Saturday, November 19, 2011

Postpartum Recovery- The Good, The Blood, & The Ugly

(Disclaimer- You are not allowed to read this post if you are "on the fence" about having children.  This is only intended for those for which it is everlastingly too late, and so, need this information.)

In some areas of life I am, pure and simple, an optimist.

I always assume that things will go swimmingly well for me.  I notice those in the same situation who seem just great, and I of course "know" that I will be the same way.

For instance, before I had a child I remember my friend Donna having a baby.  She was back at church driving a mini van in what seemed like a week.  "Natural birth!  You recover so fast,"  she quipped.  I would be just like that, I thought.

I was wrong.  I was wrong about taking my skinny jeans with me to wear home from the hospital, I was wrong about my baby never crying (because I would have breasts and a sling, DUH) and I was wrong about postpartum recovery.

Some of this innocence is due to my idiotic optimism about the realities of life, but some of it is due also to the way we still continue to ignore some of these things in American culture.

Women are often expected to be back at work full time within about six weeks of giving birth.  Movie stars (who had twins no less) are back in their evening gowns and strutting down the red carpet in the same period of time.

It looks so easy!  Their hair is perfect!  Their tummy is flat!  No bags under their eyes!

It is a lie.  Well, at least it is for me.

In fact, I think this unrealistic expectation sets women and their partners up for some serious disappointment in themselves and each other (no hubby, she will probably not have her body back in a few weeks) simply because nobody ever talks about the reality of post baby life.

Well, in an effort to prepare and encourage mothers of new babies, here goes a few things that I found surprising.

1)  It is not uncommon to bleed for a few weeks (often six or so) with the first baby-

In my experience the bleeding is often less with subsequent pregnancies, but this often takes women by surprise and the first they hear of postpartum bleeding is when they are getting ready to leave the hospital.

Some tips-


Have a wide range of maxi pads on hand, starting with huge ones for the first few days and ending with pantyliners for the last few weeks of light spotting.  Nothing internal - so pads are the only way to go.


Nobody likes to buy these- but a wise midwife once recommended Depends to me!  One of the best investments I have ever made.  You can pretend you are buying them for grandma.  But the truth is, some grown up diapers are not a bad idea for the first few days, especially when you sleep.  They insure that you won't leak blood on your bed, which will minimize laundry.  Believe me, you don't need any more laundry than necessary when you have just had a baby.

Some women also like to freeze pads that have been soaked and frozen over a round bowl for relieving soreness.  Ask your midwife about ways to do this that can give you more comfort.  Sometimes comfrey tea compresses are helpful too.  

2)  Babies and mothers produce a lot of bodily fluids-

Mom will not only be losing blood, but when her milk comes in, well.....Let's just say, the female body has a tendency to overshoot a little.  Then the baby- their tummies are very small, and milk may be plentiful, and this can lead to some serious spit up.

Sleeping on an extra sheet, (I like to use a smaller flat sheet folded up underneath me) is not a bad idea.  Lots of moms find it is easier and you get more sleep if you have the baby in your room for the first few months.  If you have a sheet or towel underneath you that can be pulled off and washed in the morning it will make your life easier and your bed feel cleaner.

3)  The Peri Bottle-

The Peri bottle is an ingenious invention for spraying on your "down there" parts every time you pee.

Despite the fact that birth is beautiful and marvelous and all that jazz, babies are big and your bodily tissues will need some time to recover.  You will probably feel bruised for a while and especially if you have stitches or tearing, you will really appreciate some soothing water on your lady parts when you use the potty.  (I just said potty.  Can you tell I have four kids?)

I like to add a few drops of soothing oils and a tiny squirt of hibiclense to the Peri bottle.

And, as I have mentioned, these things are NEVER big enough.  So having two or using a larger, squeezable sports bottle is not a bad idea.  Fill them up after you use them each time to be ready for your next potty break.  The Peri bottle will be your own little bath and your best friend for a few weeks.

4)  Sex-  Umm, NO!

I realize that some women want to get right back in the saddle after they have given birth.

Frankly, I think this is crazy talk for a few reasons.  One is because it really does take about six weeks for your body to heal, your tissues to bounce back, and things to go back to normal.  The other is because even though I have had four fabulous all natural births, the last thing I want to do immediately after them is get pregnant again.  Plus- you are probably TIRED!  You are caring for an infant that needs constant care.  Your partner matters a ton, but devoting a few weeks just to the baby is not a bad thing. 

Hubby matters.  But he can either wait a little while or you can do other stuff. Other stuff that doesn't require penetration.

Moving on.

For some women, if the birth was traumatic or stitches were done a little wrong, this can take longer for everything to feel normal again.  This is not unusual, we just don't ever talk about it.

