Weight loss after childbirth

We were two weeks away from her due date when my patient asked me how soon after the delivery she could start exercising again. It came as a bit of a surprise since up until that point my efforts to encourage physical activity had for the most part been ignored. She was concerned about losing her pregnancy weight.
We discussed that exercise after childbirth is safe and is important. The timing to some extent depends on the mode of delivery. That means whether the delivery was vaginal or through a cesarean section. Most physicians recommend six to eight weeks of recovery time after a cesarean section. After a vaginal delivery the timing depends on how the mother feels but probably two to four weeks after delivery would be reasonable. If the delivery happened to be complicated by tears or episiotomies then a discussion with the physician or the midwife is warranted.
Many women enjoy and relish the transformation that their bodies go through during pregnancy. Most of them however cannot wait to get back to their pre-pregnancy or even lower weight. That’s why I am asked a similar question quite a lot.
According to the Cochrane library review of the literature, weight retention after pregnancy can contribute to obesity. It is suggested that women who return to their pre-pregnancy weight by about six months have a lower risk of being overweight ten years later.
This review also indicates that probably a sensible approach would be to achieve this weight loss through a combination of diet and exercise.
Diet in this case does not mean severe calorie restriction. In order to see a sensible approach go to http://womenshealth.about.com/cs/breastfeeding/a/nursingdiet.htm .
Since my children were born I have tried to do something that doesn’t always come naturally. I have tried to exercise regularly and with a smile on my face! This is for the hope that they will see this as a normal part of daily living and not a torture to be endured either for health or weight loss.
I am a firm believer that starting your exercise routine in the postpartum period will help you reach your pre-pregnancy weight as well as act as a life lesson for your newborn.

Life after baby

Our son was born on September 5th 2001 at 10pm and the next six weeks seemed much tougher than either one of us had expected.
I am an obstetrician and therefore used to being up at all times of the night. Prior to the arrival of my son I would dismiss comments such as “you better catch up on your sleep while you can”. After all I had been through a tough obstetric residency and how much worse could this really be.
My wife had to be induced and so we didn’t really sleep much the night before the delivery. We were just too excited. This would eventually add to our feeling of total exhaustion by the time our son was born. I clearly could not have been nearly as tired as my wife (before anybody comments that I wasn’t the one who carried and pushed the baby out!).
Our son was 8lbs 11oz and because of his size needed some supplementation with formula immediately after delivery. This was so that his blood sugar wouldn’t drop. My wife wanted to breast feed and I told her that this shouldn’t cause any problems. I was categorically contradicted in the morning by our nurse who told us that she could not breast feed since our son was used to the bottle now. Our son had “nipple confusion”. My wife burst into tears since we had clearly failed as parents and he wasn’t even a day old.
I was recruited to clear my son’s confusion. I had a syringe full of milk draped over my shoulder which was attached to capillary tubing. This tube rested on my pinky which was meant to imitate a nipple. Perhaps if I wasn’t as tired I would have protested a little more emphatically. As it was we kept trying and eventually were sent home.
The constant attention that the little person needed was shocking. Days and nights blended into each other and for the first couple of days neither one of us wanted to admit how overwhelmed we were. Then we felt guilty if we did acknowledge how hard this was. This would mean we were unfit parents. After all when you have your baby you are supposed to be overjoyed and walking around with a constant smile on your face. You know like the ones on the cover of magazines.
Thankfully at the same time I found a support group. Not an official one but a group of wonderful physicians who used to supervise residents with me one afternoon a week. They all had children of different ages and told me that neither our experience nor our feelings were unique. It was just unbelievable that no one talks more openly about how overwhelming being a new parent can be.
Since then I try not to forget to have a talk with first time parents before they deliver. I still see that look in the faces of many women when they come back to see me after the delivery. That pale and sleepy look. They tell me how tired and overwhelmed they feel but after every sentence remind me that they love their child. As if to make sure that I don’t judge them for complaining. I tell them our story and that they are not alone. I also recommend mom and baby support groups.
Sometimes the feelings of anxiety and sadness last beyond the first few days and weeks and that is the time to call your doctor or midwife to make sure you are not suffering from postpartum depression.
Our son is soon to be eight and we have a daughter who is five. It would be silly to try and find a word that describes how much we love them. We gladly work hard to take care of them and appreciate everyday what they have added to our lives. We also make sure to tell expecting parents that the first few weeks can be tough.