Postpartum Recovery Explained: Healing, Breastfeeding, Pelvic Floor & What to Expect After Birth

Postpartum Recovery Overview 0:00

Pelvic floor dysfunction is huge after giving birth. When you are pregnant, your abs will separate, right? So then they're not holding up as much of the weight like they used to. Most of that weight is coming down on your pelvic floor. So I know a lot of people think that urinary incontinence is because, oh, you're muscles aren't strong enough. That's actually opposite of what we see. most of time. We see hypertonic or really tense pelvic, floor muscles, especially after given birth, Do you feel like your hormones have turned against you?

Trust us, you're not alone. We're Dr. Serena and Dr Heidi. And on Hormone Heroines, we explore all the root causes that are behind hormone imbalances and we teach you how to thrive through them. Join us for real talk, expert tips, and even a few laughs. Hi, welcome back to Horman Heroins. Today we're going to be talking about postpartum journeys and recovery and all of the things that you can do because I just gave birth what is it three weeks almost almost four weeks ago yeah so almost one month postpartum i figured it's a good time to chat about post-part recovery things so let's dive in so Let's start with just physical recovery right after you give birth so immediately after giving birth You gotta pee before you can get released from the hospital or at home.

And sometimes it's really hard to pee after you've just given birth. So some tricks for that. Mint oil, peppermint oil in the toilet. Yeah, well just the cooling effect and like the stimulation because of the menthol in it can, you know, have the tingles down there to get some sensation. That is the only way that I peed to be released with my first one. Well, part of that reason is because the nerves kind of get like disconnected because you've just had such a explosion go off down there. Yeah, your brain is like, there was a lot of pain.

I think I'm just going to disconnect and not let you feel anything right now.

Immediate After-Birth Care 1:57

And so then to get you to pee, sometimes those signals aren't getting sent the way they should. So if you want to try and avoid a catheter, some mint oil and toilet bowl afterwards can be helpful. Just using a water to squirt down there that's cold to stimulate it. Sometimes getting in the shower, those types of things can help. Make sure if you do get in the shower though you have somebody with you because you are still bleeding. You know after birth you bleed and you're very shaky and your body has been through a lot.

Too dizzy in a hot shower. After that then you can do things like Perry bottles. So once you go into the bathroom you use Perry Bottles to help rinse everything off instead of wiping. You can be pretty sore down there either from tears or just even if you don't tear just inflammation from everything just came out of there. And the nice thing about I mean to use the peri-bottle is that then you can also do herbal sit baths and there we have a couple different formulations that we like to us. So herbal sits bath are just healing herbs that you could basically make a tea out and then can put that in the Peri bottle to help rinse or you literally do a sit's bath with it.

Not drink. Yeah, not a drink. But it's like a tea for your bottom. Yes. Or you can use the herbal sitz bath and make your own pad sickles. So pad-sickles are basically pads that are absorbing because you're bleeding a lot after birth, but they also are frozen to help with all the pain. They make ones that you actually break open and they're cooling, or you Just put them in the freezer? Yeah, when you make your own, my favorite way to make them is to put the sits bath healing tea in them and then freeze them with that.

So then when take it out, you have the absorbency, but you also have a little bit of that nice cooling. Healing herbs. Cooling and healing herbs, so some formulations for sits back. This one has lavender, rosebud, plantain, yarrow, calendula and Epsom salts in it. And then this one has calendula, comfrey root, echinacea root witch hazel, uva ursi, sea salt, and garlic. So both of these are really good formulas that we've used. Yeah and personally I've use both them and I love them they're very soothing.

Also with taking care of everything down there you can just use witch-hazel pads which can be really for hemorrhoids but these these formulations are also good for haemorrhids. You could just use witch hazel for that as well. And then the high absorbency pads, so obviously you're bleeding a lot. Reusable ones, or you can have the disposable ones. Sometimes you need a combo, sometimes you the disposal and the reusable because you aren't bleeding so much. I feel like at first when you Right after you give birth, the disposable ones are kind of the best because you're bleeding a lot more and you need to check and see how much you are bleeding.

