After nine laborious months, a new mother deserves a real break, especially if she had a rough delivery. But for many women, the aches continue long after the baby is born.
“Every ache and pain goes back to childbirth,” attests Rebecca Palumbo, 46, of Tinley Park, Ill. Palumbo’s tailbone or coccyx fractured during her first son’s birth 20 years ago.
“He faced the wrong way so his head cracked that last bone during delivery,” Palumbo recalls. “I still wake up in the morning to find myself overarching my back to ‘protect’ my broken tailbone.”
Like Palumbo, many women find that stubborn post-pregnancy discomforts can be an ongoing pain in the rear.
Oh, my aching back
Palumbo suffers from sciatica, intermittent severe pain starting in the buttock area, then stabbing down the back of the leg, often to the foot. Causes may include swelling of tissues surrounding the sciatic nerve as it exits the pelvis, and pressure on the nerve by the enlarging uterus and developing baby, says Dr. Michele Hakakha, a Beverly Hills, Calif., obstetrician/gynecologist of and coauthor of the new book “Expecting 411."
What’s got your back? Maybe weight gain and a shift in the center of gravity during pregnancy, plus typical elevated, raging hormones, she says. Progesterone softens ligaments and supporting pelvic structures, while spinal curvature becomes exaggerated, straining nearby muscles. Postpartum back pain is often blamed on epidural anesthesia, commonly placed in the low back. Also, don’t underestimate the physical toll of the weird, twisted positions used to master the art of breastfeeding and strains of handling a newborn, suggests Hakakha.
To help soothe your back, use a lumbar support pillow and pick up everything correctly. Already doing Pilates? It’s great for core strengthening. True, most back pain goes away by itself, but if not, get help.
Allergies ... achoo!
After Anita Dubey’s first daughter was born, this 41-year-old Toronto, Ontario, mom developed severe allergies to ragweed, pollen, airborne mold and dust. Her naturopath recommended vitamins, herbs and diet devoid of tempting histamines like chocolate and red wine.
“Hormonal changes during pregnancy can alter the course of allergic responses,” says Dr. Leonard Bielory, founder of STARx Allergy and Asthma Center in Springfield, N.J.
Pregnancy hormones may cause vascular engorgement and related swelling of any mucosal surface, nose to vagina. With pregnancy rhinitis, for example, the nose can get congested, hampering breathing. Hormonal changes are also factors in increased asthma, hives and angiodema — large welts on the skin.
Shaky pelvic floor
Pelvic floor disorders include urinary incontinence (UI) or involuntary leakage, fecal incontinence and pelvic organ prolapses, where a pelvic organ slips from normal position to push against vaginal walls. UI is twice as high among women who’ve given birth vaginally compared with those who haven’t, according to a National Institutes of Health study.
When bladder pressure increases — you cough or laugh — weak bladder muscles allow the flood gates to open, i.e, the urethra that carries urine from the bladder, inside to out. Your doctor may recommend lifestyle changes, estrogen patches or cream, insertable devices, radiofrequency therapy or injections to help.
Birthing very large babies caused both UI and pelvic organ prolapse for Lisa Snipes, age 42. The Charlotte, N.C., mother underwent a “remodel”: total pelvic floor reconstruction, which also lessened urinary “oopsies” compromising her lifestyle.
Patients with organ prolapse may be offered one of the newest pelvic floor surgeries that use either biologic grafts from human or animal tissue, synthetic mesh, or combine both.
Medications and targeted exercises can help.
You brushed twice a day, flossed daily and had regular cleanings during pregnancy. Still, it may not be enough, says Sally Cram, a dentist in Washington, D.C.
Peaking hormone levels during pregnancy make women more susceptible to accumulating plaque. Problems start as gingivitis or inflammation in the gums, allowing pockets to harbor more bacteria. Left untreated, chronic periodontal disease can do irreversible damage to the jawbone holding your teeth.
“Pregnancy tumors” are really pyogenic granulomas, “big, red inflamed angry lesions that grow on gums mostly between teeth,” says Cram. If they stick around post-baby, your dentist can easily remove them surgically.
Melasma, also known as chloasma or “the mask of pregnancy,” occurs in up to 70 percent of pregnant women and persists after pregnancy in about 30 percent of cases, says Dr. Andrea Cambio, a dermatologist in Cape Coral, Fla.
These lacy brownish patches, usually on the face, are caused by pregnancy hormones that stimulate more production of melanin when skin is exposed to sunlight.
Strict sun protection during pregnancy is key, but after-the-fact treatments — which may be limited during pregnancy — include prescription creams with retinoids, glycolic acid, corticosteroids or combinations. Chemical peels, lasers and yellowish concealers may ease discoloration. Use products which contain “active soy”: soy devoid of estrogenic components, says Cambio.
Skin tags are small, fleshy growths in folded areas of skin like armpits and inner thighs, caused by weight gain and — again — pesky pregnancy hormones. Extreme-cold cryosurgery removes them, she advises.
When Alexandrea Farkas, age 35, from Brooklyn, N.Y., was pregnant, she developed crippling wrist and thumb pain. Initially diagnosed as de Quervain's tenosynovitis, says Farkas, “now it’s probably just plain old tendonitis.”
Renee Rosiak, now 42, of Milford, Conn., developed ball-of-the-foot tendonitis. Twins caused a 77-pound weight gain, yet Rosiak pursued normal activities “despite the enormous belly.” She blames her tendonitis on “extra weight my feet had to support.”
Tendonitis is inflammation of connective tissue between muscle and bone. “The best treatment for tendonitis is time off plus time,” Dr. Hakakha says. Get help with baby “activities,” buy a good baby carrier, use a solid wrist brace, apply ice and take an anti-inflammatory. Steroid injections or surgery are later resorts.
Lynne Witham, the mother of a 10-month-old delivered by cesarean section prematurely, was recently diagnosed with hypothyroidism likely triggered by pregnancy. “My endocrinologist couldn't believe I wasn't dragging myself through the door,” says Witham, age 38 from Saddle River, N.J. “My thyroid numbers were so ‘off.’ But what did I know. I am a new mom, right?”
Pregnancy is a window in time, says Dr. Michele Brown, a Westport, Conn., obstetrician, who also blogs about hot pregnancy topics at www.beautedemaman.com. Medical issues during pregnancy, she says, may offer clues to future disease.
Pregnancy hormone shifts can alter thyroid function too. About 10 percent of women may develop a “transient” type of thyroid disease postpartum within a year. It may be difficult to diagnose, says Brown, because of vague symptoms that mimic normal fatigue and depression that occurs after delivery — as with Witham, There’s a 30 percent risk hypothyroidism may become permanent.
Hypothyroidism during pregnancy also makes the chance of developing diabetes six times greater.
Long after baby’s grown, memories can sustain. “I still have the pain along with the bigger shoe and pants size,” laments Rosiak.
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