body image, Postpartum, self-care

The Struggle of Postpartum Body Image

What do you see when you look in the mirror? Do you see a beautiful, strong, courageous woman, or do you see cellulite, dark circles, stretch marks and wrinkles?

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Do you hate what you see, or can you find the good qualities that outshine the flaws? Body image is an individual’s perception of her physical appearance. It is not how the world perceives your body but how you view your external self from within. Body image can be distorted by a variety of internal struggles such as early life experiences, mood, stress, fatigue, and societal “norms” to list a few. A healthy body image does not mean that you believe that your body is perfect; it means that you are comfortable with your body as it is, flaws and all. A negative body image can have deleterious effects on a woman that can range from distressing to life altering including difficulties in relationships, low self-esteem, eating disorders, anxiety, and depression.

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Pregnancy and postpartum marks a monumental transformation in a woman’s life. The changes are physical, mental and emotional. Our bodies make an incredible transition while pregnant. The miracle of life is held within our ever-growing womb. The physical changes of pregnancy are beautiful and warmly accepted. But then the baby is born and the beauty of pregnancy is gone and you are left with a deflated abdomen, loose skin and stretch marks. The culture in the United States will tell you that this body that created and held life for 10 months is no longer beautiful unless it is nipped, tucked, worked out, and dieted back into a size 0. Our perception of the postpartum body is tainted by unrealistic expectations. There is beauty in the postpartum body. There is strength, there is courage, and there is love in that beautiful body that just carried and delivered a precious new life.mom-1508902__340

Let’s have a reality check. It is EXTREMELY rare for a woman to leave the hospital after giving birth (whether it was a cesarean section or a vaginal delivery) looking like Kate Middleton. Very few of us will be able to wear their pre-pregnancy skinny jeans as their “going home outfit”.   Your body has changed. Your hips are a little fuller, you have extra weight (that is not all lost immediately upon delivery) and your chest is fuller. This is what postpartum looks like and it is ok.

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When the world tells you that your make up should be flawless and your hair should be on point all while fitting in to your pre-pregnancy clothes within 2 weeks after delivery, it is difficult to accept your postpartum body.   How do we go about accepting our new bodies? Here are some suggestions to help in the struggle with postpartum body image:

  1. Speak kindly to yourself. Talk to yourself as if you were talking to your newborn. Imagine yourself as a child and speak kind and supportive words to your child self.
  2. Highlight the qualities you perceive as positive. If your mind starts to ruminate on negative thoughts, attempt to make a conscious switch to focus your thoughts on your positive qualities.
  3. Find your mom tribe. You will discover that you are not so different from all the other postpartum women out there. We all struggle with postpartum body changes.
  4. Get outside and move. Walking outside improves mood by increasing endorphins. Activity is not just about weight loss.
  5. Take a social media break. We naturally tend to compare ourselves to others. Avoid the trap of comparing yourself to women on social media. Life is always sunshine and rainbows on social media. Photographs can be deceiving.
  6. Let go and accept change. Give your self a break. Focus your energy on something you find enjoyable.
  7. Accept compliments by others graciously and believe them.

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For some of us it will not be easy to accept our postpartum bodies. Acceptance may require help through therapy with a psychologist or licensed mental health counselor. A woman should seek help from their physician if body image concerns are causing eating habit changes, anxiety, depression, or thoughts of suicide.

Be kind to your self, momma. Pay close attention to your internal self-talk. Speak kindness and truth to your self. Your body is a temple, it is beautiful and it is strong. Believe this!

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You got this momma!

body image, fourth trimester, Postpartum, self-care

Postpartum Hair Loss is REAL!

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I knew it was an inevitable part of the fourth trimester, but for some reason I was still alarmed when it started. Hair loss, ladies, that is what I am talking about. Lots and lots of hair everywhere! Hair in the shower, on the bathroom floor, in the brush, on the baby! Ugh, so gross. I thought for sure I was going bald! How can this be normal? Well, thankfully, it is.

Postpartum telogen effluvium also known as postpartum hair loss is completely normal. Ninety percent of mothers will experience some degree of hair loss during the postpartum period. It usually begins one to four months after delivery. It is self-limited, so by six to fifteen months after delivery your normal hair growth/loss pattern will usually return.

What is the cause you ask? During pregnancy, the change in the hormonal milieu results in the ratio of hair follicles that are in the growth phase (called anogen phase) relative to the hair follicles in the resting phase (called telogen phase) increases drastically. The result of this change is lusciously full locks by the third trimester. Then once you have had your sweet little nugget, those same hormones change abruptly which affects your entire body, to include your hair. After delivery, the ratio of hair in the growth phase (anogen phase) compared with the hair in the resting phase (telogen phase) reverses resulting in more obvious hair loss. As the hormones balance out over time you will notice that your hair growth and loss returns to its original pattern usually by about 15 months after delivery.

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What can you do to encourage healthy hair growth and reduce further damage?

