By Emilia Chrostowska
The world welcomed a new royal baby this week with the arrival of baby Archie, but in addition to the buzz about the cute as a button bundle of joy, the media enjoyed lots of discussion about why mom Meghan Markle still had a baby bump.
Turns out, Meghan is a normal mom just like the rest the world!
What is “normal” after all?
Well, pregnancy and delivery are momentous events for the female body and new mothers cannot miss all the changes that are occurring in their bodies. After delivery, most noticeably, women will realize that the stomach is not as small as it used to be, which is, indeed, completely normal. For the last 9 months, the body made adaptations to accommodate for a growing uterus and baby. After giving birth, the uterus is still enlarged, and the stomach muscles are stretched out and in a weakened state. Also, the body stores some extra fat to provide nourishment to mother and baby, which might also make the stomach look a bit larger than before pregnancy.
After giving birth, a fluctuation of hormones occurs that helps the uterus contract back to its usual size and also helps new moms burn off some extra fat. However, this change is not immediate and may take several months to occur.
What about changes you can’t see?
Not all changes of pregnancy and childbirth are noticeable to others, and urinary incontinence is also quite common after giving birth. Many women notice some urinary frequency or impaired ability to control bladder function beginning in pregnancy. However, it is not uncommon for this to persist 3-4 weeks postnatally. During pregnancy, the growing uterus causes additional pressure on the bladder and pelvic floor, causing the muscles to lengthen and weaken. This weakness is still present after delivery, many times resulting in some temporary incontinence.
Pain in the low back, pelvis, and hips is also a common unseen symptom during pregnancy and the postnatal period. Changes in hormone levels while carrying a baby contribute increased ligament laxity around the joints in preparation for childbirth. However, this additional mobility can contribute to poor posture and joint pain. Because the changes in hormones continue after delivery and while breastfeeding, it is not uncommon for this discomfort to persist for some time after delivery.
When to See a Professional:
Postnatal check-ups are important, especially for women who undergo a cesarean delivery or for those that had a tearing or episiotomy. However, we recommend that every woman see a physical therapist 6-8 weeks after delivery to ensure that the muscles of the abdomen and pelvic floor are resuming their normal function and working properly. While uncommon in the United States, this is standard practice in many other countries, so it is likely Meghan Markle will consult with an expert to confirm there are no lingering issues.
While standard postnatal check-ups may not be common in the United States, you should definitely should consult with a professional if you are experiencing discomfort or pain during intercourse, continued back or abdominal pain, vaginal bleeding, difficulty with bowel movements, straining with urination, urinary frequency, leaking urine with any activities (including sneezing, laughing, etc.), or difficulty getting back into your fitness routine 6-8 weeks after delivery.
However, do not wait to see your health care professional if you are experiencing numbness or tingling in the arms or legs, difficulty with postures for nursing or feeding, headaches, or other neck pains, no matter the timing after childbirth.
Emilia Chrostowska is a doctor of physical therapy student at Northwestern University, class of 2020.