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After giving birth, a woman’s body has to deal with any number of changes and challenges that can feel new and intimidating, from stretch marks to incontinence
The modern mother is often portrayed as calm, centred and being able to do it all: bond with her newborn, bounce back to her pre-pregnancy body, return to work in a matter of weeks... Meanwhile, she is also expected to balance her professional, family and personal relationships with a finesse that would put the world’s best diplomat to shame.
The truth is, as beautiful and transformative as the experience of pregnancy can be, most new mothers struggle to adapt to a whole new lifestyle with its new and intimidating set of demands on her time, emotions, energy and skills. As well as the stress and responsibilities that come with caring for a newborn, growing a baby for nine months and the birth itself can take a significant physical toll. For example, unwanted weight gain, stretch marks, hair loss, dry and sagging skin, bladder and pelvic floor weakness, stress incontinence and vaginal laxity are common postpartum, and they can negatively impact a woman’s mood, confidence and ability to handle her day-to-day existence.
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One of the most common changes that new mamas find hard to come to terms with is the creation of stretch marks. After rapid weight gain that stretches out the skin during pregnancy, dermal tears can occur over the breasts, buttocks and abdomen, causing discoloured and atrophic scarring. The best time to start treating stretch marks is early on, when they tend to be raised and red.
Evidence shows that popular home remedies such as olive oil, cocoa butter and vitamin E do next to nothing to reduce stretch marks, while creams with prescription levels of hyaluronic acid and tretinoin have shown some effectiveness. As with all scars, stretch marks tend to be permanent, but professional treatments at clinics—including chemical peels, microdermabrasion, light and laser therapies—can help improve and minimise their appearance.
Giving birth is also associated with loosened, saggy skin over the abdominal area. Once a new mother has recovered enough to allow gentle exercise, regular cardiovascular and strengthening exercises can help core muscles regain their tone—and the exercise-induced boost in endorphins is a plus. Women have also experienced good results from the combined use of visualised high-intensity focused ultrasound, radiofrequency and electromagnetic devices, and the injection of dermal biomodulators. These work synergistically to improve skin elasticity, firmness and texture by increasing collagen and elastin production.
The downward pressure of a growing uterus during pregnancy, in addition to vaginal or forceps-assisted delivery, can all cause weakening of the bladder, pelvic floor and vaginal muscles. This can result in postpartum incontinence and vaginal laxity, which can lead to insecurity, lowered self-esteem and less intimacy between partners. Treatments that can help include Kegel exercises, yoga and Pilates, which, with regular and consistent practice, can help strengthen vaginal and pelvic floor muscles. There are also CO2 laser or radiofrequency treatments, and high-intensity electromagnetic energy-based devices that induce muscular contractions in the vagina and deep pelvic floor for a tightening effect.
On occasion, mothers who have undergone Cesarean sections may have excessive connective tissue that forms within or outside of the borders of the surgical site, causing raised, red or itchy C-section scars. In the early months, silicone sheets or moist dressings can help to reduce the formation of such hypertrophic and keloid scars. Later on, injections of corticosteroid combined with vascular laser sessions can help diminish redness, flatten out the scar and reduce itching.
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Changes in skin texture and complexion are also common during and after pregnancy. Many new mothers discover patchy pigmentation of melasma, dry skin, and dilated capillaries or burst vessels over the face and legs. Pregnancy-associated pigmentation tends to fade in the months following delivery, but in some cases, using skincare products with ingredients that target pigmentation in conjunction with limited sun exposure can help treat postpartum discolouration. Meanwhile, dry skin, wrinkles and red spots can also be quickly treated with a combination of dermal injections, neurotoxins, lasers and light therapies.
Caring for a newborn can sometimes be overwhelming, and postpartum depression can occur in as many as one in five new mothers. A negative self-image can compound these feelings, but it’s important to be kind, give yourself time to heal, and know that there are many options to help you feel and look radiant again. All mothers deserve to find all the support they need to strengthen their hearts, souls and bodies for the wonderful and challenging business of caring for a new baby ahead.
This is part of a monthly column by Dr Lisa Chan, a Hong Kong-based general practitioner who has an avid interest in medical beauty. Dr Chan, MBChB (CUHK), MScPD (Cardiff), PgDipPD (Cardiff), PGDipClinDerm (Lond), DipMed (CUHK), DCH (Sydney), also holds a master's degree in practical dermatology with distinction at Cardiff University.
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