Archive | 2011

Transformation Through Birth

One of my favorite birth books is Transformation Through Birth. Written in 1984 by Claudia Panuthos, who also wrote the excellent book Ended Beginnings (about miscarriage, stillbirth, neonatal death, and healing all sorts of childbearing losses), it is one of the books I recommend as “going beyond” typical pregnancy/birth book material. I enjoy books that are designed to help women with the emotional work of pregnancy instead of just the physical work, with a quick dabble into the psyche. I find they are few and far between.

Some quotes and ideas from this book that I particular like:

“In some sense, childbirth is much like a marathon. Once given some general guidelines, marathon runners know how to breathe, to run, and to complete their race according to their own body signals. Similarly, women know how to breathe, to birth, and to complete the delivery according to their own body signals. Marathon runners who are true champions are free to stop the fast pace, and even quit the race without loss of integrity.”

She then makes the point that birth is really more like a “Zen marathon” in that “the focus is to become centered and one with the body, to remain on purpose and directed toward a single goal and to act from the witness or higher mind within” and goes on to say, “Because we view marathon running as an expression of ultimate physical health, a similar attitude toward childbearing may greatly aid in the altering of present attitudes that respond to childbearing as an abnormal condition requiring medical treatment.”

I use the marathon example in my birth classes usually—particularly when talking about “pain” and what birth feels like. I use the marathon analogy to illustrate how the sensations of birth are not like the sensations of accident, illness, or injury, which send us pain signals indicating something is wrong. There is nothing wrong with birth! (well, usually) The sensations of birthing are more similar to the feeling of healthy muscles working hard and working for a long time, but doing something of which they are fully capable.

I’ve posted about this before, but the marathon talk reminds me of something one of the doctors in the Business of Being Born film said that made me really outraged. He said something to the effect of: “in three months you’re just going to be pushing a baby in a stroller, so what difference does it make how you gave birth?” What difference does it make?! Would anyone even THINK to say something like that to a marathon runner or Olympian—“in three months, you’ll just be pushing a baby in a stroller, who cares that you won a gold medal?” (analogy side note, feeling good that you won a gold medal [gave birth in a triumphant and empowering way] does not invalidate or cause guilt in those who did not run the marathon, or had to quit early, or needed help finishing. There is no shame in not running, but there is also rightful PRIDE and “glory” in finishing the “race” you set out on.

Okay, back to the actual book! Another good quote, but one I have a mixed reaction to:

“Women who birth joyfully do so because of who they are, what they believe, and how they live.”

While I like the sentiment, there is an unintended subtext of—if you did NOT birth joyfully, it must be because you have a sucky life in general and does not take into consideration the millions of factors that go into any one birth (it isn’t JUST about what the individual believes and how she lives, it is also about what those around her believe and how they live, and also what our culture believes about birth).

That said, the book is very compassionate with regard to cesarean birth experiences, stating:

“For the woman who delivered surgically, her task is to see that she was attempting to save her baby’s life through an act of personal courage.”

I love this re-framing—it isn’t a failure to have a cesarean birth, it is often an act of personal courage.

The final element I love from Transformation Through Birth is the author’s concept of encouraging and preparing for postpartum EXPRESSION instead of postpartum depression (the theory being that stuffed down, unexpressed feelings, moods, conflicts, emotions contribute to depression by repression of expression. That’s my own bit of alliteration there–I’m so catchy! 😉

Pushed Thoughts

Feb23

If you are looking to get fired up about about birth activism, I recommend reading the book Pushed by Jennifer Block. This book is seriously GOOD! Lots of weighty, meaty information, scathing critiques, astute observations, and clever commentary. She has plenty of scientific backup for her claims and the book is written in an engaging, fast paced style that skillfully weaves facts into descriptive commentary and personal, illuminating interviews. I originally checked this book out of the library, but after seeing all of the data contained within—she pulls together vast quantities of data about effectiveness of “routine” practices, etc. and makes it accessible to the average reader—I quickly ended up acquiring two copies (one hardback and one soft cover, both autographed from when Jennifer was our featured speaker at FoMM‘s annual Cookie Day event!).

