What to expect postpartum

 

Pregnancy and birth are such intense emotional events. Often prenatal education classes focus solely on getting you through birth and into breastfeeding. If you are under the care of an OB here in Ontario, then you’re first follow up may be up to 6 weeks after birth. This leaves a lot of a huge care gap. Most people are unsure about what’s going on with their bodies, and about how best to take care of themselves and their babies. So, let’s talk about what to expect after birth.

Your body postpartum

Your uterus:
After birth, your uterus will continue to contract for several days, this is called involution. These contractions return your uterus to its pre-baby size and often cause “afterpains”. Afterpains are usually more intense during breastfeeding and are often less intense for your first baby than following ones. Your midwife or OB will teach you how to check where your uterus is after birth and how to tell that if it is contracting as it should. As a general rule, your uterus should contract about 1 thumbs width every day for about 1 week until you can no longer feel it below your pubic bone. Your uterus should feel firm and smooth, if it feels boggy, you should contact your care provider.

Vaginal Discharge:
Vaginal bleeding and discharge occurs for the first few weeks postpartum, it is called lochia. During the first week lochia is bright or dark red and like a menstrual period. Over the next few week it will become lighter and more of a brown colour, finally it will become pale yellow. Discharge should resolve within 3-4 weeks but can last up to 6 weeks. If bleeding suddenly becomes heavy or if you start passing clots the size of a golf ball or larger, contact your care provider immediately.

Your Perineum
Birth may result in tearing of your perineum, but even if you don’t experience tearing there will almost certainly be bruising and soreness. This can result it discomfort, especially when you’re using the bathroom. The first time you pee after birth it may take extra effort to relax all these muscles, but it is important that you pee after birth. If there is too much swelling and you can’t urinate you may require a catheter to ensure proper voiding. Bowel movements will also be painful. The best way to ease this is by making sure you have lots of easily digestible fibre and oils in your diet (think well cooked root vegetables in bone broth) and that you are well hydrated, this will ensure that your bowel movements pass easily.

Tips for healing the perineum:

• – Ice packs or “padsicles” can be applied in the first 24-48 hours after birth to help reduce swelling
  – Clean and irrigate your perineum every time you use the washroom
  – Sitz baths can be used in combination with healing herbs
  – Keep your perineum dry as much as possible
  – Kegal or pelvic floor exercises can help to strengthen your perineum before and after birth

Postpartum emotions

The first days after birth are often a roller coaster. You will experience many intense emotions both positive and negative. This can include the joy of holding your baby, falling in love, anxiety about whether or not you will be able to handle the responsibility of being a parent, confusion about what your newborn is trying to tell you. These are all perfectly normal.

Baby blues, or feeling low or anxious is very common, and most likely caused by the sudden cessation of the hormones produced by the placenta. It usually doesn’t last more than a few weeks.

The best way to help prevent and manage postpartum emotional changes is to take care of yourself as best as you can. This includes getting enough seep, ensuring you have adequate social support, maintaining proper nutrition, asking for help when you need it and openly sharing your birth and postpartum experiences with people you trust.

Postpartum depression is more severe, can occur anywhere up to 1 year following birth and can involve any of the following:

• – Feeling down, depressed of hopeless much of the time
  – Being unable to experience joy or the positive side of situations
  – Blaming yourself or having difficulty coping
  – Feeling that you want to hurt yourself or your baby

If you are experiencing any of the above, please know that there is help, contact your doctor or midwife.

Maintaining optimal health

One of the most important parts about taking care of your baby is taking care of yourself. Here are some simple tips to help you look after your own health so that you and your baby can both get off to a good start.

Getting enough sleep
Sleep when your baby sleeps
Divide and conquer sleep with your partner, one of you sleeps until they get the sleep they need, then switch
Stay in bed with your baby or with your baby close at hand until you get the number of hours of sleep that you need
Ask for help if you need it

Getting good nutrition
Incorporate each of the following in every one of your meals:

• Healthy fats: oils, nuts (almond, walnut, pecans, etc), seeds (pumpkin, flax, sunflower, etc), cold water fish, avocado
  Protein: chicken, turkey, nuts, cold water fish, rice and beans, bone broth
  Good carbohydrates: brown rice, quinoa, ancient grains, vegetables

It can be helpful to prepare meals before your birth and have them in your freezer ready to eat when you need them afterwards. In the first few weeks it’s best to have meals that are very easy to digest and warming such as chicken soup, stews, lentils and curries. You can also enlist your friends and family to bring you healthy meals when they visit. Keeping healthy snacks in different places around your house can be useful as well, especially as this means you won’t have to get up to prepare anything. To make things easier, consider a meal delivery service.

Mobilizing your support network

In the first days and weeks postpartum the most important thing for you will be to spend time with your baby. Your support network will need to be on board with this goal. Remind your friends, family and your partner that this is of the upmost importance. It may also help to remind those close to you that you are vulnerable right now and that they will need to help with some of the tasks that used to be shared.

A great way to get friends and family involved is to organize a meal train as part of your shower. Have each person sign up to bring food on a specific date, this gives them a good chance to meet baby and to help you out as well. You can also post a to-do list on your fridge and ask anyone visiting to cross one thing off of it. These are good ways to include your extended family in the care of your newborn.

It’s also important to be easy on yourself. You will need to let some things go. Your house will not always be clean. Your meals will not always be the most healthy and this is okay.

If you’re finding it difficult to balance things, you should consider hiring a postpartum doula.