Postpartum Care

Introduction To Author Of Postpartum Care

By Baby Wit

Did you see about the postpartum commercial that got cut from the Oscars line up for being too graphic? It's a very real ad and brought me back to that period of time right after delivery. I did so much prep work for my baby but I completely neglected postpartum care for myself. It was a mistake. Taking care of yourself after giving birth can make a big difference for you and your baby and should not be neglected. I met Martha Synder online as a mentor and we bonded over a similar postpartum experience she had with her first child. Martha is certified by Bebo Mia Inc as a Doula and her expertise is in fertility support, labor & birth and, postpartum care. I am excited she is sharing her expertise regarding the fourth trimester.

What I'd Do Differently

By Martha Synder

About Me

When I became pregnant as an American living in Japan, I knew I would be in for a different experience than most. Giving birth can be a difficult process on its own. When you throw in cultural differences and a language barrier, it becomes even more challenging. 

I spent most of my pregnancy learning about and preparing for labor and delivery. I studied Western standard practices and what differences to expect in Japan. This preparation helped me through the labor and delivery process. 

But, I had completely neglected to prepare for the changes and challenges of postpartum. This time was difficult being so far away from home. I found myself very lonely. It made me wonder if it would have been easier had I also put time into postpartum preparation.

A few years later, I had my second child in the US and experienced a much easier personal experience. Since then, I’ve become a fertility, birth, and postpartum doula. My intent is to help others navigate the transition to parenting. Below are some of my tips for preparing for the postpartum period.

Take a breastfeeding class

I had looked through a few websites about what to expect with breastfeeding, but it was a much more difficult experience than I had anticipated. My first delivery was a bit difficult, with my son aspirating meconium during birth. They put him in an isolet for the first 24 hours after delivery. The clinic I was in gave me no support for breastfeeding and even discouraged me from trying until my milk came in. They gave him formula and I spent the first month of my son’s life trying to wean him from the bottle to my breast. It was a long, excruciating process with cracked and sore nipples, a lot of Googling, and hours spent on KellyMom.

Taking a breastfeeding course from a lactation consultant or IBCLC would have made things so much better! Most hospitals in the US have breastfeeding courses. There are independent lactation consultants or IBCLC that offer individual or group classes.

There are even online courses, like the one through Lactation Link that let you learn on your own time from the comfort of your own home. I also wished I had known about breastfeeding support groups. La Leche League is one great resource, and welcomes and encourages people to come and learn prenatally. 

Some groups even do virtual meetings, like the La Leche League in Vancouver. This can be helpful if you live somewhere without breastfeeding support. 

There are breastfeeding prep books that give you a solid understanding of what to expect. Breastfeeding Made Simple troubleshoots common breastfeeding problems and is one of my favorites.

If you are a black woman in the USA, our system has made it even more difficult to receive breastfeeding support. Don't let this deter you. There are resources out there to help you. Your breast milk is healthy food for your infant and it is free. 

Nourishing Foods

Many people make a lot of freezer meals or have people do a meal train. This is great but there’s so much more to think about than having food available. Postpartum bodies have different nutritional needs than other people, especially those breastfeeding!

I didn't even consider what foods are practical to eat one-handed while holding a sleeping baby.

While soup may be hearty and nutritious, it is not a couch friendly food. The First 40 Days is one of my favorite resources on postpartum food. It includes recipes made for postpartum women.

There’s also a great list of postpartum meals on this post from Lily Nichols, a dietician who specializes in perinatal nutrition.

Stocking up on quick and nutritious snacks can also be helpful. Breastfeeding bodies need 500 extra calories a day. Many mothers find themselves hungry all the time while breastfeeding a newborn.

Planning what foods you have in your house can help you maintain a healthy diet and sustain your energy. You don't want to resort to foods with low nutritional value.

Placing a stash of granola bars or trail mix near your breastfeeding spot can help make sure you’re well-nourished. A water bottle in your breastfeeding spot can also help make sure you’re getting plenty of water.

