Search Results for: Postpartum

Tuesday Tidbits: Hemorrhage & Postpartum Care

March 2013 068“A bright red ribbon of blood weaves women together. We are blood sisters. We bleed and bleed, and we do not die. Usually.” –Susun Weed

These Tuesday Tidbits all come from the current issue of Midwifery Today. It is an excellent issue with tons of great information. As I referenced before, however, it is literally making my uterus ache and contract to read it since the theme is Hemorrhage. I’ve had to read it in small doses—5-10 pages at a time—and then come back to it later because the contractions/crampiness in my uterus and lower back get too intense for me to continue. I’ve always known that I have an intense response to blood, but this is the first time that I’ve really tuned in to the body memory my pelvic bowl still holds with regard to excessive postpartum blood loss. That blood loss is one of the things I don’t blog about, but today I’m writing about hemorrhage anyway (even though my back/uterus is starting up again as I type this). I guess you could call it “psychosomatic,” but I call it uterine memory.

Robin Lim’s article about postpartum hemorrhage in Bali includes a nice list of preventing and managing hemorrhage, one of the most significant being to minimize prenatal “scare” as much as possible. She writes about good prenatal nutrition and nurturing prenatal care and she also recommends this essential:

Build layers of support and trust for the mother in pregnancy and labor to help her cope with any social, psychological or spiritual challenges that she might be carrying…

Lim also says that laboring women use “qi” while laboring and birthing, which is our life force, our energy. She says that if women run out of “qi,” they have to dip into their “jin,” which is, “one’s God-given lifespan”:

“If a mother uses all of her qi to bring her baby out, then she has none left to bring her baby out and to close her uterus properly…As birth-keepers it is our job to maintain the qi of pregnant, laboring, birthing and breastfeeding mothers. The mother who maintains her qi and does not use up her jin can still be glowing and full of energy after having five children…the mother who has dipped too deeply into her jin, due to having depleted her qi, can be dangerously run down after having just one baby…”

While one might interpret this as being a little too esoteric for the practical mind and perhaps a tad too close to the victim-blaming “you create your own reality” thought processes that grate on my nerves, I really appreciated the idea of the responsibility of birth-keepers to guard mothers’ life-force energy and to act to preserve mother’s natural resources and reserves of strength.

On a midwifery education note, I love the writing of Sister MorningStar and I loved reading her thoughts on midwifery education, especially her observation that

…I’m dreaming of a way and time when women are as healthy as deer and mothers birth in the night before professionals arrive. Don’t misunderstand, I want and am willing to talk at any roundtable about midwifery education. We need everyone who cares about birth at such a table, including mothers. We need a global table with a global voice, passion and wisdom. I am not saying that birth and midwives are not made better with midwifery education, but I am saying that I have many questions about modern midwifery education and its effect on the experience of birth.

And, moving on to postpartum care, loved this quote from Darla Burns in an article by Allie Chee:

As Americans, we are under the impression that new moms are ‘Superwomen’ & can return to life as it was before baby. We must remember to celebrate this new mother and emulate the other cultures that honor new mothers by caring for them, supporting them, & placing value on the magnificent transformation she is going through. This is the greatest gift we can give to new mothers & newborns…

I appreciated that Chee included information about postpartum recovery from miscarriage and stillbirth as well, rather than assuming that postpartum care is a need only following a live birth. Consistent with my own experiences and observations she notes that, “in the case of miscarriage and stillbirth, a woman is usually sent home with no postpartum care instructions other than perhaps a list of negative signs to watch for that may indicate further complications with her health. In these instances, many friends and family members, often not knowing how to respond, leave the mother to grieve alone and to recover physically by herself.” Other interesting notes with regard to postpartum recovery after miscarriage or stillbirth include these two:

  • The depression and anxiety experienced by many women after a miscarriage can continue for years, even after the birth of a healthy child….
  • [with regard to postpartum recovery/”lying in” time in other cultures]…Amy Wong, an internationally acclaimed author and expert on postpartum writes, “Natural delivery requires at least 30 days of rest, while cesarean delivery, miscarriage and abortion require at least 40 days…”

Of course, this made me reflect on my own experiences. I feel fortunate that I was cared for with a lot of love and tenderness in my own miscarriage postpartum, with my mom bringing us food and providing child care and support, and my doula organizing and delivering meals from friends as well as offering a loving and supportive listening ear. That said, I was back in front of the classroom two weeks postpartum and felt like perhaps I was taking “too long” to get back to “normal.”

Definitely make sure to check out the complete issue! Midwifery Today is my favorite birth publication and is a treasure trove of information as well as personal experiences and reflection.

March 2013 040

Timeless Days: More Postpartum Planning

“Understand that the tremendous energy going through you during birth is the same sort of power as the force of ocean waves moving towards shore. Know that just as a bird knows how to build its nest, and when to lay its eggs, you too will build your birthing nest…” –Janice Marsh-Prelesnik (The Roots of Natural Mothering)

So, after writing about postpartum survival tips and about what to share with mothers-to-be about the realities of motherhood, I found some more postpartum notes saved in my always overflowing drafts folder from the sidebar to Time in a Bottle by Beth Bailey Barbeau in Spring 2011 issue of Midwifery Today (p. 44).

  • Encourage realistic contact between mothers-to-be and new mothers to help them shape more realistic expectations of postpartum life.” Yes! This is why I strongly encourage mothers to come to LLL meetings before they have their babies.
  • “Use language that shares your expectations and gives parents a vocabulary to articulate the demanding needs of their new infant.” Like Barbeau, I find it helpful to bring in the concept of the fourth trimester. The first three months are the “fourth trimester” during which baby pretty much wants to live on mom’s chest and replicate the womb (i.e. almost constant feeding–like the umbilical cord–constant holding and lots of motion, like being in the uterus, as well as being able to hear your heartbeat). After the fourth trimester passes, babies “wake up” even more and start really interacting with the world. I explain in a light-hearted way that even if you hold your baby for 12 solid hours a day following birth, that is a 50% reduction in what she is used to. And, I let them know that while the adult’s brain thinks, “how can this baby be hungry, I just fed him 30 minutes ago?!” The baby’s brain thinks, “it is has been 30 minutes since I’ve EATEN ANYTHING!!!!!” I also reinforce the idea that a baby that wants to be held and snuggled and nursed is a smart baby, not a manipulative one. And, of course, I also describe mother’s body as baby’s natural habitat after birth.
My husband and first baby during the first tender postpartum days.