I think with a lots of reusable ones, you can't see much bleeding as much. So I really like as a doctor, I like having them use the disposal ones for like the first 48 hours-ish. What I did was I put the disposeable ones in the reusable underwear. Because I if I bled more than the pad was in a hole I didn't want to get in on my bed and I hate sleeping on The pads that they put down. Yeah words because those are trinks pads. Yes are crinkly and uncomfortable. So yeah And they move yeah and to keep it off my beds.

That's what I did. Also, they do make sprays which are super helpful so there's herbal postpartum sprays that are very cooling that you can spray your bottom with. But my favorite, especially if you get sutures, is the post partum lidocaine spray because those are a lifesaver when the suture are healing because they are itchy and painful. used so much of that after my first baby because those sutures were... Yeah, there was no suture this time. Yeah those, sutured the first time around were driving me crazy and that lidocaine spray was a lifesaver.

So this one is four percent lidokane and then it's also got aloe, which is great, witch hazel in it as well, lavender oil, peppermint oil. And then some castor oil. That's basically it. Yeah. So that was like my favorite thing postpartum.

Managing Pain, Bleeding, and Rest 6:18

Make that in the pad sickles. Yep. Pad sickle are great. Post sutures. This time around I didn't have suture and tearing down there so I needed that stuff less but I had a lot of the post partum cramps. They were extremely intense and they lasted for a good 72 hours. And so I was alternating between Advil and Cramp Bark. So that way, I'm taking the max amount of Advill you could take and the maximum amount Crank Bark you can take. But luckily, since they are not doing the exact same thing, you take both and get dosing, get dosed more regularly.

for the pain and it made it a lot more manageable. Yeah, and cramp bark really is amazing. It helps with period cramps as well. So it's not just for postpartum, but it definitely helps for period and stuff. If you're somebody that does, like when your period does come back post partum sometimes that first or second one can be pretty rough. Cramp Bark is really great to make sure that you are not totally suffering the whole time. Yeah. Well, like I said, I was literally taking the max dose of Advil followed by the maximum dose cramp bar and alternating my doses.

So like the every four to six hours in Advill and in between those doses, taking a cram bar. And to be fair, so after your first one, after cramps are usually a lot worse. Yeah, my first when the aftercamps were like not bad at all and this time They were horrible. Yeah. Although once I passed a large blood clot, they tapered off, but it took a good 72 hours to get it out. That is bottom and cramp care postpartum immediately afterwards. The other thing that I like to stress to women and also try to do myself is the more time that you can spend lying flat on your back, with your legs together the better everything's going to heal.

So ideally at least a week in bed pretty much only getting up to go to the bathroom and nurse baby. You should be relying on your family or your partner for pretty, much everything else if you are able to. I know not everyone is able, to do this but if, you can Try to spend at least one week in bed letting everything fall back into place and stay there and the bottom heel back together because getting up and moving around and doing too much is going to make your organs and your diastasis and abdomen and everything be less likely to go back to the way it was before.

So if you can spend a little bit more time doing that, great. But I know it's hard for most of us to stay in bed that long anyway. So just if can shoot for the first week, try as hard as you. Yes. If there is a lot of tears and there's stitches and maybe even more hemorrhoids too, just make sure you're cognizant of how you are feeling. Time wise, generically about a week. Sometimes you may need more. I will say my first time, or with my fist kid, because I had all the sutures, I probably spent about two weeks in bed because the suitures were just more extreme.

This time I have a grade one tear, so I decided not to get any suture and I was pretty well healed after a week. But I did have to because i decided against the Sutures. I'm not doing that right now, just leave it alone. Im done with being messed with down there today. I was just instructed to keep my legs together for a good week. And it healed up just fine. Good. That being said, if you are going to get up, belly bands are a really good thing to have on hand. A couple things. If you're up and about, you should pretty much have it on, especially during that first week.

But you don't want to it too tight that it's pressing everything down and putting more pressure in the pelvis. So it is a little bit of a balancing act between how tight it should be. It should support your abdomen and your internal organs and pulling them all back into the places that they've been. Just not so tight that their pushing them down. Yes. After the original week of healing when things are starting to come back together, I do start to cinch it up to try and get the diastasis to comeback together as well.

