Wednesday, December 22, 2010

A Time To Heal- A look at postpartum recovery

This post was inspired by something I wrote a year ago to a friend feeling overwhelmed with life and the physical condition of her body just 3 weeks after giving birth.  I've changed a lot of it and added to it to apply to more women but the message is the same. 

Laboring at home.

I often see or hear of women pushing themselves to return to normal as quickly as possible after birth.  In a hurry to get their life and body back they jump into a myriad of activities at warp speed, often just days after giving birth.  Riding on the birth and baby high, pumped full of adrenaline yet restless from the last few weeks of pregnancy, particularly if they felt like a watched pot, these women fill their schedule, attack their house, and find new projects determined to not be slowed down, impatiently trying to control and master this new version of normal.  These women are often viewed with admiration and awe and the media highlights celebrities that are back to their prepregnant weight by 6 weeks or were spotted out jogging at 3 weeks or were back on the set of their TV show at 10 days.  This is held up as the epitome of a strong woman, give birth, bounce back, conquer world.  After all, women in China squat in a rice field, push their baby out and throw them on their back then return to work, right?

It's as though we've forgotten to celebrate.  We've forgotten how important it is to rest after a hard work and enjoy the fruit of our labors.  We've forgotten that while pregnancy and childbirth may not be an illness our bodies still need to recover from the taxing physical and emotional demands of the endeavor.  Pregnancy, labor and childbirth may be a normal part of life but it is anything but easy.  The change a woman's body goes through are massive to say nothing of the emotional journey as well.  Ignoring this reality can have serious consequences for our bodies, our emotional health, our breastfeeding relationship with our baby, our mothering, and our families.  Do not underestimate the potential for damage if we neglect our postpartum healing. 

Smunchie, 2 weeks.

I understand the temptation, the drive.  My pregnancies are difficult and I feel more alive after birth than I ever feel during the months of pregnancy so I can't wait to get back to feeling well and being active.  Two weeks after giving birth to my first we moved and I returned to teaching private lessons and was leading worship at 3 weeks.  With my second I was performing at 6 days postpartum, my dress too tight in the chest thanks to being engorged and my baby in the green room with a friend where I'd run to nurse her between sets praying I wouldn't soak through my breast pads.  With my 3rd baby I did nothing... for a week and then I was back cleaning my house, cooking and grocery shopping.  I actually had maternity leave that time and I took it, mostly.  The only reason I wasn't out shopping, taking the older kids to the park and lessons was because we all got the flu when she was just 3 weeks old.  Almost 5 years later baby #4 was born and I still hadn't learned my lesson, shopping at Baby's R Us at 2 days postpartum, walking the mall at 2 weeks and attending births at 3 weeks and that was after experiencing uterine prolapse during the pushing stage.  In the 2 years between #4 and #5 I learned a lot, worked with a lot of women as a midwife student and doula, studied different cultures approach to birth and motherhood, talked to midwives and many mothers and came to realize that we were missing something vital.  Nearly a year ago with Smunchie I did nothing for almost 4 weeks and then tried to gradually eased into activity after that.  The biggest obstacle I encountered in trying to rest?  Not my children, not the house cleaning, not the cooking, not anything I was missing out on.  No, the biggest obstacle was the voice in my head and a tiny handful of other people (including the company that came to "help") saying I couldn't let this "keep me down," I was strong and there was so much to do.  Stupid voices.

Dear pregnant women and recently postpartum women, I have a few things to say to you.  Please, please, please let yourself rest and recover, do not be impatient with this postpartum time.  You have gone through so much and now is the time to simply be with your baby.  You have not done a small thing, no.  This major organ and bag of muscles in your body grew quickly more than tripling in size in a few months. Your blood volume more than doubled. Demands were placed on your body and while it rose to the challenge this also depleted your resources. Organs shifted and were smashed.  If you had a vaginal birth your body worked to move your baby down and out, stretching, pulling, opening, applying 40-60 pounds of pressure as your uterus flexed it's great strength to bring you your baby.  Parts of your body stretched and eased out a whole person, a small person but still, a person.  And maybe not that small.  Any tearing or swelling needs time to heal.  If you encountered interventions outside of your body's own initiative then you have additional physical stress and possibly emotional stress to recover from as well.  For those that had a cesarean, you had major (as in, serious, muscle separating, invasive) surgery that removed a significant mass (baby, sorry) from your body causing significant blood loss, a shift of internal organs, and an incision that all require recovery and healing.  C-section surgery may be the most common surgery in our country but that doesn't make it any less invasive and traumatizing on the body. C-sections don't mean you get to completely skip out on postpartum recovery and "only" have to recover from surgery, no, you have both to do and this isn't easy.  Some of you labored and had major abdominal surgery too.  However your baby was born you need rest and lots and lots of it.  Either way there is a large wound inside you where the placenta was attached, it needs rest to heal.  Days or weeks into your postpartum recovery you are healing from huge physical changes and giving birth, maybe surgery, tears, and more.  Six weeks is a small amount of time to ensure you recover well.  Mothers recovering from a c-section, remember you had major surgery and you should be resting, REALLY resting for at least 8 weeks knowing that surgery can take even longer for full recovery. 