My husband and first baby during the first tender postpartum days.

  • Remind new parents that most cultures around the world have some sort of ‘lying in’ period, typically lasting 30-60 days or more.” Truly the things that support both a healthy birth and healthy postpartum are contrary to the expectations and habits of mainstream society. See Kathleen Kendall-Tackett’s handout on how other cultures prevent postpartum depression.
  • “Matter-of-factly inform the family, especially the extended family (if you have your client’s permission), that mama is going to be encouraged to stay in bed for a while after the birth and that she’s not ‘being lazy.'” Mothers can have a lot of difficulty giving themselves this permission and it can help to have the acknowledgement and encouragement to family members coming from an outside source.
  • “Remind them that a true six-week postpartum window allows for the placenta site to fully heal and supports minimized bleeding and stronger recovery.” An excellent tip for educators and doulas from Barbeau is to illustrate size of placental site healing area with hands like small dinner plate—if this was outside the body, how would you care for yourself
  • “Encourage preparation for postpartum success!” I write about the idea of postpartum expression instead of postpartum depression. See ample past articles about postpartum planning and a nice specific story about creating a nest here.

“Although pregnancy and birth is a richly intuitive and instinctive process, a woman will prepare her ‘nest’ and birth according to the style of her culture, in the same way that a particular species of bird will build its nest with whatever is available.”

–Pam England

Let’s help make sure her nest is rich, resourceful, blessed, and beautiful!

Postpartum Survival Tips

“In western society, the baby gets attention while the mother is given lectures. Pregnancy is considered an illness; once the ‘illness’ is over, interest in her wanes. Mothers in ‘civilized’ countries often have no or very little help with a new baby. Women tend to be home alone to fend for themselves and the children. They are typically isolated socially & expected to complete their usual chores…while being the sole person to care for the infant…” –Milk, Money, & Madness

324I recently shared this quote on my Facebook page and a reader responded expressing her fear at preparing to face this exact situation. I responded that it is an unfortunately realistic fear and suggested she check out some resources for postpartum planning that might help work through the fear as well as plan for a nurturing postpartum instead of a stressful one. She then responded that she has a very minimal local support system and that got me thinking about postpartum survival tips for when one’s local support system is limited…

My ideas:

  •  Suggest to your out-of-town friends and family that they contribute to a “babymoon” for you and all pitch in to hire a postpartum doula.
  • Tactfully remind people that even if they’re too far away to bring you a meal, they can certainly call up a local restaurant and order a delivery for you! I think a lot of us forget that is an option for a long distance family member (that we would bring food to if they were local). In my experience, getting enough food is a huge issue postpartum! I remember long distance friends having babies a variety of times and wishing I was close enough to bring them dinner. Duh. Many restaurants do, in fact, deliver food!
  • Be your own “best friend” by preparing and freezing meals and snacks now. I know I sound obsessed with food, but it is totally one the hardest things to take care of postpartum, but so important!
  • Put together a mama survival kit for yourself that you can then open up when you need it. Some ideas here and more ideas of variable quality here.
  • If you don’t have a sense of community work, actively work on building one—go to La Leche League meetings, Holistic Moms Network, Mothers of Preschoolers, Attachment Parenting International, or other mothers’ groups. Go BEFORE you have your baby if you can.

Other ideas for helpers:

  • In addition to my idea of ordering delivery for a postpartum family as a way of bringing them dinner long distance, is to order a dinner through the mail via the business Spoonful of Comfort. They will send fresh chicken soup, rolls, cookies, and a baby present via Priority Mail (packed with freezer packs). I send it with a note saying, “this is me, bringing you dinner!” Friendly tip from unfortunate personal experience: if you are doing this for a friend make SURE you enter THEIR address as the shipping address and not your OWN address, or you will then be forced to enjoy their postpartum meal and feel like a total idiot at the same time.
  • Don’t forget about other meals—breakfast = awesome. Muffins = awesome.
  • Pay it forward–I think sometimes people feel like they don’t know someone well enough to bring them food, or maybe they even do a mental “tally” and think, “well, she won’t be bringing me food ever, so why should I take time to bring it to her” or, “she didn’t make anything for me when I had my last baby, so I’m off the hook on this one.” When I had Alaina, a mother who had literally JUST moved to town and that I had not yet met, sent a hot breakfast casserole to me (that my lovely doula delivered to my lovely mother at the snowy end of my gravel road).  I think of that generosity when I bring a postpartum meal to a mama from whom I will never end up getting a reciprocal meal. Who cares. She needs it. You can do it!
  • Another doula commented on my post: “Do you know a mom that is about to have a baby? Or maybe a momma who just gave birth recently? Don’t even ‘offer’ just show up with a bucket of cleaning supplies, a bag of healthy food, and maybe something nice for her. Go tuck her in bed with baby, and get to work on her home.. When she wakes, she has nothing to do but nurse that baby. (If she has other kids, delegate chores with them, if to young, call mutual friends to sit for them! Our Mom’s need this, up through 6-9weeks pp, Mom’s need help, even longer for some. There is a reason the US has the highest postpartum depression issues in the developed world… Create your community! DO IT!” I would add that if you do not know mom well, do not plan to engage in a deep cleaning project and stay for a long time doing such project.

I also posted to the Citizens for Midwifery Facebook page asking for contributions for postpartum survival tips when your local support system is limited. What beautiful, helpful women we have on that page! While I didn’t get many suggestions specifically for minimal local support systems, I did get a nice collection of survival tip ideas:

