The Surprising Ways Your Body Changes After Childbirth And How To Deal With It

Many women aren't prepared for the physical changes they'll experience after childbirth. Here are some ways to help with the transition.

A woman’s mental and physical well-being requires tests, treatments, and preventions that men just don't have to deal with. But this isn't always discussed. From fibroids to diets to natal care, women's health is extremely nuanced. With this in mind, Shondaland wanted to take a distinct look into the world of women's health, all in the hopes of fostering well-rounded wellness.

“No one told me this was going to happen!?” It’s a sentiment that new and newish mothers find themselves uttering over and over again to each other and, frankly, to anyone who will listen. That’s because — despite an ever-growing mountain of information about the myriad things that happen to your body during pregnancy — there is surprisingly little out there about what happens to you afterward.


And the symptoms women encounter post-baby aren’t just happening below the belt. You knew there might be stretch marks, you’d heard stories about plastic gloves full of ice chips, but were you warned about what might happen to your face? That you might breakout in cystic acne? Were you given a warning about receding hairlines? Probably not.

“While a woman is pregnant, there is so much focus on her,” says Laura Laursen, MD, an OB/GYN at Chicago’s Rush University Medical Center. “But after she delivers, all that attention goes to the new baby.”


The realities of postpartum life are, to many, still a little too real for mainstream conversation. This made headlines in the run-up to Oscar night, when an ad for the postpartum care brand’s Frida Mom — that would have given 23.6 million American viewers a rare, raw glimpse into the physical struggles the majority of new mothers face —was rejected as “too graphic” by both ABC and the Academy.


No one’s saying that when there’s a newborn to keep alive, your splotchy weird skin should be at the top of the priority list. But Breighl Robbins, an integrative health practitioner and the founder of new post-partum wellness brand Ebi, argues that it’s healthy for new moms to think about themselves, too. “Until recently, there was such a dearth of options related to recovery,” Robbins says. “Women were expected to scramble to find what they needed, and make the best of it.”


Here are a handful of beauty wildcards to help you get a handle on whatever might pop up — both during pregnancy and the year (and, admittedly, sometimes longer) post-baby.


Hair, Hair, Hair


It’s an age-old cliche that after you have a baby, you never have time to wash your hair. But that’s not the half of it: Early motherhood is a follicular see-saw. Post-baby hair loss usually starts three months after giving birth and lasts until around month six. And it’s surprisingly random; some women experience it with one child and not another.


“The widely accepted reason for postpartum hair loss is shifts in estrogen, a female hormone that helps keep hairs in the anagen, or growth, phase,” says Annabel Kingsley, a trichologist (aka hair and scalp expert) at New York’s Phillip Kingsley salon. Estrogen levels are through the roof when you’re pregnant, hence the voluminous mane, but as they drop postpartum, so does your hair, literally. “The shedding makes sense, but often the scale tips a bit too much and you end up losing, initially, more hair than you gained.”


Kingsley rattles off a host of other factors beyond hormones that can contribute to hair issues: iron deficiency, gestational diabetes, thyroid imbalances, poor eating habits, severe blood loss during birth, and general anesthesia. “High stress levels and severe psychological distress, such as with postpartum depression, can even be the sole cause of hair loss,” she adds.


To contend with all this hair trauma, Kingsley underscores the importance of an iron-rich diet (think beetroot, spinach, and steak) and a little extra scalp attention. “A healthy scalp won’t prevent hair loss, but an unhealthy one can make it a lot worse,” she says. Shampoo no less than every three days—removing sebum keeps follicles unblocked—and regularly use a treatment (she recommends Philip Kingsley’s Tricho 7 Volumizing Scalp Drops or Stimulating Scalp Toner; another option is Act + Acre Scalp Detox). Hair usually starts to feel like its pre-pregnancy self around the time your baby turns one, but if shedding persists, ask your doctor to do bloodwork to make sure nothing else is awry. “Iron, ferritin (stored iron) and Vitamin B12 deficiencies are incredibly common post-pregnancy and they almost always contribute to hair loss,” Kinsley explains.


