Taboo Topics: Things No One Really Told Me About Postpartum

I remember hearing the typical things about what happens after you have the baby – “it’s hard to lose the weight“, “your boobs never look the same after breastfeeding” (which, I actually talked a bit about in my last post in the breastfeeding myth series I just finished up), “you’re tired all the time“. Yada, yada, yada. All these things seem to be person dependent – some people lose their pregnancy weight easily or barely gain any; some people’s breasts look better after breastfeeding (or grow – so they’re happy if that’s what they want!), and some moms seem to handle the sleep changes and energy lows pretty well.

Similarly, the things I’m about to talk about may not happen to you. They are just things that I have personally experienced that I didn’t find anyone ever mentioned to me. I spent time googling some of it when it was happening, and I’d find the odd unreliable forum post about it, but I thought I’d bring some up here and try to provide moms-who-are-worried-about-this-weird-thing-that-is-happening-to-them-postpartum some answers, peace of mind, and the feeling that as always – they are not alone.

*Disclaimer: This blog is intended for informational purposes only. The information on this blog should not be used as a substitute to medical advice or medical treatment. As always, your Primary Care Provider, a doctor, or another health professional is your best resource for specific questions and medical advice. If you believe you or a loved one are experiencing a medical emergency, please contact 911.*

1. Decreased libido…

I knew about this one, I did, but because it’s considered sort of a “taboo” topic by many (it shouldn’t be), it’s something that’s not really talked about other than usually semi-anonymously on forums or Twitter chats.

Having decreased sexual desire/libido after pregnancy (especially while breastfeeding) is very commonabout 40-50% of women report this issue in the postpartum period, globally! And as I always remind you in my posts – this is just the reported number. Imagine how many women don’t speak out about this struggle? It’s likely even more common than statistically shown.

Breastfeeding women tend to be more affected by this because they have decreased estrogen and increased other hormones (prolactin, for example) in their system for a longer period of time (depending on how long they breastfeed).

There are other factors affecting this though, even in postpartum women who don’t breastfeed, such as fatigue (major one) and decreased self-esteem due to body changes after pregnancy.

Sadly, there is a lack of research on this topic. The study I’ve been citing is only from last year, and they had a hard time referencing other studies in their literature review because there is so little research on the topic. Women’s health often is pushed under the rug… but I think it’s something that is starting to change slowly with more women in the medical & STEM fields. Yay women!

One interesting finding from the 2019 study is that lower sexual function/desire seemed to be associated with income. The authors thought this might be related to the fact that lower income status can cause stress and impact mental health, which can affect both relationships and sexuality.

For the healthcare providers in this field reading this: sexual counselling has been shown to be helpful in increasing sexual function in women in the postpartum period. Initiating a discussion about this is, I think, very important, and often forgotten. Many women are hesitant to bring these topics up on their own, thinking that it is either just something they have to live through, or worrying that it is too ’embarrassing’. There could be many reasons, but it should be touched on in order to educate, comfort, and support postpartum women.

My personal experience with it has been hard on me – emotionally! I couldn’t figure it out because I mentally wanted to do it, but my body just wasn’t reacting. I was touched out after a long day of breastfeeding. I was often fatigued as well (it’s also harder when you don’t get much true alone time, especially being a new parent in a pandemic) Honestly, I hesitated a bit about putting this in my “list” because talking about it is uncomfortable in many ways, but I also want to help other women know they aren’t alone (many lovely mamas on Twitter did this for me, so I wanted to pass the baton if you will).

I think our sexuality is a big part of who we are. I think that being educated about this happening in the early postpartum period is valuable and makes you feel less “weird” or “off” when and if it does happen to you (and no, it doesn’t happen to everyone). And I think it’s definitely something that should be talked about more! It’s not a lack of love, and sometimes it isn’t even a lack of mental desire, but can be just a physical issue or vice versa. Definitely a complicated topic that happens, needs to be discussed, and needs much more research so that maybe some more help can be provided.

Oh, also – per that study and common sense, communication is key! Talk to your partner about your struggles, as well as your provider.

2. “It’s going to look/feel different down there”, but no actual explanation of how

Again, another taboo topic (omg, vaginas!), but one that many women probably wonder about in their pregnancy, or even before they get pregnant.

