It seems like nothing brings out the questions like parenthood! In this case, the questions come from the parents, though: soon-to-be, new, and new-ish moms who are living through the peripartum or postpartum period. With our trusty Dr. Barbara Frank, OB-GYN as our guide, let’s talk about the changes and challenges that women are encountering as they prepare for and heal from the work of pregnancy and childbirth. Perimenopause Awareness Month continues with this informative chat!
Dear Dr. Babs …
Ever since I’ve had my kids, I will get a sudden urge to pee at totally random—yet consistent—times. Like, every time my toddler cries I have to run to the bathroom. What on earth is going on there?
You’re not alone! And…you’re not nuts! This can be due to something called overactive bladder or what I like to call—I forgot to take care of my own needs first! We either go every hour or right before we leave the house even though we just went because we told the kids to go or we can’t remember the last time we peed because we have had 3 cups of coffee, 2 playdates, a meltdown and a PTA meeting—oh, and we went to work! You just need to retrain your bladder.
Keep a diary to extend the amount of time between bathroom breaks until you’re able to go 4 hours. In a voiding diary, you write down everything you drink and every time you void throughout the day to see if there's any patterns.
How often are you urinating? How much are you drinking? Are you getting up at night to go? Do you feel like you've fully emptied your bladder? All of this information can tell you a lot.
I thought that the urgency and occasional leaks of late pregnancy would let up once I didn’t have a bowling ball on my bladder, but it’s six months later and I still have leaks, even when it seems like I just went. Is that normal?
First, know that your pelvic floor did a lot of work, even if you had a c-section. And while, yes, the baby is out, the muscles still need to heal. Give yourself some time to recover and reevaluate in a few months. If you are still having symptoms after 6 months, it's time for kegels or pelvic floor PT.
I've been trying to incorporate more exercise into my routine for my mental health since having my kids, but it’s so discouraging when I know I’m going to end up leaking. What tips do you have?
This is sooo frustrating and makes you not want to do anything active. Or, if you do, then you are parched because you are nervous to hydrate adequately. It will take time to rebuild the pelvic floor, so in the meantime get the right products to protect yourself from leaks so you can do those activities you enjoy. It may be time for pelvic floor PT. Good products are ones that have the right level of absorbency for your level of leaks so you can really stay dry and protect your skin, and conscientiously choose their materials/ingredients to avoid things that are irritating to your sensitive vulvar skin.
I’m newly postpartum after a rough delivery and I really need some products that will be gentle on my healing vaginal area. What should I look for?
Step one is sitz baths: You should soak at least 3 times per day and allow yourself to air dry. The water will soothe, clean and heal and you don’t need to add anything to it. When you pick products like pads (which you’ll need for a few weeks whether you delivered vaginally or via c-section), make sure they are high-quality and keep you dry while remaining free from parabens, fragrances, chlorine, lotions, and other irritants. It’s important that they do a great job at wicking away the moisture; you want down there to be dry!
Also, using a barrier cream like the one from Attn: Grace is huge to protect that delicate skin. It will heal eventually—I promise. If you are still in a world of hurt after two weeks, go see your doctor for a quick exam to ensure everything is healing ok.
Thanks to the miracle of IVF, I welcomed my kids in my mid-40s. A couple years later, I can’t tell whether my lingering pee leaks are a postpartum symptom that needs to be addressed or a normal reality of perimenopause. Help!
You may never know! It is very hard to delineate however the treatment is the same either way. If you are still getting a menstrual cycle naturally then you have enough estrogen and you should focus on the pelvic floor exercises!
I’m in total nesting preparation mode with my baby due in just a few weeks! What products should I definitely have on hand for the early postpartum weeks? What can I expect from my body before the six-week appointment anyway?
Before I go into products, one thing that is forgotten in nesting is to have the list of “your village” ready to go. I know it may seem fun to just be home with the new baby and your partner but I promise you that you will want—and likely, need—more help! Good ways to bring in your village are meal trains, someone to cuddle baby while you shower or nap, or someone to do a load of laundry. Your village might also include baby nurses, night nurses, lactation consultants, doulas, or child care for any other children.
Back to the question. Quality pads and barrier cream are key to the healing bottom, as I mentioned above; these kinds of products will protect your vulvar skin and allow it to heal. Silicone breast pads that go in the fridge are great. Set up a nursing/changing station on each floor of your home or anyplace that you sit down. That means that if you like to plop on the couch, next to you should be a basket filled with diapers/wipes/etc. but ALSO it should have a water bottle, a snack, a phone charger. It will always happen that you sit down, baby latches and now you’re stuck. Having all of this at your fingertips is super helpful!
Before the 6-week visit, you will be having the biggest changes hormonally. You will have heavy bleeding that should subside by 6 weeks. Your bottom should start to feel better by 10-14 days, and if you had a c-section you can expect to feel 80% better by 14 days. If anything feels out of the ordinary, you know your body best and should reach out to your provider. Many places are now encouraging a two-week check for both mood and body! If you think you want that, don’t be afraid to ask to see the doc or the nurse for a check in.
Thanks for these words of wisdom from our medical advisor, Dr. Barbara Frank, OB-GYN. Through both our products and our content, we strive to be a destination and resource for every stage and phase of womanhood. The growing awareness of real experiences most women face is something to be celebrated and we’re proud to be a part of the conversation during Perimenopause Awareness Month.