  • Trust your own instincts. Many women have great advice but if your heart is telling you something else, go with it.
  • Craniosacral therapy… one session for you and one for the baby.
  • In addition to lots of suggestions to hire a postpartum doula, there were lots and lots and lots of shout-outs for placenta encapsulation. I echo it myself.
  • Get out of the house alone! For me, it’s been crucial to my sanity to leave my home, by myself, even if only for an hour or two between nursings. Just a Target run was therapeutic!
  • Kangaroo care for high needs babies.
  • Lots of mentions of it being okay to accept help and okay to ask for help.
  • A lot of new moms get really overwhelmed by family and friends coming by to see baby, and it’s important for them to remember that they can always put out a sign that says “mom and baby sleeping!” (even if they aren’t) anytime they need a break.
  • Watch only positive stuff without violence on TV (cooking shows, home improvement) as regular TV is really violent for new mamas and she may be watching more with all the nursing/healing.
  • Have homemade high protein frozen meals (and snacks) in the freezer before birth so anyone can warm them up for the household after birth. If breastfeeding, get much more rest than you think you need from day one to ensure an abundant milk supply (*note from Molly: it is true that prolactin receptors are “laid down” during the first days of breastfeeding. Breastfeeding “early and often” makes sure that there are an ample supply of receptors in your brain.)
  • Have a sign up sheet for family and friends to choose which chores to help with, gift certificates to a cleaning service, stocking up on disposable plates and dinnerware…
  • A new mommy group can be a life saver. Just knowing that other mommies are going through the same thing help
  • Food registries such as mealtrain and mealbaby. Not enough families know about these amazing and free services. (*note from Molly: we often use Care Calendar locally.)
  • Plan ahead and freeze several of your favorite freeze-able meals. Let the clothes be a little wrinkled. Use paper and plastic ware instead of worrying over dishes. Stay laying down first 3 days postpartum (preferably naked: it gives a certain message and is better for baby anyway) and the first week stay in pajamas. Enjoy frequent rest times, even if you can’t sleep.
  • Baby wearing….lots of time in bed, sleeping cuddling and feeding babe skin to skin…brest friend nursing pillow
  • Send a subliminal message to the limited visitors you’ll have (set limits early with partner) by wearing your robe for several weeks
  • Eat well, accept all offers of help and food, get out of the house alone!
  • I loved getting meals brought by friends, but I didn’t always want to socialize. So, someone to run interference, or maybe a drop-off location for leaving food. (*note from Molly: my doula was the perfect person for this job.)
  • Ask for help! No one will know what you need if you don’t speak up.
  • Don’t go without showering for more than four or five days. Brush your teeth once a day no matter what, even if it ends up being at a weird time. Take your vitamins/ herbal supplements/tea. HYDRATE! Nap with baby if you need to, arrange childcare for older siblings sometimes, but also listen to your instincts—one of my worst baby blues moments was with my third when my older two were gone and I wanted them home!
  • LOVE yourself, nap when you can , Yes you are doing it right, No it’s no ones business (breastfeeding/cosleeping/pumping etc.) allow opinions and advice to slide off, drink lots of water , eat small snacks/meals, love your baby look into their beautiful eyes and connect, skin to skin whenever even with dad or siblings (safely) cherish these moments they don’t last forever, the laundry will get done, the dishes will be get cleaned …
  • Take a “babymoon”. Put on a robe when someone comes to the door–even if you have real clothes underneath. Sleep when the baby sleeps. Don’t answer the phone. Remember, self-care is essential for you to be able to care for your baby.
  • I loved having herbal soaked pad (frozen) to wear afterwards, felt soooo good. Have easy one-handed snacks available and a BIG water bottle.
  • In those last few months of pregnancy I prepare meals to freeze (I start about month 5 or 6). I make up 6 weeks worth of dinners (they always last longer since we have a great church family and friends that bring us meals). After baby is born I can put 2-3 dinners in the refrigerator (to thaw) a few days before I need them. Then all I have to do is pop one in the oven and BAM….dinner’s ready. I love “Don’t Panic, Dinner’s In The Freezer” I & II. The recipes are amazing and all freeze well. Hope that helps!
  • Skin-to-skin in bed for as long as possible; 40 days of rest, recuperation, establishing breastfeeding, bonding, limited visitors, and limited activity; drink when the baby nurses; sleep when the baby sleeps; nurse on demand; learn to wear your baby; and use a peri bottle when peeing! A postpartum herb bath and massage are nice, too.
  • Hot water bottle for afterpains
  • Placenta encapsulation and WishGarden Herbs ReBalance tincture!
  • Chiropractic adjustments, ASAP
  • Call in your mom. My mom’s job after my second was born was to keep me fed and to spend some quality time with my older child.
  • Drag oneself outside and BREATHE! 🙂
  • Water…..hot tub, shower, steam, pool, raindrops, snow, sauna, bath, river, stream, ocean, lake! If you can, immerse yourself, if you cannot, imagine yourself floating 🙂
  • Lots of water, lots of protein and healthy fats, placenta encapsulation and low expectations of anything other than bonding time with baby.
  • Don’t try to impress others with how quickly you can get up and going, even if you can, just take it easy!!!!
  • It’s not in the asking for help; its in the accepting…
Surround her with support!

Surround her with support!

Check out these previous posts:

Mothers Matter–Creating a Postpartum Plan

Planning for Postpartum

Some reminders for postpartum mamas & those who love them

and a great one for helpers written by my own doula:

The Incredible Importance of Postpartum Support

And, remember…

“The first few months after a baby comes can be a lot like floating in a jar of honey—very sweet and golden, but very sticky too.”

–American College of Nurse-Midwives

This article is crossposted at Citizens for Midwifery.

Guest Post: Mothers Matter–Creating a Postpartum Plan

I connected with today’s guest post author, Rachel Van Buren, via Facebook. Rachel has a passion for postpartum support and so do I. When she mentioned that she was teaching a postpartum planning workshop, I asked if she’d consider writing up her notes into a post to share and she did!

IMG_5598“Mothers matter” – Creating a postpartum birth plan
by Rachel Van Buren

The Neighborhood Doula

I feel compelled to state the obvious: Society fails to meet the needs of the laboring, birthing, postpartum woman. Because these women lack the support that seems obvious for those around them to give, they assume their feelings are not normal. I am here after having birthed 4 children over the last 13 years to reassure you that your needs are normal. So normal, that I can read ten thousand threads in one afternoon of women who are crying out for support during the postpartum months. Why is it that we dismiss our feelings, and label ourselves as “ungrateful, needy, or weak” because we read one perfect looking blog, or Facebook post? Don’t misunderstand…the 4th trimester is beautiful. It really truly is. But it’s also life changing. Have you ever experienced a life change without experiencing anxiety? Of course not.

My message here is this: Women need to plan for the postpartum time period. It is essential. We get so wrapped up with birth, we forget about what happens when we bring baby home.

There are 3 areas of importance to explore before you bring baby home: Dealing with friends and relatives, how to delegate without guilt, and the importance of self-care.

Let’s explore these topics together.