How will my body change? I don’t know what I imagined happening to my vagina, but I feel like it was something awful in my mind. I was advised by my midwives not to look down there at least for a few weeks – which I did. I actually ended up waiting even longer because I was scared!! I had no idea what to expect!

Well, if you get stitches – things are probably going to look or at the very least, feel different. I can’t speak to C-sections or births without tearing, but I imagine there will still be some changes (in feel or appearance) if you really feel like investigating, or you were really familiar with the appearance of everything before.

Well one thing that happens and that relates strongly to #1 above is less lubrication, at least in the beginning. Again and unfortunately, this tends to hit us breastfeeding mothers a little harder because of our longer decreased in our good old friend estrogen. This should return to normal after breastfeeding, or for non-breastfeeding moms, when your hormones regulate.

Dryness can cause discomfort and pain during sex and you guessed it… decreased sexual desire as a result, or it is in the very least associated with it. Lube is your friend. Any severe pain should be reported to your provider, or anything that just doesn’t feel right – they are there to answer your questions.

Your vagina may also just ‘feel’ different during sex because it did have to you know, accommodate the exit of a baby (sometimes a large baby!). Even with a c-section, dryness and discomfort are common as a result of the decrease in estrogen. I’ve spoken before about pelvic floor exercises in other posts I think – they are always a good option for helping everything feel & work better after childbirth! Talk to your provider or a pelvic physiotherapist before starting anything – they can help you find out if anything is going on (if you’re having a lot of pain, discomfort, any bulging parts down there that don’t seem right, incontinence, etc. – these things might indicated a prolapse or other issue), and give you exercises to use that may help sex feel more normal.

Ah, and finally, stitches. Whether you have them or not, you will have soreness and swelling from a vaginal birth. Your maternal care provider should give you recommendations on how to deal with this, and when to call them.

Stitches, anywhere on the body, can cause scarring afterwards – this is the same with any stitching from tearing during birth. Some people may be more prone to more obvious scarring than others.

Another thing that can happen that is less discussed is hymenal tags – there are different types, but they can result from tearing during childbirth (and let me tell you it is actually really hard to find reliable resources online regarding these – which is bad because it can happen and not being able to find reassurance may make women worried!). The hymen is a very misunderstood piece of tissue – people often associate its presence with virginity, however it looks different in every woman, and can take many different ‘forms’ (I like this image a lot). It is a common misconception to believe that it always fully covers the vagina, when usually there are many different perforations in it from the get go .

After childbirth, and especially after any stitching in that area, its appearance can change sometimes drastically – the appearance of “tags” may be one of the ways it presents itself (I try not to use Healthline as a resource but it is edited by a team of medical experts and honestly – there is VERY little online info on this occurence!). If you notice any tag-like protrusions when you take a look down there, don’t panic however it’s still good to get assessed especially if you’re feeling anxiety or concern over it. A OBGYN or your PCP should be easily able to diagnose these tags during a pelvic exam or pap smear. They can go away, or they may not cause you any discomfort so you might not be bothered to have it removed – but this can also be an option especially if they cause discomfort during intercourse or you just don’t like the appearance of them. Sometimes, if you are planning on having more children, they will offer to remove it after your next birth, or it can be done quickly in office.

3. You may sweat more! Not just at night.

I was warned multiple times of the possibility of night sweats during pregnancy and early postpartum – personally, I was spared from both experiences. I don’t really sweat much overnight – but I did notice that I randomly sweat more during the day. This is likely as a result of the same mechanismsthe dreaded shift in hormones. They seem to cause all our problems in life, don’t they? (While simultaneously being involved in many great parts of life as well – like having a baby!).

Unfortunately, there is little research on this topic specifically. Are we surprised though? Sadly, no – just disappointed.

If you are having night sweats it’s good to tell your provider about this just in case something else is going on. As long as all as well, there is some evidence that exercise may reduce night sweats – and it’s good for you once you’ve been cleared to do it postpartum! And it is totally doable with a little one (especially before they’re mobile) – check out my tips for working out with a little one at home.

4. Wearing a tampon may not be the same as before..

You should not use a tampon for any immediate postpartum bleeding in the first 6 weeks, until your provider has cleared you to do so – pads and adult diapers are your friend in the immediate postpartum period.

When you are able to use one again, you may feel a bit of fear (I know I did). Even though a tampon is of course much smaller than a child, the fear of pain is still there. The other thing that may happen is it may feel different to use one. You may need to change the absorbency of the tampon you do use as well (or you may not – everyone is totally different with all of these things).

