Real Talk: I don’t love my postpartum body and it’s been over three years since my last pregnancy. Dealing with postpartum body image can be challenging, and it’s something many mothers struggle with. After all, pregnancy, labor, delivery, and breastfeeding can all change us physically and mentally. It’s natural to feel a mix of emotions, from admiration for our bodies’ accomplishments to a longing for our pre-baby shape.
In this series, we will explore the raw and honest reality of dealing with body image dissatisfaction in the postpartum period. We’ll look at the emotional impact of body dissatisfaction, the reality of postpartum body changes, and practical steps you can take to accept and love your postpartum body.
Wherever you are in your postpartum journey, know this: it’s never too late to learn, be kind to yourself, and feel empowered just the way you are. Whether you’re a new mom or it’s been years since your last pregnancy, you deserve to feel confident and beautiful in your own skin. So let’s dive in and learn to give ourselves the grace and acceptance we need to embrace our imperfections.
THE REALITY OF POSTPARTUM BODY CHANGES
Warning: As a former science teacher, I completely geeked out on the physiology of postpartum body changes and couldn’t stop myself, which is partly why this post is two parts. If you’re the ignorance is bliss type, feel free to skim, but I hope you will find it intriguing and relevant to what you are going through or have been through. We’re about to Miss Frizzle through your postpartum body, so buckle up, Mamas!
It doesn’t take long after your little bundle arrives for your body to change. According to an article published in the National Library of Medicine last year, nine organ systems are affected in the postpartum period, which lasts from immediately after birth to about six months. Everything from your skin to your kidneys and beyond!
Right after delivery, fatigue sets in, your pulse and blood pressure rise, your temperature increases, your respiratory rate begins to fall back to the pre-pregnancy level, and you lose roughly 13 pounds on the spot.
postpartum body changes by system
You are probably acutely aware of the changes in your reproductive system, but here’s a quick breakdown so you have the complete picture:
- Involution occurs, which is the process of the reproductive organs returning to their pre-pregnancy state.
- Your uterus and placenta contract rapidly, causing some wicked cramps.
- Blood vessels in the uterine lining constrict.
- Vaginal discharge (lochia) appears.
- Your lady bits are sore, swollen, and most likely torn. The article says, “The female might complain.” Um, you think?!
Ever wonder what actually occurs during lactation?
- Colostrum increases, preparing the breasts for lactation, which typically begins a few days after delivery.
- Oxytocin triggers milk release; another hormone, prolactin, maintains milk production.
- Nipple soreness, blocked ducts, engorgement, and mastitis are all super fun conditions many of us develop in our breastfeeding journeys.
In our endocrine system, our hormones are going haywire.
- Progesterone levels plummet after birth and don’t return until you have a menstrual period, which researchers believe may play a role in postpartum depression and increased irritability.
- You are also low on estradiol, which deprives you of your natural defense (serotonin) against depression.
- In addition, you may have lower dopamine and variations in thyroid hormones, which can lead to imbalances.
If you’re keeping score, we’re up to more hormone changes than we can count on one hand! At my six-week appointment, after I had my twins, I burst into tears when my OB asked how I was doing. I will never forget the empathy he showed me in that moment. He said, “Nicole, your hormone levels are literally at zero. You have none. Give yourself some grace.” Then he pointedly looked at my husband, and he became my favorite human.
Over in our renal system, we may be experiencing changes in urinary patterns, which can include:
- Overdistended bladder
- Urinary retention or (more common) urinary incontinence.
Who among us hasn’t perfected the mom-leg-cross when coughing or sneezing?
Our cardiovascular system is working hard, returning to normal.
- Did you know your heart grows during pregnancy?! Recent studies report an increase of up to 40% in the left ventricular wall, and in the four weeks following delivery, it shrinks back to pre-pregnancy size. First: Mind. Blown. Second: Aww. How sweet is that? Our hearts literally grow for our bebes!
- We’re also experiencing changes in our blood cells, and our risk of thrombosis (clotting) remains elevated.
Perhaps some of the most uncomfortable changes occur in our gastrointestinal system:
- The emotional trauma of your first BM after birth, due to inflammation and constipation.
- Girl, don’t even get me started on the freaking hemorrhoids.
- One *good* side effect: the hormone responsible for the increase in acid (gastrin) returns to normal. Thus, you can take that bottle of Tums out of your purse now and eat a hamburger without popping one (or three). Did anyone else get heartburn from drinking water during pregnancy? Just me?
