While most new moms know that a baby will change their world, few are prepared for the emotional and physical challenges that follow childbirth. Women are often embarrassed or ashamed to talk about the less attractive side of giving birth—postpartum anxiety, anger and hormonal imbalances, and physical pain and loss of strength—leaving new moms feeling unprepared and alone in their postpartum distress. While these issues are more commonly discussed than they used to be, there continue to be misconceptions that need to be addressed.

“As a system, we need to do a better job at creating an environment where women feel safe to be honest about their feelings after having a baby,” says Alexa Anne Weeks, licensed master social worker and therapist for Tree of Hope Counseling in Rochester, N.Y. “It is normal to have troubling or scary thoughts as a new mom and we need to help women deal with those feelings.”

PPD comes in many forms, including feelings of anger, anxiety and numbness. Some women experience insomnia and even memory loss. However, PPD is not the only challenge facing new moms. New moms also experience physical discomforts like painful sex, uterine pain, hair loss, postpartum bladder incontinence and other related symptoms, says Dr. Tera Conway, a physician at Zubritzky & Christy OB/GYN Associates in Pittsburgh.

Just to Name a Few

Many new moms experience postpartum uterine pain, which can last for several days after the baby is born.

“Most women will experience some degree of cramping,” Conway says. “The main reason is that the uterus is working very hard to get back to its normal state so it uses contractions to do that.”

Conway says that women who try to do too much, too quickly after childbirth may experience more intense cramps. Therefore she recommends moms take it easy for a few weeks after giving birth.

Because a woman’s hormones increase during pregnancy many will find that their hair looks better than ever. However, once the baby is born that often changes.

“There is a rapid decrease in hormones that happens postpartum. That hormonal shift can lead to hair loss,” Conway says. “We recommend women stay on their vitamins for a couple of months after their pregnancy and throughout the time they breastfeed.”

In the first weeks after having a baby, a woman’s hormone levels change dramatically, which can reduce their libido. Some women also experience pain during sex, which makes them reluctant to have sex postpartum.

“Your body has gone through a lot of changes in the postpartum time,” Conway says. “Women who give birth vaginally may have scar tissue that makes intercourse painful and women who are breastfeeding may experience vaginal dryness that makes it uncomfortable.”

Find Support

No matter what symptoms a woman may experience after having her baby, physicians and counselors recommend seeking professional assistance from a medical doctor and even a counselor. Also consider finding a network of moms who are likely having similar experiences.

“Childrearing was not meant to be done in isolation,” Weeks says. “Find someone whom you feel most comfortable talking to, someone who understands you well outside of this experience. You can’t get help without first being honest about the help that you need.”