5 Things You May Not be Expecting Postpartum

1. You may leak a little urine.

Yeah, this happens. Your mom, aunt, cousin or friend may have joked about peeing themselves a little when they laugh, cough, sneeze or workout after giving birth, but it’s real.

1 in 3 women experience urinary incontinence (bladder leakage). And, guess what? This includes women who haven’t even given birth! Also, it includes celebrities like Shania Twain, who recently shared that she leaked while performing on stage.

“I stood up from my chair to get up and sing. I peed myself, and the puddle, I just knocked my glass of water over,” Shania Twain revealed on What Happens Live With Andy Cohen.

Here’s the thing about urine leakage: it doesn’t have to be permanent.

You don’t have to cross your legs every time you sneeze or stuff pads into your purse every time you leave the house. There are many options for treating urinary incontinence, like surgery, pills, or noninvasive at-home solutions. There are real treatments that greatly reduce or completely eliminate urine leakage.

The hardest part is finding a treatment that is safe, effective and not painful. Our advice: do your research and weigh your options. Also, always consult your healthcare provider before trying something new.

2. Your sex life won’t be the exact same.

Okay, we’re pretty sure you’ve heard this before, but do you know why sex isn’t the same after giving birth? Physically, your sex life will change post-childbirth for two reasons:

Weakened pelvic floor. Being pregnant puts extra strain on your pelvic floor muscles (the “hammock” of muscles that hold your bladder, uterus and rectum) causing them to weaken.

Loss of collagen in your vagina. Giving birth (especially vaginally) causes a stretching of the tissue in the vaginal canal. This stretching can cause decreased sensation during sex, or a feeling of “looseness” called vaginal laxity.

“Some of these vaginal changes result in a loss of collagen, when it loses its strength and structure. Some vaginal procedures can rebuild and renew this weakened collagen,” said Dr. Maria Canter, Urogynecologist of the Urogynecology Center Nova in Virginia.

Many women are opting for treatments to restore the tissue in their vaginal canal or for Kegel exercises to strengthen their pelvic floor muscles. It isn’t about aesthetic appeal, it’s about feeling and function and treating real medical conditions that diminish a women’s quality of life.

“My patients don’t come in to have their vaginas rejuvenated; they come in because they are having medical problems that need a solution,” Dr. Lauren Streicher, Medical Director of the Northwestern Medicine Center for Sexual Health and Menopause in Chicago, told Coveteur.

(Check out our post to learn the in-depth reasons why your vagina changes over time or after childbirth.)

3. Perinatal mood disorders affect 1 in 7 women and they’re treatable.

Perinatal mood disorders include postpartum depression, anxiety and OCD. While the most common is postpartum depression, a woman can experience any of these disorders.

What you need to know:

It’s normal. Giving birth is a major, life-altering event. In addition to being physically and mentally taxing, giving birth doesn’t usually go the way we plan. We create a birth plan, but our birth experience rarely follows a checklist.

It’s treatable. From therapy to support groups, to exercise, diet or medication—you have options.

It isn’t something to be ashamed of. More and more women are opening up about their postpartum mental health.

“I too struggled with postpartum depression after my first baby was born,” actress Sarah Michelle Gellar told People Magazine.  “I got help, and made it through, and every day since has been the best gift I could ever have asked for. To those of you going through this, know that you’re not alone and that it really does get better.”

4. You may have a checkup before 6 weeks postpartum.

Up until recently, a woman’s first checkup was at about 6-weeks postpartum depending on her birth. But the American College of Obstetrics and Gynecologists (ACOG) is changing postpartum care.

Instead of the standard “6-week check-up,” ACOG recommends a woman’s check-ups be comprehensive, timely and personalized.

Each woman’s pregnancy, labor and recovery are different, so shouldn’t each woman’s postpartum care be different? Also, we need more than one checkup after giving birth. And ACOG agrees.

“Postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual needs,” wrote ACOG in an official statement.

5. You may want to share your birth story and you may not.

Each person processes a major life event differently. Sometimes it helps to talk about the experience, but for others this doesn’t help. Either is normal and okay.

You may be extremely jealous of a friend/family member’s birth story, or you’ll want to brag about yours. Or, you’ll want to snap at people who ask you about your birth story. This is your experience and your choice.

“I don’t like how people assume that anyone who’s ever had a baby is just dying to discuss childbirth…I don’t want to tell you mine. I actually feel quite protective over the details of my son’s entrance into the world. To me, it felt like a private event. Invite-only. I am not interested in giving you the recap.” –Aubrey Hirsch, blogger for The Toast.