Postpartum myths: what's the truth?

The postpartum period is a time when women need to recover. In many cultures, it is also considered a vulnerable time, leaving new mothers susceptible to illness, and specific traditional practices are observed to support recovery and prevent health issues in the years ahead. 

We're not suggesting you stop washing, of course (hello lochia, milk leaks, and night sweats), but do opt for a gentle, unscented soap that won't mask or interfere with your natural scent.

One study examined newborns' responses to amniotic fluid during their first attempt to locate their mother's nipple. Researchers observed the spontaneous choice of newborns between a breast whose nipple had been moistened with amniotic fluid and an untreated breast. 23 out of 30 infants chose the breast treated with amniotic fluid. The authors suggest that the observed attraction to the smell of amniotic fluid may reflect foetal exposure to this substance (i.e. prenatal olfactory learning). Given the importance of biological scents for newborns, products that eliminate or mask these signals should be avoided during the perinatal period [5].

Breastfed and bottle-fed infants show different responses to maternal scents. A series of 5 experiments was conducted to determine whether newborns, at around 2 weeks of age, could recognise their mothers by scent alone. Breastfed newborns were able to distinguish their mother's scent from those produced by unfamiliar lactating women. In contrast, bottle-fed infants appeared unable to recognise their mother's scent when it was presented alongside the scent of another woman [6]. Breastfed children are exposed to strong maternal scents and quickly become familiar with their mother's unique olfactory signature. It seems that orientation towards the scent of the mother's breast is an innate adaptive response in newborns [7].

Babies are born with very limited vision, and the world outside the womb is highly stimulating and bright for them. Their sense of smell takes over from their sight, before their vision gradually sharpens over time. The smell of breast milk is very similar to the smell of amniotic fluid, which helps them identify you, as well as having a calming effect [8]. 

Of course, not all women will experience postnatal depression !  

The baby blues is a transient state, occurring between the second and fifth day after birth, with a peak on the third day. It generally lasts between four and seven days, and can sometimes be reduced to twenty-four hours.

Figures [9] indicate that between 60 and 80% of women will experience baby blues, which occurs between the second and fifth day after birth and generally lasts between 4 and 7 days, and sometimes only 24 hours. It rarely requires medical treatment and normally resolves with support, among other things. Baby blues is a mild mood disturbance affecting mothers after the birth of their child. It is not a "depression" or a pathology, but a transient disruption.

However, up to 20% of these mothers are likely to develop postnatal depression [9].

The prevalence of postnatal depression is estimated at 10-20% worldwide [10].

Western medicine considers the post-partum period to be 6 weeks.

This myth stems from the fact that in the United States, for example, women are often given an appointment with their gynaecologist six weeks after the birth of their child. This idea of six weeks was invented as the point at which women should have seen their pelvic organs return to normal [11]. It is a completely ridiculous plan!

We need to normalise the fact that the full transition into motherhood unfolds over several months, or even several years. Expecting to "bounce back" and return to "normal" after this magical 6-week period is setting unrealistic expectations.

This is one of the most widespread myths in the field of post-partum recovery. It is recommended that the definition of the post-partum period be extended to 1 year, as many of the physiological changes caused by pregnancy persist for at least 1 year after childbirth [12].

When it comes to exercise, your six-week check-up is nothing more than a green light to resume gentle exercise.

Proponents of human maternal placentophagy report that encapsulated placenta is an excellent source of dietary iron. A randomised, double-blind study compared the effect of encapsulated placenta ingestion on postpartum maternal iron status to that of a placebo [13].

Mean iron concentrations were considerably higher in the encapsulated placenta (0.664 mg/g) compared to the placebo (0.093 mg/g), but provide only 24% of the recommended daily iron intake for breastfeeding women.

The results revealed no statistically significant difference in maternal iron status between women in the placental supplementation and placebo groups. It therefore appears that eating your placenta does not significantly improve maternal iron status in the postpartum period. 

The truth is: every person is different, and while some women lose the weight within a few months, or even a few weeks, others find it much harder to get back to their pre-birth body. (We know — we're not keen on that expression either.) 

To find out more, read our article on breastfeeding and weight loss.

