Knowledge of what a baby needs in its first few months of life, and proper management of expectations on the part of the mother and her support team, are essential in meeting the needs of the newborn while also alleviating the stress of the mother.

Would you prefer to start motherhood by sabotaging yourself, being exhausted, slowing your own healing and not meeting the baby’s needs?  Or, would you rather set yourself and your baby up for success and look back on this time with joy?  Postpartum has never been an easy period for new mothers.  But, in today’s society more and more women are struggling in the postpartum period.  In analyzing the cause for this, I hypothesize that new mothers are setting unrealistic expectations for themselves and/or they don’t have a clear understanding of what they and their baby need during the first few weeks after birth.  When new mothers have realistic expectations and adequately care for themselves and their baby in the immediate postpartum period, they will both be healthier and happier.   

According to the World Health Organization (2012), the postpartum period, or puerperium, is the period of about six weeks after childbirth. “This period covers a transitional time for a woman, her newborn and her family on a physiological, emotional and social level.  For women experiencing childbirth for the first time, it marks probably the most significant and life-changing event they have yet lived.  It is marked by strong emotions, dramatic physical changes, new and altered relationships and the assumption of and adjustment to new roles.  It is a time of profound transition, making great demands on the woman’s resilience and capacity to adapt.”

Expecting parents today have access to much more information and research about pregnancy and birth than is available for the postpartum period.  As a result, many new parents are unprepared for the challenges they face once the baby arrives.  As Kim-Godwin points out in her article for The American Journal of Maternal/Child Nursing, in Western Cultures, the focus tends to be on the baby rather than the mother.  She is expected to return to her normal activities almost immediately.  Her needs are often suppressed, and the baby’s needs prioritized.

In her blog, Tyckled Tales, Karen To compares different postpartum practices from around the world.  She points out that in Non-Western Cultures, there is a greater emphasis placed on the health and recovery of the new mother, so she can restore her energy to focus on caring for her baby and herself. Modern medicine says that it takes approximately six weeks for a woman’s internal organs and tissues to heal after birth.  As a result, non-Western beliefs and practices encourage rest and confinement for the mother up to 40 days after delivery to regain energy and strength.  The Chinese call this a “Sitting Moon,” where the mother rests for a full moon cycle after birth while she is nurtured and replenished with nutritious foods and herbs to renew her energy and prevent post-labor problems.  When women honor this time and take care of themselves, they feel better, and it also lines up with the baby’s needs.  Western cultures would benefit from adopting and following the non-Western practices.

This paper shall examine the needs of a baby and her mother in the postpartum period and see how they line up perfectly with each other.

What is happening for Mom:

Pelvic Floor Rest- In the postpartum period, a woman’s body is healing from pregnancy and childbirth.  Giving birth is like running a marathon.  It will take several weeks for the mother’s body to fully recover and for her to fully regain her equilibrium and energy.  The stability of the pelvic floor muscles and the ligaments supporting the pelvic organs need time to shift and heal.  Resting after birth and staying off one’s feet allows the pelvic floor to heal properly by relieving the pressure that standing can apply downward on the pelvic floor.  Being too active can lead to severe organ prolapse concerns.  Even simple chores like housework or grocery shopping can lengthen the healing process.  New mothers should also try to refrain from straining while having a bowel movement or doing any exercises that would cause her to strain and negatively impact her pelvic floor (McCulloch 2016). However, most women don’t acknowledge these needs because they aren’t outward, visible wounds but hidden, internal injuries that go unnoticed.

