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Postpartum Problems

Postpartum Blues

Urinary and Fecal Incontinence

Urinary incontinence and, less commonly, fecal incontinence, plague some new mothers shortly after giving birth.

The inadvertent passage of urine, especially when laughing, coughing or straining, usually is caused by the stretching of the base of the bladder during pregnancy and delivery. Usually, time is all that's needed to return your muscle tone to normal. You may hasten the process by doing Kegel exercises.

In the meantime, wear protective undergarments or sanitary napkins. If the problem persists, talk to your doctor, who may be able to prescribe medication to relieve the problem. If you experience pain or burning, or have an uncomfortable urgency to urinate, tell your doctor. This could be a sign of a bladder infection.

Lack of bowel control often is attributed to the stretching and weakening of pelvic muscles, tearing of the perineum, and nerve injury to the sphincter muscles around the anus during delivery. It is most common in women who have had a prolonged labor followed by a vaginal birth.

Although fecal incontinence usually disappears after several months, talk with your doctor about exercises to help you regain control of your bowels. Fecal incontinence that does not resolve itself over time may require surgical repair.

Hair Loss

That lustrous sheen that pregnancy brought to your hair may fade by the time your baby is 6 months old. You'll likely notice hair loss as well. During pregnancy, skyrocketing hormones prevent the normal, almost imperceptible daily loss of hair. Several months after delivery (or when breast-feeding slows or ceases), many women begin to fear the worst as they watch their hair fall out at an alarming rate. Rest assured, the hair you're losing is only equivalent to the hair you would have shed during pregnancy had your hormones not stepped in. Generally, the sudden change in hair volume is temporary and not noticeable to others.

Postpartum Depression

Most women experience a case of the "baby blues" after the birth of their child. Changes in hormone levels, combined with the new responsibility of caring for a newborn, make many new mothers feel anxious, overwhelmed or angry. For most, this moodiness and mild depression go away within several days or weeks.

Longer lasting or more severe depression is classified as postpartum depression (PPD), a condition that affects 10% to 20% of women who have just given birth. PPD, which usually becomes apparent two weeks to three months after delivery, is characterized by intense feelings of anxiety or despair. Lack of sleep, shifts in hormone levels and physical pain after childbirth can all contribute to PPD, making it difficult for some women to cope with their new role and overcome their sense of loneliness, fear or even guilt.

The first step in treating postpartum depression is enlisting the support of family and close friends. Share your feelings with them, and get their help in caring for your infant. Be sure to discuss any PPD symptoms with your doctor, who can prescribe medication or recommend support groups to help you better cope with these new and unfamiliar emotions.

If your depression is combined with lack of interest in the baby, suicidal or violent thoughts, hallucinations or abnormal behavior, get immediate medical attention. These symptoms could indicate a more serious condition called postpartum psychosis.

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