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Post natal body

+ 9 months

4th Trimester

Your little one is finally here.  The baby has been in a safe and warm environment for nine months and needs to get used to all the new things around them.  A newborn will have a desperate need for their parents straight after the birth.  By providing warmth and comfort the baby will feel safe and secure.  A baby carrier wrap or harness is a good way to keep the baby close to your body during this time. Some baby’s like to be swaddled.  

The baby still has to learn everything. Because he/she develops quickly during the first couple of months after the birth, the baby can be restless sometimes. Most children will also cry a few times a day while they are processing their new environment.  Most babies will reach their crying peak around 6 weeks after the birth.   

If you feel your baby is crying more than normal or you are struggling to cope with this, please contact JGZ for help and advice.

Sleeping Pattern

In the beginning a baby often has a ‘day-night reversal sleeping pattern.  Eventually the baby will learn when to be awake and when to sleep longer at night. Remember that it will take time for both parent and baby to find a pattern they are both comfortable with. It is not recommended to let all babies sleep through the night. If the baby does not wake up and ask to be fed, then it is okay.  But there are many babies which require night time feeding.

Cramps

A baby can sometimes suffer with cramps, this is normal. The intestines are still getting used to the milk. Soothing the baby and allowing it to suckle is the best way to provide comfort.  There are over the counter remedies available such as (VSM cinababy and infacol) but any benefit from these has never been scientifically proven.  Sometimes relief can be given by having the baby’s tummy rest on your lower arm, which provides some counter pressure.  Massaging the tummy using warms hands and little oil, in clockwise motions, can help against cramps also.

How long will it take?

Your body needs time to revert back to a ‘pre-pregnancy’ state. Usually six weeks after the birth your body has mostly recovered from the birth. Any stitches will have healed by now and blood loss has stopped.

But the full process of your body reverting back to a ‘pre-pregnancy’ state takes a lot longer. Many women indicate that it takes a year before they feel both physically and mentally themselves again. Being pregnant, giving birth and becoming a mother is not for the faint hearted.  Your body needs time to restore the hormonal balance and refill your energy reserves.  

Don’t try to push yourself and avoid comparing your situation with others too much. Be kind to yourself during this period and be aware that going back to normal fully takes time.  

Hormones

After the birth your body needs time to get back in balance. If you are breastfeeding, this may take a little longer. Many women experience hair loss a few months after the birth, possibly because your skin is restless and you feel irritable and emotional.

Mental health

Just like during puberty, pregnancy is a time where hormones change your brain functions.  This results in an increased likelihood of developing mental health problems.  Your memory is temporarily impaired; it can take up to 2 years after the birth for this effect to disappear completely. It will take time to get used to being a new parent and finding a balance regarding family life.  It is important that you get sufficient rest and relaxation. A happy parent is a happy baby. Try to eat healthy (enough vegetables and fruit) and get some gentle exercise, for at least 30 minutes every day.

1 in 10 women experience post natal depression. This is different from maternity tears; these usually don’t last longer than 10 days after the birth. The most common symptoms of depression are:

  • continued feelings of sadness
  • a sense of emptiness
  • not in the mood to do anything
  • worrying that you are unable to take care of the baby
  • not able to enjoy the baby or feeling a strong sense of dislike towards the baby
  • not having any maternal feelings
  • a feeling of guilt
  • being very tired
  • crying a lot
  • being irritable, reacting aggressively
  • concentration issues, feeling confused and forgetful
  • little appetite or overeating
  • trouble sleeping or wanting to sleep a lot
  • low confidence, feeling unworthy and unsuitable as a mother
  • anxious, desperate
  • headache, nausea, dizziness
  • thoughts of self harm 
  • thoughts and fear of harming the baby

(source: thuisarts.nl)

Post natal depression can often be treated easily. Talk about your feelings with friends or family and contact your doctor. Sometimes medication is required. Don’t worry too much if some days you feel insecure or just not yourself. This is common with being a new parent and is not immediately a symptom of depression.

Pelvic Floor

Your pelvic floor muscles are under strain during the pregnancy because the growing baby is causing pressure and ligaments and muscles are weakened by pregnancy hormones. After the birth your pelvic floor needs time to recover. You can read in this leaflet how to rebuild your pelvic strength in a sensible manner (link leaflet physio) we have our own information leaflet which lists effective exercises also. (link own leaflet). Once you have given birth it will be important for the rest of your life to maintain your pelvic floor health by exercising. Please note: it is very important to alternate between tightening your pelvic floor muscles and relaxing them again completely.

 Your pelvic floor will recover in principle but this takes time. You can compare it to a heavy sports injury. During the first week after the birth you may experience poor bladder control, this is normal. If you still have a weak bladder at 6 weeks after the birth, contact your midwife for advice.  A consult with a pelvic physiotherapist may be necessary. You can achieve much with the correct exercises.

