Postpartum Problems (cont.)

Urinary incontinence and, less commonly, fecal incontinence, plague some new mothers shortly after giving birth.

The inadvertent passage of urine, especially when laughing, coughing or straining, usually is caused by the stretching of the base of the bladder during pregnancy and delivery. Usually, time is all that's needed to return your muscle tone to normal. You may hasten the process by doing Kegel exercises.

In the meantime, wear protective undergarments or sanitary napkins. If the problem persists, talk to your doctor, who may be able to prescribe medication to relieve the problem. If you experience pain or burning, or have an uncomfortable urgency to urinate, tell your doctor. This could be a sign of a bladder infection.

Lack of bowel control often is attributed to the stretching and weakening of pelvic muscles, tearing of the perineum, and nerve injury to the sphincter muscles around the anus during delivery. It is most common in women who have had a prolonged labor followed by a vaginal birth.

Although fecal incontinence usually disappears after several months, talk with your doctor about exercises to help you regain control of your bowels. Fecal incontinence that does not resolve itself over time may require surgical repair.

Hair Loss

That lustrous sheen that pregnancy brought to your hair may fade by the time your baby is 6 months old. You'll likely notice hair loss as well. During pregnancy, skyrocketing hormones prevent the normal, almost imperceptible daily loss of hair. Several months after delivery (or when breast-feeding slows or ceases), many women begin to fear the worst as they watch their hair fall out at an alarming rate. Rest assured, the hair you're losing is only equivalent to the hair you would have shed during pregnancy had your hormones not stepped in. Generally, the sudden change in hair volume is temporary and not noticeable to others.

Postpartum Depression

Most women experience a case of the "baby blues" after the birth of their child. Changes in hormone levels, combined with the new responsibility of caring for a newborn, make many new mothers feel anxious, overwhelmed or angry. For most, this moodiness and mild depression go away within several days or weeks.

Longer lasting or more severe depression is classified as postpartum depression (PPD), a condition that affects 10% to 20% of women who have just given birth. PPD, which usually becomes apparent two weeks to three months after delivery, is characterized by intense feelings of anxiety or despair. Lack of sleep, shifts in hormone levels and physical pain after childbirth can all contribute to PPD, making it difficult for some women to cope with their new role and overcome their sense of loneliness, fear or even guilt.

The first step in treating postpartum depression is enlisting the support of family and close friends. Share your feelings with them, and get their help in caring for your infant. Be sure to discuss any PPD symptoms with your doctor, who can prescribe medication or recommend support groups to help you better cope with these new and unfamiliar emotions.

If your depression is combined with lack of interest in the baby, suicidal or violent thoughts, hallucinations or abnormal behavior, get immediate medical attention. These symptoms could indicate a more serious condition called postpartum psychosis.

Discomfort During Sex

You can resume sexual activity once you feel comfortable -- both physically and emotionally. After a vaginal birth, it's best to postpone intercourse until the vaginal tissue heals completely, usually four to six weeks (less if you didn't have an episiotomy). After a cesarean birth, you doctor will probably advise you to wait six weeks.

You may find sex to be physically uncomfortable, even painful, for up to three months after delivery, particularly if you are breast-feeding. Because breast-feeding reduces levels of the hormone estrogen in the body, your vagina may be unusually dry during the postpartum period. A water-based lubricant can help relieve some of the discomfort. Tenderness at the location of an episiotomy also is not uncommon for weeks or months after giving birth.

Even after your body heals, you may find that you are less interested in sex than you were before your baby arrived. Physical exhaustion accompanied by new distractions and emotional changes can take their toll on your libido. Many women battle feelings of unattractiveness in the postpartum period, and some find it more difficult to achieve orgasm. Breast-feeding can also change how you and your partner perceive sexual intimacy. Sharing your feelings with your partner and recognizing that these issues usually are temporary may help you deal with them more easily.

Regaining your pre-pregnancy shape

Exercise is one of the best ways to lose post-pregnancy weight, regain your energy level, relieve stress, and restore your muscle strength. Unless you've had a cesarean delivery, difficult birth or pregnancy complications (in which case, you should talk with your doctor), you can usually resume moderate exercise once you feel up to it. If you exercised before and during pregnancy, you have a head start on postpartum fitness, but don't expect to jump immediately back into a vigorous exercise program.

Brisk walking and swimming are excellent exercise and good ways to build up to more intense activities. Because of the risk of bacteria entering the healing tissue of the vagina, however, you should not swim for the first three weeks after delivery.

Toning and strengthening exercises, such as sit ups or leg lifts, are one of the best ways to jumpstart your postpartum program. Light, repetitive weight lifting also can help your body get back into pre-pregnancy shape. But remember, take it slow and focus more on long-term health than on short-term results.

© 2005-2014 WebMD, LLC. All rights reserved.