Feet, body hair, and those pesky stretch marks
Pelvic floor Pelvic floor is a nice term for the "down there" region where so much of the action of childbirth takes place. This area, also called the perineum, can change drastically after vaginal births. Instead of looking like a pencil point, the opening of the cervix will look more like a fish mouth. The vagina will be larger after serving as the interstate for a seven- or eight-pound baby. The clitoris also often remains enlarged after pregnancy, according to Angier. One of the repercussions of all this is incontinence; about 25 percent of postpartum women suffer from it. "The perineum is like a lawn chair. When you have a lot of weight sitting there for a long period of time, it begins to sag in the middle," says Dr. Irwin. The sagging of muscles leads to less control over the bladder and even the anus. Pregnant women know they should do their Kegel exercises to strengthen the pelvic-floor muscles, and Kegel slackers are punished by slacker muscles. Still, certain factors that are mostly out of a woman's control may put her at more risk for pelvic-floor damage. They include prolonged pushing during labor, a forceps or vacuum delivery, large babies, and episiotomies.
Feet Fourteen years after the birth of her first child, Tina Moody still has dozens of pairs of shoes that she outgrew by half a size, but refuses to let go of. "No one told me that every shoe in my closet would become too small after my pregnancy," says Moody, a therapist from Dripping Springs, Texas. Who knows how many pairs of shoes are sold every year to restock postpartum women with exaggerated extremities? According to researchers at the University of Vermont College of Medicine, feet don't actually get longer or wider during pregnancy. But the volume of the foot increases due to fluids retained by your body -- 6.5 extra liters on average, some of which pools at the feet and then sticks around -- along with extra fatty tissue.
Spider and varicose veins Months of carrying around the additional load of pregnancy can take its toll on the legs in the form of spider veins, and their uglier cousins, varicose veins. Spider veins, dilated blood vessels, can look like tiny red and blue sunbursts. Varicose veins are larger, dilated veins that may stick up above the skin surface. "Estrogen relaxes the smooth muscles in the veins, which can cause them to dilate," says Diane Berson, M.D., a Manhattan dermatologist. In addition, blood volume during pregnancy increases by more than a pint, and veins expand to carry the extra blood. The tendency to develop spider and varicose veins is hereditary, and both usually remain after pregnancy. The best preventive step, especially if you have a family history, is to wear support hose during pregnancy, which helps keep blood vessels from stretching out. Also, avoid standing for long stretches, prop your feet up when possible, and exercise to help circulation. Spider veins can be diminished by a dermatologist, who will inject them with a saline solution. The treatment for varicose veins is more complex. Problem veins can be blocked, stripped out, or removed by laser surgery.
Stretch marks Fifty to 90 percent of pregnant women suffer from stretch marks -- those squiggly lines that look like so many lightning bolts and are often found on the abdomen, buttocks, thighs, and breasts. Some are reddish and purplish, others become white breaks in the smooth surface of the skin. Brought on by the rapid weight gain and loss during and after pregnancy, stretch marks are caused by a breakdown in the connective tissue of the skin. There's little that can be done about them, so think of them as mementos of your fertility! Special creams during pregnancy can alleviate the itching that sometimes comes with the stretching, but won't prevent the marks. Retin A may help fade stretch marks, but you should never use it during pregnancy or while nursing. And laser resurfacing isn't usually effective, either.
Skin changes Other reminders of your pregnant days that have staying power include the linea negra, the dark line from the pubic area to the sternum that often develops as estrogen and pro-gesterone increase, which may never quite disappear. "You can also see an increase in benign growths during pregnancy," says Dr. Berson. The most common are skin tags -- extra dollops of skin that develop wherever you have folds in the skin, such as underarms and the stomach -- and angiomas, which are clusters of blood vessels near the surface of the skin that appear as round red dots. A dermatologist can easily remove skin tags and angiomas.
Body hair About 5 to 8 percent of women have more body hair after pregnancy, showing up in inconvenient places such as the chin and the nipple. "This is because progesterone -- one of the two pregnancy hormones -- contains some of the male hormone androgen," says Dr. Hoskins. Fortunately, excess hair can be removed by plucking, shaving, or -- more permanently -- by electrolysis. Head to toe, these changes of motherhood can be devastating and deflating. The best treatment? Looking at the smudged and smiling faces of your kids, and knowing that you wouldn't trade anything, not even the bulges, sore back, or bigger feet, for the experience of being a mom.
Jeannie Ralston is a Parenting contributing editor and mother of two boys, Gus, 8, and Jeb, 6.