How to deal with relatives and visitors during those first few weeks:

  • Have a clear vision of what your postpartum time will look like. If you aren’t sure, have that discussion with your partner now. Do not wait.
  • Set clear boundaries: Everyone does better when they know what to expect.
  • Set phones to go directly to voicemail.
  • Change your outgoing voicemail greeting. For example: “You have reached the _______ family, we are sorry we can’t take your call right now, as we are busy enjoying some quiet time together as a family. We are all doing well, and really appreciate your thoughtfulness in calling. We will return your call when we have the opportunity to talk, or are ready to expect company. So good to hear from you, and have a great day!”
  • Stay in bed.
  • Stay in pajamas.
  • Do not offer beverages. Visitors will be less likely to overstay if you are not in the entertaining mode.
  • Have partner or Postpartum doula mediate and advocate to well-intentioned but pushy friends or family. A BFF, parent, or close relative shouldn’t serve in this capacity. Prepare with them an “elevator speech” regarding visitors “Their Doctor/Midwife has encouraged the family to take a postpartum “Baby Moon” and they are really taking that advice to heart.”
  • If mom is breastfeeding: A gentle reminders to others, that she is nursing the baby about every hour(maybe even more) and are spending lots of time skin to skin, so visitors are just not practical right now.
  • Use social media to the fullest…
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Update your Facebook status as a way of giving a “heads up“.

Delegating without the guilt: I find it interesting to meet a lot of women that perceive themselves as feminists; they have no problem advocating for a natural/intervention free birth, defending their right to an elective Ceserean, or advocating for their future right to nurse in public. However many of these women come home after birth, and suddenly find themselves struggling to find their inner voice. Suddenly things become sticky because we’re now dealing with people that we have relationships with on a personal level. Boundaries can be tough to establish and maintain because our desire is really to our loved ones. Here’s when guilt creeps in. Perhaps guilt over losing exclusive relationships (first child, partner, or even self). Guilt of not living up to our mother’s example, our friend’s example, or the “perfect” mother on Pinterest who is sewing her own postpartum maxi pads and cloth diapers.

I’m a believer in learning to delegate. It decreases levels of guilt from not being able to be Mrs Cleaver. It lightens our load. Whether it’s with our partner, or our children, we need to do it. The days are gone where we can “do it all”.

Here are some simple steps to practice in order to delegate without feeling guilty:

  • Set your ego aside: There is more than one right way of doing things. Yours is not the only way. Invite the possibility that they might even do the task better or faster than you.
  • Stop waiting for people to volunteer: It is your job to communicate your needs. Partners are not mind readers. Just because they don’t offer, does not mean your needs aren’t normal.
  • Ask and you shall receive: Get to the root as to why you struggle with asking for help (shame? guilt?). Learn a different way. Learn to ask for help.
  • Delegate the objective – NOT the procedure: Dignify the person helping you by allowing them to do it as they choose, but make clear what your desired end result is. This will stop you from being the ever annoying micro-manager. After all, you are not training a robot, but a human being who can adapt and improve.
  • Be patient: The person you delegate will make mistakes, it is part of the learning process. Work consciously to keep a positive and realistic attitude.
  • Recognize your helper: Make sure they hear you brag about them to your friends or family. Everyone loves praise, and when they are appreciated they will be more apt to tune into your needs and want to help. Say THANK YOU! Let partner know that it makes you feel so special that they are working so hard to meet your needs.
  • Avoid controlling partner’s feelings. It doesn’t build up the relationship, and only adds resentment. (“I won’t ask partner to load the dishwasher because I don’t want to hear complaints. I’ll just do it myself to avoid the argument”) Partner has feelings, and is entitled to them, whether you perceive them as “good or bad”. Feelings are not facts. They are interpretations of the facts.
  • It’s OK to feel guilty. NO ONE has ever died from guilt!! (excellent mantra during particular moments of delegating)
  • Avoid saying “yes” when you really mean “no”.
  • Change your “normal”. Embrace the fact that the next 3 months are truly a time to expect the unexpected.

Self care:

Postpartum self-care is an absolute necessity. Get in the habit now of taking care of yourself. I firmly believe that how we take care of ourselves is learned behavior. Surround yourself with women who value their physical and mental health. Watch them, and copy them.

Here is a list of self-care ideas for your physical postpartum recovery: Alaina064

  • Ice packs for perineum
  • Postpartum massage
  • Belly binding
  • C-scar massage
  • Herbal bath (with baby too!)
  • Lots of sleep
  • Ask for help
  • Eat nutritious living food
  • Stay hydrated
  • Listen to your favorite music.
  • Avoid any negative television.
  • If you are already caring for a child with special needs, make sure that support is already in place to continue caring for them during those first few months until you are back into somewhat of a routine.
  • Create a network. Women want intimacy. Do not isolate. Isolation breeds anxiety.
  • Stick to your spiritual routine (whatever that looks like) Feed your soul daily.
  • Avoid stress triggers (if overbearing mother in law is coming by, let partner and baby spend time with her. Go take a shower, or get some rest)
  • Hug your partner. A lot
  • Avoid alcohol and caffeine. These both will be very tempting, and can be OK depending on your circumstances. If you are feeling blue, or have a history of depression, I recommend avoiding during the 4th trimester.

And most of all, listen to your instincts. Don’t compare yourself to others. Believe in yourself. Postpartum is a special time in which we evolve, allow yourself to be transformed.

Be empowered: create a postpartum plan today!

Rachel Van Buren is a birth and postpartum doula living in Charlotte, NC with her husband and four children. Visit her online at The Neighborhood Doula.

Originally posted at The Neighborhood Doula,
Dec 6, 2012

You can read past Talk Birth posts about postpartum here:

Planning for Postpartum

Postpartum Thoughts/Feelings, Part 2

The time of danger, what needs to be survived, comes at different times for mothers. For me, it came early — during my [child]’s infancy.

From Sleeping Beauty & The Fairy Prince: A Modern Retelling By Cassie Premo Steele

After posting my “playing my music” essay containing an exploration of my postpartum feelings after the birth of my first son, I went back and forth about continuing to explore the subject. I’ve written about it a lot, but the feelings are scattered throughout a variety of locations—including partially written articles and also blog posts from my first, no-longer-updated blog. I actually wrote this post last year, immediately after my part 1 post, and then ended up not sharing it, but moving straight on to Postpartum Feelings, Part 3 instead.

