preparation

Preparing Well for Postpartum Recovery
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Preparing Well for Postpartum Recovery

The longer that I am a mom and midwife, the more I have come to realize how important it is to adequately rest and recover after giving birth. But this does not “just happen”…it takes some serious thought and planning!! Why is it that we spend hours and hours preparing for pregnancy and birth, yet no time or focus is given to what happens AFTER the baby arrives? With this in mind, I’m hoping that these questions and comments will help families to come up with a plan on how to cultivate an intentionally restful and healing postpartum period. I’d encourage you as a couple to sit down and talk about these questions, and figure out what you could do to be better prepared emotionally, mentally and physically for the initial 6 weeks after giving birth.

If you want to read more about some of my own favorite items to have nearby during the initial days postpartum, check out the link here

Reading and Preparation:

Let’s start with some book suggestions. We spend lots of time reading books about pregnancy and birth, right?!? So why not read about how to care for oneself postpartum? Here are some titles to get you started. I’ll note that I don’t endorse everything these authors share, but I do appreciate the way they help me to think through our thoughts and expectations surrounding postpartum adjustments and recovery.

Some Facts to Consider:

As you talk about your expectations for postpartum, it’s good to think about some facts, especially for the dads who wonder if it’s really necessary for mom to spend so much time resting! I love to show the new parents the placenta after the birth, which is generally the size of a small dinner plate. Picture a wound of the same size on the inside of mom’s uterus. Seriously! That’s the wound that needs to heal, and even though the uterus continues to contract and get smaller over those first days/weeks, there is a still a significant amount of healing that needs to happen inside. Add to this any amount of blood loss, any stitches/tears, the length of labor, swelling, and the amount of work it takes to push a baby out, and you can quickly see why it’s important for mom to take care of herself! All of a sudden the reasoning behind “not lifting anything heavier than your baby” makes complete sense, doesn’t it? Along the same note, almost anyone recovering from any type of surgery is usually given a two week minimum recovery time…new moms need AT LEAST that long!

As the postpartum days progress, mom’s body is going through a lot of changes, which include a drop in hormones from the expulsion of the placenta and baby, and a surge of more hormones as her body transitions into producing milk. Keep this in mind those first days…mood swings and emotional roller coasters are NORMAL. But it sure helps if you are expecting that as part of those initial days. And it’s good for husbands to know that this is a normal part of adjustment. Mom needs rest, understanding, and sometimes NO MORE VISITORS!

Another thing to remember is that you won’t be getting a lot of sleep those first few weeks. It’s good for baby to eat every 2-3 hours to establish good nursing habits and milk supply, but it does not contribute to a restful mom. Keeping life low key, and expectations to a minimum can really make a difference in allowing this time to be as stress-free as possible. Along the same lines, nourishing foods and lots of liquids are also hugely important in helping to establish a plentiful and healthful milk supply.

Lastly, try to view the postpartum period as a 6 week MINIMUM. I understand you may not be able to take that much “time off” of your normal home duties. But the longer you can rest and care for yourself in the initial weeks, I can promise you the better off your long-term postpartum experience will be. These initial 6 weeks your baby needs you as much as he needed you when he was inside, and this means an unpredictable schedule, lots of nursing, skin-to-skin time, and lots of cuddles. A slow re-entry into normal life will be beneficial to everyone, and lowering your personal expectations of this time can be a life saver!

Initial days postpartum:

  • Consider staying in bed for several days, getting up only to use the restroom, and perhaps joining the family for one meal a day. This can be beneficial for several reasons: visitors don’t stay as long if you’re in bed, you can sleep when baby does, and it reminds everyone that you are recovering!!
  • Prepare your room or a special corner ahead of time to make it a pleasant place for recovery. You’ll relax better if you find your space enjoyable and refreshing. Think about getting some special reading material or audio books together ahead of time to enjoy while you spend hours nursing your new baby. And don’t forget to have some comfortable clothes to wear that promote easy nursing access and yet allow you to rest well!
  • Limit visitors, and the amount of time that they stay. This can be dad’s job: remember that even if your wife loves people, new moms find extra company more draining than they initial expect. Short 10 or 15 min visits are sufficient, and this allows mom to not be separated from baby too long (since many visitors want to hold the new baby the entire time they are present).
  • Have nourishing snacks, foods and drinks gathered ahead of time: a new nursing mom is ALWAYS hungry and thirsty that first week!
  • Remember that your body is going through some major changes and may need some help: have some ibuprofen, nipple cream, icepacks, heat packs, hemorrhoid balm and magnesium available in case you need them.
  • Consider some ways to have meals taken care of: freeze some ahead of time, or ask a friend to organize a meal train or signup list where friends can bring food. It can be nice for the entire family to have meals provided for the first days/weeks as the whole family adjusts to the new baby.
  • If you have older children, it’s a good idea to think about how to implement the “no lifting” rule…sometimes it can be helpful to invest in a step stool that the older sibling can use to climb up beside mom so that she isn’t tempted to lift him or her up.