Even our skin is involved in postpartum changes. In our integumentary system:
- 90% of us experience hyperpigmentation in pregnancy (melasma and linea nigra – the mustache and the belly line), which can take up to eight weeks to disappear.
- There are also the spider veins, edema (swelling), and varicose veins; oh my!
- Stretch marks may also adorn our abdomen and legs for the rest of our lives despite our obsessive application of cocoa butter.
In our musculoskeletal system:
- Our overstretched ab muscles take their sweet time regaining their normal tone and elasticity.
- A lucky 33% of us even deal with diastasis recti up to twelve months postpartum.
I intend not to scare you with these facts or paint a bleak picture. It’s just the opposite. Mama, look at where you’ve been! This list is far from exhaustive and doesn’t even consider C-section Mamas or our psychological and emotional changes.
Your body is so incredible, and so are you! Yes, you brought life into this world, and that’s the purest form of joy. But let’s take a minute to appreciate the resiliency of the female body. Holy crap!
The fact that you can go through all this while caring for a newborn who relies on you for everything, possibly go back to work, and resume regular household duties, among a million other things, is bananas! B.A.N.A.N.A.S. When you look in the mirror and judge your softer tummy or new tiger stripes, remember that your body has done many incredible things.
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The Emotional Impact of Body Image Dissatisfaction
We all have moments when we’re self-conscious about certain aspects of our appearance or unhappy with our bodies, which probably started in our teens when we became more aware of the cultural ideals of beauty.
Body image is how you feel when you look in the mirror or when you picture yourself in your mind. It encompasses your feelings (both negative and positive) about your physical appearance, thoughts about your body characteristics, and overall comfort in your skin, according to The Office of Women’s Health.
In general, females are more likely to have a negative body image. They are also more likely to develop certain mental health conditions related to their body dissatisfaction, such as eating disorders, depression, and body dysmorphic disorder.
It is important to note that body image dissatisfaction is NOT the same as body dysmorphia, a severe mental health disorder. According to the International OCD Foundation, you have body dysmorphic disorder (BDD) “When these thoughts and feelings [about body image] become time-consuming and cause significant emotional distress (such as anxiety, sadness, or self-consciousness).”
When you have BDD, the distress you feel about your body’s appearance becomes so consuming that it interferes with your ability to function normally. A recent study found that 14.9% of pregnant women and 11.8% of postpartum women reported clinically significant symptoms of BDD. Individuals with BDD tend to fixate on a specific area of their body and engage in repetitive and excessive compulsive behaviors. BDD requires medical intervention and treatment. The International OCD Foundation has some great resources to help you learn more.
POSTPARTUM AND DEPRESSION
Research suggests that postpartum depression (PPD) and body image dissatisfaction are directly correlated, though there is still some debate about which comes first. It has been observed that women are least satisfied with their bodies during postpartum, with up to 70% of women reporting body image dissatisfaction during this period (Dettmer et al., 2018). Given the combination of elevated stress levels and rapid physical changes, it is unsurprising that women are more susceptible to experiencing symptoms related to body image dissatisfaction and PPD.
Postpartum depression refers to depressive symptoms in women within the first year after giving birth. Postpartum depression “affects 11-20% of women who have given birth and has quite negative consequences for both the mother and the newborn.” However, it remains under-treated and under-diagnosed, according to a recent study on Body Image Dissatisfaction as a Risk for Postpartum Depression. It is characterized by a negative mood, reduced engagement in activities and social interactions, low energy levels and motivation, and decreased spontaneous thoughts and enjoyable experiences. PPD is also linked to an elevated risk of self-harm and suicidal tendencies.
Experiencing these symptoms while caring for a newborn who depends on you for everything is nearly impossible. Addressing these feelings with a qualified healthcare professional, seeking support from loved ones, or joining support groups is imperative.
You are not alone in this journey, and this is not your burden to bear alone. So many other women are going through similar experiences and facing similar challenges, and we could all use a reminder that we are more than our perceived flaws. We are more than our scars, and we are more than our struggles. We are strong and resilient, and we are in this together.
up next...embracing your postpartum body
In Part 2, we will discuss how you can embrace and accept your postpartum body, navigate the social pressures to “bounce back,” and take steps toward body confidence. There will be a lot less science and statistics and a whole lot more loving on you, Mama! Catch you in Part 2!
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Sources:
Phillips, K. (2023, April 21). What is BDD (body dysmorphic disorder)?. BDD. https://bdd.iocdf.org/about-bdd/
