By Deborah Jeanne Sergeant
Imagine struggling with a chronic illness for nine months and then running a marathon, followed by experiencing a large, acute wound in an internal organ and major tear in the skin.
That’s somewhat like what carrying and birthing a child is like: nine months of physical changes and struggle, hours of labor, vaginal tearing (or episiotomy) followed by stitches and a wound the size of a dinner plate (about 8.5”) in the uterus where the placenta was attached.
On top of all of that, the mom’s hormones are thrown for a loop as her body had to gear up to grow, birth and then feed a baby.
Bouncing right back from all of that in a couple of weeks isn’t advisable — or in nearly every case, possible.
It takes a few months for the mom’s body to recover, even for women who have textbook-perfect pregnancies. Undergoing complications like Cesarean section, hemorrhage, preeclampsia or severe tearing may take longer.
“They say that raising a child takes a village, which is also true for recovering from delivery,” said physician Jordana Gilman, an instructor of clinical obstetrics and gynecology at Highland Hospital and attending physician at Highland Women’s Health. “The postpartum period is known as ‘the fourth trimester’ for a reason. The first three months after delivery contain huge changes in the physical, mental and emotional state of the pregnant person.”
It’s hard to get rest while caring for a newborn, so Gilman advises accepting help from friends and family and adhering to the “5-5-5 Rule,” which means five days in bed, five days on the bed and five days near the bed after delivery.
“This can help with bonding and setting boundaries to make sure that you get to rest and time to heal,” she said. “It may not be for everyone, but can be adapted to your needs and family situation as you see fit. Taking gentle walks in the first weeks postpartum can help with physical recovery and preventing blood clots. Then, as you feel better and better, increasing the duration and speed of walks can be a great way to get back into an exercise routine.”
Nursing and pumping moms have even more challenges, as the physical rigors of nighttime feedings and the body’s process of making milk can be exhausting. Nursing mothers burn up to 800 calories daily just making milk. Although a natural process, nursing isn’t always easy for many reasons.
“We have lactation specialists in the hospital and at the Breastfeeding Medicine Clinic who can help you with latch, position, pumping and pain or infections,” Gilman said. “Breastfeeding is a great way to bond with a baby and providing breast milk, whether through direct breastfeeding or pumping milk, provides the baby with important nutrients and antibodies that help their immune system fight off disease.
“Breastfeeding can also help postpartum patients get back to their pre-pregnancy weight because it burns so many calories to provide milk for the baby. You may find that you are hungry all the time.”
Those supporting new moms should help by providing plenty of things to eat and drink while she’s nursing or pumping for the baby. Eating right at mealtime aids in birth recovery and lactation.
“A higher intake of nutrient-dense foods is recommended to achieve increased nutrient needs to support hormonal, metabolic and physiological changes for optimal maternal and infant health throughout both pregnancy and lactation,” said Shalene McNeill, P.h.D., executive director of nutrition science, health and wellness for National Cattlemen’s Beef Association in Denver. “Lean beef is an example of a nutrient-dense food that provides many of those essential nutrients for pregnant and lactating women.”
Beef is a good source of zinc, iron and protein.
Alison Spath, internationally board-certified lactation consultant, DONA-certified doula, registered yoga teacher and co-owner of Beautiful Birth Choices in Rochester, likes for clients to focus on nourishing their bodies with “whole foods, soups, salads, fresh fruits and vegetables and foods that are high in nutrition, not just empty calories to support post-partum recovery.”
She recommends the book “The First Forty Days: the Essential Art of Nourishing the New Mother” (2016: Heng Ou, Amely Greeven and Marisa Belger).
When family members and friends ask what they can do, families should ask them to bring food. They can also set up a schedule on websites like Mealtrain.com, a free calendar where friends can schedule meal deliveries for people in recovery at home.
People dropping off food should consider providing ready-to-eat food that can easily be eaten with one hand and served in containers they don’t need back. Moms should not feel obligated to allow visitors to see the baby or be entertained. At this point, anyone stopping by should either stay very briefly or wash dishes, walk the dog, run the washer, mop the floor or do whatever else needs doing.
“As a birth doula, I tell clients if they can spend the first few days after birth just resting in bed and learning how to breastfeed and get to know their baby and be skin to skin, that releases oxytocin,” Spath said. “The goal is to slow blood loss.”
She wants moms to give themselves grace about getting back to an active lifestyle. It can take months.
“Limit in those first couple of weeks doing things outside the house,” she said. “Keep trips outside of the house short and close to home.”
Baby Blues or Postpartum Depression?
“The mental and emotional demands of pregnancy, labor – delivery C-section and postpartum are some of the most intense in a person’s life,” said physician Jordana Gilman, an instructor of clinical obstetrics and gynecology at Highland Hospital and attending physician at Highland Women’s Health. “Accepting that there are hormone shifts at each of these time points, as well as significant stressors, can help give yourself grace.
“Baby blues are common and you should speak with your OBGYN about episodes of tearfulness. Postpartum depression is typically a few weeks later and can occur up to a year after the delivery. This can range from mild to very severe and it is important to get help. If you or someone you know may be struggling with postpartum depression, please reach out to your doctor or a national hotline. Postpartum psychosis is a very extreme version of mental health changes after pregnancy and should be treated as an emergency.”
Postpartum Support International: 1-800-944-4773 (4PPD) English and Spanish. Text in English: 800-944-4773 Text en Español: 971-203-7773 www.postpartum.net