Soon after Sharon Oakley gave birth in 2018, acquaintances were quick to congratulate her on her appearance. "Oh, you look really good – you've really bounced back!" she says people told her within months of having her baby.
She may have looked like she'd 'snapped back'. But the reality was different. While she had lost most of the weight she’d put on during pregnancy, physically, she was suffering. An avid runner, Oakley, a Canadian who lives in Yorkshire, UK, loved jogging with her son in the stroller, a routine she took up six months after giving birth. But she'd leak urine the whole way. Back at work, she started experiencing bladder leaks in the office, too.
After a complicated diagnosis journey that included a six-month wait for a physiotherapist referral, Oakley was diagnosed with bladder, rectocele and uterine prolapses – where the pelvic organs, not adequately held in place by a weakened pelvic floor, slip out of their normal position.
Four years later, her condition has improved. But she still has occasional leaks. She carries spare knickers with her everywhere. She worries when she runs. For a while, she thought she might have to quit her job.
"It is a very strange part of our culture where we gauge a woman's postpartum period in terms of how they look, rather than how they're feeling," says Oakley. "I look fine – but I have these birth injuries that I'm still navigating every day."
Stories like Oakley's are far more common than they are talked about publicly. While not always symptomatic, pelvic organ prolapse alone affects up to 90% of women postpartum. Urinary incontinence, which can also be caused by a too-tight pelvic floor, scar tissue or nerve damage, is experienced by about a third. Diastasis recti, where the abdominal muscles that separate to make room for a growing belly haven't yet knitted back together – something which can make the belly look like it bulges and cause pain, constipation and urine leaks, as well as make walking or lifting difficult – affects 60%.
And even in the absence of specific pregnancy or birth injuries, the drastic physiological changes that happen during pregnancy, labour and postpartum – from the hormones that tell the body to hold onto fat stores, to pressure on the pelvic floor, to the nutrients being siphoned out of the mother's diet to feed a foetus or breastfeeding infant – mean that it takes time to recover and heal.
But many women find that, once the baby is born, the messaging they're getting isn't to rest and recover. It's to 'snap back' into the bodies and behaviours they had before getting pregnant.
In the media, postpartum celebrities' bodies are dissected based on whether they have or haven't lost weight, with little or no knowledge of what other conditions the person might be dealing with. Diet and fitness programmes aimed at mothers abound, relatively few of them led by experts on postpartum health. Friends, family and even colleagues often make comments about a mother's physical appearance. And while 'dad bod' – referring to a man with an 'average' physique – is having a celebratory moment, the people who actually give birth rarely enjoy the same latitude.
For some mothers, the pressure to lose weight quickly, combined with inadequate medical support and care postpartum, can be a toxic, even dangerous mix – one that can make birth injuries worse and healing harder. It can also take a toll on both mental and physical health in one of the most vulnerable, sleep-deprived, emotionally turbulent periods of life.
Inevitable changes
Becoming a mother means more than entering a new life stage. It is a transformation of one's life, mentality, even identity.
For many women, it's likely to be the first time they've been completely responsible for a small, vulnerable human – one who needs them nearly constantly. It also might be the first time they haven't worked or are financially dependent on a partner. Particularly in countries without adequate parental leave or childcare support policies, they may be contending with financial stress. And when, or if, they do return to their careers, mums often feel pressure to project an image that motherhood hasn't changed them – often to avoid the ‘motherhood penalty’, in which women see their wages and job prospects suffer. That's even though it’s well known that becoming a parent not only affects people’s priorities (and makes things like, say, late nights at the office more challenging to juggle), but even changes the brain.
All of this is happening, of course, at a time when many women are more exhausted than they've ever been. They're recovering physically from pregnancy and birth. And more than a quarter are experiencing mental health challenges like postnatal depression or birth-related PTSD.
Yet on top of all these omnipresent stressors, mothers are contending with the pressure to 'bounce back'.
Many cultures, especially in the West, put immense pressure on postpartum women to look like pregnancy, birth and motherhood never happened – and quickly.
"Many new birthing parents feel that they have to do a lot to prove that their pregnancy didn’t change them or their bodies at all," says Dr Jennifer Lincoln, an obstetrician-gynaecologist and lactation specialist in Portland, Oregon, US. This is an "unattainable reality for many", she says, yet women still internalise this pressure – and sometimes push their bodies to the brink in dangerous ways.
"I’ve seen people who started up exercising just a week postpartum who then had issues with cervical and uterine prolapse because they went too hard as well as had increased bleeding," says Lincoln, who is also author of the book Let’s Talk About Down There: An OB-GYN Answers All Your Burning Questions… without Making You Feel Embarrassed for Asking. "I’ve also had birthing parents who were breastfeeding but who cut down their calories too drastically and their milk supply tanked."
Even in a healthy, uncomplicated pregnancy and delivery, the body changes a great deal. Many of those physiological changes mean that a return to vigorous exercise or cutting calories needs to be undertaken with caution. Other physical transformations may be here to stay, making bouncing back an impossible goal.
