In all my years as a birthworker, I still find that one of the most overlooked topics in childbirth preparation is adequate preparation for postpartum—those early weeks, or months, with a new baby. In my personal life, I experienced a difficult postpartum adjustment with my first baby, an easier one with my second baby, and two delightful, nurturing babymoons with my last two babies. Years after training as a postpartum doula, good postpartum care remains one of my passions, so I really enjoyed this post from a mother of five. Her feelings of rushing to get back to “normal” feel very familiar even though almost twelve years have passed since my first, tender, postpartum adjustment:
“I remember coming home from going out for the afternoon with Hero at 7 days postpartum. After we got back to our tiny apartment I came down with a fever. I was probably wearing the cutest non-comfortable outfit I could squeeze into. I probably didn’t think that 7 days after giving birth required anything of me other than “getting back to normal.” Life went on, and I urged it faster. In fact, that’s the way I parented, too. Smile, laugh, roll over, sit, crawl, walk, run, milestone, milestone, grow, grow, grow…
When I think back on my postpartum times (for the most part) I remember being exhausted, being emotional, being upset at Kirby for not doing enough, feeling fragile, feeling sad, and feeling weak. And then I got pregnant with Peter… And by the time I had him, I had interacted with enough wise mothers who had screwed up enough to know better and they told me what to do and I listened. After five babies I could finally say I did it right. I’m not saying you have to do it like me. Maybe you’ve already got your postpartum flow down and you need no such advice. In that case, a w e s o m e…”
Now I realize that some moms can just go, and they are happier that way! I get that. But it took me too long to realize that that’s not me. And I don’t want you to spend too much time thinking that should be you if it isn’t. Don’t spend four days, don’t spend four weeks, and certainly don’t spend 4 entire babies feeling like a shell of a person trying to figure it out…
Unlike my early memories of my first son’s life, rather than looking back with sense of regret and fatigue, I look back on the weeks postpartum with Tanner (fourth and final full-term baby) with a tinge of wistfulness for the sweet, delicate, care-full time we spent together, nestled in bed in milky, marveling wonder. The author of the post above describes it as a “little sacred space,” and that is exactly how I feel. It also needs to be fiercely protected.
I look at that one week postpartum as a little sacred space that I will never get back. It’s a space where, for the most part, it’s just that brand new baby and me. And I’m selfish about it. And not sorry. Life will keep plummeting forward rapidly and I won’t ever stop it. But I can have a week with a floppy new baby on my chest in my bed and I’ll take it. And I’ll protect it.
AND IF THAT DOESNT TUG AT YOU MOTHERLY HEARTSTRINGS KNOW THIS… (super practical advice I got from my midwife with Peter)
When you have a baby you are recovering from an injury that is deeply internal. Your blood needs to stay concentrated there to bring essential nutrients to heal your organs and make you strong again. When you get up and walk around, your blood abandons your core and flows into your extremities, which can massively prolong your recovery. Stay rested and keep yourself down as much as you can. Just think of your organs! They need you!
It isn’t just the weeks following a new baby’s birth that matter, the first hour matters too and can set the tone for the rest of the postpartum journey:
…The way your baby is cared for and nurtured immediately after birth significantly impacts their transition from the womb to life outside.
In a culture that commonly separates mothers and babies for routine procedures such as cleaning, weighing and measuring, most babies are missing that critical time of being skin to skin with their mothers, which has short and long term consequences for all.
As these procedures are not necessary to maintain or enhance the wellbeing of either mother or baby, there is no reason why they cannot be delayed beyond the first critical hour.
Why doesn’t this uninterrupted hour and subsequent caring postpartum support happen for all new families? One reason is related to the “treatment intensity” of the US birth culture:
The questions you post in your article are good ones: Are midwives safer than doctors? How can homes be safer than hospitals and what implications does this study have for the US?
It’s a super knotty issue and it shouldn’t be about the superiority of midwives over doctors or homes over hospitals. The debate we should be having is over “treatment intensity” in childbirth and when enough is enough. The concern is that patients can be harmed by doing too much and by doing too little–in the US I worry that we cause avoidable harm by always erring on the side of too much.
Another is related to routine hospital practices that are not evidence based:
1. Start with giving the birthing woman antibiotics in high doses so that the baby develops candida (thrush) and colic. Then mix in a lot of stitches, either to repair the perineum or the lower belly/uterus.
2. Separate the mother and newborn. Make the mother walk a long distance (with her stitched body) to be able to see/feed her newborn…
On a related note, we find that breastfeeding gets off to a better start when birth is undisturbed. We also find that decisions about breastfeeding may be made months before the baby is actually born:
…Recently, a nurse contacted me asking for ideas for teaching an early pregnancy breastfeeding class. I think this is a great idea, since mothers’ decisions about breastfeeding are often made before the baby is conceived and if not then, during the first trimester.
It isn’t just postpartum during which we need these reminders about the “cycle of care.” The cycle of care of young children can be largely invisible, both to those around us and to ourselves. I’ve taken some time this week to appreciate my investment in my baby and cut myself a little slack on the other things I always want to “get done.” Brain-building is important work too!
Speaking of said baby, who has been taking his first steps this week at nine months old, I was amused this week to come across one of my older posts on family size decisions, in which I decreed my doneness with my childbearing years. Instead of embarrassing, I find the post oddly affirming or reinforcing that at some level I really did know that we weren’t quite “done,” there was still space in our family (and our hearts!) and there really was one more baby “out there” for us.
We decided we’d make the final, ultimate decision after she turned two, because too much longer after that point would make more of an age gap than we’d want. I posted on Facebook asking how do people know they’re “done.” I had an expectation of having some kind of blinding epiphany and a deep knowing that our family is complete, as I’ve had so many other people describe: “I just knew, our family was complete.” I didn’t have that knowing though—I vacillated day to day. What if I never know for sure, I fretted. Perhaps this sense of wistfulness and possibility with continue forever—maybe it is simply normal. One more. No, finished. But…ONE more?! And, I have a space in my heart that knows with great confidence that four (living) children would be the ultimate maximum for us. I definitely do not want more than four…so, does that mean there still is one more “out there” for us?
However, I also find it to be true that four is most definitely the ultimate maximum. We laughed earlier this week remembering that a couple of weeks after Tanner was born I kept saying that I thought maybe we’d picked the wrong name for him. Mark asked me what I thought it should be and I said I kept thinking that maybe it should have been “Max.” While we joked at the time that this was because he is Maximus Babius, I only now caught on to the unintended double joke that he has definitely pushed our family size to our “max”!
I got this book about midwives in Mexico to review and have been zooming through it. It is SO good!
(read more: Sneak Peek: Pregnant Mama – Brigid’s Grove)
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