Weird thoughts

Anyway, I wanted to briefly address the weird/intrusive thoughts that I experienced postpartum with both of my boys. I think one of the reasons I have trouble broaching this topic on this blog is that to look back at my thoughts and feelings is to begin to acknowledge to myself that I very likely experienced a postpartum mood disorder, even though I—perhaps purposefully—did not identify it as such at the time. With my first, I had a recurrent image of the bookshelf in my computer room at the time falling over and squashing me. I also had the sense that the baby was trying to “squash” me—as in stamp out my life spark (actually, who am I kidding, life with kids still makes me feel like this is their goal sometimes! ;-D) and the best way I could come up with to describe my feelings at the end of a long day was that I had been chewed up and had my bones spit out. This is a pretty intense description that some people might feel is ridiculous or over-the-top, but is the way I would have described it.

When my second son was a baby, I planned much better for postpartum and experienced a fairly pleasant babymoon at home with him. I felt like in general, mothering him was easier than mothering my first and as he grew, I frequently would say (and feel) that having a second child was the best thing I’d ever done. Despite those feelings, I had a recurrent image that would pop into my mind unbidden of falling backwards through a grate, my body dissolving into water as I fell and dripping through the grate and the skin of my face remaining a “mask” on the grate, eventually also dissolving/dripping through. I also had a weird, recurrent sensation that my shin bones were fragile somehow and I would imagine them snapping.

So, after typing this out I officially felt mentally ill, and that is why it hasn’t been posted until now.

The current

With my second son, I described my mood to my husband in this way: There is a current that underlies all of my emotions. I feel like I can “dip” into this current and test out how it feels, beneath the mood that I present outwardly or how I feel on the surface. My current lately is always sad—even when I am happy and feeling/acting happy, if I take the time to “dip” beneath, what I feel is sad. I used to actually chart the feelings on my calendar, with a little notation for the surface feeling and a different notation for the current. I tried to explain to him that I did not feel like I had a neutral point and that I would like to feel “even.” However, I also acknowledged that if to feel “even” or neutral as my “current” would mean trading in all peaks of emotion, rather exuberant or despondent, I’d rather have the ups and downs. During this time I looked up various mood disorders, thinking that I might possible qualify as having cyclothymia.

Wal-Mart “angel”

Then, one day, when my second son was perhaps a year or so old, I had an interesting experience at Wal-Mart with a very friendly and cheerful checker. She chatted along with us and was just very nice and pleasant to be around. That night I had a vivid dream that this checker was actually an angel and that she had come to “heal” my feelings. When I woke up that morning, I had very dramatic sensation and announcement of sorts in my head, “you are not depressed anymore” and indeed, when I dipped into the current it had become a wellspring of joy, rather than sadness. Since this time, my “current” has never again shifted back to sad. While I definitely have sad or “down” moods or get distressed about things, I now feel like it is only that surface emotion that is being buffeted, but that what waits underneath is always doing all right. Perhaps you have to know me in real life to understand how strange of an experience this is for me to describe. I have never had another “angel” experience and do not connect with angel imagery. The word “angel” is not one that I use to describe anything, really, and I feel extraordinarily skeptical and uncomfortable when other people say things about having guardian angels. I suppose if I did have PPD, it could be looked upon as a “hallucination” almost. However, I do not have a way to describe what happened to me without using the word. Indeed, I feel so oddly about it, that I have never actually told anyone else about this—I told my husband about the current shifting, but left out the “Wal-Mart angel” piece of the story.

Why tell it now?

As I noted, I’ve been waffling about posting this. It is close on the heels of another post that may seem woo-tastic. It makes me feel vulnerable and embarrassed. Why? Why bother sharing things that bring up these sorts of feelings? My answer was almost, just don’t, and then I read a fabulously amusing essay in the winter issue of Brain, Child magazine about a woman’s experience teaching “sexuality and the new mother” workshops at Babeland in New York City. In her postscript closing the essay, Meredith Fein Lichtenberg writes the following:

“…writing this now, years after it happened, I still felt that sharing something personal cast stark light on the Inner Vat of Chaotic Shit I Haven’t Figured Out Yet. The desire to hide that is amazingly strong; I see it in my students, and I see it in myself. But I also see that when we bend our lives’ stories into words to be shared, everything changes. Sharing stories reminds us we’re not alone with our icky mess of doubts and questions. In the light of day, frightening concerns and general weirdness become more understandable, forgivable, human.”

Reading this, I knew I wanted to share after all. And, it reminded me of another quote, this one by Carol Christ, a thealogy scholar that I love:

“When one woman puts her experiences into words, another woman who has kept silent, afraid of what others will think, can find validation. And when the second woman says aloud, ‘yes, that was my experience too,’ the first woman loses some of her fear.” –Carol Christ

Postpartum Feelings, Part 1

Postpartum Feelings, Part 3

Some reminders for postpartum mamas & those who love them

Postpartum with Alaina, February 2011

I recently finished a series of classes with some truly beautiful, anticipatory, and excited pregnant women and their partners. I cover postpartum planning during the final class and I always feel a tension between accurately addressing the emotional upheavals of welcoming a baby into your life and marriage and “protecting,” in a sense, their innocent, hopeful, eager, and joyful awaiting of their newborns.

This time, I started with a new quote that I think is beautifully true as well as appropriately cautionary: “The first few months after a baby comes can be a lot like floating in a jar of honey—very sweet and golden, but very sticky too.” –American College of Nurse-Midwives

Matrescence

In Uganda there is a special word that means “mother of a newborn”–-nakawere. According to the book Mothering the New Mother, “this word and the special treatment that goes with it apply to a woman following every birth, not only the first one. The massages, the foods, the care, ‘they have to take care of you in a special way for about a month.'”

There is a special word in Korea as well. Referring to the “mother of a newborn child,” san mo describes “a woman every time she has had a baby. Extended family and neighbors who act as family care for older children and for the new mother. ‘This lasts about twenty-one days…they take special care of you.'”

These concepts—and the lack of a similar one in American culture—reminds me of a quote from Sheila Kitzinger that I use when talking about postpartum: “In any society, the way a woman gives birth and the kind of care given to her and the baby points as sharply as an arrowhead to the key values of the culture.” Another quote I use is an Asian proverb paraphrased in the book Fathers at Birth: “There is a proverbial saying in the East: The way a woman takes care of herself after a baby is born determines how long she will live.” While this quote usually gets some nervous laughter, I think it is impresses upon people how vital it is to plan for specific nurturing and care during this vulnerable time.

Dana Raphael, the author of Breastfeeding: The Tender Gift, who is best known for coining the word “doula” as it is presently used, also coined another valuable term: matrescense. “Nothing changes life as dramatically as having a child. And there was no word to describe that. So we invented the word—matrescence—becoming a mother.”

