Part 1: A Challenging Transition

Having your own child is one of the unspeakable joys of life that has to be experienced – just ask any mother and they’ll agree. After nine months of unusual food cravings, temporarily passing up on passionate hobbies and adapting to the ever-growing weight around your belly; the culmination into a crying child cradled in your hands is overflowing with intense emotions, brimming with hope and life.

It’s no surprise that many parents-to-be spend much time reading up and preparing across the various stages of pregnancy and various trimesters. And that’s not including the things we do for our unborn babies- from eating healthy superfoods to playing classical music and buying a bundle of brightly-coloured goodies, specific to your baby’s gender. Sadly, many forget to prepare for the difficult journey ahead – a mother’s transition into post-pregnancy and seeking effective post natal care to embrace her new season.

From hormonal and emotional changes to the very real challenge of raising a newborn who needs your constant attention, the post-pregnancy transition is one that demands strength and stamina. There’s a known phrase, ‘It takes a village to raise a child’, but people often forget the mother’s needs too, and to that extent her existing family as well. Society also celebrates resilient ‘supermothers’ who can juggle full-time jobs with raising their child, but we ought to extend greater support to mothers who experience a more challenging season.

At Orchard Clinic, we’re here to help with your post natal care needs. We will cover a few common challenges that mothers face during the post-pregnancy period, as well as what to expect during each stage of the postpartum period.

Part 2: Tackling Post-Pregnancy Challenges

Post-pregnancy comes with a plethora of challenges, from the fatigue of recovering from childbirth to inconvenient physical changes, along with mental health challenges that may arise. We believe that there is nothing shameful to discuss about them, and that through being aware of these challenges, we hope that mothers can experience a healthier and more holistic path towards recovery, as well as receive much-needed and meaningful support from their loved ones.

2.1 Diastasis Recti

Diastasis Recti, colloquially known as post partum belly, is a very common occurrence amongst mothers, with an estimated two in three mothers experiencing it. Showing up as a protrusion of the belly, it refers to the separation of the abdominal muscles due to the prolonged period of pregnancy, which causes the left and right abdominal muscles to separate.

Diastasis Recti is attributed to a variety of factors – from the weight gain during pregnancy and your baby’s weight, the natural elastic stretching of recti muscles fibres to make way for the baby, the inner movement of various organs to make space, as well as hormone production for increased muscle elasticity.

To many Singaporean mums, Diastasis Recti is just a normal facet of pregnancy, and it naturally goes away during their recovery period. However, for some mums, they may face a more trying time with increased discomfort. Symptoms that can adversely affect quality of living include lower back pain, poor posture, constipation and bloating. It can even last for years, leading to awkward conversations on expecting another child even when one isn’t pregnant.

A popular and proactive option to combat Diastasis Recti is to do diastasis recti exercises. However, contrary to popular belief, classic core exercises, such as sit-ups, planks and crunches, aren’t optimal and can even exacerbate the condition! This is because they strain the midline, causing the connective tissue to stretch even further and weaken, instead of being used to strengthen one’s core.

Diastasis recti workouts should focus on a good variation of exercises that involve different muscle groups, such as core breathing, pelvic tilts, toe taps and single-leg stretches. It also helps to work your oblique muscles to help realign your abdominal area. Do consult an experienced doctor or therapist to help prevent injury and plan an optimal routine that you can do from the comfort of your home. It’s important to also take note of the right time frame before you begin – usually six weeks post-pregnancy.

Eating healthily also goes a long way, particularly eating food that’s rich in collagen and essential nutrients, such as Vitamin C, Vitamin A, zinc, protein, iron and fatty acids. They include fruits, nuts, meat, eggs and oil-rich fish; amongst many other foods. While a healthy diet is best combined with a proper exercise regimen to help your recovery, it is important to consider possible allergies or previous muscle strain that may affect your routine.

