Your Postpartum Body: What to Expect and What to Do

Our experts—doctors, trainers and physical therapists—will help guide you, body part by body part, through this strange new land.

Everything in this slideshow

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Upper Body

The problem:
Many moms-to-be don't stick to a regular upper body workout during pregnancy, leading to flabbiness and weakness. Additionally, your body produces the hormone relaxin in larger amounts during pregnancy, and this can weaken the joints afterward.

As a result, out-of-shape arms are ill-equipped to lift a baby from car seat to crib to stroller to changing table and back again several times a day, while wrists and shoulders may hurt and feel weak.

The solution:
Toning and strengthening the arms, back and shoulder muscles can also help relieve strain on the wrists. The best time to start is during pregnancy, says Megan Flatt, a trainer and fitness educator in San Francisco and creator of Bump Fitness, a prenatal and post-baby workout program. After giving birth, wait six weeks before starting to exercise.

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Swollen Fingers and Ankles

The problem:
"During pregnancy your body produces roughly 50 percent more blood and other fluids than normal to accommodate your growing baby," says Lyssie Lakatos, R.D., C.D.N., C.F.T., a personal trainer and nutritionist in New York.

Hormone fluctuations can also contribute to edema, or swelling of the hands, face, ankles, neck and other extremities. It can take weeks for all the extra fluids to leave your system.

The solution:
"Choose foods rich in potassium, such as fruits and vegetables; it helps counteract the water-retaining effects of sodium [salt]," says Lakatos.

Lakatos also suggests drinking more than the recommended eight glasses of water per day, especially if you are nursing.

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Breasts

The problem:
Immediately after delivery, the breasts become larger as they fill first with colostrum and then with milk; most will stay that size for a few weeks.

Breastfeeding mothers will experience enlarged breasts for as long as they nurse exclusively. The whole process, including being pregnant, causes most women's breast tissue to stretch, whether they breastfeed or not.

"Once pregnancy and nursing end, most women lose breast volume, retain stretch marks and experience some sagging," says Robert Brueck, M.D., a Fort Myers, Fla.-based board-certified plastic surgeon with 30 years of experience in mommy makeovers. The nipple may also look displaced.

The solution:
Most women accept the changes in their breasts as a rite of passage to motherhood. Some may want to do exercises to firm up the chest wall behind the breasts, "lifting" them a bit.

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Belly

The problem:
Your belly undergoes more changes during pregnancy than any other body part. Depending on your age, genetics and the amount of weight you gain, this can mean stretch marks and excess flab, or a "pooch," postpartum.

It can take as long as six weeks for the uterus to revert back to its old size, which will decrease the size of your belly. But since the abdominal skin has been stretched and pulled, it may never again be as taut as it was. Additionally, some women will be left with stretch marks.

The solution:
"Keeping the core muscles [abdominals and back] strong during pregnancy helps the abdominals recover faster," says Flatt.

As for that extra pooch, most experts recommend Pilates-based abdominal work. Targeted abdominal exercise will get most women the results they want.

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Thighs and Butt

The problem:
"During pregnancy, very often a woman's activity and nutrition levels go down," says OB-GYN Michael Dawson, M.D., of Atlanta Women's Specialists. "These factors mean you gain weight. The extra fat then gets distributed to places where women most often put on weight: the backside, hips and thighs."

Even if you do continue a healthy eating and exercise routine, pregnancy alone may determine where you put on extra pounds.

The solution:
It can take up to a year to lose the weight gained during pregnancy, says Dawson. To shed pounds gradually, experts recommend a mix of exercise and well-balanced nutrition. Low-calorie, high-fiber foods, such as vegetables, promote a feeling of fullness, making it easier to eat less. As for exercise, Flatt recommends moves that work multiple muscles.

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Vaginal Region

The problem:
Women who had a vaginal delivery often experience tearing of the perineum (the area between the vaginal opening and anus) or had an episiotomy (a surgical incision through the perineum), both of which need at least six weeks to heal.

Incontinence, or the inability to stop urine from leaking, is also a common complaint. Some women also experience painful intercourse or pelvic organ prolapse, a condition in which the bladder, uterus or rectum falls out of its normal position, straining the pelvic floor muscles.

The solution:
Kegels, Kegels, Kegels, says Suzanne Aceron Badillo, P.T., W.S.C, clinical program director of the Women's Health Rehabilitation Program at the Rehabilitation Institute of Chicago. By tightening and then releasing the muscles surrounding the vagina, Kegels strengthen the pelvic floor. This helps control bladder function and stabilizes the pelvic area.

In cases of painful intercourse, relaxation is key. If you've had an incision or tear in the perineum, you may be unconsciously flexing your pelvic floor, which can cause sex to hurt, says Badillo. To help prevent a tear in the perineum, Badillo suggests daily massage of the area in the final weeks of pregnancy. Postpartum, a daily massage will help a scar become more pliant.

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Feet

The problem:
When you're expecting, your extra weight, shifting center of gravity and swelling can often increase your foot size (usually by a half size), sometimes permanently.

"During pregnancy, there is a slight tilt of the body forward," says Philadelphia- based podiatrist Edward Chairman, D.P.M. "Because nature wants to compensate, the forefoot spreads and the arch flattens, causing the foot size to increase." Additionally, the extra weight of pregnancy puts pressure on the veins in the legs, causing your feet to swell.

The solution:
Chairman recommends being fitted for an orthotic (a device worn inside the shoe that can help correct posture) and, for best results, to do so early in your pregnancy. Post-pregnancy, an orthotic can help prevent further damage.

And, of course, when possible, Chairman encourages both prenatal and postpartum women to "sit down and put their feet up."

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