The postpartum law of threes

I also share the “law of threes” with my clients which I learned from an article titled “Baby Moon Bliss” by Beth Leianne Curtis in Natural Life, Fall 2008:

A helpful tool I share with students and clients of mine is what I describe as the ‘law of threes’ when beginning the postpartum period. The first three days after your baby is born, try to stay in bed or at least in your bedroom. Many other cultures worldwide have much longer ‘lying in’ periods for mother and baby. If you can give yourself the much-deserved rest of focusing on breastfeeding, sleeping, eating, and recovering from the work of labor, your body and your baby will thank you for it. While birth is a healthy, normal event, honor the recovery process that your hard working body needs and deserves. The less you physically do in the initial few days following childbirth, the better and stronger you will feel in the weeks ahead. …Next, prepare to have three weeks of meals readily available for breakfast, lunch, and dinner….” (don’t forget plenty of snacks at easy reach for breastfeeding!)

Finally, understand that those first three months after birth are truly a time to embrace the unexpected…for some mothers, after three months is when breastfeeding really begins to be fun and easy. Many parents find that at the end of this [fourth trimester] transitional time, baby has moved through any colicky phases and that suddenly baby looks and acts more like a ‘real person.’…Physically, this is when your body begins to return to its pre-pregnancy state.

When I present about this topic to groups, sometimes I hear the following types of remarks: “Getting back out made me feel better, I would be miserable lying around in bed all day”—at the time when my own first baby was born, I would have said this was true for me as well, but looking below the surface shows me something else. Someone who hadn’t planned for a nurturing, comforting, supportive postpartum cocoon and who hadn’t given herself permission to rest, relax, and restore. The same high-achieving style that served me well in the workplace did not nourish me physically or emotionally as a tender new mother. I firmly believe that a nurturing postpartum downtime lays foundation for continued “mother care” self-nurturing for the rest of your life.

Then, in my notebook, I found the following relevant quotes that I had saved from the book Natural Health After Birth by Aviva Jill Romm:

“Too often women develop the mindset that a good mother gives all and takes nothing for herself. Remember, this is a great cultural fallacy. A good mother gives of herself to her children, but she has to have a self to give. A good mother nurtures herself, develops her own interests, even if in small ways, and grows as a person along with her children. Children don’t need us to be martyrs; they need us to be their mothers. A self-actualized mother sets an example for her own daughters that becoming a mother expands identity, not limits it.”

–Aviva Jill Romm, Natural Heath After Birth

“To put a child on Earth, an immense amount of creative intelligence flowed from the Great Spirit, through nature itself into your body, heart, and mind–remaining now, as an integral part of your own spirit. This energy is yours forever. Like a pocket, deep and filled with magic seeds of creativity and healing, this is the source of unconditional loving from which every wise woman since the beginning of time has drawn her strength.”

–Robin Lim

“Motherhood is raw and pure. It is fierce and gentle. It is up and down. It is magic and madness. Single days last forever and years fly by…Be gentle with yourself as you travel, dear mother. Don’t miss the scenery. Don’t miss conversation with your traveling companions. Laugh at the bumps and say ‘ooh, aah!’ on the hairpin turns. Buckle your seat belt. You’re a mom!”

–Aviva Jill Romm

Helpful articles

Planning for Postpartum—this is one of my past articles that I remain proud of

How other cultures prevent PPD—helpful article by Kathleen Kendall–Tackett

DONA’s handout for making a postpartum plan—I think couples should spend at least as much time to developing a postpartum plan as they do to making their birth plans.

Support & Sanity Savers handout for class from Great Expectations—this is one of my very favorite postpartum handouts to use for birth classes, particularly the last page which is a “request for help after the baby is born” letter to prospective helpers that includes a “coupon” for people to fill out with what they’re willing to do for the new parents.

Placenta Encapsulation—Three Days Postpartum Comparison…

I’ve been wanting to write a quick post about placenta encapsulation for ages. I had it done after Alaina was born and I’m a total convert. A month or so ago, the topic came up on a breastfeeding email list I belong to, with concern raised by several IBCLCs about the possibility of hormonal disruption of milk supply with placenta ingestion. Several women stated that they would not be comfortable doing it until there is some real evidence to support it. All I had to offer to the conversation was my own personal experience (and, I’m well aware that the plural of anecdote is NOT “data”) and also the observation that it is common practice for mammals to ingest the placenta. Of course, mammals eat it all at once and don’t powder it up into little capsules first, but then again, mammals also don’t wear socks or read stories to their kids or drive cars or sleep in beds in warm comfy houses either. I only found minimal evidence online via these two articles (which I think cite the same sources): Research Studies supporting Placenta Encapsulation and Scientific Research (from Placenta Benefits which certifies placenta encapsulators).

Anyway, this is what I shared with the list about my own experience:

I had it done with my last baby (born in January) and I’m a total convert. I have never felt better during postpartum. I joked that I was “placenta powered.” I felt and looked great—good color in my face, etc. Tons of energy. Total opposite of my other postpartum experiences in which I felt completely depleted and run over by a truck. I didn’t even ever feel like taking naps during the early weeks—you know how new mothers are often all strung out and exhausted. I was vibrant, cheerful, and alert. (I also swallowed a small piece of it raw, immediately pp.) I do not think there is any real research on milk supply and I had/have the same questions as you—if it is putting those “discarded” hormones back into the body, couldn’t it have a milk supply reducing effect? My guess is that the amount you take is so small (one placenta makes around 100 capsules), that it does not have a significant impact on supply one way or the other. I only have anecdotal evidence to offer in favor of it. In addition to various long-distance friends, three in-person friends have also done it during the last six months. Three of the four of us have had oversupply—one of which had not had oversupply with her other three children (my other friend and I had oversupply with previous children who we did not do placenta encapsulation with), though she is tandem nursing, so I suspect that as the cause more than placenta (she also has had mastitis with the current nursling).

I had less trouble with oversupply this time around than with previous children—my first baby and I struggled with it for 10 months, my second baby and I did 12 hour block feedings to get it under control. With my new baby, I started block feeding her from birth (I know this isn’t an officially recommended strategy, but I truly think it made a very positive difference for us). While we still had some issues with it, including several days of 12 hour blocks and one day with 24 hours on one side only (her choice, not mine!), it was much less stressful than my previous experiences. (And, BTW, I did have a couple of plugged duct incidents that quickly resolved with ginger tea compresses.)