My roses from The Piano Man after Smunchie's birth and my baby hanging out.

The western world has placed unrealistic expectations and demands on new mothers during the postpartum period. We not only neglect them but we ask them to neglect themselves! I'm a firm believer that staying home, lounging in your PJs for 6 weeks with good food, real support, and helpers is the best way to set a new mother up for success. In cultures where this is practiced PPD rates are significantly lower, mothers report being happier and more confident and marriages are stronger. A woman's partner sees that she has gone through a physically trans-formative experience and respects that more in her. I am a huge advocate of pregnancy and birth as normal, life events, not an illness but at the same time recognize that we must embrace the changes that this normal process brings our bodies with peace, rest, and gentleness for ourselves.

I know it's hard, I know you've been stuck feeling crappy at the end of pregnancy for what feels like ages and it is hard not to be in a hurry to return to normal. But here's the reality check we rarely talk about: you have a new normal now.  Life will never go back completely the same, everything has changed.  Normal is now redefined. This new normal includes having been pregnant and giving birth, being a mother for the first time or having one (or 2 or 3) more children than you did before.  Busy before looks nothing like busy now.  Sleep is changed.  Instead of handbag you carry a diaper bag.  You don't even pee the same way.  Our culture tells us these things are the bad parts of becoming a mother but maybe they are actually the good parts.  I don't know but what I do know is that at first it is just crazy overwhelming. Your postpartum time can help you ease into this new normal as much as possible. Pull out of your regular activities, they will be fine not having you for a few weeks I promise. You will too. Recognize that there will have to be a lot of flexibility because your baby simply isn't going to be reading the same things you are. Just like with labor and birth take it one step, one minute at a time. Go easy on yourself and show yourself some grace.   Even if you have other children already you need this time and the truth is they do to.  Embracing the changes you are all experiencing means giving room for them to happen.  And by the way, those celebrities you see, they have help, lots and lots of help.  Not to mention they're not respecting themselves either by ignoring this time.

The Piano Man sitting with a jaundiced Smunchie in the sun while I napped, well, napped after I took this pic.

Now, I'm pulling out the mommy tone... you can ignore me if you like but I have to say it.

Put the car seat down. For that matter, put the keys down. You don't have to be super mom. In fact, if you try you are likely to burn out and find yourself much worse off. Take it or leave it but I'm giving you permission to not wash your hair, not change your clothes, not leave the house, not wash a dish, not pick-up a toy and not do anything else than put a DVD on, sit on the couch with your precious baby and be the postpartum woman you actually are.  Stare into your baby's eyes, stare at partner staring into your baby's eyes. Close your eyes and take a nap when all three of you are tired of staring.  Focus on breastfeeding and getting your supply well established, take the time to get both you and your baby comfortable with breastfeeding.  Sip a glass of wine once in a while, take a long shower while someone else holds your baby, ask a friend paint your toe nails.  Have your husband bring food home, if you don't care, let him pick, if you do care, call ahead and have the order placed and just let him know where to stop on his way home. Order extra so there are left-overs for tomorrow.  Ask him to help pick up around the house even while you just lay in bed or sit on the couch.  Yes, he's tired, yes, he may be working a lot and dealing with the stress of sleep issues with a newborn in the house (maybe) but, sorry, you still have the trump card of 9 months of major body changes, the extreme workout of your uterus contracting and pushing our a baby or the muscles in your abdomen recently severed, pulled apart and opened and your baby extracted from your insides after which you were put back together but not completely. Put the car seat down. Oh, I said that earlier. Well, I mean it. Ask for help, friends, family, or hired help (postpartum doulas are great) and actually let them help.  You need rest and healing. Whatever that looks like. Who gives a flip if you take 6 weeks to do nothing?  Being truly rested and healed is worth the time.  You don't have to be on house arrest the whole time by any stretch but after giving yourself a good 2-3 weeks staying in, ease yourself into the outings slowly and listen to your body and go home when it says it's had enough and it's time to rest.

Your body has ways to tell you when you're not resting enough.  If you spot any of these in yourself it's time to slow down. 

Bright red bleeding- The first few days the lochia (postpartum discharge of blood, tissue, and mucus) is usually heavy and red but it tapers off to pink and mucusy and then brown.  When you see bright red after it has changed then you are doing too much. 

Thirst- Change in blood volume, hormones, sweating, and breastfeeding make staying hydrated important.  If you're thirsty then your body is telling you it's dehydrated so please slow down and drink more and eat food rich in water. 

Exhaustion- Being tired goes with having a new baby but if you're exhausted you're setting yourself up for a host of other problems including postpartum depression.  Sleep is important.  The old adage to nap when the baby naps isn't just for fun, you really need to try to sleep every chance you can. 

