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“I was shocked by how swollen my face looked.” What you need to know about postpartum swelling

Why do I look so puffy after giving birth?

Postpartum swelling, also known as postpartum edema, is a common condition after giving birth. It affects various parts of the body, but it’s particularly noticeable in the feet, ankles, legs, hands and face.

What are some signs of postpartum edema?

Some common signs of postpartum edema or swelling include:

  • Swelling or puffiness of the tissue directly under your skin, especially in your legs or arms.
  • Stretched or shiny skin.
  • Skin that retains a dimple (pits), after being pressed for several seconds.
  • Increased tummy size.

What causes it?

Postpartum swelling is caused by the body retaining extra fluid during pregnancy and after giving birth. These are some of factors that contribute to fluid retention:

  • Hormonal changes: Hormonal shifts during pregnancy, especially changes to estrogen and progesterone, can lead to changes in fluid balance. These hormones (which are high during pregnancy) rapidly plummet immediately after giving birth. This causes the body to release excess fluids, leading to swelling.
  • Increased blood volume: The body produces extra blood during pregnancy to support the growing baby. After delivery, the body gradually reduces this increased blood volume. However, it is a bit of a slow process which is why you might still look swollen.
  • IV fluids during labor: Intravenous fluids are often given to women during labour to maintain hydration and help manage the delivery process. This infusion of fluids can contribute to temporary swelling post-delivery.
  • Lymphatic system changes: The lymphatic system, responsible for draining excess fluids from tissues, might be temporarily compromised during pregnancy and after childbirth. This can result in a slower removal of fluids from the body.
  • Physical changes: The pressure exerted on blood vessels and the uterus during pregnancy can affect circulation. After delivery, as the body adjusts to its non-pregnant state, circulation gradually improves, which can lead to fluid shifting and subsequent swelling.

Is it normal?

Most postpartum swelling is normal and tends to resolve within a week or two after delivery. However, severe or sudden swelling, especially when accompanied by other symptoms like high blood pressure, headaches, or vision changes, should be taken as a red flag. Get in touch with your GP or midwife straightaway if you are experiencing these symptoms.

How long does it last?

Postpartum swelling typically peaks around 2-5 days after giving birth. It then gradually reduces and usually fully resolves after a week or so. For most women, the puffiness tends to subside within a week of delivery. Here’s a rough timeline:

  • Immediate postpartum period (first few days): Swelling tends to be most pronounced in the first few days after childbirth due to fluid shifts and hormonal changes.
  • First week to two weeks: In the subsequent days after delivery, the swelling gradually decreases. By the end of the first week or into the second week, many women notice a significant reduction in swelling.
  • Two to six weeks: While most of the swelling subsides within the first couple of weeks, some residual swelling might persist for up to six weeks postpartum.

What are the risks of postpartum swelling?

Postpartum swelling, while common and usually harmless, can sometimes indicate underlying complications. The risks associated with postpartum swelling primarily revolve around distinguishing normal swelling from more serious conditions that might present with similar symptoms. Here are some potential risks:

  1. Preeclampsia: In some cases, severe swelling after giving birth might be a sign of preeclampsia. This condition is characterised by high blood pressure.
  2. Deep Vein Thrombosis (DVT): Postpartum women are at a slightly higher risk of developing blood clots, especially in the legs (deep vein thrombosis) due to changes in blood flow and increased clotting factors during pregnancy. Swelling accompanied by pain, warmth, or redness in one leg could indicate a blood clot.
  3. Infection or inflammation: Swelling, especially in the perineal area after vaginal birth or around the incision site after a C-Section, can sometimes be a sign of infection or inflammation. It’s crucial to monitor for signs of infection such as increased redness, warmth, pain, or discharge.
  4. Other complications: Severe or sudden swelling accompanied by high blood pressure, headaches, visual changes, or difficulty breathing might indicate other complications like postpartum eclampsia or heart issues. These conditions require immediate medical attention.

