels open. Use stool softeners like Metamucil or fibrogel which are safe to use regularly.
• Rest with your legs elevated to relieve the pressure.
• Wear firm supportive underwear to support the area
• Use a haemorrhoid cream
• If there is no improvement consult your doctor.

If you have faecal incontinence you may have

• No control over passing wind (farting)
• Urgency related to getting to the toilet
• Leakage of some bowel movement (faeces) staining your underwear.

Faecal incontinence is less common after birth than urinary incontinence. It is caused by damage to the nerves or the muscle that controls the opening of the bowel (anal sphincter). It is more likely to be damaged during a forceps or vacuum assisted birth.

There are some things that you can do

• Take the problem seriously and speak with your doctor
• Talk to a physiotherapist
• Do pelvic floor exercises regularly (they may not cure however they are not harmful).

About 44% of mothers experience back pain after birth. This pain may be caused by postural changes, weakened abdominal muscles, or softening of the ligaments during pregnancy.

If back pain is a problem you can

• See your doctor about taking non-steroidal anti-inflammatory drugs for severe pain.
• Keep active
• Ask for help with household tasks while the pain is severe
• Take care when caring for the baby not to strain when bending. It is better to kneel by the bed than bend over at a bench that is too low.
• See our fact sheet: Pelvic and lower back pain during pregnancy and postpartum.
• Consult a physiotherapist for advice regarding abdominal exercises, posture and ways to protect your back.
• Try to lead as normal a life as possible.