Anyway, IMHO, placenta encapsulation= awesome. I really support it!

Oh, and one side effect I did experience was bad headaches when I started “weaning” off the placenta pills. I’ve always been sensitive to hormone changes provoking headaches (get one with ovulation and then again with menstruation, etc.).

As I was typing and thinking about my experiences, some pictures came to mind and so in this post I want to do a photographic comparison of how I looked at 3 days postpartum with each baby. (I left out Noah’s post birth pictures, because how I look in those is complicated by grief as well as blood loss.)

First baby--pretty happy and pretty tired. Note the eyes, pale skin, and the semi-exhausted tilt of head.

Second baby. Could NOT find another 3 days pp that was any better than this. Again, note pale skin and kind of distant, tired eyes.

Second baby again, but now one week postpartum. I've perked up! Still see tired eyes and pale-ish skin.

Last baby--note pink cheeks and happy, sparkling, semi-manic, placenta-powered eyes!

Of course, when this picture was taken I had actually hardly ingested any of the placenta, but for me, it visually sums up the vastly different physical recovery experience of this most recent postpartum time. I also think part of the difference is also in my emotional relief at her live birth!

Postpartum Feelings, Part 3

When I published my article about my postpartum feelings with my first son, I envisioned it as the first part of a series of three posts comparing/contrasting my postpartum feelings and experiences following each child. Here’s what happened—I wrote part two in which I shared some of the recurrent thoughts I had in the year following my second son’s birth and decided that I just don’t feel like publishing it. Reading it back over makes me feel like I probably could have been considered mentally ill and I don’t really feel like sharing that right now. I started to analyze why I feel like sharing any kinds of feelings via blog anyway—really, what is this about? Why “expose” myself? In part, because that is what helped, and still helps, me the most; knowing that I’m not alone in my feelings and that other women have “been there.” So, I feel I have a responsibility of sorts to share my own “been theres.” When I began this website/blog, it was primarily about gathering and sharing information with others, not about telling my own story or sharing my personal experiences. I didn’t start it intending to have any element of a, “personal journal published online” feeling. After the birth-miscarriage of my third son and then my pregnancy-after-loss journey, it took on more of the personal journal flavor. And, I’ve liked that. I’ve enjoyed sharing my feelings and experiences and learning from the comments other people leave that I’ve “spoken” to something in them, and/or helped someone to understand their own experiences (or me) better. That said, I don’t have to share everything I write just because I’ve bothered typing it and I just don’t feel like sharing my second post about weirdo, “crazy” postpartum thoughts right now. So there! Maybe someday I’ll hit “publish” on it.

Of course I know (and firmly believe!), that you’re “postpartum for the rest of your life” (Robin Lim), but I feel like this current postpartum experience is different than my others in some qualitatively different ways. I first credited it to having taken placenta pills this time around. My doula encapsulated my placenta for me and I took all 95 capsules during the first 6 weeks postpartum. It was amazing! I have become a total “convert” to the benefits of placenta encapsulation. I felt GREAT and I had tons and tons of energy, instead of being wiped out and weak and exhausted feeling. I’ve only taken about two naps in Alaina’s life (this may come back to bite me with regard to lactational amenorrhea , we’ll see…) and that ISN’T because I’m crazy and was pushing myself too hard, it is because I haven’t felt like I needed to take any naps. I highly recommend placenta encapsulation. Amazingly powerful!

Another thing that is different about this experience is that I don’t feel “restricted” after having her—I don’t feel like I’ve had to sacrifice or let anything go, I feel like she has integrated smoothly into our lives. I had a phone counseling session with an intuitive healer the afternoon before Alaina was born and one of the new “neural pathways” I set was, “the new baby seamlessly integrates into our lives.” I think it worked! 🙂 What is interesting, is that I have put quite a lot on hold lately, but it doesn’t feel like she MADE me, it feels like what I want to do (or not do, as the case may be). When my first son was born, I had to let go of most of my old life and work and it was very painful. With my second son. I felt like I had a lot of energy to give to the “world” that was being blocked/couldn’t find expression. This time, there is more balance. I’m continuing to teach college classes in-seat and online and that feels really good to me. I’m homeschooling the boys and doing well with that (we actually “do school” almost every day!). I read all of the time (55 books so far this year!). I’ve started a doctoral program. And, I make time for a variety of other smallish projects like facilitating quarterly women’s retreats, editing the FoMM newsletter, and answering breastfeeding help calls/emails.  Oh, and making birth art sculptures (new pictures to follow soon!) And, here’s what I’m not doing: writing new articles, working on my books (I have three in progress), doing much birth work, staying caught up on articles/news/research, teaching prenatal yoga or prenatal fitness classes or leading birth art sessions (all of which I trained to do last year), creating (or teaching) any new craft classes for our annual craft camp, writing the dozens of blog posts that come to mind (or even pulling old material into this blog the way I’d like to do), staying caught up with book reviews, keeping up with the garden, etc., etc. More about balancing mothering and personing will follow someday. I promise!

With previous babies, I’ve felt very haunted by the “list” of all I’m not doing. While I still feel this way sometimes, I more often have a less familiar feeling—that of amazement at my own capacity for adaptation and change. I regularly feel kind of proud of myself—like, look how I can expand and enfold and how I can create a life that works and is satisfying as it continually evolves and changes.

This time with my baby has been the sweetest and most delicious time in my life. Yes, I’m still busy and overextended and hard on myself about a lot of things, but there is a different clarity to the experience. I feel like every moment with her is so vivid, clear, and memorable and like each one is being etched into me. It is just so real this life we have together now and it is weird for me to realize how quickly things change and how pretty soon, this life that I’m living in this moment, will just be our past. I do feel like I savored my boys’ infancies as well, but I don’t remember this sharpness of feeling and observation.  I feel like I will never forget what it is like to be this mother of my baby girl. However, I also know that the reality is that the growing baby and then toddler, and then child replaces the one who came before (even though it is the same person—those other versions of them are replaced by the vivid reality of the now). So, while I retain distinct mental snapshots of my life with the boys as babies, their current, vibrant, and ever-growing selves are much more intense and real (obviously), and I know it will be the same with her. And, it makes my eyes well up to know that this sharp sweetness will float away on the rivers of time and that before I know it, I will be the mother of two men and a woman. It is hard to explain what I mean in writing—what I want to say is, “but this is SO REAL now.” Well, duh. It IS real now. And, later will be real as well. That is just the flow of life, Molly dear ;-P However, one of the main reasons I wanted to get her pictures taken yesterday is to try to capture what it is like to be her mother NOW:

Then, last night while I was nursing her to sleep in my arms as I have done every night for five months, I took this picture myself to capture how well we fit together. I wanted to get how her little feet are nestled into my legs so perfectly and how her hands rests on me and how her head cradles in my arm:

I know this one isn’t a pro picture, but this is what it is like to be her mama 🙂

Birthing the Mother-Writer (or: Playing My Music, or: Postpartum Feelings, Part 1)

A friend and colleague of mine recently wrote some very touching and honest posts about her recent postpartum experiences. It is amazing how powerful the written word can be at clarifying and explaining one’s feelings.