Baby Blues- It's completely normal to have a wide range of emotions after having a baby and feeling a little blue isn't uncommon.  However, when that feeling is stronger than just a bit of the blues or you find yourself battling overwhelming sadness, anxiety and stress, look and see if your schedule is too full.  Don't hesitate to talk to your doctor about it if the blues turn into something much more oppressive. 

Constipation- There are several causes for constipation including diet and fluid intake but did you know that if you're not getting the rest you need and not taking the time to eat and drink well it can also contribute?  And after pregnancy and birth you want to keep things easy down there. 

Trouble sleeping- Babies wake often to feed so sleep can be a little difficult to come by in the early days.  If you find yourself unable to sleep when you do actually have the chance it could be because you're not getting enough rest and are overtired.  Activity can help with sleep to but don't rush into anything, take your time and be well rested to avoid a vicious cycle. 

Breastfeeding troubles- There is nothing like staying home for weeks, putting your feet up and making sure you and your baby get off to as good a start as possible.  This takes work, attention and sometimes perseverance.  The first week is particularly important, lay in bed, eat, drink, nurse, change diapers there, and get your supply established by feeding on demand. The dust bunnies can wait, someone else can do the dishes or use paper plates but this breastfeeding relationship is for the long haul and not something that you want to worry about fixing later. 

Continued bleeding- Most women stop bleeding anywhere between 3-6 weeks postpartum.  I have seen with myself and with other women that the postpartum bleeding time can be greatly reduced by resting and for those that don't rest it often extends, sometimes going much longer than 6 weeks. 

Touched out- Babies like to be close which is great, we like to have them close too.  But sometimes you may wonder when was the last time someone wasn't touching you.  If you start feeling touched out and overwhelmed with physical contact it may be time to let someone else hold your baby.  Your brain is signaling for you to take care of yourself and being fatigued will make you overly sensitive to stimulation.  Feed your baby and hand him/her off while you take a nap alone, shower or make a run to the coffee shop drive-through.

It wasn't until my 5th baby that I finally rested postpartum.  Looking back I don't regret taking that time at all and I wish I had respected myself and my babies more the 4 times prior.  Due to some health concerns with Smunchie it wasn't exactly the restful period I had hoped for but it was significantly more so than it had ever been with my 4 older girls.  My bleeding time was 3 weeks, we stocked up on cuddles as a family, I was actually able to sleep even with a crazy breastfeeding and pumping schedule, and I felt great.  There were moments when I felt I should be doing something but nothing was left undone that either someone else couldn't do or couldn't wait for me to get around to it.  To combat feeling lazy and unproductive (sleep is productive though!) I did knit some and really enjoyed having my baby laying next to me while I knit her some sweet clothes.

Roses, baby and my knitting 1 week postpartum.

In all of my long-winded babbling my point is respect yourself, respect this time.  Hold onto it, it will pass quickly and there are precious moments here.  Moments of healing, moments of growing, moments of developing, moments of transition, moments of deepening and moments of memory.  The first six weeks or so pass in a blur as it is, slow down so you don't miss them entirely.  If you are too busy for those moments you will feel like you missed something and your body will not be in a place to help support the pace of life having a new baby now puts you.  There is no doubt you can do it but how you begin can make a huge difference in how you continue.  Rest for now, busy will always find you again later and your new normal will engulf you soon enough.


  1. I really wish I had read this 6 months ago. I sit here and cry because i really wish I had done all of this cause now I am tired, overwelmed and stressed. This was number 3 and i spent 1 day in bed, was at walmart by day 2, was supposed to have ppl help me but at 5days pp relatives came and I was the host. At 5wks my niece was born and I was there for that than they came and stayed with me because it was her first and my brother was working out of town. I wish I dropped the car seat and ignored ppl telling me to get out and STOPPED trying to be supermom and the person everyone was in awe of because I was out and about. PPL who are pregnant or have just had their babes this article should be followed to the T! Enjoy your baby time flies to fast and you won`t even now where it went.

  2. THANK YOU! Loved this post! I have written some similar things in some venty blog posts. While I still over did it with my second baby (a VBAC...But I had a 19mos old and not nearly enough support), I really took it easy the first THREE Months... I just kept extra activities down, and it took that long to feel a bit more normal (I heal slowly).It was so frusraitng to me, becuase I felt a lot of pressure and guilt that I wasn't bouncing back...But I had learned after my firstborn (a cesarean) that over doing it in the early weeks can have some horrible results...I landed myself in the hospital with bad complications from a gall bladder stone and ended up there for a week also coming down withe the Flu. It took me NINE months to recover and be able to lift my legs with out pain. It was a hard costly lesson to learn, but I learned! Next baby I plan to be even more organized, have help lined up for the first month before I am even on my own with the kids. I just NEED that, my body seems to heal very slowly and I need to respect that. I will be passing this post around and around, this is wonderful! Thank you!


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