Women’s bodies change and expand as they grow a baby for the typical nine months of pregnancy. When having a baby, not only do women deal with incorporating their new addition into their lifestyle, but they also need to navigate how their postpartum body looks, as well as all the emotions that come into the mix of new motherhood. As time passes, moms tend to wonder when their bodies will align and “shrink” back to what they were pre-pregnancy, and can become disappointed to learn they will rarely ever be what they were before.

Jade Elliott spoke with Natalie Lanham, DSW, LCSW, Intermountain Healthcare, about postpartum body image.

The postpartum body myth

It’s a myth to think that one’s body will look as it did pre-pregnancy. As moms grow and give birth to their babies, their bodies change. Everyone has a different body type. And no two pregnancy and postpartum experiences are alike. Some women need to go on bedrest or have caesarean sections or experience other pregnancy or childbirth complications that affect how their body recovers. Plus, factor in nursing or bottle feeding, or returning to work, which can all affect how a woman’s body recovers.

“I’ve done a lot of counseling with moms over the years, and there seems to be a greater amount of pressure in the culture in Utah than across the U.S., for women to look a certain way in a certain amount of time post-childbirth,” said Natalie Lanham, DSW, LCSW, a licensed clinical social worker with Intermountain Healthcare.

“Moms need to look at their bodies and realize they birthed their beautiful babies. It’s normal to gain weight in pregnancy. It takes nine months to grow a baby, so bouncing back right away isn’t realistic. It’s helpful for women to understand they don’t need to be “perfect” or fit a certain mold,” added Lanham.

According to Lanham, it’s important to focus on what bodies can do instead of what they look like. And accepting a postpartum body is closely tied to many aspects of a woman’s new identity as a mother.

“Social media tends to portray false narratives about what a postpartum body should look like. Take a break from social media if needed. Consider unfollowing any accounts that promote dieting or weight loss that include aspects of toxic diet culture,” she added.

Diet and exercise

Lanham encourages women to find healthy ways to work towards a healthier body. This may include eating a nutritious diet, slowly easing back into an exercise routine during the postpartum recovery period, and being patient and kind with themselves.

“Exercise can help women feel stronger, happier, and more energized, when they find a type of exercise they enjoy. It helps to listen to the body’s cues. Do physical activities that bring those good feelings. Figure out what triggers negative feelings. Get rid of those first,” she added.

Dieting is one of the most important predictors for eating disorders. Having a distorted body image doesn’t help moms who are going through postpartum body changes.

Having a sudden urge to do whatever it takes to regain their former body can lead to unhealthy behaviors. Keep things in balance. Eat balanced meals. When pregnant or nursing, moms need to eat for themselves and their growing babies.

“If you’re concerned about overeating, half the portion and save the other half for another meal or someone else,” said Lanham.

“While working towards physical fitness goals, find clothes that are flattering and fit well. Wear what’s comfortable and embrace it,” she added.

Goal setting

When it comes to settling goals, it’s vital to be realistic.

• Discover what contributes to a healthy body image first
  
• Talk it out with someone else
  
• Don’t engage in negative self-talk about goals
  
• Get a partner to set goals with – they can provide perspective
  
•  Women need to be patient with their body because it’s healing
  

Affirmations

Affirmations can be helpful when wanting to maintain a positive outlook on body image and self-worth. And different affirmations work for different people.

When thinking about affirmations, it’s important to think about the reasoning negative thoughts are happening. It’s helpful if women identify the top five things they beat themselves up about.

“When negative thoughts begin, women can identify them, and then tell themselves to stop. Turn it around and say, “I am beautiful because…”, “I have a great___ because…” Turn the negative things into positive affirmations. At the end of the day, it helps if women congratulate themselves about the positive things they love about themselves,” said Lanham.

Some examples of affirmations include:

• “I will enjoy the present moment…”
  
• “My body went through an amazing change and created a beautiful baby”
  
•  “I am enough”
  
•  “My body image is not my body”
  

Postpartum mental health and disorders

According to Lanham, postpartum blues typically last about two weeks. However, some women may get into a downward spiral with hormone changes, since estrogen and progesterone spike upon having a baby, causing significant hormone fluctuations. The body needs to adjust to new hormone changes which is normal to a degree. Some symptoms of the baby blues are mood swings, anxiety, sadness, irritability, feeling overwhelmed, appetite problems and trouble sleeping.

If a mom feels these feelings for more than two weeks, it’s wise for her to reach out to her provider for a referral to a behavioral health specialist who can help screen her for peripartum anxiety or depression.

Symptoms of peripartum mood disorders include:

• Severe mood swings
  
•  Difficulty time bonding with baby
  
•  Overwhelming fatigue
  
• Reduced interest in previously enjoyable activities
  
• Hopelessness
  
•  Feelings of guilt and inadequacy
  
•  Difficulty making decisions
  
•  Severe anxiety (panic attacks)
  
• Thoughts of harming self or baby
  
•  Recurrent thoughts of suicide.
  

The difference between the baby blues and a mood disorder is that these feelings may last for months or longer. If such is the case, get immediate help.

Call a local behavioral health hotline such as the Intermountain Healthcare Behavioral Health Services Navigation line available from 7 a.m. to 7 p.m. at 833.442.2211.

Sometimes, moms experience an extreme mood disorder that’s a more severe long-lasting depression called postpartum psychosis. Insomnia or undiagnosed or treated mood disorders may contribute to moms experiencing hallucinations, delusions, extra energy or paranoia. If a loved one is noticing this in a mom, then it needs to be addressed immediately.

If symptoms are severe and urgent, go to a walk-in behavioral health clinic or a hospital emergency department.

Moms who feel they are high strung or tend toward anxiety will want to talk to their provider while pregnant. It’s best to call the provider when anxiety kicks up a little more than usual, and they can make a referral to a behavioral health provider. Or sometimes postpartum anxiety can kick in after the baby is born.

While moms struggle with hormone fluctuations during the postpartum period, fathers too may struggle with this period as they adjust to this major life change. Some common feelings fathers who struggle in this period are:

•  Sadness
  
•  Fatigue
  
• Overwhelmed
  
•  Anxiety
  

These symptoms can trigger changes in eating and sleeping and dads can exhibit similar symptoms to moms in the postpartum period. Dads most at risk are those with previous anxiety problems. This can have negative effects with partners and babies since dads can have high anxieties over how to care for and provide for their family. Dads need time with their friends too and it’s okay. They often find nurture as a pack.

Self-Care

Self-care is vital for moms. Make time for it. It looks different for everyone, but it helps maintain some grounding between the different roles that people play in their life.

“It’s helpful if you think of there being 10 little buckets that make up self-care: psychological, social, emotional, mental, spiritual, familial, financial, physical, educational, personal. And you can’t fill every bucket, every day,” said Lanham.

“Each morning, choose to put a marble in four of the buckets. By the end of each week, at least one marble should be in each of these buckets to fulfill self-care. We struggle with sticking a few in one or more of these buckets and making these unbalanced. The idea is to have at least one in each bucket by the end of the week for balance. This helps people realize how much time is being spent in one category and focus on creating a balance,” she added.

Moms often don’t take enough time to practice self-care. Meditate, listen to music, stretch, bathe, put on lotion that smells good, or use a good product for body self-care. This helps take the stress from the day. Keep in mind that each body deserves to be honored, respected, and nurtured and that life is here to be enjoyed.

For more information about Intermountain behavioral health and women’s health services visit Intermountainhealthcare.org. Or call the Intermountain Healthcare Behavioral Health Services Navigation line, available from 7 a.m. to 7 p.m. at 833.442.2211.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.