Congratulations on your new baby! It is exciting to finish your pregnancy, but as your body gets back to your new normal, a lot of changes are happening. If you have scoliosis, spinal fusion, or back problems, you may have different symptoms than most new moms. Let me share some things that you can expect, as well as tips for recovery
Postpartum Anatomy and Physiology
Whether you have back problems or not, there will be major changes happening in your body over the next few weeks. Here is a brief overview of the anatomy and physiology underlying this period of time.
With a c-section, you have surgical incisions that need to heal. You will notice weakness in your musculature, especially where the incisions were made.
With vaginal delivieries, you may have pelvic floor tears, lacerations of your perineum, or episiotomies. There may be swelling and bruising in that area as well.
Your abdominal wall, after being stretched for 9 months, will be loose and lax.
Your uterus, which grew to 20x it’s normal size during pregnancy (wow!) will shrink to half it’s size in the first week, and by week 6 postpartum be back at normal size. As your uterus returns to its prior state, you will also experience bleeding, which will be fairly significant for the first week and will taper off.
Hormonally, your progesterone and estrogen that have been very elevated during pregnancy will drop significantly. Prolactin and oxytocin levels rise dramatically with delivery, and will stay elevated, especially with breastfeeding
Relaxin, a hormone that helps prepare your body for delivery and dilate your cervix during labor, levels will be high for the first week and it will continue to decrease over the next 6-9 months. This hormone is responsible for increased joint and ligament laxity that will affect your recovery.
Symptoms Specific to Scoliosis or Fusion
After all of that being said, you won’t be surprised by some of the symptoms unique to those of us with scoliosis or spinal fusions in this postpartum time. Here are a few of the more common challenges you might have.
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Back pain and muscle soreness
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The first few days postpartum you will most likely have more back pain, but don’t worry, it should improve quickly. Due to laxity in your abdominals and pelvic floor muscles, your lower back will be taking responsibility for more stability in your core which can lead to overworking and muscle soreness. Additionally, depending on how your labor went, you may have soreness from muscles you were using. For me, I was gripping my bed rail hard, and so had a lot of shoulder soreness for the few days after birth.
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This can be alleviated by using a stomach/core brace for the first few weeks. I like to use the Belly Bandit when I know I’m going to be up on my feet for extended periods and it greatly helps my low back.
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Also, my muscles in my hips and sides were very tight from working hard during pregnancy. Stretching them the first few days postpartum felt great.
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Numbness
- Depending on your scoliosis curve and/or fusion, you may have some sensory changes with pregnancy. For me, I have a sharp left curve in my upper thoracic spine, and have had numbness in my L shoulder blade for the past 18 years. I realized however, that this also has spread to my L chest, with decreased sensation there. It doesn’t cause any problems, in fact it has helped ease the discomfort of nursing and engorgement.
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Additionally, I had more numbness in my hands the last few weeks of pregnancy, especially with sleeping. This won’t go away immediately, but slowly returns back to normal over the next few weeks.
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Difficulty finding comfortable positions
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Due to high levels of relaxin from labor, your joints will be very loose the first week. It is important for you to rest and recover during this time, but you want to make sure you are positioned well to avoid stress/strain on your back.
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Avoid any sacral sitting, which is slouching or rounding your low back, for prolonged periods. This will cause soreness and pain that can travel down your legs.
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You probably will need to continue using pregnancy pillows and supports while sleeping. While your joints and abdominals are so lax, you will need extra support to help. Also, if you have a scoliosis curve, you should use small pillows or rolled towels to fill gaps to provide support your curve needs and allow your muscles to fully relax while you sleep.
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Diastasis Recti
- Due to decreased mobility in your back due to fusion, your body will find other places to spread your baby during pregnancy. If you have a shorter torso (like I do) due to surgeries and scoliosis, a lot of pressure will be put on your stomach. This may lead to separation of your 6-pack abdominal muscles, called diastasis recti. This will be prominent the first few weeks postpartum, but should improve with time as long as you take care not to strain it.
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Interestingly as well, due to increased abdominal pressure during pregnancy and birth, the tip of my xiphoid process broke with my first child. It hasn’t healed but doesn’t bother me too much. It wiggles and pops in and out of place with contraction of my abs.
Hopefully, your recovery goes smoothly. There are a few gentle exercises that you can start as soon as you feel ready. They won’t impede or slow you recovery, however if you feel like something is off, listen to your body. The exercises you can try are: posterior pelvic tilts, kegels, TA activations. Look for another post soon for more guidance on postpartum exercises with scoliosis and spinal fusion.
You’ve got this.
<3 Hannah