Sun Sensitivity


Protecting skin is critical during pregnancy, but also in the months after, when hormones are still going haywire. “It takes a while for levels to return to normal after birth,” explains New York dermatologist (and mother of two) Dendy Engelman, MD. With hormones running high, UV exposure can result in hyperpigmentation, aka melasma, the diffuse brownish pigment also known as chloasma — and sometimes ominously dubbed the “mask of pregnancy” — that can show up on cheeks, forehead, and upper lip (it also often appears in women taking hormonal birth control). According to NYC dermatologist Carlos Charles, MD, melasma is especially prevalent among women with darker skin tones. The best way to handle it: avoid getting it in the first place, via dutiful sun protection, preferably by wearing a hat plus a physical or mineral sunblock, such as zinc oxide. The good news is, if melasma does show up, you don’t have to wait to treat it. Engelman says an over-the-counter glycolic acid (which is an alpha hydroxy acid [AHA] versus a beta hydroxy acid) is safe to use in lower percentages while pregnant and breastfeeding.


Acne


If you went off the pill before becoming pregnant, that shift alone can be seismic for skin. The estrogen in birth control pills can reduce acne, Laursen says, “so removing those pills will sometimes lead to more of it.” Hormonal fluctuations during pregnancy and in the period after, particularly with the return of your menstrual cycle, can cause an increase in progesterone and androgens that can lead to more oil production, and, in turn, more acne. It’s like puberty all over again. Hormone surges can also lead to more intense breakouts—so suddenly you may find yourself dealing with acne of the painful, cystic variety for the first time. There’s no magic bullet here: Even after pregnancy, doctors will tell you to steer clear of most gold-standard acne remedies (retinoids and Retin-A, tetracycline, Accutane), especially if you’re breastfeeding. Engelman suggests swapping in products with antioxidants and exfoliating glycolic acid instead. “Vitamin C, resveratrol, and Vitamin B3 are all proven to be powerful at reducing oxidative stress,” she adds. Her favorites: Skinceuticals CE Ferulic, Skinbetter Alto Defense Serum and L’Oreal’s new 10% Pure Glycolic Acid Serum.


Eczema


Though it’s largely hereditary, eczema is often triggered by something that happens to be a regular postpartum occurrence: stress. Lack of sleep, which is unavoidable in early motherhood, can be another trigger. The usual treatment rules apply to postpartum flare-ups, when skin appears dry, red, scaly and cracked: Consistent moisturizing with a product that is both emollient and fragrance-free (like Cerave moisturizer); brief, lukewarm showers; and fragrance-free soaps and laundry detergent. Engelman advises layering products for optimal moisturization. “Instead of applying one thick, heavy cream, layer products, starting with the lightest and finishing with the thickest, to provide multiple barriers,” she says. “The more pliable and moisturized skin is, the less it will be prone to crack and itch.”


Perioral Dermatitis


These small, red itchy bumps around the mouth — often mistaken for acne — are another hormonal side-effect. Bacterial or fungal infections, rosacea, and environmental factors like excess heat can also contribute to flare-ups. Engelman advises patients to avoid fluoridated toothpastes, take a daily probiotic, and use a face wash with sulfur such as Mario Badescu Special Cleansing Lotion C. Depending on the level of intensity, the bumps can take up to a month to clear up.


Keloids and Skin Tags


The raging hormones that helped you build a human can also rev up your own skin cell production, causing benign growths known as skin tags, often along the neckline and underarms (wherever clothing rubs against the skin). Both Engelman and Charles say skin tags are harmless, but they can get caught on clothing and jewelry, becoming inflamed or infected. And you may just dislike the look of them. If so, they can be removed by your dermatologist with liquid nitrogen, electrodesiccation, or surgically.


Keloids, or large raised scars formed by an overgrowth of scar tissue, will be especially familiar to women with darker skin. “They can occur in response to any form of trauma or inflammation,” says Charles, “and are often seen after C-section deliveries, along the incision line.” There are lots of ways to treat keloids: the PicoSure, a “picosecond” laser treatment, which targets pigmentation; steroid shots break up the excess collagen in thicker scars; and photodynamic therapy uses light to target keloid fibroblasts and other lesions. Plastic surgeons and dermatologists can also perform scar revision surgery, which involves excising the scar with a small punch and suturing it closed. But all of these options are best done after you’ve stopped breastfeeding.