I think one of the most common misconceptions that I encounter in my work is that you are recovered from pregnancy and childbirth at six weeks postpartum, here's why that's not true.
The issue with this timeframe is that while you may be medically cleared to return to certain activities including sex- just because these activities are safe, does not make them optimal at this time.
Just because your stitches (perineal or abdominal) may have healed and your uterus has shrunk back down after being stretched over nine months, and the wound on your uterus where the placenta was attached (that was the size of a dinner plate initially- yes, you read that correctly) has healed- it does not mean that the healing process is complete. There are so many other factors we need to take into consideration when it comes to postpartum recovery.
Some of those considerations would be the fact that you’ve been pregnant for nine months and your body has undergone changes in that time- stretched and grown, in addition to hormonal changes. And then of course, the event that is childbirth, which often comes with some form of injury be it an abdominal surgery or muscle tearing among other things. Softened ligaments, stretched and torn muscles, a stretched anterior abdominal wall and more. While I have no intention of pathologizing childbirth, it is important to know that it is a major event in the body, and there are often injuries associated with it. We also need to remember that our bodies recover and heal when we sleep. Our cells repair when we sleep. Many (most) of us are not getting the same kind of rest that our bodies really need to recover optimally in those early months, or even years postpartum. I never want to fear monger I don’t want you to think that it will be 18 months before you feel good or five years before you can run again- but I do want people to be gentle with themselves and remind themselves what it is their body has done and what they’re asking of their bodies repeatedly through parenthood, especially early parenthood.
The world health organization recommends a minimum of 18 months between pregnancies with an ideal of 24 months, this is not from delivery to delivery, this is from delivery to conception.
I think a lot of people are astonished by that, but when you really look at the whole context of what is involved with pregnancy, childbirth, and particularly that first year postpartum, it starts to make sense. I don't say this for family planning purposes because there are so many other factors at play here, but I still think it's important to know this information. So many people walk into my office not understanding why they don’t feel like themselves at six months postpartum and we sit down and have a talk about what their bodies have actually been through and are currently going through and it all starts to make sense. All of this to say, give yourself grace, be patient, be gentle with yourself. So much of what I talk about, is how to find and create spaces for rest, and a lot of it comes from my own personal experience of not having a lot of support around me for various reasons when my first was born- and realizing the dramatic impact that had on my recovery from my first birth, which, by definition would’ve been considered an uncomplicated ‘smooth’ vaginal delivery, however, as the actual birther, I can tell you it did not feel that way and my recovery felt anything but smooth or simple.
If we add breast or chest feeding or pumping to the mix, your estrogen levels stay low- which has implications for your pelvic floor beyond the stretching through pregnancy and potential tearing that happens if you've had a vaginal delivery.
I always encourage people to see a pelvic floor physio - regardless of delivery mode, and to get some guidance before returning to regular activities, particularly if those activities involve anything high impact. And then to make sure that we aren't just pushing past our limits for the sake of "getting back" to something. It's important to understand our limits may have moved a bit since birth and we should respect that process. It doesn't mean you won't be able to do all of the things you want to do; it just means it might not be the time frame you expect. And quite frankly, isn't that what parenthood is all about? Adjusting expectations.