We hear this all the time.

"Your vagina will become loose after giving birth."

I really do think this is a myth,

and one that we hear quite a bit.

[sighs] My favorite.

"Once you have one C-section,

you'll need to keep having them."

One C-section doesn't mean always a C-section.

I'm Dr. Laura Riley,

and I'm the chair of OB-GYN at Weill Cornell Medicine

and NewYork-Presbyterian Hospital.

I'm a high-risk obstetrician,

otherwise known as maternal fetal medicine specialist.

And I'm Dr. Dena Goffman.

I'm the chief of obstetrics at Columbia University

and NewYork-Presbyterian Hospital.

I'm also a maternal fetal medicine physician,

and today we will be debunking postpartum myths.

"Your baby bump disappears after you give birth."

We wish.

Your baby bump is probably going to last

several weeks after birth,

so don't bring anything too tight

to the hospital to go home with.

You still have the baby bump because your uterus

does not completely contract down to its normal size

after having a baby.

There is normal weight gain in pregnancy,

which isn't lost immediately.

Decrease in bowel function.

Everything needs to sort of take time

to move back towards normal.

So don't be discouraged if it takes time

for your baby bump to disappear.

"Your vagina will become loose after giving birth."

There may be changes in the short term.

And they'll say, "Oh, it just doesn't feel right."

You know, my answer to that

is just give it a little bit of time.

The blood flow to the vagina is great,

and so it's going to heal really quickly.

Those lacerations will heal,

but it may take a little bit more time

for some of the swelling to go away,

but that's going to all get better within weeks.

The other thing I would add

is that there are muscles in the vagina,

and those muscles may not have been used as much

during a nine-month pregnancy

or the immediate postpartum period,

but they can also be strengthened and improve over time.

"You can have sex right after childbirth."

So, this is a myth.

I can assure you that you won't want to have sex

right after childbirth,

no matter what your birth experience is.

For most patients,

this isn't something that they're thinking about doing

in the immediate postpartum period.

Yeah. I think that there's kind of two parts to this.

One is comfort.

It's unlikely that you'll be comfortable.

But the other reason is sort of a safety thing.

If your cervix is open, which we know it will be,

our concern is that the organisms in the vagina

will get into your uterus and increase the likelihood

that you get an infection.

And so that's part of the reason that we tell people

don't have intercourse

until the bleeding is completely stopped.

Oh, boy. OK.

How bad is it?

"Breastfeeding will come naturally." Oh.

Many patients after having gone through

pregnancy education, childbirth education,

and lactation education

still feel like they're supposed to know how to do this

as soon as they have their newborn in their arms.

And I would just really want to debunk that myth,

that somehow we're born to know how to breastfeed.

I remember my own frustration.

I thought, "I've been a physician for six years.

I've done all the education,

and I've educated other people."

And I get this baby, and the breastfeeding,

it felt like a disaster.

Breastfeeding is a process.

You got to be patient with yourself,

you got to be patient with your baby,

and sometimes it's working and you just don't believe it.

The way you know that the breastfeeding is working

and your baby's getting enough is weighing your baby.

You'd go to the pediatrician, and the pediatrician says,

"Your baby looks beautiful."

Maybe he's gained a little bit of weight,

or your baby's not continuing to lose weight,

and your baby's not jaundiced.

All those things point to the fact

that the breastfeeding is working.

And I think sometimes our patients feel like

because it's breastfeeding

that they're single-handedly responsible

for this piece of the newborn's life.

I like to make it a team sport

where everyone's participating,

to have someone else do some of the other stuff,

the burping, the changing, putting down to rest,

while you actually get some rest

so that your body can do this important work.

"Breastfeeding will help you

lose all the baby weight quickly."

You do need to increase your calories,

but most people will burn somewhere

around 800 extra calories a day in breastfeeding.

That is going to help you lose the weight.

I just wouldn't say

it's going to help you lose all the weight.

Breastfeeding is wonderful, but it's not magic.

Patients will come back at the six-week visit,

"Why am I still holding on to this?"

It took you nine months to put this weight on.

It's going to take some time to take it off.

Four months, six months for most people.

Is it normal for nursing to hurt?

It's not normal for nursing to hurt.