Yes, I was a geeky fangirl in the Capitol rotunda in 2009 when Jennifer Block spoke at the annual Friends of Missouri Midwives Cookie Day event.

Pushed is a thorough critique of obstetrics as an industry and how women and babies are being HURT by the systems ostensibly in place to “protect” them. Especially thought provoking is Block’s descriptive exploration of the cesarean epidemic. She points out on one occasion when discussing the whole uterine rupture straw man used to deny women VBACs, that people must prefer “controlled uterine rupture” (i.e. cesarean) than the small chance of natural uterine rupture. Later, in a separate section regarding blood loss during birth, she mentions that average loss is 300-500 mil and over 500 is considered a hemorrhage. She then notes that during a cesarean the average loss is 1000 mil. Reading that, I thought so essentially with a cesarean you have a 100% chance of a uterine rupture AND a 100% chance of a hemorrhage. ::sob:: 😦

The information about blood loss wasn’t new to me, but I did learn something I hadn’t known at the time–300-500 mil of blood is approximately 8-9 menstrual periods worth. Isn’t the female body thoroughly awesome?!

—

Some assorted random thoughts and quotes from Pushed:

Re: EFM (external fetal monitoring): “For the natural childbirth movement, the emergence of the monitor was unfortunate timing. Just as activists were urging women to get up and birth, hospitals reined them back down in bed and strapped them, both physically & psychologically, to a machine that falsely promised a safe birth.”

—

While my feelings about unassisted birth have been “refined” and tempered somewhat since first reading Pushed in 2008, I did find the sections about UC to be frustrating and annoying. Quoting a midwife re: unassisted birth: “‘That’s not why you’re hiring a midwife. You’re hiring a midwife because you want her there for complications’ Some of Linda’s clients are such believers in birth that they toy with the idea of going unassisted. To this, Linda is fond of telling the story of a birth she attended where the baby had its umbilical cord wrapped around its neck three times and need resuscitation. ‘You never know when you’re going to have a problem,’ she says. ‘It’s like playing Russian roulette.'”

This makes me frustrated because those kinds of scare-tactic comments and implied “you must not really love your baby” subtext is EXACTLY the same as the conventional medical system’s attitude toward homebirth. The midwife quoted seemed totally oblivious that her remarks are virtually identical to the things OBs say say about homebirth and, regardless of any other personal opinions, I think they are just as demeaning and restrictive to women as the anti-homebirth sentiments are.

Okay, brief rant aside for another quote, this one while the author was observing a home water birth:

“It is at this point that I begin to fathom what supporting normal birth really entails. Linda is on her knees, sleeves pushed up, gloved hand in a soiled kiddy pool up to her bare elbow, gleaning diarrhea wisps with a spaghetti strainer by flashlight. I try to imagine a doctor doing this work and have great difficulty. This is not medicine. This is birth. It is messy, backbreaking, humble work.” [emphasis mine]

—

During the conclusion of the book after a discussion about the NAPW and whether childbirth is a reproductive right or not:

To her [a doctor who thinks it is not], it is a medical issue, one that may need reform, but one that belongs under the purview of physicians. ‘To my mind, I’m all for people having a pleasant and safe birth experience,’ she says. ‘But my highest priority would be for them to have a safe birth experience.’ But what’s considered safe is political. What’s safe changes. Thirty years ago obstetricians said VBAC was dangerous. Then they said it was safe. Now they’ve gone back to saying it’s dangerous. ACOG says out-of-hospital birth isn’t safe, but the research has consistently suggested that for women with normal, uncomplicated pregnancies it is not just safe, but safer, because those women are far more likely to have a normal, spontaneous vaginal birth and far less likely to experience harmful, unnecessary interventions….”

“…The goal is to have a healthy baby. ‘This phrase is used over and over and over to shut down women’s requests,’ she [Erica Lyon] says. ‘The context needs to be that the goal is a healthy mom. Because mothers never make decisions without thinking about that healthy baby. And to suggest otherwise is insulting and degrading and disrespectful’…What’s best for women is best for babies. and what’s best for women and babies is minimally invasive births that are physically, emotionally, and socially supported. This is not the kind of experience that most women have. In the age of evidence based medicine, women need to know that standard American maternity care is not primarily driven by their health and well-being or by the health and well-being of their babies. Care is constrained and determined by liability and financial considerations, by a provider’s licensing regulations and malpractice insurer. The evidence often has nothing to do with it.