Relationship and sex

Suddenly there are three of you (or four, or five). There is now a shared responsibility for bringing up and caring for your little one.  This means that your roles within the relationship have changed and you need to find your way. You are different people with different backgrounds, so it is normal if you don’t always agree!

1 in 3 couples split up before their child is 3 years old. Invest in your relationship and discuss how you see these new roles and how you can support each other.  Don’t waste time in requesting help from e.g. the JGZ or your family doctor if you feel you are not adapting well.

It is important to take time to be lovers/partners in addition to being parents.  Try to share moments which do not involve the baby (or work or your telephone) and give each other attention. Plan these moments in your diary, because before you know it you are spread out on the sofa or something else will interfere.  

After giving birth, each person is different when it comes to regaining their sex drive (libido). It is always a good idea to wait until the blood loss has stopped. When you are breastfeeding it is possible that your vagina feels dry during intercourse, so you may want to use a lubricant. Sex does not have to mean penetration and you could try touching the area with a finger first and see if it is enjoyable. When you feel ready for penetration, make sure this is not painful .Continuing despite pain or believing it is part of it, will cause problems in the long term.

Being intimate with each other does not always mean having sex. Give each other a cuddle more often, a kiss or just to be together.  

Having sex after the birth can be a little stressful for the man as well, as the vagina may feel different. Any stitches should have healed around 6 weeks after the birth, when there is little chance of ‘something going wrong’.  Some women are fully healed before 6 weeks. We will check on your stitches (if you have any) at your post natal appointment.   

Who to contact and when

When the first week after the birth has come to an end we will transfer the care of you and your baby back to your family doctor. Your family doctor will then be responsible for any medical matters relating to you and your baby. The Child Health Clinic (part of the Centre for Youth and Family) will be providing medical care for your baby. This is where you can ask questions about (breast) feeding, health and parenthood. On the Centre for Youth and Family Utrecht website you can find details of your local Child Health Clinic.
Here you can have the baby weighed; there are usually separate clinic hours for this. You can get more information at the Clinic or ask the maternity nurse who will visit you during the first week after the birth.

  • Blood loss for longer than 6 weeks after the birth -> midwife
  • Painful pelvic floor ->midwife up until 6 weeks, after that the family doctor
  • Weak bladder or other pelvic (floor) related problems ->midwife up until 6 weeks, after that the pelvic physiotherapist
  • Feelings of depression after the birth -> family doctor
  • Need of support with parenthood -> JGZ or family doctor
  • Painful intercourse after the birth -> family doctor
  • Baby has a fever during first 3 months -> emergency doctor or HAP

‘Support from other new mothers’

After a pregnancy with regular checkups with the midwife or doctor plus a maternity week where the maternity nurse and midwife were often present, you can sometimes feel a little lost once you are ‘on your own’.  There are no carers available for immediate advice and you still have lots of questions.  

This can feel lonely. It can be a comfort to meet with other new mothers.  Every young parent will have the same questions and it might help to exchange experiences. Think about friends or family members with young children. Or the women you have met during your pregnancy class. There are different initiatives such as the Mamacafé.

Exercising/Sports

You can usually start exercising again six weeks after giving birth. It is very important to do this slowly and gradually. Running should only be done from 4 months after the birth. Otherwise there will be too much impact on your recovering pelvic floor.

It is recommended to do this under the guidance of a trainer who is experienced with building up exercise levels for women who have given birth recently.  (See leaflet physio)

If you experience any problems despite building up slowly, get advice from a pelvic physiotherapist. For example Gezondheidscentrum or Lutmers

Post natal check up

At 6 weeks after the birth you can have a post natal check with us. We would like to hear how you are doing now. We will talk about how you have experienced our care during the pregnancy, birth and maternity week. If there were any issues during these periods, we will discuss with you what this means for a possible next pregnancy. If you have any questions, please ask us.  

We will take your blood pressure, check on your abdominal and pelvic floor muscles and see if your stitches have healed (if you have any).

It is usually nice to book your post natal check with the midwife who was there at the birth. For the best availability, contact us about 2 weeks after the birth and our assistant will book the appointment for you.  

Do's for dads

After nine months the time bomb has finally exploded and the damage is huge.  If you were ever in any doubt about a women’s high pain threshold, you know for sure now. Don’t cheer too soon as she is talking a walk in the park after a couple of weeks. It can take up to a year before she is fully recovered, both physically and mentally.  One in ten women experience a period of depression after the birth. Of course not many people feel cheerful after a lack of sleep but visit your family doctor together when it is getting too much for you.

During this time, you will both probably not feel much like having sex. You are still somewhat traumatised and she has just finished pushing a football through a letterbox. But that doesn’t mean you should ignore her. A little bit of flirting and a compliment here and there will make her feel better. This woman has achieved a miracle and deserves a statue. Tell her this.

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