Forget the pressure. That weight gain after childbirth is 100 percent normal

When Nina Gakima, got her baby in November 2020, she expected that the extra weight gained during pregnancy would fall off a few months down the line. 

It was a huge worry, when a year out, she was still 10kgs above her pre-baby weight. During pregnancy, she had added 25kgs on top of her 60kgs normal weight. One year down the line, her son was finally sleeping through the night, she was working out fairly regularly, and eating well, yet the needle on the scale would not budge.

Being 70kgs for her 5'5 inches might not sound like much, but it was bad weight. Nina was desperate to shed off the jelly donut that settled right around her middle.

It seemed unfair. "Why me? I had done everything "right". I had gone into pregnancy a normal weight. I was still breastfeeding, allegedly a huge calorie burner. And although I was tired and drained with a new baby and being back at work, I was managing to work out a few times a week," Nina, 28, says. 

"So why couldn't I get the weight off? What was wrong with me?" she constantly barraged herself. This weighed on Nina, especially after going through her Instagram reel and seeing influencers and celebrities who seemed to magically get back to the perfect weight after childbirth. 

Nina is not alone. Many women are in the same boat. 

So do all these women have a problem? Well, No. This experience is 100 percent normal. Experts say that getting back into shape after pregnancy takes time. Most women slowly lose most, but not all, of their baby weight for a full year after giving birth. That popular adage "nine months on, nine months off"? Yeah, not so much.

But the pressure to have a flat tummy after birth weighs on many modern women especially fueled by perceptions in the media mostly from celebrities and influencers. 

According to a 2017 study from researchers at the University of Illinois and Brigham Young University in the US, 46 percent of new moms are frustrated by their post-birth physique. According to the study, the biggest reason is unrealistic standards of the speed of bouncing back after childbirth, often accelerated by the media.

For some, this struggle becomes an obsession, as they try everything in the book, as fast as possible, for their bodies to go back to how they used to be.

That was the case for Suzie, a medical practitioner in Nairobi when her quest to get to her previous weight almost became an obsession. Last year Suzie who is in her late 30s gave birth to her set of twins via caesarian section.

She bore a healthy son and daughter. Of course, this should have been a cause for celebration, bearing in mind that for more than five years she had struggled to conceive.

However, while she was in awe of the existence of her babies, she did not feel the same sense of pride in her appearance. My stomach was swollen and honestly unsightly, while my midsection collapsed," she explains.

This, she says, was made worse with the fact that she kept coming across pictures of this celebrity who gave birth at the same time, but her body had gone back to normal. For this reason, she felt the pressure to be perfect and return to her previous self. And to recover, she says, she pushed herself, sometimes to a point of starving herself.

"I began dieting, contrary to the doctor's advice. I avoided red meat and fats. I ignored hunger cues. I often went to bed hungry, and I started working out."

It did not end there, she also took an extra mile when it came to exercising, sometimes spending hours at the gym. "I used to run five kilometers, thrice a week and sometimes would spend up to four hours in the gym working out," she says.

All this bore fruits. She recovered her body in less than four months; even before her maternity leave was over, receiving compliments from friends who were amazed by how she was able to achieve this.

But it came with a price, she says. "While I was busy worrying about my image, my babies were deprived of milk because with all the dieting and exercises, I wasn't able to produce enough milk. It was at this moment that I realised I had a problem, and that was the turning point for me," she explains.

For Becky, a housewife and a mother of two, the case was completely different. After giving birth to her son two years ago, she completely gave up when it came to her body image. "I gave birth via caesarian section and had to stay in the hospital for longer. The issue of the postpartum wrap was out of the question."

Things were made worse by her postpartum diet. "After being discharged from the hospital, my mother-in-law pitched a tent at my house, ensuring that daily I had to finish a five-liter jerrican of traditional porridge, and a bowl of black eyed peas (njahe). I did it for four months nonstop," she adds.

According to Becky she had a lean figure before birth and enjoyed wearing all types of outfits; be it a bikini or skinny jeans. But not anymore. "Being a stay-at-home mum now, all you can find me in are jumpers and tracks, and sometimes maxi dresses and skirts."

Her tummy, she says, is totally out of control and it hangs so badly. "I had to quit my job as a receptionist since my look was different from how it was previously."

She also has other issues to worry about as a result of her weight gain. "I have had problems with my husband who seems bothered with my weight. He wonders why I have been unable to shed the weight and especially the hanging tummy, contrary to what happened after the birth of our first child, five years ago."

For Sheila Nandwa on the other hand, the quest to get her body back was not only her mission but her mother's too. When she gave birth to her second-born daughter a year ago, her main worry was whether her body would bounce back, just as she had managed to do after the birth of her first child, eight years earlier.

Just as the first time she was lucky to have a normal delivery, thus she didn't have issues when it came to the postpartum wrap. "Immediately I gave birth just as our tradition stipulates, I had to move to my mother's house for the first two weeks so she could take care of me and the newborn," she explains.

And when she stepped foot into her mother's house, just as like the first time, she was met by tough weight rules. "My mother ensured that I ate a well-balanced meal every time, but other than the diet, my mother couldn't imagine seeing me with a hanging tummy. She bought me a postpartum belly band right away, and ensured that I wore it every time, even when sleeping," she says.

According to Sheila, it may have seemed harsh and a little bit inconsiderate considering that she hadn't fully recovered, but she believes it helped her regain her previous figure and confidence after birth. "At the moment, my only worry is stretchmarks," she says.