This the TRUTH and I hope women hear it.

The only critique I have of this book is one I echo from several other reviews. The book fires you up and has a lot of passion and energy, but provides no outlet or ideas for where to channel that energy. There is no “resources” section, no suggestion to join Citizens for Midwifery or your state midwifery advocates, no list of birth-positive organizations who are working diligently for birth change in our culture, etc.

For some ideas that address the above, read my small-stone birth activism article 🙂

OBs and Normal

Feb20

I’ve been looking through posts on my old book blog, because I shared lots of birth-related thoughts/quotes there that are now lost in the shuffle and would be more relevant transferred over to this blog. From the book The Mother Knot by Jane Lazarre, written in the 70’s she shares an anecdote about her OB that I think carries a huge ring of truth still today:

My obstetrician had whispered a secret to me on a sunny afternoon. I had come to the office prepared with my written list of questions. Why was I feeling nauseated, I asked, and what was all this pain in my thighs? And he had answered wearily, ‘If you want answers to questions, have a miscarriage, or toxemia, or let something else go wrong with your pregnancy. We don’t know anything about normal births.’ So much for technological know-how. [emphasis mine]

This is a perfect example of the differences in approach to caring for women present in the midwives model of care and the modern obstetrics model of care. Another good example of some differences is in the Snow Baby story I put on the CfM blog on Friday.

Time Round

Feb18

I connect to the circle now

and see my life and death

in the child before me–

the glorious whole that spins so fast

it seems not to move

as the sun stands still in the heavens

until we glance again at dusk.

Where did it go and when

did we forget to look?

No matter, just turn.

The circle: our map

The heart: our book.

–Karen Engelmann

I copied this poem onto the first page of my journal when my second son was a newborn. I’m not totally sure what the meaning is intended to be, but I take it as a reminder to slow down and remember to look 🙂 My new baby is already one month old (tomorrow). How is that possible? I still look at her with surprise and amazement almost daily—sort of a, “where did you come from?!” feeling. There is something magic about her.

I have surprised myself by not having much urge to write in the last couple of weeks—usually I am consumed with blog post and article ideas. Something switched this week and the topics are flooding in again, as well as the sense of frustration of not having “enough time” to write them all. It may be because of Mark going back to work and now I feel like I am no longer “off” either and have to get caught back up with real life again. So, I remembered that poem and got it back out again. I also want to remember that my conditions of enoughness for the foreseeable future are:

1. take care of my baby.

2. take care of the boys–including doing some school every day.

3. eat enough food.

3. teach my online class.

That’s it. Write scintillating blog posts is not on the list. Nor is write books, which has suddenly popped back into my consciousness as a “want to do RIGHT NOW!” Nor is laundry really, though it has been haunting me this week. Even birth activism efforts are not really on my list, though there is a lot going on right now that I could/should contribute to. I’ve had a familiar sort of pressure this week to get back to “normal” and to prove to myself that I can handle everything I need to handle (without help).

But look…

This is where my heart is right now.

Fatherbaby

Feb15

“Nurturing is not a genetically feminine attribute. Tears and laughter are not the province of women only. The last time I looked, men had tear ducts. They had arms for holding babies. They cared about their children. And they cried at births…let the shared experience of childbirth reclaim the human soul.” –-Ariska Razak (midwife and healer)

Daddy and his two week old baby girl!

Yesterday, my husband went back to work for the first time since our new baby was born last month. He was off for slightly under 4 weeks. I strongly encourage all of the fathers who take my classes to take off as much time as possible after their babies are born. Many of them seem surprised by the suggestion, a few of them seem disinterested (like, “but isn’t that her job?”), but most of them express sadness and regret at their workplaces’ unsupportive attitude towards (or flat-out refusal to grant) paternity leave. Many of them are only able (or only feel able) to take the day of the birth off and perhaps one to two more days. I meet many who will only be able to be at home with their new families if the birth straddles a weekend. I could almost cry at the social attitudes this reflects—a complete devaluation of the father’s role, his birth as a father, and his baby and family’s need for his presence. Fathers as well as mothers absolutely need this time to “cocoon” with their new babies. To absorb the magnitude of the changes in their lives, to have time to consider the meaning of their new roles, and to re-integrate into the “normal” rhythms of home life after having experienced the rite of passage and labyrinth of birth.