And here is the evidence: according to a study published in the International Journal of Obstetrics & Gynecology [16], sexual activity resumes earlier than vaginal intercourse (53% of the 1,500 women studied resuming sexual activity at 6 weeks postpartum and 41% attempting vaginal intercourse). 
At 8 weeks, the majority of women had attempted vaginal intercourse (65%), rising to 78% at 12 weeks and 94% at 6 months. Compared with women who had a spontaneous vaginal birth with an intact perineum, women who had a spontaneous vaginal birth with an episiotomy or a sutured perineal tear were more likely not to have resumed vaginal intercourse at 6 weeks postpartum. Similarly, women who had an assisted vaginal delivery or a caesarean section were more likely to delay resuming sexual intercourse. So do be gentle with yourself!

It is perfectly normal to resume sexual activity soon after pregnancy, just as it is normal to feel ready only six to eight weeks later. The decision to have sex with your partner (or yourself) should not be made by a clinical care provider who "clears" you, or by an arbitrarily set date, but rather based on how you feel and what you want. 

The American College of Obstetricians and Gynaecologists (ACOG) states that postpartum exercise has many benefits [17]: 
It helps strengthen and tone the abdominal muscles
It boosts energy levels
It may help prevent postpartum depression [18]
It promotes better sleep
It helps relieve stress
It can help you lose the extra weight gained during pregnancy.

They also indicate that, in general, you can start exercising a few days after giving birth, or as soon as you feel ready. For women who have had a caesarean section or other complications, it is important to consult a healthcare professional for the green light.

The only thing to approach with caution is taking part in extreme sports or vigorous exercise, and remembering to stay hydrated during physical activity. To find out more, read our article: exercise after childbirth. 

I must not lie on my front for at least a month after giving birth: FALSE

False: you can lie on your front from the very start of the postpartum period if you feel comfortable in that position.

According to Dr Reigstad, a specialist in obstetrics and gynaecology and researcher at the Norwegian Centre for Women's Health Research at Oslo University Hospital, when you lie on your back, the vagina points backwards and downwards, whereas when you lie on your front, any tissue fragments in the uterus can drain more easily [19]. Sleeping on your front may help the uterus return to its pre-pregnancy size, but no scientific study has yet been conducted on this subject.

Leaking after childbirth is normal: COMMON but not normal

After giving birth, you may experience leakage, which is medically referred to as urinary incontinence. This is not a normal phenomenon but rather a postpartum symptom, which can result, among other things, from pelvic trauma related to childbirth (damage to the muscular and neural structures of the pelvic floor) [20]. Data show that the rate of urinary incontinence at 6 months is 26% and varies depending on the type of delivery. Vaginal delivery is associated with an incidence of urinary incontinence nearly 3 times higher than that of caesarean section. Forceps delivery increases this risk by 1.5 times compared to spontaneous vaginal delivery [21].

The consequences of this pathophysiology are not limited to urinary incontinence. Pelvic organ prolapse and anal incontinence are also troublesome sequelae of vaginal delivery [22].

In the postpartum period, it may be recommended to consult a physiotherapist specialising in pelvic health. They will help you understand why you are experiencing leakage and develop a long-term strategy to address the issue.

Applying cold to the perineal area can provide relief: YES

It turns out that controlled, randomised studies show that applying cold to the perineum may help reduce pain by half [23], support healing [24], and reduce the use of analgesics. Our cold gel pack Perineal pad is designed to support you during this period.

Using an abdominal wrap will help my abdominal organs return to their normal position: CAUTION

A correctly applied wrap or support belt relieves any pressure from the abdominal organs (including the uterus) on the abdominal muscle wall, thus helping them return to their natural pre-pregnancy state [27].

In a controlled, randomised study of nearly 180 women who had undergone a caesarean section, researchers evaluated the effect of using abdominal belts on pain, symptom distress, and postpartum haemorrhage. 

Women who received abdominal belts reported less pain, lower distress scores, and a reduction in haemorrhage [28]. It may also improve mobility [29].

Caution: there may be risks if you use an incorrect abdominal belt or fasten it too tightly (pain, excessive pressure, pelvic floor prolapse, itching or skin rashes).