According to Dr. Martin Ajujo, a plastic, reconstructive & aesthetic surgeon at the Nairobi Metropolitan Services (NMS), many women struggle with bodyweight after childbirth, and this takes a toll on their psychology and self-esteem for some. This, he says, has pushed many into a quick fix to gain back their pre-baby curves as fast as possible. For those with financial capability, cosmetic surgery is usually the solution.

According to Dr. Ajujo, significant changes that lead women to require plastic surgery are weight gain, anterior abdominal wall muscle separation, and abnormal distribution of fat.

"Up to 60 percent of pregnant women will develop separation of muscle (rectus diastasis) in pregnancy. This combined with unfavourable deposition of fat in stubborn areas leads to a "big tummy" and requires reconstructive procedures.

Here in Kenya, Dr. Ajujo says, the mummy-make-over procedures are very common and account for 60 percent of plastic surgeons' aesthetic workload.

The common procedures that women come for, he says, include tummy tuck, which serves the purpose of both removing excess and sagging abdominal skin and, if present, repairing separated abdominal muscles. "Also there is the breast lift to restore the breasts to their pre-pregnancy position, breast augmentation to add back the volume that is typically lost after breastfeeding, and liposuction to remove stubborn fatty deposits gained during pregnancy that just won't respond to diet and exercise."

According to Dr. Ajujo, there are many women interested in mommy makeover procedures. "However, there are barriers such as awareness of the availability of the services in Kenya, cost, myth and misconceptions and stigma. An average of seven out ten women who come to her clinic for consultation eventually do the procedure," he adds.

Maryanne Wanza, a clinical dietician at Strathmore University Medical Center, says, prolonged weight gain after birth becomes a problem because some new moms eat more than what is required. "For instance, during this time some consume a lot of carbohydrates, unaware that this doesn't do any good as far as milk production. And at the same time it adds more calories," she adds.

According to Wanza having a well-balanced diet of whole grain, vegetables, fruits, proteins, and adequate fluid intake, is not only adequate for milk production but also ensures that the mother gets enough calories for milk production.

She says it is important to note that the amount of food needed after birth is not as much as portrayed. "Other than the diet, if possible, women should exclusively breastfeed during the first six months of birth, as it is also a crucial remedy for postpartum weight gain."

Studies are mixed on whether breastfeeding mothers actually lose more weight than formula-feeding mothers. And when studies do show a benefit, the added loss is typically small, only a kilo or two.

Prolactin–a key hormone involved in breastfeeding–also stimulates our appetites. You can blame prolactin when you suddenly find yourself devouring a jug of porridge.

Does breastfeeding never help? No, of course not. For some lucky women, breastfeeding does help. For others, it makes no difference. Or it even causes the opposite. Tennis star Serena Williams complained breastfeeding made her hang onto extra weight. 'I was vegan, I didn't eat sugar. I was totally eating completely healthily… and I wasn't at the weight that I would have been had I not breastfed… What I've learned is that everybody is different – no matter how much I worked out, it didn't work for me. I lost ten pounds in a week when I stopped [breastfeeding]," she said.

Wanza insists that it is important to get your body moving again, by doing light activities. "Normally, six weeks after birth, a woman is usually cleared to do many things. During this time, you can start doing light activities," she says.

According to Evelyn Owala, a personal trainer and managing director, Eveal Health and Fitness, one needs to still be mindful of their body which is yet to recover fully from the pregnancy. She says the biggest mistake many women do after birth is starting abdominal workouts, unaware that the body is yet to fully recover.

"Remember you're trying to adjust from pregnancy. The back is still very weak as it is trying to get back and do everything like normal people.

For natural delivery without any complications, eight weeks is a good time to give yourself. For the post caesarian section, three months is the best time. "But you can start small, perhaps with a 30 minutes walk. Those who are recovering from CS have to be careful because it takes time for the wound to fully heal," she explains.

After recovery, she says, instead of abdominal workouts, one could begin with compound workouts such as body lifts, squats, and lunges to engage more muscles. "Start very light, remembering you're feeling your body again. Remember losing weight is a process that cannot be achieved in one day."

Dr. Ajujo says, the solution is to maintain a healthy lifestyle before, during, and after pregnancy. "We encourage expectant ladies to be active and on a balanced diet. However, once the separation of muscle (rectus diastasis) has set it, a reconstructive procedure has to be done to bring back the muscles together. Without the repair, there would be a bulge (Ventral Hernia) that may later bring complications."

He says the cost will depend on the number of procedures, and the price ranges from Sh1.2 million to Sh2 million.

Another drag is your age. Women in their 30s usually hang onto more baby weight than women in their 20s. And this gets worse in your late 30s and early 40s.

Also not a myth. Losing weight, the second time around really is harder, notes experts. If this is not your first baby, expect some extra padding to settle around your middle. More babies equal a bigger postpartum belly. 

Is all this depressing? Sure. Also potentially reassuring? Maybe, yes. It's hard for most of us to completely shed our pregnancy weight. Knowing this means women can let go of absurd standards, like getting their bodies back in six weeks. 

Plus, experts say, realism can pave the road to acceptance. "Many of us learn to love our new, squishier, softer selves. A lot of mothers end up embracing their "new normal" as a badge of honour. (This body grew a baby!)," says Suzie. 

The truth is we may want to look like Kim Kardashian after childbirth but we are unlikely to look like her. Nor should we expect to. We are mere mortals, after all. And we don't have her team of nannies and night nurses, personal trainers, and private chefs.