First Two Weeks:

  • An old midwife’s adage is “5 days in the bed, 5 days on the bed and 5 days around the bed”. While many moms balk at this amount of recovery time, it’s not a bad idea to consider! Mom will continue to bleed for around 2 weeks, and the longer she rests oftentimes the shorter the time she bleeds.
  • Continue to follow the “no lifting anything heavier than baby” rule until at least 2 weeks to maximize the uterine healing that needs to happen.
  • Keep stressful visitors to a minimum-this may mean telling well-intending friends and family that they need to wait to come see mom and baby, especially if that entails a lengthy visit of several days. Sometimes it’s hard for people to remember that mom is recovering and needs to spend time with baby, so this is NOT the time to be socializing and holding a newborn for hours on end.
  • Consider getting some household help these first weeks (longer if possible!). This would preferably be someone who can come and keep up housework, prepare food as needed, entertain older children if present, and take care of household duties so that mom can rest mentally as well as physically. As you consider this possibility, keep in mind that this works best if it is someone that mom feels completely comfortable with-sometimes this is a family member, but sometimes it is someone totally unrelated, and even hired for this express purpose. Talk honestly about what type of person would work best in your family situation. After my fourth child was born, we were blessed to have a girl who was willing to come spend 2 days a week with us during the first three weeks. This was sufficient time to catch up laundry, clean the house, and keep after work that wasn’t getting done, as my husband had a flexible work schedule the other days of the week. I found it much easier to rest when I knew the house wasn’t falling apart while I rested!
  • As you feel your energy increasing, start slow…remember that the sooner you jump in to “normal life”, the sooner everyone else will expect you to stay that way!
  • If people offer to help, take them up on it! An offer to babysit can mean an extra nap for mom, and many friends are more than willing to run get your groceries if they know you need something. Don’t turn any offers of help down!

Weeks 3-6:

  • This is when it can get hard to remember to rest. Even though you feel much better by now, remember that you need to go slow, and say no to anything extra in life, even if you FEEL energetic. Your baby still needs lots of time to nurse, and your body is still going through significant changes. One day you feel on top of the world, and the next you are in the dumps…all of this is part of your body learning to regulate it’s hormones again! There are supplements you can take to help with this-check with your midwife if you experience lots of these swings.
  • Start slow with exercise. It’s best to wait the full 6 weeks before engaging in anything specific to rehab, but I do encourage moms to get out in the fresh air and start taking slow walks if they are having minimal or no bleeding by week 2 or 3. Put baby in a stroller or in a carrier, and stroll. Don’t push yourself, just give yourself the chance to get some sunshine and fresh air.
  • Make sure you are taking your prenatal vitamins and consider adding some extra Vitamin D and Evening Primrose Oil to help with hormonal balance.
  • Try figuring out a way to get just a little bit of time to yourself each day…perhaps your husband can take care of the children while you slip out for a short walk, or perhaps you can meet up with a friend for coffee (and let her hold the baby!), or even get a chance for a short nap by yourself. These things can help with managing the mental load, and can be a big step in preventing postpartum depression.
  • Find a friend you can talk with and share with as you go through the many adjustments during these weeks. It’s always reassuring to be reminded that this stage of life doesn’t last forever, and you will sleep again someday!
  • Continue to get help with basic household duties as you can, and don’t turn down the offer of food!
  • Consider trying to get some intentional time as a couple: the unique stress of this period, combined with mom’s unpredictable hormones, interrupted sleep, and all the other factors can add some significant stress on your marriage. Getting away for an hour (with baby in tow) to concentrate on your relationship can really help you to navigate this time and grow stronger in your relationship.
  • Eat nourishing, healthy foods, and don’t worry about weight loss while your body is establishing milk supply!

 

In closing, I’d love to hear what you would add to this list? What was most helpful to you when you were anticipating the arrival of your little one? What helped you recover? Please share your tips and input!

Preparing for birth-some excellent resources!
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Preparing for birth-some excellent resources!