  1. Eat a healthy diet full of fruits, vegetables and lean meats (such as eggs, chicken, fish).
  2. Avoid over styling your hair with heat (blow dryer, curling iron, flat iron) or chemicals (improper coloring techniques).
  3. Avoid wearing your hair up in tight ponytails or buns.
  4. Get plenty of sleep.
  5. Continue your prenatal vitamin – especially if you are breastfeeding.
  6. Reduce stress.
  7. Gentle scalp massage – encourages blood flow to the hair follicles.

Because postpartum telogen effluvium is self – limited there are no medications that are FDA approved to treat this condition. Your normal hair growth and loss pattern will return on its own. I get a lot of questions about Rogaine. Rogaine for women is not appropriate for postpartum hair loss.

What if your hair loss seems excessive? If you feel like your hair loss is excessive, you are noticing bald spots, or your hair is not re-growing over time, you may have an underlying medical condition that should be evaluated. A dermatologist would be able to evaluate your symptoms, medical history and perform testing to determine the source of hair loss. A few of the common medical conditions that can be associated with hair loss include:

  1. Anemia
  2. Thyroid disease
  3. Diabetes
  4. Polycystic ovarian syndrome
  5. Lupus
  6. Skin conditions such as seborrheic dermatitis or psoriasis

 

You got this momma!

body image, Postpartum, self-care

Five Things Every Mommy Needs to Keep in Mind when Recovering from a Cesarean Section

Cesarean sections are the most commonly performed abdominal surgery in the United States. Approximately 30% of all deliveries are cesarean sections. A majority of cesarean sections are performed due to complications of the labor process. Only about 1% of cesarean sections are elective. In my experience with my patients as well as being a patient recovering from a cesarean section, it is commonly forgotten that a cesarean section is major abdominal surgery. Here are five important things to keep in mind when recovering from a cesarean section:

  1. Time.  I thought I would be able to hop right up and start back into my normal routine within two weeks of surgery. Ummm…that was a big fat NO. I have seen some patients be able to do this and I credit these ladies for their strength, incredible pain tolerance and faster than normal healing process. However, this is very rare and you should not compare your experience to anyone else’s because it can vary so widely.   Most of us will need good old fashion time. Remember to give yourself time to recover. Six weeks is the minimum amount of time to allow for healing prior to returning to full activity. Now, of course, light activity is encouraged immediately after surgery, as tolerated. My rule of thumb is: if it hurts don’t do it. The first 6-8 weeks after a cesarean section is not the time to push your body. Do not push past the warning signs. At the least be sure to give yourself a full 6 weeks to recover after your cesarean section.
  2. Patience.  I found this one difficult too. If you are normally a very active person, recovery from a cesarean section can be frustrating at times. Pain and fatigue will limit your activity for the first 4-6 weeks and even longer. I found that I wasn’t able to run normally without pain for about 12 weeks. Have patience to give your-self the time to recover. I think I was afraid that the first 4-6 weeks after delivery were the new norm, so I tried to push myself, which always ended in frustration resulting in impatience with everyone around me to include myself. If you are patient, nine times out of ten your body will return to its pre-pregnancy state. The pain will resolve, the swelling will resolve, the fatigue will resolve.
  3. Help.  You need help. You can’t recover from a cesarean section and take care of your new baby all by yourself. The more help you can enlist, the better. You will need help with routine chores (ie washing clothes, vacuuming, mopping floors, cooking dinner, etc) for at least the first two weeks after delivery, but potentially longer depending on how you feel. Do not feel guilty asking for help. Help does not mean you are an incapable momma.
  4. Sleep.  Hahaha, yah, I know sleep and newborn are an oxymoron, but this is where help comes in. The adage of sleeping when baby sleeps cannot be overstated for women who have had a cesarean section. During the first 4-6 weeks postpartum the household chores can be completed by helpers (family, friends, or paid professionals). The most important activities for you during the first 4-6 weeks after your cesarean section are feeding baby, bonding with baby and sleeping. When you are breast-feeding, sleep is definitely a commodity because unless you are pumping, no one else can help you feed the baby in the middle of the night so that you can sleep. You will have to remind yourself that every time baby naps, you should be napping as well, day or night. Do not underestimate the importance of sleep. During the time you are sleeping, your body is healing itself. Sleep deprived individuals do not heal as well and are at risk for both physical and mental illness. Even though it may feel like ground hog’s day for a month or so, getting good sleep in the first 4-6 weeks after your surgery will set you up for a healthier postpartum period.
  5. Pain relievers.  I have not encountered a patient (myself included) who was able to tolerate the postoperative pain of a cesarean section without some kind of pain medication.  Some women are able to tolerate the pain with ibuprofen and Tylenol, and that is fantastic as long as the pain is managed well enough that you are able to get out of bed and perform activities of daily living (i.e. get dressed, move around the house, fix a meal, sit on the toilet, etc) without agonizing pain.  A majority of women will require some sort of narcotic containing pain medication for the first 3 to 5 days after their cesarean section.  It is ideal to take the lowest effective dose of narcotics to control pain and to wean off narcotics within 5-7 days after surgery.  You should be able to control postoperative pain with ibuprofen and Tylenol by 5-7 days after surgery.