Stock up on Household supplies

The last thing you want postpartum is to find yourself out of toilet paper. Stocking up on common supplies can help you avoid emergency trips to the store. Especially while dealing with postpartum exhaustion when you are likely to forget why you went to the store in the first place.

I recommend buying several bottles of hand sanitizer to keep handy around the house. Spray it liberally on visitor's hands and carry one in your diaper bag.

Postpartum Recovery Kit

A lot of care goes into creating a baby registry for the items that you’ll need for your baby. But you will also need some items for your own recovery after birth.

While postpartum care items for mom aren’t as cute as the baby items you’ll get at your shower, they are important for a comfortable recovery.

Bleeding

When recovering from birth you may experience heavy vaginal bleeding that will taper down after about 10 days. You’ll need large maxi pads for vaginal discharge and bleeding called lochia. 

By the time you are home, you may still need extra absorbent pads for several days. You may continue to bleed up until your six-week postpartum visit with your health care provider.

You can take home any extra pads from your hospital room. Just make sure you have a package of overnight pads at home. Another option is to buy some sexy incontinence underwear. They are more comfortable and you don't have to worry about ruining your daily underwear.

Postnatal Care of Your Lower Area

• Padcicles-Soak pads with witch hazel and aloe and then freeze them to soothe your perineum after a vaginal delivery.
• Pain medication & Stool Softeners-Will keep you more comfortable, especially with postpartum bowel movements. These can be difficult for the first few days.
• Peri Bottle-Fill with warm water and spray to dilute your urine. This will stop stitches and minor lacerations from stinging.
• Sitz Bath-You can take an Epsom salt bath or get a specialized bundle of herbs from your local herbalist or a company like Earth Mama to promote healing.
• Hemorrhoids-Witch hazel in a small spray bottle, dermoplast, or tucks pads can help with your tender bottom.

Place all these items in a medium-sized box and keep them on the back of your toilet seat for easy access. If you have several bathrooms, you might consider making one for each bathroom.

Boundaries for postpartum guests

After the baby is born, everyone wants to come by and take in some baby snuggles and to sniff that intoxicating newborn smell. But, that may not be what is best for your recovery. I advise clients to think about their own personality and what they find restful.

Think about the kinds of people that request to come by. An extrovert might be craving conversation and welcome guests that want to sit and chat. An introvert may find that overwhelming and exhausting. Some guests might be great at helping out and leaving when you are getting tired. Other guests may expect you to entertain them and stay way past their welcome.

Discuss your preferences with your partner. If you set up guidelines for your family health, you can be more confident about scheduling. You are under no obligation to host other people, even if they are family members. A great phrase to use with persistent people is “I’m not feeling up to a guest right now, but in a week or two when I’m feeling better I'd love to see you.”

When guests do arrive, it can be helpful to state your expectations so that folks don't overstay. Throwing on a bathrobe before people come can be a great signal that the visit should be a short one. I also recommend having a list of ways that guests can help during their visit.

People will often offer to help, but it can be hard to come up with something specific in the moment. If you have a list of tasks (wash some dishes, bring me some water, put in a load of laundry...) you can direct your guest to your list where they can choose an appropriate task.

Do Less

A few weeks after delivery, our family of three trekked across town to a party at a friend’s house. I arrived excited to have an adult conversation but I spent the majority of the party trying to find a quiet place for my son to sleep. Or figuring out a comfortable place to breastfeed him. My mother came to Japan to see the baby. But her arrival made me feel obligated to show her our favorite sites around the prefecture. I finished my maternity leave worn out after so much activity.

While I’m not sure I would want to stay inside my home for several weeks postpartum as many cultures practice, I know I would plan to do less and rest more. I wish I had said no to more outings and spent the majority of my time at home resting and only gone out when I needed to or really felt I wanted to. A great way to gauge whether you’re doing too much is to monitor your postpartum bleeding. If you’re bleeding returns after stopping or gets heavier, that is your body’s way of telling you to slow down.

Be aware, if your bleeding is is ever very heavy (filling up a pad an hour for over three hours) or you have clots larger than the size of an egg, you should call your health care provider immediately as this could be a sign of postpartum hemorrhage or retained placenta.