First, of course, there is weight gain. "When you’re pregnant, you have a surplus of all these hormones that tell us to hold on to this weight because we need it," says Jenna Perkins, a women’s health nurse practitioner and expert in pelvic floor disorders practising in the Washington, DC area. "We need these fat stores around our belly to protect our sensitive uterus and the baby that’s growing inside."
Meanwhile, the muscles in both the abdominals and the pelvic floor are stretched paper-thin. Carrying a foetus, and the stress of vaginal delivery, puts increased weight and pressure on the pelvic floor. Even the bones move: during pregnancy, the pelvis tilts and becomes, on average, around 2.5cm wider.
Many women also undergo the common procedures and injuries that can result from pregnancy and labour – not just pelvic organ prolapse and diastasis recti, but healing from a C-section or perineal tear, for example. This can take longer than what many women are told; six weeks after a caesarean section most caesarean section scars haven't fully healed, and the abdominal fascia, which holds organs and muscles in place, has regained less than 60% of its original strength.
All these changes and possible outcomes, say experts, means that the idea that women can physiologically return to their pre-pregnancy body within weeks of giving birth is inaccurate at best, risky at worst.
In Indiana, US, Shelby Alley says she started experiencing the pressure of snap-back culture before even giving birth in 2022. "My boss at the time, even before I had my baby, was like, 'Are you so excited to get your body back?' And that was such a bizarre thought to me, because I'm literally growing a human. My body is more mine than it's ever been. But that was when I first felt that pressure," she says.
She internalised the messaging – and changed the way she treated her body as a result. "Once my son was here, it was like, 'Okay, I don't have to keep feeding my body because I'm not growing another human. I can start limiting my diet'," she says.
But when she began to cut calories, the first thing she noticed was that her breastfeeding supply decreased. "I went from an oversupply – I could pump about eight ounces – to barely making enough for my son. He was nursing every hour; he didn't seem full," she says. Already sleep-deprived from life with a new-born, she felt even more exhausted. Her mood dipped.
Alley no longer restricts food, but still feels "guilty" sometimes about not having lost all the weight from her pregnancy. "It was hard reconciling what the world wants you to be, versus what nature needs you to be," she says.
‘I’ve lost all this weight – you should, too’
Despite these realities, the messaging women face post-partum is clear: restore your body, and do it as quickly as possible.
The emphasis on postpartum weight loss stems from a number of factors. But at its heart, bounce-back culture springs from our ideas of modern motherhood in general, says Sophie Brock, a motherhood-studies sociologist in Sydney, Australia and the host of the podcast The Good Enough Mother.
"Mothers are subject to certain social rules and expectations in ways that those who are not mothers are not," she says. "'Bounce-back' cultural pressure is an example of that. Mothers are expected to be able to erase any physical evidence of ever having children, while devoting their 'all' to their children – while trying to fulfil the competing pressures and demands of what it means to be a perfect mother/wife/worker.” But, she adds, "it's not possible – we're asked to fulfil competing ideals and can never be 'enough'".
Celebrity culture is both a symptom and a cause. Some celebrities, like model Emily Ratajkowski, seem to have had flat abs just days after giving birth. Other high-profile stars have shared details of their weight loss publicly, down to their diet and workout plans. And when celebrities haven’t immediately returned to their pre-baby bodies, the media often spotlights these women as different or exceptional. That constant focus means post-partum bodies endure as a topic of conversation – sometimes becoming the centre of public opinion, regardless of the context in which these articles are presented.
"You see Rihanna at the moment being called out for not losing her baby weight, or being praised for not losing the baby weight," says British television presenter and social-media influencer Ashley James, who gave birth to her first child in January 2021. "Why is it even the main topic of conversation?"
Some experts believe that, while originating in predominantly white, Western societies, bounce-back culture has gone global. Surabhi Veitch, a physiotherapist and postpartum fitness coach based in Toronto, Canada, says she increasingly sees the pressure to lose weight experienced by clients of all ethnicities and nationalities.
This, says Veitch, "stems from white supremacy culture, where whiteness or Eurocentric standards of beauty are the norm. I see this impacting white women, Asian women, Indian women, black women". When India-born Veitch was a child, she says it was "better to be a bit bigger, to be curvier… But now, as India has absorbed more of these Western ideals, there's this pressure there to be thin, to have those flat abs". She adds she’s also observed this for other Asian cultures, such as with the Korean, Chinese and Japanese women she works with.
Product marketing also plays a role in creating pressure. Social media and Google are awash in advertisements for boot-camp workout classes and diet plans aimed at mothers. There are even physical products positioned as ‘solutions’ to restoring pre-baby bodies.
Margo Kwiatkowski, an orthopaedic and pelvic floor physiotherapist in Ventura, California, points to the popular use of belly binders – compression belts for the abdomen that some women use after birth. "They're not going to shrink your belly," she says. But her dislike goes beyond that. "A lot of the belly binders that are sold online and marketed to post-partum people are legitimately like a corset", she says, which can potentially make a prolapse worse.