I wrote the following article about my own postpartum feelings several years ago and have submitted to various publications, but it has always been rejected. So, I decided to finally “publish” it here. I plan to then do a follow-up post about my postpartum experiences with my other children.

Birthing the Mother-Writer* (or: Playing My Music)

By Molly Remer

After my first son was born in 2003 I felt silenced. Stifled. Shut down. Squelched. Denied. Invisible. Dissolved. Muted. I felt suffocated, chewed up and my bones spit out, erased, deconstructed, worthless, and useless. (In hindsight, I see the PPD-ish glint behind these feelings, though some of these feelings also featured in my pre-motherhood neuroses.) Postpartum was the most vivid and painful transition point of my life.

I felt slapped in the face by postpartum. I was triumphant and empowered in birth, but diminished, insecure, and wounded postpartum. I had a difficult physical recovery due to unusual labial tearing that was not repaired. I hypothesize that perhaps this contributed to my difficult adjustment to early motherhood. I’ve long tried to analyze the difficulty, concluding that it is not uncommon in the least, but wondering why/how others survive without mentioning this pain. How is anyone doing this? I would wonder, concluding that I must not be “cut out for this” and that I was the only one feeling alone, stifled, shut down, and unheard. As a consistently overachieving type, it was humbling as well as psychologically painful to not “get an A” on this new “assignment,” my baby. Each time he cried, I felt it was evidence of failure, failure, failure. I would see women and couples without children and think, “it isn’t too late for you” and, “if only you knew.” When I would see women who were pregnant I would feel a sense of grief for them, “Just wait. You have NO idea what is coming.”

I felt a duality in motherhood for which I was completely unprepared. How is it possible to feel simultaneously so captivated and yet also so captive, I would wonder. Bonded and also bound.

Maybe these feelings mean I’m egocentric, selfish, or immature (I certainly lectured and berated myself about that!), but they were my reality at the time. The experience was so scarring to me that for about 18 months after my first baby was born I considered not having any more children;  not because I couldn’t handle pregnancy, birth, or even the mothering of a baby and toddler, but because I could not stand the idea of experiencing postpartum again. I came to realize that my only regret about these days of early motherhood was not in how I related to my baby, or in how I took care of him, or loved him, or appreciated him, or marveled at him. My regret is that I was so very mean to myself the whole time I did those things—in reality, I was actually fairly skillfully learning how to mother. I was responsive, nurturing, kind, and loving and I took delight in my baby, but I was cruel to myself almost the entire time and failed to appreciate or notice any worth I had as a person or to accept and have patience for my birth as a mother.

When my first son was almost one, I wrote in my journal:

I feel like I have no one to talk to. I feel like no one understands me. I feel like I cannot express what I really feel inside. I feel like no one believes me. I do not feel accepted. I feel like my needs are not being met. I feel burned out. I feel drained. I feel angry. I feel sad. I feel desperately unhappy. I feel guilty. I feel wrong. I feel alone. I feel unworthy. I feel like I am not good. I feel invisible. I feel ignored. I feel small. I feel bad. I feel like I cannot say what I mean and actually be heard. I feel like I can’t explain my “bad” feelings. I feel trapped. I feel suffocated. I feel stressed. I feel overloaded. I feel like snapping. I feel mean. I feel unfair. I feel selfish. I feel disconnected.

I miss Mark. I miss our relationship. I miss feeling right in our marriage. I miss being alone together.

I feel like I am not enjoying motherhood the way I am “supposed” to. I feel confused. I feel conflicted. I feel torn. I feel low. I feel resentful. I feel worried about the future. I feel anxious about being good enough. I feel stretched. I feel taut. I feel like changing.

What helped me a great deal during this time were the voices of other women. Not women face-to-face, though I had begun building a network of wonderful female friends, it seemed too painful or dark to broach the question with them—-“Do you hate this sometimes too?” And I couldn’t really bear to voice my feelings to my own mother, also a tremendous source of support for me, because to risk hearing her say, “Yes, sometimes I did feel tortured by YOU” was not really what I needed. She also has a well-meaning, but frustrating tendency to meet genuine expressions of despair with comments that imply I should put on a happy face. Instead, it was the voices of women reaching off the printed page that met my hunger for contact. For truth. For rawness and a look at the “ugly.” I gobbled up books about motherhood and women’s experiences of mothering and have a permanent place in my heart for the “momoir.”

A quote from Wayne Dyer that serves a recurrent guidepost (or almost obsession) in my life is, “Don’t die with your music still in you.” During my abovementioned painful transition to motherhood I couldn’t shake the feeling that I wasn’t letting my “music” out. Then, following the birth of my second son in 2006, sort of accidentally, I began writing again and in earnest this time (articles, essays, blog posts, journals) and later realized that I no longer have any fear about dying with my music still in me. And, I also don’t feel depressed, invisible, worthless, or muted anymore. During my original fretting over this phrase, I felt like it was another type of “music” that I needed to let out (mainly that of the social service work that I had been groomed for in graduate school), not words necessarily. However, I’ve finally realized that maybe it was literally my words dying in me that gave me that feeling and that fretfulness. They needed to get out. I’ve spent a lifetime writing various essays in my head, nearly every day, but those words always “died” in me before they ever got out onto paper. After spending a full three years letting other women’s voices reach me through books and essays, and then six more years birthing the mother-writer within, I continue to feel an almost physical sense of relief and release whenever I sit down to write and to let my own voice be heard.

—–

Molly Remer, MSW, CCCE is a certified birth educator, activist, and writer who lives in a straw bale house in central Missouri with her husband, two young sons, and infant daughter. She blogs about birth at https://talkbirth.wordpress.com.

*title inspired by Literary Mama.

Planning for Postpartum

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.