So diasticis recti is what she's talking about and it's when you're pregnant, your abdominals will, you know, they'll come apart a little bit. Your six pack muscles. Will come a part a Some people have it worse than others. We do it, we measure it by finger. So like one finger, two finger three fingers, just depending on what goes, it can be up here. It can all the way down here, sometimes it goes the whole way. Sometimes it's up to four fingers. And that one takes a lot longer to heal. But so that's what she's talking about when it supporting your abdomen, and it kind of pushes that back together so, that way it is much better for healing.

Really they just start pulling the abs back together, so not under any strain to further widen. So if you have a diastasis and you want it to heal up and want to try and avoid surgery, sometimes surgery is unavoidable to completely resolve it,

Diastasis Recti and Belly Band Support 11:33

but there's things you can do to avoid that and promote the best recovery. Because it is an elective surgery so it's not one that's covered by insurance so a lot of women never end up being able to get it fully resolved. Lots of women complain about the pooch after having a baby and it never gets better. One of the causes of that is the diastasis recti, so here's ways to prevent it. But like we just said, the belly band. Also, no ab workouts for at least six months. You want to avoid doing any crunches or sit-ups or anything like that for What I'm doing currently and what really all women should do is even just getting up off the couch, I pull my belly button into my spine and I try to engage my whole core all the way around.

Front and back. Yes. All the around using my obliques. I tried to engaged all of it, pulling my button in the spine, and then get up instead of doing just this big crunch. Yep. crunching this further because every time you do a crunch, it actually widens it because once the six-pack muscles are separated, if you crunches before it's had time to heal back together, its gonna widen it further and actually make the diocese recti worse. So you want to avoid using them for a good six months. I know that feels counterintuitive, but that's how you're gonna prevent it from getting worse and get it to heel up the best it possibly will on its own.

And then the belly band. So the other thing about belly bands that I really want to point out is that they make different ones. There's just like a plain band, but there's also bands have this extra like little band in the smaller band and the middle. You want get one big enough to cover basically the top of your hip bones up to the bottom of the ribs. And they have ones that have an extra strap in middle that then you can pull and cinch up and you do that at an angle. It helps pull those muscles together more than just the plain bands wrap around.

Yeah, because you want your obliques to pull everything together. And then once you can start doing exercises again, and the only other exercise that you could do before the six months is up is oblique exercises and that is basically just doing, pull the belly button to the spine and you twist to side and pulse and twist the other side, pulse, that's all you should be doing to heal your diastasis recti for the first six month. Okay. Moving on, let's talk about breastfeeding and nipple care. So my favorite thing in the whole world for nipple care is the cooling gel pads because you've never had anything stuck in your nipples that much in life.

I like to explain to dads if their partner is breast feeding when she sucks in and is like like that when they first latch on it it is a lot of sharp pain that feels like you're getting a million paper cuts all at once or razor blades or just a bunch of them all. At once they're like little needles. I will say first time around it was much rougher yeah second time. Around it's there but it''s not as bad the first. Time around those cooling gel pads for your nipples lifesaver they were amazing. Nipple butter is nice and all but the cooling.

Gel pads were or the wind. Other things to do is you can get ice packs or heat packs for your breasts, especially if they're feeling really engorged or you're starting to get a little bit of a plugged up. If you are getting a plug duct, you want to make sure either you fully drain that breast before moving on, which you should do anyways, or if you take a nice warm shower and kind of try to express the milk yourself or pump it, because you always want get the out so that it doesn't turn into mastitis.

And the other thing that you should do is try different angles. So either pumping or baby, if you're always feeding in the same angle, then sometimes certain ducks drain less. You should change the angles a little bit so you actually are draining the whole breast. Also, nipple shields, all those things are super helpful. They do make nipples shields that change colors when they're cold versus hot, which is helpful if your trying to find it in a bed. But one thing I want to point out is with breastfeeding, if you are still having pain after the first month, that is not normal.

It's painful at first, it really is, but it should get better and it shouldn't become not painful. it Should be anywhere from like nothing at all to maybe even pleasant after that first one. The pain should really resolve. Or if your milk supply was fine at first and then all of a sudden it dips, that is not normal. That has nothing to do with your breast. It's probably related to how baby is latching on and you should have them assessed for a tongue tie or talk to a lactation consultant. Also, it can feel counterintuitive because everyone wants to cradle their baby to feed them.