Bleeding- For weeks after giving birth, women will experience bleeding (lochia).  Inside a new mother’s uterus, where the placenta was attached, there is essentially an open wound where the placenta has detached after birth.  In the beginning, the bleeding will be bright red, but as the wound closes and heals, the bleeding lessens and the color transitions to brown and eventually stops.  As new mothers nurse their baby, their body releases hormones designed to help shrink the uterus to pre-pregnancy size (WHO 2012).  As the uterus gets smaller, that open wound becomes smaller, similar to the effect of seeing the graphics on a balloon shrink as the balloon loses air and retracts in size.  However, if a woman is too active in the postpartum period, she will notice an increase in the bleeding and a brighter color as she has delayed the healing of the wound through agitation of the uterus.  Resting and nursing one’s baby will help new mothers’ uterus return to normal size and for the bleeding to end sooner while simultaneously providing the baby with the nutrition it needs

Support- After giving birth, new mothers should plan to spend the first few weeks only eating, sleeping, and nursing their baby.  For this to happen, someone else will need to take care of everything else such as preparing meals, doing laundry, dog walks, etc.  These chores can be taken care of by one’s partner, but he is likely to be tired and adjusting as well and bonding with the new baby.  Therefore, it is good to plan support from other sources.  A postpartum doula is trained for this exact situation and can provide support as well as answer questions regarding breastfeeding, baby care, and postpartum healing.  New mothers can invite family members and make clear the expectation that the baby will spend most of its time with the mother, but they can help with the chores.  Or, mothers can arrange for friends to bring meals or help with cleaning.  Support during this time is imperative.  Numerous studies have shown that a lack of support from the spouse, family or others is strongly correlated with Postpartum Depression (Corrigan 2015).  Mothers should not wait until they are feeling overwhelmed.  They should make a postpartum plan during pregnancy and have the team standing by to help.

Breastfeeding- Breastfeeding can sometimes take time to learn for both mother and baby.  Newborns also spend a lot of time feeding in the first several weeks.  During this time, it’s best to minimize visitors as mother works through issues and determines how to feed the baby properly.  As previously stated, a baby sucking at the breast can spur uterine contractions and help reduce postpartum bleeding.    Breastfeeding releases the hormone prolactin, which is also known as the “mothering hormone.”  This hormone induces maternal behaviors, making a new mother want to respond to her baby and meet the baby’s needs.  It also promotes a feeling of calmness and relaxation.  Grantly Dick Reed, obstetrician and author of Childbirth Without Fear said, “A newborn baby has only three demands.  They are warmth in the arms of its mother, food from her breast, and security in the knowledge of her presence.  Breastfeeding satisfies all three.”  Breastfeeding is metabolically expensive, meaning new mothers will burn calories producing milk (Worthington-Roberts, Vermeersch & Williams, 1985).  Fortunately, during pregnancy, the mother's body has stored extra fat for this purpose.  Therefore, breastfeeding often helps women get back to their pre-pregnancy weight sooner and provides baby with fat high in DHA, an essential nutrient for brain development (Lassek 2007).

Adequate Nutrition- The nutritional status of a woman during adolescence, pregnancy, and lactation have a direct impact on the maternal and infant health in the puerperium (WHO 2012).  New mothers need to ensure they are eating healthy, adequate meals to assist their body in healing and producing milk.  However, as she will be resting, recuperating from birth and nursing a baby, steps must be taken ahead of time to ensure meals are prepared and brought to mother while she is doing this important work.  Mother's nutritional reserves will be depleted if she doesn't pay close attention to her dietary intake.  

Self-Care- In the days after a baby is born, new mothers will need time for hygiene and healing.  They make many trips to the bathroom to change blood-soaked pads.  If the mother’s perineum was injured during birth or if a cesarean birth occurred, these wounds must be tended.  New mothers often deal with nipple pain and need to ensure adequate oxygen for their nipples between nursing sessions.  Mothers will be tired and want to sleep when the baby is sleeping.  It is essential to make time and space for these needs, undisturbed by visitors in the postpartum.  When mothers take care of themselves, they are more rested, heal faster, and are more able to handle the challenges of caring for a newborn.

Stay tuned for part 2/2 next Tuesday!

Image Credit: Kelly Sikkema @ Unsplash