Alternatively, you can consider physical therapy in Singapore to treat your post partum belly. One example is electromagnetic therapy, which stimulates neuromuscular tissue and facilitates muscle strengthening through a High Intensity Electromagnetic Field. Other options include shockwave therapy and ultrasound/radiofrequency treatment, which use a variety of waves to strengthen muscles and tighten skin. Visit Orchard Clinic to arrange a consultation and learn more about our treatment options.

2.2 Postpartum Blues/Depression

Another common side-effect of post-pregnancy is the postpartum blues. Also known as ‘baby blues’, it’s also incredibly common amongst mothers, with four in five mums experiencing them post-childbirth. It arises due to the extreme hormonal fluctuations following birth, along with the stress of a major life change following a newborn child’s birth. But there’s some good news – baby blues often go away on their own after one to two weeks following childbirth, without requiring any treatment.

Some symptoms of the ‘baby blues’ include crying spells, mood swings, difficulty sleeping and being worried about parenting over your newborn. To have a smoother transition through this period, it helps to get sufficient rest, and be open to ask for as much support from your partner, family and friends. Don’t forget to take time for self-care too, and try to avoid substances that can alter your mood.

If symptoms persist beyond several weeks or months, they could reflect the more severe postpartum depression. Compared to postpartum blues, symptoms of postpartum depression adversely affect a mum’s quality of life, and may not necessarily go away on their own. It affects around 15 percent of births, and symptoms include severe mood swings, exhaustion and a sense of hopelessness.

A key reason to not take postpartum depression lightly is that in addition to your own mental and physical health, the health of your newborn child is also highly dependent on your support and care. Having postpartum depression isn’t something to be ashamed of, and it helps to find trusted people whom you can entrust your emotions to without judgement. Seeking early medical treatment and proper post natal care also prevents it from escalating and negatively affecting your health and especially your child’s.

Postpartum depression is treated in two key ways: medication and therapy. While they both can work alone, combining both increases the efficacy of both treatments. Various forms of therapy are available, from support groups with other mums to seeing counsellors or psychotherapists. For more severe cases, medication may be prescribed alongside psychological therapy.

Other ways you can practice self-care include exercising, getting as much proper rest as possible – with the help of loved ones, and to eat healthily and regularly. Above all, it’s important to remember that these thoughts do not define you; and that it’s ok to be vulnerable and find support to walk you through this difficult period.

2.3 Urinary Incontinence

Urinary incontinence, also known as involuntary urine leakage, is a common occurrence during both pregnancy and after giving birth. It affects over half of all mums, and comes from a weakness of the bladder and subsequent loss of control over the urinary sphincter. There are various types of incontinence, and each type affects different groups of people. Women face a higher rate of incidence due to a variety of factors; from pregnancy to childbirth and eventual hormonal changes during menopause.

For pregnant women, the most common incontinence they face is stress incontinence. It is due to physical pressure on the bladder, and often a direct side-effect of pregnancy. When engaging in physical movement, from laughing to sneezing or even standing up, the extra pressure on your bladder weakens the muscles and leads to incontinence. In addition, your growing baby also adds extra pressure upon the muscles across the months of pregnancy, especially in the third trimester.

Changing hormones also affect your bladder and urethra lining, and other factors such as pre-existing medical conditions and urinary tract infections (UTIs) can also increase the likelihood of experiencing incontinence. Urinary incontinence can still occur after pregnancy, due to weakened muscles via a regular vaginal delivery of your child. As your body recovers from childbirth, stress incontinence can still lead to experiencing urine leakage, although it often clears up naturally over time.

Urinary incontinence is not something to be embarrassed about, and for more severe cases, we strongly recommend seeking early and effective treatment. Some examples in Singapore include physical therapy and medical technology to strengthen your pelvic floor muscles, helping you regain control over your bladder function. From simple exercises that you can do at home, to using technologies such as HIFEM electromagnetic waves, you’re in good hands with Orchard Clinic’s various treatments. Find out more here.