But a lot of times the football hold is much better for breastfeeding because then you can really line baby up Their mouth up with your breasts. So my baby's only liked the foothold Yeah, I do both depends to get the breast to drain. I did both. Yeah Okay Moving on to a little bit later. That was all the kind of immediate stuff right after postpartum So then as you start to heal and you're getting back into the flow of things for the body and Pelvic floor. Yes, pelvic floor dysfunction is huge after giving birth.

So I know a lot of people think that urinary incontinence is because, oh, your muscles aren't strong enough.

Breastfeeding and Nipple Care 17:00

That's actually opposite of what we see. Most of the time, we seen hypertonic or really tense pelvic-floor muscles, especially after given birth, because you've had to hold all that extra weight. And so your muscle's inside your pelvic floors are really tensed, and you have to release them. So pelvic floor therapy is a great option for that. So there's external components and there are internal components. Generally speaking, we don't do any internal component until about eight weeks postpartum because that's when the vaginal tissue usually heals most of the way, if not all of that way.

Sometimes that vaginial tissue is really hard to heal after giving birth because if you're breastfeeding, your estrogen is very low and estrogen really helps to kill vagina tissue. It just kind of depends on that. But also you can start doing your kegels before then and start trying to build up the strength if weakness is the issue. Right. but oftentimes it's not weakness. You're just tense. It's too much tension that's causing. If you are squeezed this tight, you cannot squeeze harder to stop the flow of urine.

That's the thing is like it already squeezed as much as it is going to go. Or it can't relax to let everything empty and then you have a little bit of dribbling afterwards. the different versions of incontinence. Fun things you get to deal with. Yes. So, pelvic floor therapy is probably number one in other countries. It is standard of care for all women to get pelvic for therapy after giving birth. Just think about that. Okay, just to round out this early one to two months. So you are going to be bleeding for the first month.

You want to make sure that you're not overdoing it because you do have a huge scab where that placenta was and it has to heal. And basically just think of that. it can come off earlier so that very loosely healed initial part you can basically like slough off that scab if you do too much activity too soon. So you want to be careful because then you're going to bleed more and you wanna stop bleeding as soon as possible because it's just no fun. So monitor your activity level. Once the bleeding starts to decrease, it really shouldn't increase again.

And if it does increase, again, It's probably because you overdid it. Yeah. Which I believe, if I remember correctly, I had to tell somebody that with their first birth. I don't know what you're talking about. Pretty sure we had that conversation. I've been good this time around. Okay. And then that next month, even though you aren't bleeding anymore, I will tell you that your vaginal tissue and everything is still very tender and you want to avoid putting anything inside of it, still probably using the peri-bottle just because it's more comfortable than wiping, especially if you've torn it all.

I mean, if he didn't tear it at all about a month, you're usually pretty good, but you know, I've done both times. It's still fragile tissue. Yeah. And, you know, a lot of OBs and midwives will say, wait six weeks before you have sex. I tell all of my patients, and I think you do too, we tell them to wait eight weeks because if you are breastfeeding, your estrogen is low and it cannot heal the vaginal tissue as well. There's also other things we can do to help heal that vagino tissue. We can vaginol estradiol cream.

And we can also do external estradiol and DHEA that will help to heal the tissue faster for you.

Pelvic Floor Recovery and Intimacy 20:30

Because when you are breastfeeding, your prolactin is high and your progesterone and estrogen are low. And estrogen is what helps to feel the vaginal tissue. Also, I would comment on it that when you have scar tissue scar, tissue actually takes a full year to completely remodel. So yes, it may be strong enough to not tear right after that first six to eight weeks, but that doesn't mean it's stretchy at that point and it can hurt. Yes. to get the elasticity in the scar tissue because our skin is stretchy and down there is clearly very stretchy.

I just got a baby out of it. Yes. But in that initial year where the Scar tissue is remodeling, it is not as stretchy as it was before you got that wound. So sex afterwards can be painful even though it's fully healed because it has been the six weeks or eight weeks. It can still be painfull one because the scar tissue isn't fully remodeled and you don't have that elasticity in it or two because you have no estradiol in your body and that tissue has only healed just enough to not tear. Yeah, doesn't mean it's comfortable.