Focus on sleep

I know people hate the cliche of sleep when the baby sleeps, but sleep is so important for healing and bonding with your baby. Penny Simkin in her book  The Birth Partner explains that you need to fully commit to getting sleep or else you will let other activities get in your way.

One of my favorite ways of doing this is staying in bed until you get the appropriate amount of sleep for the day. This may take some planning with your partner or other people. Especially if you have older children. But it is worth it to help you heal and have more energy when you are up. It may take most of the day to get in your eight hours of sleep, but as you and your baby settle into a routine, the time should get shorter and shorter.

Getting enough sleep helps combat the Baby Blues, postpartum depression and other Postpartum Mood Disorders. Be aware of postpartum symptoms that are warning signs of Postpartum Mood Disorders.

Postpartum Checkups & Health Care

Make sure to call your doctor and follow through on a comprehensive postpartum visit before the 12 week mark. It should include a full assessment of your physical, social and emotional wellbeing. You should talk to your doctor about care for your baby, feeding your baby, care of yourself, birth control & sleep issues.

The American College of Obstetricians in their 2018 Postpartum Toolkit lists various common complications from childbirth. These include urinary and anal incontinence, perineal pain and low libido. Hair loss is quite normal weeks after birth and your hair should return to its normal volume within a year. Remember, you are not alone.

Gather support

It is impossible to predict how you might feel and what you might need after your baby is born. It is useful to gather lists of people and activities that might be helpful before your baby is even born. Think of people like a chiropractor or massage therapist, who can help both you and your newborn recover from any misalignment from labor.

Having the name of someone that specializes in health topics around pregnancy and childbirth, postpartum, and newborns can be helpful should you need it.

A pelvic floor therapist should be on everyone’s list, and in some countries are part of standard care for everyone postpartum. A pelvic floor therapist can assess any damage or weakness and help you know what exercises to do to restore your body. You may have heard many mothers complain about peeing when they sneeze or cough, and while that might be common, this is not a normal experience. It is a sign that your body has not recovered. A pelvic floor therapist can help make sure you’re doing things like Kegel exercises correctly. They can fix or diminish any urinary incontinence you may be experiencing.

Postpartum doulas are trained in baby care, postpartum recovery, emotional and physical support, and many other specialized areas. Just as you might interview obstetricians and gynecologists, you can also interview postpartum doulas before your baby is born. You can hire one who can start the day your baby is born or one can be hired several months postpartum. If you aren’t sure you will need doula support, you might still want to interview a few so you know who you would want should you find you need the extra support. Postpartum doulas can come for as long or as often as you need and help build your skills and confidence as a parent.

Your individual life might have additional people you add to your list like a dog walker, house cleaner, or a therapist. If you need recommendations for local people that specialize in perinatal support, ask your care provider, local mom group, or doula for some recommendations.

When you feel up to venturing out, postpartum support groups and breastfeeding support groups can help you connect with other parents with similar aged children. When you get the OK from your doctor and feel ready for some exercise, you can look for postnatal yoga or a baby and me exercising group. Don’t discount simple and simple things like walking or swimming. These low-impact workouts can be the perfect way to re-engage your muscles in a safe and gentle way while your body is healing. You can also find many online exercise videos through professionals like Every Mother or videos on YouTube.

Just remember to listen to your body and stop if you get unusually tired, dizzy, or generally feel unwell after working out. Also remember the return or increased amount of lochia is a sign to slow down.

Remember too that recovery is an ongoing process and your body may never be exactly what it was before. It takes nine months to grow your baby. Expecting your stretch marks and baby weight to disappear in less than that time should not be a goal.

Addendum

Back to Work

By Baby Wit

Unfortunately, we live in a country that does not typically offer paid parental leave. A majority of postpartum women must return to work before they are ready. Companies with more than 50 employees must offer 12 weeks of unpaid leave. But, many of us can ill afford to go without an income for 3 months straight. In the USA you need a network of support that you can lean on to manage this difficult transition. Martha offers a return to work plan to help you navigate this change. If you are in another location search locally for a doula who can help you.

Photo by Raul Angel on Unsplash