As much as any individual person might not want to 'buy in' to bounce-back culture, it is hard not to be affected at all, says sociologist Brock. She compares the ubiquitous messaging that surrounds us to living in a 'fish-tank' of motherhood. "We can't 'jump out' or make ourselves immune from its influence," she says. "Culture plays out through our families, relationships, careers, institutions, what media we're exposed to, etcetera. So, some will be able to build/develop/have more ‘immunity’ to this messaging than others."
One person who has found that these messages took a toll is Lucy Kingsford of Cambridge, UK.
When her son was born in January 2022, Kingsford had an episiotomy, a common procedure where the perineum is cut during childbirth to make way for the baby. The stitches became infected. The pain was so excruciating she couldn’t sit down without an inflatable ring. “I couldn’t even lie down properly. If I would walk for more than five minutes, it would open the stitches up. I was on three different rounds of antibiotics and had to stop breastfeeding because they were making the baby ill,” says Kingsford. Let alone return to her pre-baby body, it took four months for her to start walking again.
Despite all she’s been through, she also feels barraged by cultural pressure to snap back – a reality that’s left her feeling defeated, now eight dress sizes larger than she was pre-pregnancy.
“These new-born days are hard enough as it is. And then you’ve got the media just churning out article after article, saying, ‘Oh, these celebrities look great just a few weeks post-baby’. But the worst ones are from ‘normal’ people, not celebrities, saying ‘I’ve lost all this weight – you should, too’,” she says. “I had postnatal depression quite badly, and I don’t think seeing these articles on Facebook helped.”
In the case of Alley and others, bounce-back culture is often reflected back to them even by close family members, who emphasised Alley’s weight throughout her pregnancy. “No-one should feel like they have to bounce back so quickly after having a baby. I know that I went too hard to fast,” she says. “I think that if I had had a more supportive community, or a community at all, in general, who told me ‘Hey, everything’s going to be fine’ – I think I would have been a better mother, sooner.”
Another woman who has been vocal about the consequences of bounce-back culture on women’s physical and mental health is influencer James. “I remember I was like, ‘Six weeks is done, I’m going to get my GP check and I’m going to go for a run again’,” she says. “My pelvic health physio said, ‘Can you just come and see me before you start running again?’ … And that was when she diagnosed me with prolapse. She said if I’d have carried on running, it would have actually been dangerous, because I’d have made the prolapse worse.”
Fortunately, says James, she went into pregnancy and postpartum having already worked on her relationship with her body – largely due to reaching a prior low period, around 2014, where she had panic attacks before events because she was worried she looked "enormous".
"When I got pregnant, I was excited, because I was like, 'Bring on the changes'," she says. "I've got lines on my tummy from where the skin is stretched, but I actually quite like them … I like the idea that your body is almost like a tapestry by mother nature, and all the little scars you have from different stories of your life, and bearing your child.”
But sentiments like James’ remain the exception, not the norm.
'My husband actually took away the scales'
Of course, there is another reality: for many women, no matter how much they exercise or diet, their bodies will not return to how they were before pregnancy.
This is normal, says Veitch. "I often talk about postpartum as puberty. We don't go through puberty and expect our bodies to look like they did when we were nine or 10. We know our bodies have changed permanently," she says. "In pregnancy or post-partum, we're not changing as drastically, but there is a massive change. And most women will not go back to looking exactly how they did."
But in a culture that prizes the snap-back and makes it sound as if bouncing back is accessible and healthy for every woman, not having a slim physique and a body capable of everything it was before pregnancy can feel like failure.
Even women who prioritised bouncing back and think it was, overall, positive have mixed feelings. Before falling pregnant, Hannah Lucy Galliers of Gloucestershire, UK, had always made fitness a "big priority". But among Covid-19 lockdowns, gym closures and pregnancy, she says, "I didn’t recognise who I was anymore – I didn’t recognise my face in the mirror." After healing from a C-section, she was immediately back at the gym.
"I’d always use exercise to regulate my mental health and it was really important to me to get that back," she says. But, she says, she’s been motivated by wanting to look thin, too.
It's been hard to find a happy medium. "When I started to get upset that the scale hadn’t gone down, or had increased slightly, my husband actually took away the scales because he didn’t want me to make myself more ill," she says. "It can become very obsessive, because we live in a society where women’s values are determined by the number on the scales."
James, who has been part of the resistance to snap-back culture on social media with posts celebrating her body’s changes, points out that the focus on a post-partum person's weight isn't just risky for mental and physical health. It's also a bizarre reversal of how women tend to be treated during pregnancy.
"It's nine months of growing a baby where everyone tells you how glowing you are and how lovely you are. And then afterwards, they're a bit like, 'Ew'," she says. "It shouldn't matter how you look on the outside. It should be like, 'Wow, thank you for bringing life into this world.' Like, 'Are you okay?'"
Source: BBC