Yeah. So what I tell patients is if when they are having sex for the first time after giving birth, if they feel during insertive sex, it feels like the tissue is raw and you're getting like paper cuts with every single movement, then they're not ready to have sex. Their vaginal tissue has not healed enough. And that's when we'll go into doing the estradiol cream vaginally, because if there are breastfeeding, their estrogen is not high enough to heal it for them. Also, you can have vaginal atrophy postpartum because of the lack of estrogen.

So we talk about perimenopause a lot and menopausal and how the vaginotissue atrophies because the low estradiol. The same thing can happen in post-partumn women because they have no estrdiol and your vagina tissue can literally... Yeah, post partum is kind of like post menopsis. Yeah, so just be aware of that. Also, the minimum six weeks is related to the fact that you have a huge wound in your body and you don't want to introduce any bacteria or infections that your bodies not used to fighting because that could turn into a very bad hospitalization if you sex too soon postpartum and introduce some type of infection into that giant wound.

In your uterus. So that is why the six weeks is there, but we do the eight weeks more for the vaginal tissue to recover. Because if you're going to have sex, it should feel good. It shouldn't hurt. Yes, sorry. So, that's why we did eight week,s but the 6 weeks are also just the bare minimum to make sure your uterus is healed up enough so you don't get an internal infection. Okay, so pelvic floor therapy also does like pelvic blocking and a lot of external work to kind of get your hips back in. And so when you have your hip back, in that lower back pain, the hip pain.

A lot times the thoracic pain is usually from breastfeeding because people will slump over. So make sure you're having good posture with your breast feeding. But that can all be addressed with pelvic for therapy too. Yeah, and chiropractic care too. Okay, let's quickly wrap things up with just daily support. So in past episodes we've talked a lot about postpartum mood disturbances, so we're not going to get into that too much, but I do want to make a comment about how in my post-partment experience I usually deal with a I wouldn't say it's super bad.

I mean, I would say, it was part of mood disturbances, for sure. But what has helped me a lot is I did placenta encapsulation, which is helpful to restore all the nutrients, get me kind of back to where I was before. So that has been super helpful for dealing with the mood stuff, but also just nutritionally replicating myself. And the other aspect is some herbs for mood support is lemon balm. I find it super helpful. But also if things got worse, my go-to would be oral micronized progesterone for the mood stuff.

Postpartum Mood, Support, and Closing 24:30

Especially like the intrusive thoughts kind of anxiety. Yeah. So lastly, I just want to really stress that in the postpartum period, you shouldn't be afraid to ask for help because you're recovering a lot and you need a lotta support. And accept the help and it doesn't make you any less of a good mom. Yep. If you do need care for the medical aspect, definitely reach out to your OB, your midwife, or primary care doctor and get the help that you need for that. Don't be afraid to ask for help. And my biggest thing, my big tip, would be don't afraid trade off nights with your partner.

Yeah, because your body is healing and you'll need sleep. So set up a schedule, tradeoff nights, if you're breastfeeding, you know you are feeding every few hours, but they can bring the baby to you. and then take the baby away and you can go back to sleep. So don't be afraid to do those types of things. Have people meal prep for you, all of those. Yeah, we have to go because the baby's crying and ready to eat. Yep, so I gotta go take care of that. Life of folks part, and we'll see you next time.

Have a great day. You know how us women are always just pushing through it, And then when we go to find help, We're often not taken seriously or told, Oh, that's just part of being a woman. Yeah. We've lived through, prioritizing everybody else and then our own health falls to the wayside. That's why we started blossoming longevity by women or women. We created programs that meet women where they are, addressing the root causes and all of the struggles that come with every stage of life. Like our vitality program.

It reconnects you with your youth and your life so that you can thrive through the years. And with Clarity, we go beyond the skin to restore your health, clear your complexion so you feel radiant from the inside out. With our silhouette program, we help you reclaim your strength, optimize your metabolism, and your body composition so that you can feel great in your own body again. And with Harmony, We help rebalance your hormones to heal from within so you feel vibrant and ready to take on the world.

That is why it's time to stop saddling and start flourishing. Visit FlossamingLongevity.com today. Thanks for watching Hormone Heroines. If this episode spoke to you, follow the show and share it with someone who also needs to hear it. And write a review. That helps more people find their way back to balance. See you next week.