It shouldn't be excruciating or painful.

I think there are discomforts in the initial period.

Getting your newborn to latch appropriately

is a new sensation,

and then the first time the milk lets down,

that's another new sensation.

I hear what you're saying,

but the very first time that baby latches properly

and puts a huge amount of suction

on an area that is incredibly sensitive,

that is not nice.

I think that that's pain,

but the issue is it initially is uncomfortable,

and then it starts to get better.

It shouldn't continue to hurt for weeks.

So if it is seriously painful,

that's when you want the consultant to come in and say,

is this baby properly placed?

Because if the baby isn't properly placed on the nipple,

it really will hurt.

You can get little cuts.

You don't want to go down that road.

I tell people to get frozen peas.

That cold will help reduce

some of that discomfort and engorgement

and will actually conform to your breast,

and you can just plop them right into your bra.

"Your milk supply can't be improved."

Your milk supply can be improved.

Your body makes milk

when it perceives the need for milk.

So the more you put the baby to the breast

or a high-quality pump

that can do almost as well as a newborn

to drain what's currently in the breast

is the signal for your body to make the next batch of milk.

You just have to keep feeding, stimulating,

telling your body that there's a baby here who needs milk,

and your body will make it.

Your body learns that habit,

which is just fascinating to see and to have experienced.

It really is about breastfeeding regularly, pumping,

and then paying attention to the fact

that hopefully you're not dehydrated,

you're not overly stressed,

you're not running around doing all these other things

that can make it hard for your body to continue to keep up.

"Breastfeeding makes your baby clingy and dependent." Myth.

This is definitely not true.

Breastfed babies end up needing you for those feeds,

but the feeding doesn't mean that they need you more.

If you're exclusively breastfeeding

for the first eight or 12 weeks of a newborn's life,

they will be with you during those feeding sessions.

They're very frequent when they're little.

I don't think that necessarily means

that the babies are needy or clingy,

it's just a function of the fact

that that's where the breast milk is.

Once breastfeeding is well established,

there is definitely a role to pump

and have someone else feed breast milk in a bottle,

offload some of that breastfeeding

with other support people and family members.

The next myth is, "You shouldn't nurse if you're sick."

Not true.

There's very few instances where we will say

you should not nurse.

If you're sick, the good news

is that you are developing antibodies

to whatever it is that made you sick.

Those antibodies then get into the breast milk

and are transferred to your baby

and will actually protect your baby

from getting that same infection.

I think we've learned a lot in the last year and a half

about hand hygiene. If you're sick,

you should use those hygiene strategies

and continue to nurse your baby

so they get the antibodies that you're producing.

And we would suggest that you breastfeed

unless you're told otherwise.

"Breastfeeding will prevent pregnancy."

So, this is another myth

that we've certainly seen people get in trouble with.

So, breastfeeding is not a form of contraception.

It is not a reliable form of birth control.

When you're exclusively breastfeeding

in the early postpartum period,

you are less likely to resume menstruation and ovulation.

But when that resumes for different patients is different,

and it's very hard to predict.

And so if you are having unprotected intercourse,

even if you're breastfeeding,

there is a chance that you will conceive.

We've unfortunately seen people

who have conceived and not realized it

because they were under the impression

that this myth was true and that they were protected.

Breastfeeding is not a form of contraception.

We have a whole list of other opportunities for you.

"Everyone gets postpartum depression."

Postpartum depression is quite common,

more common than we previously recognized or acknowledged,

but definitely everyone does not get postpartum depression.

Riley: People who have anxiety

or depression prior to pregnancy

are at particularly high risk.

Postpartum depression

is really something to keep on your radar

for those first six to eight weeks

and not something that you should dismiss

if it doesn't happen right away.

Although a few people will get postpartum depression,

more people will actually experience baby blues.

Baby blues we think of as feeling down in the dumps

or very emotional or very anxious

for about 10 days, max two weeks, after the delivery.

So if you're still feeling super anxious,

really depressed, not normal in your own skin,

I think that it's really important to speak up

if it's three weeks after the delivery,

four weeks after the delivery.

And while we think postpartum depression

does have a hormonal component,

it doesn't mean that the support person

is free of that risk.

So I think that's a more recent recognition on our part,