Stress incontinence is also a frequent concern for older women who are undergoing menopause, with increased impact from 50 years and older. In addition to weakened muscles and aging, there is also the reduction of estrogen, a key hormone involved in the regulation of menstruation. This can lead to weakened pelvic muscles and hence reduced bladder control, in addition to the thinning of the urethra lining.

Besides stress incontinence, other challenges for older women in menopause include urge incontinence, referring to a fast and sudden urge to pee. Some women also experience painful sensations when peeing, or constantly getting up at night to use the toilet, impacting their quality of sleep. Past history of other illnesses, such as diabetes, can affect the likelihood and intensity of urinary incontinence too.

Treatment methods in Singapore include physical therapy, such as pelvic floor exercises to strengthen pelvic muscles, and Other methods focus on lifestyle changes, such as reducing weight and cutting back on consuming caffeine and alcohol. If necessary, medication can be prescribed as well. Learn more about how Orchard Clinic is here to support you through the season of menopause here.

2.4 Raising A Newborn

Last but not least, post natal care extends to a condition that all mums face – caring for a newborn in the first few days and weeks. Especially so for new mothers, it is a challenge to balance the demands of your newborn while still recovering from the exertion of childbirth. From soothing your newborn’s constant cries to requiring you to breastfeed almost immediately after giving birth, the first few days and weeks are certainly a daunting challenge for mothers.

A frequent concern for new mums is the nature of breastfeeding. It is recommended that babies be allowed to breastfeed within an hour of their birth, and this lasts up to their first year, where they will gradually shift to solid food. With effective post natal care and support, new mums can learn from more experienced mothers on the optimal way to breastfeed their newborn. From learning how to getting your newborn to latch onto your breast, to the frequency of feeding – it’s all a natural part of raising your newborn.

It’s also essential for husbands to be a constant pillar of support for their wives, and to be willing to take up roles and chores that are traditionally seen as more ‘maternal’. Even so, the increase in demands for both sides will often put strain on the marriage, with a rise in fatigue and emotional exhaustion. Ultimately, it benefits both parties to sit down and discuss the best ways to support one another, in order to adapt to this new season and celebrate a new life.

Part 3: Walking Through The Postpartum Period

Comprising the first six weeks after birth, the postpartum period is an intense period of life that requires the utmost of post natal care and support from family and friends. As a mother, this entails a range of changes; from physical, psychological and emotional, along with the natural changes of motherhood. We share more on what you can expect and the possible challenges – to help you come out empowered and ready to embrace the joys of motherhood with your baby.

3.1 The First Week

The first week is the most physically strenuous and tiring one, having just endured the arduous yet inspiring miracle of delivering your child, and is where post natal care is key. For traditional vaginal deliveries, perineal soreness and bleeding is a normal affair and usually clear up in a few days. For mothers who underwent a cesarean section (C-section), recovery time will naturally take longer, given the nature of the surgery. Remember to seek medical advice during this particular period.

Abdominal cramps and soreness across the body is an inevitable outcome, especially in the first week. From painful contractions in the uterus to a stiff back and headaches, it’s important to seek proper pain relief, through a combination of painkillers, warm showers and massages, or taking slow steps around if you are able to. Seek medical advice for what is the most optimal pain relief for you.

With your baby’s birth, your weight change is a major event right after pregnancy. While the bulk of your weight gain has been rapidly lost with the birth of your baby, it’s common to still appear pregnant due to both stretched skin and extra fluid retention. It’s perfectly normal to have some weight gain in the short term, and weight loss will occur naturally with healthy eating, exercise and constant breastfeeding.

It is important to constantly monitor your own health, the degree of pain you may experience, along with taking your temperature often to ensure that you do not experience any risk of infection from the wound. Keep yourself well hydrated to help avoid constipation, try to eat regularly and nutritiously, and to get as much rest as you can.