When our first baby was born in 2003, my husband took one week off and then followed it with a week of half days. He was crushed to leave us—describing it as feeling like we were his “wolf pack” and he was having to leave his pack when he really belonged with us. When our second son was born in 2006, we’d wised up somewhat and he took off 4 weeks. It still didn’t feel like enough for any of us, but it seemed to be viewed by his workplace/co-workers as an unusually long length of time to take off. This time he again took 4 weeks and it hasn’t felt like enough for any of us. I’m interested by how his time off seems to be viewed by most as him needing to be home in order to “help” me, not as a time with inherent value to him. While I certainly do need his “help” while postpartum, I view our relationship as a partnership and our family as just that, our family, not as an exclusive maternal domain with occasional visits from the “daddysitter.” No thanks. Is spending time with his new baby, taking care of his other children, and taking care of household tasks in the home we share, “helping” me, or is it being a complete part of our real lives?! A part that is completely ignored/denied by the modern workplace culture and social attitudes. Spending time with Alaina is of value and importance to both of them, as people who will have a lifelong relationship with each other. Also, somewhat ironically, I am the one who took no time off this time around. I teach online and I had no leave from doing so—it was my own choice to sign a contract for this session and the online staff doesn’t even know I was pregnant or that I had a baby. I took 5 hours off and then posted in my class again. I obviously wouldn’t be doing it if it wasn’t compatible with having a newborn—it is excellently compatible—and I prepared those around me for weeks before her birth that the only things I planned to be responsible for for the first two months or so, were my baby and my class (and, obviously, taking care of my other kids too—but, not even them in the early days postpartum!).

We have discussed how each of our babies has been a catalyst for big changes in our home situation. Our first baby was the catalyst we needed to move away from our by-the-highway-no-yard townhouse in a city and onto our own land in the country near my parents. Our second baby was the catalyst we needed to finish building our real house and to move out of our temporary house and into our permanent home. So, we are now wondering what kind of catalyst our baby girl will be? We have spent our entire married life (13 years!) saying that we want to live a “home based life.” I truly do not think it is (biologically) normal, desirable, or healthy for anyone to spend 40+ hours a week out of their home, regardless of whether or not they have children or who the primary caregiver is. I don’t think fathers belong at work that much time, I don’t think mothers do either, and I don’t think children belong at school every day. The home-based life idea came to us long before we had kids and it came from all the reading and thinking I did about the simple living movement. So, I wonder—and hope—that maybe our new baby will be the catalyst we need to finally face the fear of possible failure (and/or no money!) that accompanies jettisoning his full-time job and building our other “multiple streams of income.” Maybe we will, maybe we’ll keep talking ourselves out of it, but that is what our baby girl makes us feel like doing!

So, here’s to Papatoto! May the fatherbaby unit be recognized as having inherent worth and value.

“When he becomes a father, a man leaves behind his life as a single individual and expands into a more inclusive role. He becomes a link in an unbroken chain. And in doing so, he himself undergoes a birth process–the birth of himself as a father.” –John Franklin (FatherBirth)

”The absolute miracle of a birth and the emergence of a new human being into the world catapults both mother and father into the realm of awe and wonder. They are flooded with non-ordinary feelings and energies that support a deep connection not only with the newborn and each other, but also with the mystery and power of life itself.” –John & Cher Franklin

Birth Quotes Update

Feb10

“Remember that most of the people who really need your work are not hanging out in the oversaturated twitterverse, but in places where what you do isn’t common. Get out of the crowded room and go where there’s a dearth of and a thirst for what you do. Don’t try to shout over lots of shouting.” –Tara Sophia Mohr

(Not specifically birth-related, but an excellent reminder from this post. I’ve often felt with blogging and writing for birth publications that maybe I’m just clamoring to …be heard in a cacophony of other voices (that also have good things to say–am I contributing anything unique?!)