While these risks exist, it’s important to note that the vast majority of postpartum swelling is normal and resolves on its own within a week or two. However, being aware of the signs of more serious conditions and seeking prompt medical attention if experiencing severe or concerning symptoms is crucial to rule out complications and ensure appropriate care.

How long will my stomach stay swollen?

The duration of postpartum stomach swelling varies among women. Factors such as the woman’s body type, the number of pregnancies, the type of delivery (vaginal or C-Section), and individual healing processes all contribute to the timeline for recovery.

Immediately after giving birth, the uterus starts contracting to shrink back to its pre-pregnancy size. This process, known as involution, begins soon after delivery and can involve after-birth pains. Initially, the uterus is still enlarged and feels firm. Over the first few days and weeks postpartum, the uterus steadily decreases in size.

Here’s a general timeline for postpartum stomach changes:

  • First few days: The uterus contracts and starts to reduce in size. However, the abdomen might still feel swollen, and there could be some retained fluid.
  • First week to two weeks: Many women notice a significant reduction in stomach swelling during this time. The uterus continues to shrink, and postpartum fluid retention gradually decreases.
  • Two to six weeks: By around six weeks postpartum, the uterus typically returns to its pre-pregnancy size. Stomach swelling should diminish considerably by this time for most women.

Engaging in gentle postpartum exercises that target the core muscles, maintaining a healthy diet, staying hydrated, and allowing time for the body to heal can aid in reducing stomach swelling and restoring muscle tone. However, it’s essential to be patient and not rush the process, as the body needs time to recover from pregnancy and giving birth.

What should I wear?

Comfort is always the most important criteria when thinking about any postpartum clothing, but especially when dealing with postpartum swelling. Loose, breathable, and comfortable clothing is best, especially because you’re likely to feel a bit sore everywhere, regardless of how you gave birth. (Reminder: giving birth is a bit like a marathon, it requires proper rest and recovery!)

Opt for loose-fitting clothes, stretchy waistbands and comfortable underwear. Maternity clothes are also great in the postpartum stage as they provide support in the last places and have a bit more room too. A belly band can provide extra support for the tummy area and compression socks will also help reduce swelling in the legs and feet.

What can I do to manage the swelling?

Postpartum swelling should gradually ease on its own but there a few little self-care things you can to help manage any discomfort:

  • Rest and elevate the legs.
  • Stay hydrated.
  • Gentle exercise, like walking.
  • Avoid tight clothing and wearing comfortable shoes.
  • Avoiding prolonged sitting or standing.
  • Eating a balanced and healthy diet.
  • Limiting salt intake.
  • Compression garments, like compression socks or belly bands.
  • Gentle massage or lymphatic draining techniques.

If you notice the swelling become more severe, painful, or accompanied by other concerning symptoms like high blood pressure, severe headaches, or visual changes, contact your midwife or GP immediately.

How can lymphatic massage help?

Lymphatic drainage massage is a gentle technique that aims to stimulate the flow of lymph. Lymph is the fluid that helps remove waste and toxins from the body while also supporting the immune system. The massage involves light, rhythmic strokes that follow the natural flow of the lymphatic system.

The massage technique encourages the movement of excess fluids and waste products through the lymphatic vessels. By promoting lymphatic circulation, this massage technique can help to reduce fluid retention, improve circulation and reduce inflammation.

It’s essential to consult with a qualified massage therapist or healthcare provider experienced in postpartum care before undergoing any massage therapy, especially after childbirth. They can provide guidance on when it’s safe to start massages after delivery and ensure that the technique is appropriate for your specific postpartum recovery needs.

Sources

Details

https://www.webmd.com/baby/postpartum-swelling-what-is-it

https://www.nhs.uk/pregnancy/labour-and-birth/after-the-birth/your-body/

https://www.nice.org.uk/guidance/ng194/chapter/recommendations#postnatal-care-of-the-woman

Birthbabe does not provide medical advice, diagnosis, or treatment. the resources on our website are provided for informational purposes only. you should always consult with a healthcare professional regarding any medical diagnoses or treatment options.

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