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I love collecting birth resources-be it books, DVD’s, magazines, articles-you name it! The only problem is, with the limited amount of “extra” time I have (or don’t have!), I don’t always get a chance to preview and read the resources I collect right away. And I find myself hesitant to pass along information to clients and friends that I haven’t read or previewed myself.

    This winter I’ve found myself in the remote hills of Arkansas, with more time on my hands than usual, as my husband is teaching at a small winter Bible School for young people. Keeping the children occupied is my main job here, but with the absence of our usual activities and schedule AND having all our meals provided, I’ve enjoyed the chance to finally dig into some of the resources that have been sitting on my shelves at home waiting for me to get to them.
    So, with that introduction, I want to mention a few EXCELLENT resources that would be worth any of you expectant moms, or anyone wanting to learn more about birth, to take time to watch or read. I can’t believe I’ve had these around this long and didn’t realize what treasures they were!
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The first one I’ll mention is the Parent Class DVD by Spinning Babies teacher Gail Tulley. I’ll confess that this one I have recommended to clients as I’ve taken one of her classes in person myself, and know she has alot to offer. But I didn’t realize how many jewels were in this educational presentation! It was a great refresher to me as a midwife, as Gail does and excellent job of teaching you how to help “make room” for your baby in your pelvis, and help your entire body to function more efficiently with less discomfort. The only drawback with this DVD is that, while she is teaching this class to a participating group of expectant couples, she does get fairly technical with some of her explanations. But in the long run it is helpful, as I think it helps you to get a better idea of WHY some of her positional suggestions and exercises help to eliminate certain issues. Using a great variety of teaching aides, examples, charts and object lessons, Gail shows you how exactly the uterus, baby, brain and body all work together, and how you can help. This would be great DVD for an expectant couple to watch together, or for any midwife or doula to watch in order to give you some great ideas of how to help your clients through specific issues and achieve better positioning for babies. It is well worth the $ you would need to invest, in my opinion! You can find out more about Gail, and purchase this DVD here.
    Next in my pile of resources was a book by Ina May Gaskin. If you’ve been in the childbirth realm long, you’ll recognize this name as one of the most famous midwives in the USA. Ina May has been practicing since the 1970’s, and is probably most well known for her involvement with births on “The Farm” in rural TN. People have come from all over the world to have their babies in this community that has come to be known for it’s amazing work with natural childbirth. I’ll admit that while I’ve appreciated many of the things I’ve read or heard taught by Ina May, I was still a bit skeptical of her book “Guide to Childbirth”. I think I was expecting it to have a real “back to earth” or “hippie” type flare, which I know can turn off families who are looking for evidence-based and scientific information on preparing for birth. I was in for a big surprise! Ina May’s Guide to Childbirth has been amazing. Written in an easy-to-read manner, it is full of so much helpful information. Starting with birth stories to help women realize that birth is both natural and do-able, it then proceeds to teaching you about the things you really need to know about how your body works, how to care for yourself during pregnancy, how to understand tests and the “whys” behind them, helpful suggestions for choosing both caregivers and birth locations, ways to prepare for labor, and the list goes on. I love her honest, down-to-earth style of writing, yet all of her information is based on evidence, research, and studies, and she includes citations and information for further study. If you are wanting just one book to help you understand pregnancy and prepare for birth, this one is it. And it’s not just for moms planning to birth at home-there is information in this book that would help anyone to be better prepared and ready for the amazing experience of labor and delivery.
    The last resource I’ll mention here is a DVD that was given to me by one of my clients. She had purchased it during her last pregnancy, and wanted to pass it on to other moms when she was done with it. “Practicing for an Active Birth”  is basically a childbirth class presented by Instructor Neri Choma by Birth Coach Method. While Neri could probably be a bit more dynamic in her teaching style (I’d suggest watching 30 min. at a time-the DVD is about 2 hrs. and 15 min. long), she does a very good job of helping  you to understand the process of labor and the terms used to talk about each stage, and gives couples LOTS of great position and relaxation techniques. Using charts and models, she helps you to learn how to visualize what is happening during each stage of labor, and how you might be able to help facilitate comfort and relaxation during each stage, working together as couples. While I think that it is best for couples to take a live childbirth class whenever possible, this would be an excellent option for those who might not have that opportunity in their area.
    I personally feel like much of preparing for a great labor and birth involves understanding how your body works so you are not tensed with fear of the unknown. If you KNOW what is happening, understand WHY you are experiencing certain sensations, and have IDEAS for what to do and when, you and your partner will be able to relax and work together much better. Moms (and dads!) that are prepared tend to do much better emotionally and physically through the marathon of labor. I would strongly recommend you look into any or all of these resources as ways to prepare for a wonderful experience of bringing your baby into the world.
    I’d love to hear about what worked for you. Do you have any favorite resources you would care to share with others? Tell us about it in the comments! And consider sharing  this post with your pregnant friends to help them hear about ways they can prepare for labor and birth from the comfort of their own home.
Some Recommended Reading
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Some Recommended Reading