“When my kids become wild and unruly, I use a nice, safe playpen. When they’re finished, I climb out.” ~Erma Bombeck (via Moby® Wrap)

“The miraculous nature inherent in the unfolding of a flower is the very same that moves through a woman as she gives life to the world. We can neither control nor improve upon it, only trust it.” -Robin Sale

“…the stories I see of birth in the media don’t reflect the intense emotions, the physical power, or the immense impact of the experience itself. Women screaming, fathers fumbling about, doctors doing most of the heroic work–these images don’t do justice to my experience. I felt empowered, strong, heroic in my efforts to bring my daughter into the world yet, I am painfully aware how little others see the heroism in my birth experience.” –Amy Hudock (essay in Literary Mama)

“It’s not only children who grow. Parents do too. As much as we watch to see what our children do with their lives, they are watching us to see what we do with ours. I can’t tell my children to reach for the sun. All I can do is reach for it, myself.” – Joyce Maynard (via Literary Mama)

“Giving birth, certainly, should rank among the pivotal heroic adventures celebrated in our culture. Certainly it is more heroic than catching a football or acting in front of a camera, and perhaps even more heroic than going off to war. Men return from the battlefield with victory, but women return from the birthing room with life…” –Amy Hudock (in Literary Mama)

“...if you want to know where a woman’s true power lies, look to those primal experiences we’ve been taught to fear…the very same experiences the culture has taught us to distance ourselves from as much as possible, often by medicalizing them so that we are barely conscious of them anymore. Labor and birth rank right up there as experiences that put women in touch with their feminine power…” –Christiane Northrup

“The intrinsic intelligence of women’s bodies can be sabotaged when they’re put into clinical settings, surrounded by strangers, and attached to machines that limit their freedom to move. They then risk falling victim to the powerful forces of fear, loneliness, doubt , and distrust, all of which increase pain. Their hopes for a normal birth disappear as quickly as the fluid in an IV bottle.” ~Peggy Vincent

“So many words commonly used to describe childbirth–support, patient, management, delivered by, coached, helped, guided–suggest that a woman does not have the power to give birth without being dependent on somebody else. This isn’t the case at all.” –Michel Odent

(This reminds me of that Odent quote about not actively supporting a woman in birth that stirred me up a couple of months ago. That one I had some objections to, the one above, I can definitely get behind, even though I think he is actually …saying the same thing in both quotes!)

“I believe that natural childbirth is a right and a privilege…Our country needs to step up to the plate in educating women about the benefits of natural birth, and we need to help women actually do it – not just hear about it.” –Mayim Bialik (via ToLabor Doulas Dallas)

“In the moments of labor and birth, all the forces of the universe are flowing through a woman’s body.” – Sister MorningStar (The Power of Women)

Birth Art: Final Chapter

Jan31

As I have noted before, this was my most art-making pregnancy. Rather than make birth art just because I like it (I do!), during my most recent pregnancy I used it as a way to work on—or through—various things. I wrote more about this in this post. So, now that my pregnancy has been completed with the powerful birth of my magical tiny daughter, I felt an intense urge to make two final pieces of birth art (that are directly related to my own current experiences, rather than just birth art for birth art’s sake!). Since I pushed her out on my knees and caught her myself and had worked on my pushing fears with birth art previously, I felt like making a new type of crowning mama sculpture. (Yes, her arms are raised and not doing the catching—because it just works better for me to make them with raised arms!) I have also written previously about the labyrinth metaphor for pregnancy and birth and so it seemed fitting to put this mama in the center of the finger labyrinth that my friend made for me as a blessingway gift 🙂 She’s taken her journey and she is birthing her baby!

Crowning mama in the center of the fabric labyrinth that my friend Denise made me for a blessingway gift

And, the logical final sculpture in my “series” is a mama WITH her baby!

This mama is happy to finally have her baby to hold and nurse!

I wish I had put the baby in a sling, so it doesn’t look so much like it is desperately clinging on with no support! I didn’t think of it until today though (I made these last night).