Besides the physical recovery, the ‘baby blues’ are also a common occurrence during the first week, with fluctuations in hormones following both the birth and your baby’s feeding. As you grow accustomed to breastfeeding, diapering and comforting your child, give some time to settle into a routine, and seek help if you need from both medical staff and family.

3.2 The Second Week

In the second week, you should be continuing your recuperation from the comforts of your home. For regular deliveries, after being cleared by your doctor, you can return home within one or two days of giving birth; while C-section deliveries usually take up to four days before returning home. Bleeding should gradually slow down and grow less heavy, and some itchy sensations signify that the vaginal area is undergoing its natural healing.

It is also common to experience ‘night sweats’ or ‘hot flashes’, where one wakes up drenched in sweat due to hormonal changes and shedding excess pregnancy fluids. While uncomfortable, it should naturally pass in a few weeks, and it helps to sleep on a towel to avoid drenching your bedsheets and requiring constant changing.

The effects of postpartum blues should begin to clear up as well, as you grow more accustomed to your new daily routine, and your loved ones also learn how to better support you in this period. If sadness and anxiety still affects you, or you find yourself laden with stressful thoughts or pushing away your newborn, do seek medical support. If possible, try to get a little movement daily, as well as resuming normal, non-strenuous activities and eating nutritious and potassium rich foods.

3.3 The Third To Sixth Weeks

Your body should continue its recovery, with a reduction in bleeding, pain and general fatigue. It’s perfectly normal to be exhausted more from the caring of your newborn, but if symptoms persist, check with your doctor for undiagnosed postpartum depression.

Try to keep away from vigorous movement and exercise for the time being, even if you may feel energetic and raring to go. It can be tempting at times to try to regain your pre-pregnancy physique and to reduce your post partum belly, but your post-pregnancy recovery is key for now.

During this period, the more intense symptoms of postpartum blues should subside. If severe symptoms persist, visit a medical professional to check for undiagnosed postpartum depression.

3.4 Six Week to Six Months

At six weeks, it’s a common procedure to go for your postnatal check-up, as part of your post natal care. Your doctor will conduct an elaborate physical examination to measure your recovery, mood, and well-being. They will also ask about any problems you might have had, such as tenderness, abnormal cell changes via a pap smear, and tests to check on your glucose and blood pressure levels. There will be days that you feel exhausted and overwhelmed, but it’s important to practice self-care and to share them with your doctor, so as to seek treatment for postpartum depression if necessary.

For mothers seeking to have another child soon after, your doctor will also discuss birth control options for you. The recommended time between pregnancies is approximately one and a half years, to allow for a full recovery and a smooth subsequent pregnancy. It helps to note down the various concerns and questions you may have before the postnatal check-up, and to best plan for your future as a mother.

Your uterus should have also returned back to its pre-pregnancy size, and with your doctor’s approval, can return to more intense activity such as exercise and sex. This includes more strenuous diastasis recti exercises after 6 weeks, and 12 if you have had a C-section. As always, do consult your doctor or a medically trained professional before starting your exercise regime and strengthening your recti muscles. Avoid over-straining yourself, and if experiencing pain or discomfort, do stop and seek medical attention.

If you are still experiencing urinary incontinence post-pregnancy, you can also start doing various Kegel exercises to strengthen your pelvic floor muscles. As with diastasis recti exercises, seek medical approval before you commence your routine, and stop if you feel lingering discomfort.

Conclusion

The post-pregnancy period is a challenging one, and admittedly a mother bears the brunt of it, with the pains of recovery, sleep deprivation and constant nursing. But thankfully, you don’t have to walk through it alone – with family, friends and experienced medical support. Regardless of the unique challenges each mother may face, Orchard Clinic celebrates the beauty of birth and believes in helping women fully embrace motherhood through quality post natal care.

Visit us and find out more on the full range of our treatments and physical therapies in Singapore.

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Orchard Clinic is a specialised centre for Postnatal and Postpartum conditions, helping clients achieve healthy and pain-free lifestyles.

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Orchard
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