As I mentioned above – there are many changes to the vagina as a result of childbirth, and this can impact the ‘feel’ of the tampon inside you. Dryness also doesn’t help, and the presence of a hymenal tag could also cause discomfort on insertion (which is one of the reasons people often get them removed).

Strengthening the pelvic floor can help with this (and many other discomforts that occur postpartum) – so talk to your provider/physiotherapist (one that specializes in the pelvic floor is probably best) about exercises to help.

5. Digestion is uh… different.

Have you ever seen any visual representation of what pregnancy does to your intestines? There is a great image on this page. Needless to say, it is a big change for your body.

The changes that occur to the GI system during pregnancy are pretty well known (things like constipation for many, acid reflux, hemorrhoids), but the changes in postpartum seem to be less discussed. Constipation can persist, as can hemorrhoids; some women may even develop incontinence after childbirth. Gas is common in the early days as things shift back to their pre-pregnancy locations.

Interestingly, a study from 2017 also showed that the microbiome of a mothers gut also experiences changes as a result of mom being sleep deprived and not meeting nutritional needs. The study showed that this change may actually be related to postpartum depression.

What about IBS? I personally suffer from this and I went 9 months free of symptoms during pregnancy – it was amazing. I felt like a normal person who could eat food I wanted and not worry when I went out where the bathroom was. This may not be the case for everyone though – there is a lack of studies on this topic specifically so it’s hard to say, but if your pregnancy is particularly stressful and stress triggers your IBS symptoms, it could be worse.

There is currently no evidence that suggests IBS worsens after baby though (however, I imagine this area is equally understudied).

6. Your period may be unpredictable when breastfeeding.

So many people told me about how amazing breastfeeding was because they didn’t get their period back for a year, or more. However, I know a lot of women who exclusively breastfed and got theirs back at 6 weeks. It’s totally different for everyone so I’d advise not assuming it will take forever to come back – every body is different!

Depending on you and your baby (specifically, whether or not they are sleeping longer stretches at night), your period could return really at any time, usually sooner for those who are not breastfeeding. I was so confused when my period return at 5 months postpartum, went back to clockwork as usual (because that is apparently how my body works), then suddenly stopped! After a pregnancy test and a few days it came – then I realized it was delayed because Maggie had gone through a period of a few weeks where she was waking very frequently to feed (like newborn amounts). Suddenly it all made sense!

Even if it does return, if your baby then goes through a growth spurt or sleep regression, and starts feeding frequently overnight, it may be delayed or become somewhat irregular for a time. Always good to discuss with your provider an appropriate form of birth control if needed – because lactational amenorrhea is limited and specific!

7. You’re going to feel overwhelmed, overtired, confused, happy, excited, and so many other emotions and feelings… sometimes you might even need to cry a bit (happy tears, exhausted tears, or bittersweet-my-baby-is-growing-too-fast tears) – and that is OK. It’s also okay if you feel more than this and you need help dealing with it.

We need to make a safe space for women to speak out about their struggles and recognize that not everyday is going to be rainbows and butterflies as a new parent.

Recognize that “influencer moms” are only showing you their highlight reel and a very careful selection of their struggles (if they do at all).

Know that it’s okay to seek out help if you need it – you’re not weak or a bad parent for doing so, but a strong, great parent. There are supports available for you – talk to a trusted provider.

It’s also okay to want or need a break sometimes – to care for our kids well, we need to care for ourselves too. This is so important. Switch out with your partner or family member, do something to relax that you enjoy. This can literally be doing nothing or sleeping – all of that is self care.

Some days I feel like super mom, others I feel like a chicken with its head cut off. Most days I feel like I’m somewhere in between – just a regular mom who is doing my best for a kid that I love more than anything.

You’re doing a great job – postpartum is hard. Just look at the very few surface things I touched on in this post – there is a lot going on WITHIN you, let alone around you and with your baby. Take each day one step at a time. Give yourself grace and space to grow. When you feel like you’re at the end of your patience, take a seat and breathe (I know sometimes that seems impossible or not like a good idea, but I can tell you it helps immensely to recenter yourself). Remember that your body was the home for another person for 9 months and went through many changes to do that – so, there will be a lot of changes afterwards too (any concerns – speak to your provider, as always). You’re doing a fantastic job!

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