Side view

I actually made this one while nursing my own baby 🙂

And finally, here is a picture of my little treasure trying out the Ergo for the second time today. She looks a little skeptical!

Close enough to kiss!

Birth Quotes of the Week

Jan29

“I believe that natural childbirth is a right and a privilege…Our country needs to step up to the plate in educating women about the benefits of natural birth, and we need to help women actually do it – not just hear about it.” –Mayim Bialik (via ToLabor Doulas Dallas)

“In the moments of labor and birth, all the forces of the universe are flowing through a woman’s body.” – Sister MorningStar (The Power of Women)

“These hands are big enough to save the world, and small enough to rock a child to sleep.” –Zelda Brown

“Birth is as vast and voluminous, as unfathomable and inevitable as the rising and setting of the sun. And true to the inexorable power and rhythm of their life-giving bodies, women will continue to birth with dignity, grace and courage.” —Mandala Mom

“In the sheltered simplicity of the first days after a baby is born, one sees again the magical closed circle, the miraculous sense of two people existing only for each other.” –Anne Morrow Lindbergh

‎”I feel the most important thing the birthing woman does is to listen to her own body and find out what her body is telling her she needs to do. And that neither the partner, nor the midwife, nor the doula, or whomever, should be giving orders, ‘Now do this’ or ‘Now do that’ because that interferes with what she is really trying to get from her body…” ~Marsden Wagner, M.D. (via Birth Without Fear)

‎”All labor that uplifts humanity has dignity and importance and should be undertaken with painstaking excellence.” – Martin Luther King, Jr. (via Literary Mama)

“A baby, a baby, she will come to remind us of the sweetness in this world, what ripe, fragile, sturdy beauty exists when you allow yourself the air, the sunshine, the reverence for what nature provides…” – Sarah Werthan Buttenwieser (in Literary Mama)

My Baby Girl is Here!

Jan23

“A baby, a baby, she will come to remind us of the sweetness in this world, what ripe, fragile, sturdy beauty exists when you allow yourself the air, the sunshine, the reverence for what nature provides…”

– Sarah Werthan Buttenwieser (in Literary Mama)

Three generations!

Alaina Diana was born at 11:15 a.m. on January 19th, 2011! She only weighed 7lbs, 8oz and was 20 inches. (My other babies were 8lbs4oz and 9lbs, 2oz.) I’ve sent a short-version birth story to a couple of friends over the last couple of days and decided I could work it up into a short blog post as well (of course, a full-length birth story will eventually follow). I actually had a little trouble getting started in writing about her birth—it was pretty uneventful until the end and I felt like the best description would be: walked around the kitchen, sat on the birth ball, walked around a little more, more time on the ball, hummed and ooohhhhhed, seemed as if suddenly things changed and I felt big, big things happening and then baby was born all at once! And, I caught her! Emotionally more than temporally, it felt like a long labor and I felt like I experienced less mind-body integration than with previous labors (the actual moment of birth was much more instinctive and powerful than with the other babies though). In general, lots was unexpected about this labor—-it lasted longer than I expected (about 5 hours that were serious, but some warm-up time before that too) and was somewhat erratic and I had quite a bit of back pain. Right before pushing, contractions were still 4-8 minutes apart and it was hard for me to assess where I was/how “active” of labor it was—I was thinking I could either be at the 3cm point OR the transition point! My water didn’t break until seconds before she was born and I felt like it REALLY needed to break, but wasn’t. My kids weren’t here, because her birth was during the day (also unexpected, and a Wednesday, not a weekend!). It was just Mark, my Mom and me.

I spent a lot of time on the birth ball and Mark would stroke my back in just the right way

After criticizing myself at length for being “too analytical,” “thinking too much,” and not letting “my monkey do it,” I experienced a spontaneous birth reflex and pushed her out in a kneeling position and it only took one contraction—her whole head and body came out all at once, no moment of crowning or head birthed and then body following, just a bloosh of entire baby. I caught her myself. Mom and Mark both missed seeing her come out, because the phone rang at the same time. My mom went to stop it and Mark was moving around to the front of me, and when they looked again, I was holding her (Mark says it was about 12 seconds). So, no birth pix 😦

I did tear again, exact same extra-delicate and non-“traditional” place from what I can tell. Feels better than previous births already though–I know how to heal from this (even though I wish I didn’t have to).

