What to expect when you're expecting (181 page)

Your vagina, which will have contracted and regained much of its muscle tone

The episiotomy or laceration repair site, if any; or, if you had a cesarean delivery, the site of your incision

Your breasts

Hemorrhoids or varicose veins, if you have either

Questions or problems you want to discuss—have a list ready

At this visit, your practitioner will also discuss with you the method of birth control that you’re planning to use (if you’re planning not to get pregnant again immediately, that is). If you plan on using a diaphragm and your cervix has recovered, you will be fitted for one (toss your old one, because it won’t fit properly anymore); if you’re not fully healed, you may have to use condoms until you can be refitted. Birth control pills may be prescribed now, too, though if you’re breastfeeding, your oral contraceptive options will be limited to those that are safe during lactation, such as the progesterone- only minipill. For more on birth control options, see
What to Expect the First Year.

“I knew I’d be tired after giving birth, but I haven’t gotten any sleep in more than four weeks, and I’m so exhausted, it’s not funny.”

No one’s laughing—especially none of the other sleep-deprived new parents out there. And no one’s really wondering why you’re so exhausted, either. After all, you’re juggling endless feeding, burping, changing, rocking, and pacing. You’re trying to tackle the mountain of laundry that seems to grow larger and more daunting each day and the pile of thank-you notes that never seem to get written. You’re shopping (out of diapers—again?), and you’re schlepping (who knew how much baby stuff you’d need to lug just to pick up milk at the supermarket?). And you’re doing it all on an average of about three hours’ sleep (if you’re lucky) a night, with a body that’s still recovering from childbirth. In other words, you have multiple good reasons to be calling yourself Our Lady of Perpetual Exhaustion.

Is there a cure for this maternal fatigue syndrome? Not really—at least not until your baby starts sleeping through the night. But in the meantime, there are many ways of regaining some of your get-up-and-go—or at least enough so you can keep getting up and going:

Get some help.
Hire help if you can afford to. If you can’t, rely on volunteers. Now’s a good time to let your mom, your mother-in-law, or your best friends lend their helping hands. Suggest they take baby out for a stroll while you grab a power nap or they pick up your groceries, dry cleaning, or that bag of diapers you desperately need.

Share the load.
Parenting—when there are two parents—is a two-person job. Even if your partner-in-parenting is holding down a 9 to 5, he should be sharing the baby load when he’s home. Ditto the cleaning, laundry, cooking, and shopping. Together, divide and conquer the responsibilities, then write down who’s on for what and when so there’s no confusion. (If you’re a single parent, enlist a close friend to help out as much as possible.)

Don’t sweat the small stuff.
The only small stuff that matters right now is your baby. Everything else should take a distant backseat until you’re feeling more energetic. So let the dust bunnies breed where they may (even if it’s on top of those thank-you notes you don’t have time to get to). And while you’re ignoring those thank-you notes, buy some time by sending out a bulk e-mail with baby’s picture attached.

Find deliverance.
Now that you’ve delivered, it’s time to find stores and restaurants that will deliver, too—whether it’s the hot meal you’d never have time to cook, or the rectal thermometer you forgot to buy. Even groceries can find their way to your home via the Internet. Ditto all those baby essentials. Order in bulk so you don’t run out of diapers so quickly (but don’t buy so far in advance that baby outgrows the diapers before you get a chance to use them).

Sleep when the baby sleeps.
Yes, you’ve heard it before, and probably snorted at the thought. After all, baby’s nap time is the only time you can tackle the 300 other things that never seem to get done. But stop snorting and start snoring. Lie down for even 15 minutes during one of the baby’s daytime naps, and you’ll feel better able to handle the crying when it starts again (in 15 minutes).

Feed your baby, feed yourself.
Yes, you’re busy feeding baby—but don’t forget to feed yourself, too. Fight fatigue by grazing on snacks and mini meals that combine protein and complex carbs to serve up long-term energy instead of the momentary rush: string cheese and crackers; trail mix; precut veggies with bean dip; a smoothie; a yogurt, banana, and a granola bar. Keep your fridge, your glove compartment, and your diaper bag stocked with such grab-and-go snacks so you’re never running on empty. While sugar and caffeine (that king-size candy bar and that five-shot latte, taken in quick succession) may seem the obvious solution for the energy-challenged, remember this: Though they may give you the boost you crave in the short term, they’ll quickly lead to an energy crash and burn. And don’t just eat; drink plenty of water, too—not only because you’ve lost a lot of fluid during delivery, but because dehydration can lead to exhaustion. All of these tips apply to all new moms, but are especially important for nursing moms who are still eating for two.

If you’re really beat, check with your practitioner to rule out any other physical cause responsible for your exhaustion (such as postpartum thyroiditis; see
page 460
). If you’re feeling a little blue or depressed (see
page 456
), take steps to get that under control, too, because baby blues are tied to fatigue as well (and also to thyroiditis). If you get a clean bill of health, rest assured—that is, when you can rest at all—your zombie days are numbered. You will live to sleep again.

“My hair seems to be falling out suddenly. Am I going bald?”

You’re not going bald—you’re just going back to normal. Ordinarily, the average head sheds 100 hairs a day (just not all at once, so you don’t usually notice them), and those hairs are being continually replaced. During pregnancy, however, the hormonal changes keep those hairs from falling out, which means your head hangs on to them (remember how thick your hair felt back in the pregnant days?). But all good things must come to an end, including your reprieve on hair fall. All those hairs that were slated to go during pregnancy will be shed sometime after delivery, usually in the first six months postpartum—and often in unsettling clumps. Some women who are breastfeeding exclusively report that hair fall doesn’t begin until they wean their baby or supplement the nursing with formula or solids. You’ll take comfort knowing that by the time your baby is ready to blow out the candles on that first birthday cake (and has a full head of hair of his or her own), your hair should be back to normal—and business as usual—too.

To keep your hair healthy, continue taking a vitamin supplement, eat well, and treat your mane humanely. That means shampooing only when necessary (as if you had time for any shampoos now), using a conditioner and/or a detangling leave-on spray to reduce the need to tug at tangles, using a wide-toothed comb if you do have to untangle wet, and avoiding frying your hair with curling or flat irons (as if you have the time to style it, anyway).

Talk to your practitioner if your hair loss seems really excessive.

“I thought I’d have more control over my bladder once my baby was born, but I gave birth nearly two months ago and I’m still peeing when I cough or laugh. Is it going to be like this forever?”

So your new-mom bladder is letting you—and your panties—down? It’s completely normal to occasionally leak some urine involuntarily in the months (yes, months) following delivery, usually while laughing, sneezing, coughing, or performing any strenuous activity—and it’s pretty common (more than a third of moms spring this particular leak postpartum). That’s because pregnancy, labor, and delivery weakened the muscles around your bladder and pelvis, making it harder for you to control the flow of urine (it took a licking and therefore keeps on dripping). Plus, as your uterus shrinks in the weeks following delivery, it sits directly on the bladder, compressing it and making it more difficult to stem the tide. Hormonal changes after pregnancy can also batter your bladder.

It can take between three and six months, or even longer, to regain complete bladder control. Until then, use panty liners or pads to absorb leaking urine (no tampons, please—they don’t block the flow of urine, because it’s a different outlet, and they’re off-limits postpartum period anyway), and take these steps to help regain control faster:

Keep your Kegels up.
Thought you were done with your Kegels now that your baby’s delivered? Not so fast. Continuing those pelvic floor–strengthening exercises will help you recover bladder control now and preserve it later on in life.