During pregnancy and vaginal childbirth there are lots of body changes. Commonest changes include enlarged abdomen, stretched abdominal wall skin,
weight gain, breast enlargement, nipple and areola changes, fluid retention and swelling, stretch marks, acne, red skin blemishes (spider angiomas), varicose veins, hair thinning, pigmentation of areola and linea nigra (brown line down middle of abdomen), haemorrhoids, vaginal stretching, stretching of vaginal opening (introitus), prolapse.
After a woman has had her baby, she typically is keen to get back in shape and to get her figure back. So, what can she do to help facilitate this?
The good news is many of the pregnancy changes resolve spontaneously after delivery.
Enlarged abdomen. Immediately after delivery you will be aware your tummy is flatter. There will continue to be improvement over time and the uterus shrinks in size.
Some women wear a body band. This will help them look better and so feel better. It will give them a flatter tummy and will reduce discomfort and backache. Body bands are comparable the girdles worn by women in the past.
Body bands will not improve the tone of the abdominal wall muscles, which is what you need to do if you want a flatter tummy without wearing a body band.
The abdominal wall muscle tone will improve, and abdominal muscle separation will reduce over time usually. If you want to get there sooner, then you will need to do abdominal muscle exercises. Going to the gym and having a personal trainer is good idea. Overwise being very active and exercising, focusing on exercises that tone your abdominal wall muscles is a good idea. Pushing the pram up hills is good. There are community exercise groups for postnatal women. They meet in parks and exercise together. These are good for getting back into shape, getting support with being a new mum, socialising and building friendships.
Some women have extreme separation of the abdominal wall muscles that will not significantly improve with exercise. These women will continue to have a bulging tummy and often backache. If you are such a woman, once your family is complete, a plastic surgeon should be able to help.
Stretched abdominal wall skin. This will improve with time but sadly for some women this will be an ongoing problem. It is independent of abdominal wall muscle tone and so no matter how much you exercise it will persist as a problem. If you are such a woman, once your family is complete, a plastic surgeon should be able to help.
Weight gain. You weight will reduce once baby is out. Weight gain which is due to fluid retention will go as the fluid retention resolves. Persisting weight gain is a challenge and can only be sorted out with diet and exercise. Diet is more important than exercise. There are lots of approaches to dieting, some of which are just fads and are of no long-term benefit. Personally, when I want to lose weight, I go on a 1200 calorie per day food intake. I only have quality food, and almost no sugar. You will need to read labels as sugar and fat can be hidden in foods even when the box says the contents are healthy. The food manufactures do this to improve the taste and so encourage you to buy more. Remember food manufactures’ goal is for you to buy more, and so will do all sorts of devious things to get you to do this.
There are now available injections that you can self-administer can help, such as Saxenda. Such medications are on prescription. You will need to see your GP to see if you qualify and for a prescription. These medications are a safer and easier approach than bariatric surgery, which is another option.
If you are breast feeding the weight will come off slower than otherwise.
Breast enlargement. This will persist and indeed increase if you are breast feeding. It will them resolve. Sadly, some women’s breasts don’t go back to their prepregnancy appearance. Some women end up with saggy breasts because of stretching of breast skin. A good bra can hide this. If you are such a woman and this upsets you, once your family is complete, a plastic surgeon should be able to help.
Nipple and areola changes. These should resolve after breast feeding.
Fluid retention and swelling. This will resolve after pregnancy. It can get worse for a week or so after having baby.
Stretch marks. Sadly, these will persist, though they will fade. They are due to tearing in the deeper layers of the skin and so applying expensive creams in pregnancy will make no difference. They tend to be genetic so if you mum has none you probably will not get any. Usually, they happen with the first pregnancy and so if you had none with your first usually you won’t get them with subsequent pregnancies. There is nothing that can be done by you. If you develop significant stretch marks and have significantly loose abdominal wall skin once your family is complete, a plastic surgeon should be able to help.
Acne. Acne is due to hormones of pregnancy and so will resolve once you stop breast feeding and will improve once baby is delivered.
Red skin blemishes (spider angiomas). These are hormonal and so will resolve once baby is delivered.
Varicose veins (including vulval varicosities). These will often resolve after delivery. Sometimes they persist, though to a lesser extent. If you have an ongoing challenge with varicose veins, once your family is complete, a vascular surgeon should be able to help.
Hair thinning. This should resolve after you stop breast feeding.
Pigmentation of areola and linea nigra. This usually resolves after you stop breast feeding. It will come back with your next pregnancy and often if you go on the oral contraceptive pill.
Haemorrhoids. These usually resolve after delivery. Sometimes they persist. If you have an ongoing challenge with haemorrhoids, once your family is complete, a colo-rectal surgeon should be able to help.
Vaginal stretching. There will always be vaginal stretching after a vaginal delivery. The stretching will reduce immediately after childbirth and further overtime. But for all women who have had a vaginal delivery the vagina will never regain exactly the same shape as it had as before childbirth birth. Pelvic floor exercises and pilates can help restore vaginal tone.
Vaginal entrance (introitus) stretching. There will always be vaginal introitus stretching after a vaginal delivery. The stretching will reduce immediately after childbirth and further overtime. But for all women who have had a vaginal delivery the vaginal introitus will never regain exactly the same shape as it had as before childbirth birth. Exercises will not help. Once your family is complete, a gynaecologist should be able to help with a day surgery operation procedure.
Prolapse. This can be problem for some women after a vaginal delivery. Pelvic floor exercises and pilates can help. If there is major ongoing prolapse problem, then a urogynaecologist surgeon should be able to help. If you have such surgery before your family is complete, then you should have subsequently Caesarean section deliveries so the surgical good that was done is not undone with other vaginal deliveries.