My plan for immediate postpartum worked out perfectly and just like we planned. The midwife came about 40 minutes after the birth and checked blood loss. My doula was here about 20 minutes after and fed me a bite of placenta—and, I ate it! No gagging or anything!

I have very different post-birth feelings this time around—though I still had the “I did it!” moment, I felt less euphoric and triumphant and more relief and the feeling that, “we survived!” Blog posts about this will eventually follow…

And, did I mention that I caught her myself?! 🙂

Shortly post-birth

My "40 weeks" picture--due date was Jan. 22nd, so took a picture on that day to show how she could (theoretically) still fit! (though she wasn't breech!)

Planning for Postpartum

Jan18

I have been meaning to share this article on my blog for a long time. Now that I’m rapidly approaching another “babymoon,” it feels like a most excellent time to review my own reminders about planning for postpartum!

—-

Planning for Postpartum

By Molly Remer, MSW, ICCE, CCCE

Originally published in The Journal of Attachment Parenting, 2008.

When my first baby was born in 2003, I had a made a classic new mother error—I spent a lot of time preparing for the birth, but not much time truly preparing for life with a new baby.

I had regularly attended La Leche League (LLL) meetings since halfway through my pregnancy and thought I was prepared for “nursing all the time” and having my life focus around my baby’s needs. However, the actual experience of postpartum slapped me in the face and brought me to my knees.

My son’s birth was a joyous, empowering, triumphant experience, but postpartum was one of the most challenging and painful times in my life. I had not given myself permission to rest, heal, and discover. Instead, I felt intense internal pressure to “perform.” I wondered where my old life had gone and I no longer felt like a “real person.” A painful postpartum infection and a difficult healing process with a tear in an unusual location, left me feeling like an invalid—I had imagined caring for my new baby with my normal (high) energy level, not feeling wounded, weak, and depleted. And yet, at five days postpartum I was at the grocery store, at seven days at the post office resuming shipments for my small online business, at two weeks attending meetings and fulfilling responsibilities with an organization (though I still had difficulty walking normally due to pain), at six weeks hostessing at a fundraising ball, and at eight weeks teaching a volunteer training workshop. In retrospect, I have no regrets about how I cared for my baby. He was always with me and I was sensitive to and responsive to his needs. What I regret is how I cared for myself, what I expected from myself, the demands I placed upon myself, and how I treated myself.

I actually slightly delayed having a second child, not for fear of mothering two, but for fear of experiencing the overwhelm of postpartum again.

In 2006, I gave birth to my second son at home. This time I had planned realistically and specifically for a “babymoon.” My husband took four weeks off of work and I stayed at home for the majority of the first month of life with my new baby. Though I again experienced an unfortunate tear and a painful recovery from it (which was still much quicker and less traumatic than the first time) and also some rapidly shifting mood changes along with some tears and anxiety, I look back on this time with my second son with fondness instead of regret. Instead of rushing to rejoin the world, I allowed myself the time, space, and permission to rest and cocoon, knowing that I would be “real” again soon enough.

Reflecting on my two postpartum experiences leads me to offer the following suggestions for postpartum planning:

