Dear New Mom,
Like many women, you may have waited a full six weeks before seeing your OB after giving birth. You struggled and pushed and stayed up all hours, and maybe had major abdominal surgery (hi, c-section), and then a few days later you were waved out the door with an infant and no instruction manual. Six weeks of a whole new life: crying, rocking, pain, joy, struggle, love, and drama. Then, you get to your six week postpartum visit, sleep deprived and overwhelmed, and your OB says that you’re “healed” and “good to go” back to exercise, sex, and work. And you were probably thinking, “What?!?!”
I want you to know that no woman has ever told me they felt back to normal at six weeks postpartum. You are not alone. The six week visit can be traumatic because of the vast chasm between how you feel now and what you knew as normal before. You may look at your OB and wonder if they really recognize you, do they really see you?
To give your OB the benefit of the doubt, they likely mean you are progressing normally through this recovery process. Their time with you is so limited, they really only have the opportunity to check on healing of your uterus, any perineal tears or c-section scars, and talk to you about birth control. It is relatively rare the OB will check for prolapse or diatasis recti and they almost never assess your pelvic floor muscle awareness or strength. This brief visit and the recommendation to return to all activities can result in the unrealistic expectation that you should feel back to normal after 6 weeks.
This interaction may make you feel behind the curve or ashamed of your current body and how different it is. You may worry your OB is saying this is your “new normal”, and that this is all the recovery you can hope to achieve. This shame or worry may stop you from sharing how you really feel with others. You look around at other postpartum women, who seem to be happily coping and focused on their babies, and wonder, “Is this just me?” No, it’s not just you, and we need to talk about this together!
I want you to know that we’re here to help. Your body took nine months to prepare for this and will need time to recover. Fun fact: just the uterus shrinking back down to normal size takes about 11-12 weeks! There will be so many changes and you need knowledgeable, caring providers supporting you through this process.
In some other countries (bonjour, France!), this is standard care. Every postpartum woman gets referred to pelvic floor physical therapy after every birth. This makes sense! Your whole body changes during pregnancy and the delivery process can be very physically (and emotionally) traumatic. In the US, if someone tears their ACL, they often receive up to 6 months of rehab. Well, a lot more than your knee is affected during pregnancy and birth...
Postpartum women need support here in the United States AND we need to talk openly about our bodies and how we really feel.
Things are slowly changing in the US and the American College of Obstetrics and Gynecology has revised their recommendations for the postpartum period, to offer earlier postpartum visits and extend care through 12 weeks. Until more of these changes take effect though, you will need to continue to self advocate and seek out support. You do not have to get used to incontinence, painful sex, feeling weak in your core, or pelvic pain. Please reach out to pelvic floor PTs, The Lotus Method, postpartum doulas, lactation consultants, and support groups to help you on this journey.
Jessica Abele, PT, DPT, NCS
Therapy Roo Physical Therapy