As we’ve headed into a new year, I’ve been taking the time to update old records/files/paperwork, etc. One of the fun things I’ve updated is my current library list. While the internet can be an excellent resource for many topics, I still enjoy a good book that can stay on my nightstand, or be read while I nurse baby (one of the best things about having a nursing baby is getting guilt-free time to sit and read a book!). This past year I was introduced to a number of books that I had not read before, and I thought it’d be fun to share a few of those titles to you, in case you’re looking for something new to read!

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One of the library shelves in my office

  • Ina May’s Guide to Breastfeeding by Ina May Gaskin: I found this jewel at a thrift store this summer, and picked it up just because of Ina May’s name. It’s a great resource to have on hand if you’re wanting some extra help or information on breastfeeding issues. One thing I appreciated was that she actually dove into the issue of tongue-ties causing nursing difficulties, which is something that many manuals on breastfeeding overlook. Overall, this book was a great easy-to-read book that I would recommend adding to your home library!

 

  • Pushed: The Painful Truth about Modern Maternity Care by Jennifer Block: This book is not your “feel-good-warm-and-fuzzy” type, but if you’re in to making informed choice, and understanding the politics and protocols that go on behind the scenes, especially here in the US, this is an eye-opener. Jennifer explores the history behind different changes to the maternity care scene, how insurance companies dictate much of hospital’s protocols, how our lack of understanding our bodies and understanding the normal function of birth contributes to the rise of interventions, the limitations in so many areas of good alternative care options, and more. While it can be a bit depressing at times, it was definitely educational, and helpful in understanding risks vs. benefits of different medical choices.

 

  • The Official Lamaze Guide: Giving Birth with Confidence by Judith Lothian: While this one has been around for awhile, I had never taken the time to pick it up and read through it. I found that it really wasn’t all about a particular “method” for birth, but more about understanding how your body works, and how to work with it. Clear, concise information written in an easy-to-read style, with birth stories to boot.

 

  • Cut, Stapled, and Mended: When One Woman Reclaimed Her Body and Gave Birth on Her Own Terms After Cesarean By Rosanna Rosewood: This one deserves a disclaimer-while the story was fascinating, I don’t recommend or agree with everything this mama pursued in her quest for a VBAC. However, this book helped me to understand many of the challenges that brave VBAC mothers must make as they recover, heal, and prepare for birth from an emotional, spiritual and physical standpoint. I found it valuable as I seek to help mothers who desire a VBAC without having personal experience.

 

Besides the mentioned books, I’ve encountered a few new resources that I would heartily recommend:

  • Spinning Babies DVD’s: The Parent Workshop & Daily Essentials. Gail Tully, the instructor of these DVD’s and the brains behind the Spinning Babies website, has so many tips, suggestions and information to offer-and it all helps to make pregnancy more comfortable, understand your body, and encourage baby to be in good postion…which ultimately helps your labor, birth and recovery to go so much smoother! If you haven’t spent time on Gail’s website, it’s worth looking in to!

 

  • VBAC:Know the Facts by Jen Kamel: Jen has compiled an immense volume of research and facts surround VBACs, and presents them in a fascinating seminar that can be taken online or attended live. This 6+ hour seminar addresses subjects such as myths, actual research results, how and why different hopsitals have different protocols, what complications can increase risks (and how to avoid some of them!), and the list goes on and on. If you are considering a VBAC and have questions, or just want to learn more about the subject, this would be a very worthwhile investment. I learned so much from it!

 

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More books…and they don’t all fit here, either!

This past year I had a friend who contacted me-she was newly pregnant, lived in another state, and wanted to know where to start in figuring out what she wanted for her pregnancy, birth, caregiver, etc. What a list of questions! And where do you start?!? So I’ve been on a quest to find factual, evidence-based information to help new moms in making decisions and sorting through all the myriads of opinions and information. If you have a resource that was particularly helpful to you, I’d love to hear about it! Feel free to comment (below), leave a message on the facebook page, or send me an email at: gentlemidwife@gmail.com. I’d love to hear from you!

And if you want to check out my updated Recommended Reading/Library List, feel free to look at it here:  https://gentlemidwife.wordpress.com/recommended-reading/  Remember, clients have access to this library as part of their maternity care package!