Try to minimize your out of home commitments in advance. Put a hold on projects and “retire” from committees and responsibilities. I joke that with my first baby I thought I needed to get my responsibilities squared away for six weeks and with my second I realized I needed to try to get them squared away for two years.
Have a good book on hand about postpartum. When my first baby was born, I was well stocked with baby care and breastfeeding books, but none about the transition into motherhood. My favorite postpartum book is After the Baby’s Birth by Robin Lim. It offers such gems as, “you’re postpartum for the rest of your life” and “when the tears flow, the milk will flow” (with regard to the third day postpartum). Other good postpartum readings are The Post Pregnancy Handbook by Sylvia Brown and The Year After Childbirth by Sheila Kitzinger. A classic for support people is Mothering the New Mother by Sally Placksin.
Prepare and freeze a lot of food in advance. Batches of nutritious muffins are a favorite of mine—freeze them and the reheat one as needed for a quick breakfast or snack. These are great for nursing mothers!
Plans to spend three to seven days just in bed with your baby. Skin-to-skin is even better.
Everyone is familiar with the “sleep when the baby sleeps” advice, but even if you don’t feel the need to sleep, stay in bed and use the quiet time for reflection or to read or write in your journal. Rest is definitely essential every day, but it doesn’t have to be actual sleep to be restorative.
If you have other children, arrange for plenty of help caring for them. Do not feel like you “should” be able to handle them all right away. Of course, you could do it if you had to, but you and your new baby will benefit from an extended period of cocooning together. Plan quiet projects that you can do in bed with your older child while the new baby sleeps (a favorite with my older son was making puppets and masks out of felt. I cut them out while still lying down. He actually started calling our bed the “party deck” because we did lots of fun projects there while I was resting with the new baby. I have no idea where he got the phrase!).
Give yourself permission to rest and be off duty.
When people ask what they can do to help, give them a specific task (go grocery shopping, pick up pictures, bring me dinner, etc.).
Ease back into “real life.” Resist the temptation to catch up with email and so forth. Respond to email or phone requests for time or help with a firm, “I just had a baby and I’m not available right now.”
Become comfortable asking for help (I vastly prefer being the helper to being the helped and this is particularly hard for me).
Similar to a birth plan, make a written postpartum plan that includes a list of the people in your support network, arrangements for help with household duties (or a plan for what can be left undone), people to call for meals, and so forth. List what each person is willing to do—laundry, grocery shopping, cleaning, childcare, meal preparation (notice that “holding the baby so you can work” isn’t on the list!). An example postpartum plan is available on DONA International’s website.
If you have relatives coming to help after the baby is born, make sure they know that their job is to take care of you and the house while you take care of the baby. It is not acceptable for you to be fixing meals and sweeping floors while grandma “helpfully” rocks the baby—it needs to be vice versa!
Prepare your partner and anyone else in your support network that you will be Queen for a Month and let them know what you will need from them (also, get it fixed in your mind that being Queen is okay!).
Expect to be “nursing all day long.” It is okay and good for you both (10-14 nursings in 24 hours is perfectly normal and acceptable!).
Encourage your partner to take as much time off as possible—either saved up vacation time or unpaid FMLA time. He can benefit from an extended period of cocooning with his newborn too!
Explore the idea that postpartum can be a time of postpartum expression rather than postpartum depression—letting all of your emotions flow, expressing your needs clearly and assertively, and being aware of and accepting of your continuum of feelings are ways to be expressive. (This concept comes from the excellent, but little known book Transformation Through Birth by Claudia Panuthos.)
Plan a few special things for yourself—have a little present for yourself to enjoy during postpartum (a new book, good magazine, postnatal massage, whatever is self-nurturing and brings you pleasure. Personally, I do not encourage TV or movie watching because it can become a passive time filler that distracts you from enjoying your babymoon. Some people may include favorite films as their enjoyable postpartum activities though).
As postpartum stretches on, if you experience decreased libido, it is okay to honor and accept that.

Planning for a restful, nurturing, “time out” with your new baby is way to honor this new stage in your family’s life cycle and a way to honor yourself as a woman and mother. I hope you will create space in your life for a time in which vulnerability is accepted. Postpartum is a time of openness—heart, body, and mind. I hope your experience is one of tenderness and joy.

Molly Remer, MSW, ICCE, CCCE is a certified birth educator and activist. She is editor of the Friends of Missouri Midwives newsletter, a breastfeeding counselor, and the mother of two young sons and a baby girl on the way. She loves to write and blogs about birth at http://talkbirth.me, midwifery at http://cfmidwifery.blogspot.com, and miscarriage at http://tinyfootprintsonmyheart.wordpress.com.

This is a preprint of Planning for the Postpartum Period an article published in The Journal of Attachment Parenting Volume 11, Issue 1, pp 28-29. Copyright © 2008 Attachment Parenting International. API’s website is located at: http://www.attachmentparenting.org.