Long-term impacts of childbirth

Your breasts may look different after you’ve had a baby.

They start changing as soon as you get pregnant. They may get bigger, and the nipples and surrounding skin (called areola) often get darker to help your new baby find them. After birth, the blood supply to your breasts increases, and your milk comes in, making your breasts heavier and more full.

As your breasts get bigger, the ligaments that support them may stretch, and it’s this stretching that can lead to saggier breasts.

After your milk supply has settled, your breasts may return to roughly the size they were during pregnancy, and they’ll normally stay that way until you stop breastfeeding. If you return to your pre-pregnancy weight, your breasts may return to their pre-pregnancy size, too.

Your breasts might not be the same shape as they were before you became pregnant, especially when you first stop breastfeeding. After you stop breastfeeding, fatty tissue will gradually replace the milk-producing tissue in your breasts, and this will likely leave your breasts feeling fuller. Breasts change as we age, regardless of whether we have babies or not. Ligaments stretch over time, and breast shape can also be genetic – how we're made will determine the shape and size of our breasts.

Your stomach muscles and the skin on your tummy may be looser after you've had a baby.

Pregnancy stretches the abdominal muscles and the skin, and often leaves stretch marks and some loose skin.

Stretch marks usually fade over time, but sometimes the saggy skin stays. You can normally improve stomach muscle tone with exercise.

If your abdominal muscles separated during pregnancy (diastasis recti), talk to your doctor about safe exercise.

If you’ve had a vaginal birth and/or you’ve had tearing or an episiotomy (a surgical cut to enlarge the vaginal opening) during the delivery, it’s no surprise your vagina may look and feel different afterwards.

Penetrative sex can sometimes be quite uncomfortable or even painful, especially if you’ve had stitches.

Your vagina probably won’t return to its pre-birth shape, but how much it changes depends on:

• the size of your baby
• your genetics
• whether or not you did pelvic floor exercises during pregnancy
• the circumstances of the birth, like how long you pushed, whether forceps or suction were used, and whether you had tearing or an episiotomy
• how many deliveries you’ve had before – how toned or previously stretched your vaginal opening already is — each birth will likely stretch your vagina a bit more.

One in three women who've had a baby leak urine, especially if you sneeze, cough, run or jump. The pelvic floor muscles that support your bladder, uterus (womb) and bowel stretch 2.5 times their resting length during a vaginal birth, and more stretch is caused by a forceps birth, suction or pushing for a long time.

You can work on strengthening your pelvic floor muscles when you’re sitting on the couch, lying down, or standing at a desk and no one will ever know.

• Squeeze and tighten your back passage (imagine you’re stopping a fart).
• Squeeze and tighten your vagina like you’re holding a tampon.
• Squeeze and tighten your bladder as if you’re stopping the flow of wee.
• Hold the squeeze for a few seconds – you might only be able to do it for a couple of seconds until your muscles get stronger again. Later, try to count to 10.
• Relax and then repeat about five times.
• Try to do this several times a day.
• Keep breathing - don't hold your breath while you do these exercises. If you're pulling in your stomach or squeezing your bottom when you squeeze, you're using the wrong muscles!

Avoid doing pelvic floor exercises when you’re actually having a wee, as it might stop you from properly emptying your bladder.

These exercises can also help improve faecal incontinence (where poo escapes from the rectum). Around one in eight women who’ve had a baby have faecal incontinence or trouble controlling their gas.

Pelvic floor physiotherapy can help with incontinence. 

Around half of all women who have a vaginal birth have a prolapse – but many may not realise it. This happens where the walls of the vagina have been stretched, allowing one or more of the pelvic organs – bladder, uterus, or rectum – to bulge down into the vaginal area. Don't worry – it's treatable.

Treatment depends on the type of prolapse you have, your age, your symptoms, other health problems, and whether you’re sexually active, and includes:

• using a pessary – a removable device inserted into the vagina to support the pelvic organs
• pelvic floor physiotherapy
• changing your eating habits – for people with bowel problems
• surgery.

Talk to your doctor about which option is the best for you.