I find it really disturbing that we as a people expect women to do so little for themselves postpartum and really disrespect this important and vulnerable time.  Sure, in some countries women squat and give birth in the field and then get up and keep working.  I asked a midwife about this once.  Her response was that this only happens when women are very poor- and guess what- they die more often.

Relax.  Eat.  Drink.  Sleep.  Those four things will make you a better mother to your baby and better able to care for those around you. 

5)  Weight Loss-

I see women who by the time they are back out in public are in their regular clothes.  I thought I would be like those women.

Sadly, I am five months postpartum and still have thirty pounds more on me than I did when I got pregnant.  This kind of sucks, but it isn't that strange.

Most people probably lose about twenty pounds with the birth process (baby, water, blood, placenta, etc).  For me, the rest of it requires some time and some hard work.

Most of us don't have trainers and cooks and people helping us all the time with the baby.  This isn't an excuse to not get healthy, it is just the reality of modern middle class life.

It takes nine months to gain the weight and it will probably take that long to lose it.  So don't beat yourself up.  Also, if your partner has a hard time with the fact that you didn't bounce back as quickly as Victoria Beckham, tell him he doesn't look much like David Beckham and....where is the Ferrari?

Partners need to be patient too.  The portrayal we see of postpartum women in the media is simply not realistic.   

The Good-

I promised some good stuff, didn't I?

After all the surprising and bloody things about birth, there is good stuff.

The most important of which is that you have a baby!  Hopefully you have some time and some loved ones that will help you really devote some time to raising that baby.  Love it, cuddle it, feed it, and just focus on being a mother.  I can guarantee that you will be a better mother if you give yourself some time to heal.

Every time I decide I am "good" and jump back in too soon, I pay for it later.  On the other end of things, if you really take these few weeks to relax and heal, you will recover FASTER.

Often, people want to help.  Let them.  Ask them.  Accept some service in your life.  

Other things that I found helpful-

Prepared frozen meals in my freezer for a few weeks.  When you are cooking the last few months before baby, just make double of some things (lasagna, enchiladas, fresh mac and cheese, Shepherd's pie) and put the extra one in the freezer.

Stool softeners.  I refuse to explain this, but not necessarily a bad idea.  Your body will probably be kind to you for a little while, but mentally, they can be helpful.

Staying home.  I don't know of many other cultures that expect women to be up and around so quickly.  After my second child was born I was on a plane traveling the third day postpartum. 

Needless to say, it was awful and a nervous breakdown was part of the experience.

Anyway, I met some guys from Africa at the airport and they were horrified that I was traveling.  They said in their country, mama and baby stayed together for a solid month and rested....IN BED.

Let's start cherishing these precious weeks and we will see happier and healthier mothers and babies. 

Feed, grow, and love your baby in peace and without guilt that your aren't accomplishing anything-  You are accomplishing something fabulous, priceless in fact.  You are raising a baby.  Enjoy it.


19 comments:

blossomgirl said...

Thank you for your honesty! It's so refreshing to read about the reality of post-partum recovery. I have no children yet. Luckily you haven't succeeded in putting me off. ;)

Mrs B said...

Yes! I give all the new moms I know a pack of depends before the baby arrives. They saved my life and made pp recovery so much more comfortable the first time around!

I was so shocked by how difficult the pp period was after the birth of my first baby, but the second time around was a breeze, so i know that both kinds exist.

I would add to that list of things Sitz bath - it helped SO much with the initial inflammation and swelling! Also, if you tear and can't bear to pee (for me this was harder than giving birth) - run a little really hot water (as hot as you can handle) in the bath tub, add your sitz bath "tea" and sit in it while you try to relieve yourself. Then rinse with fresh water. I had to repeat this process about 5 times a day, but it beat the burn!

Knitted_in_the_Womb said...

Lots of GREAT stuff in this post!

I would say though that while I think it is important to take plenty of time to recover after a birth, but what that looks like is different to each woman. I know some women who have stayed pretty much in their bedroom for 2 weeks, and LOVED it. I would go stir crazy. I was at Walmart 3 days after my first was born, at a Valentine's dinner (with baby in tow) less than 30 hours after my 3rd was born, and at Old Country Buffet barely 24 hours after my 5th was born (celebrating my first born's birthday-LOL!), and these were all the right choice for me. But I wasn't the one pushing the cart at Walmart, and going out for dinner meant someone other than me was cooking and washing dishes.

Also, regarding post-partum sex...some women actually DO want to have sex sooner because they feel so "free" having had that quick weight loss. If a desire to avoid pregnancy is enough of a reason not to have sex, most couples would not have sex the vast majority of the time! I think we do women a disservice when we only tell them that they will not want to have sex.

Regarding penetration or not...yes, of course if a woman has stitches or is sore at all, that isn't a good idea. But unfortunately there is NO research about how long a couple must abstain after birth.

The OB for my first two births told me that at least 30% of his clients had already had intercourse prior to their 6 week post-partum visit, and he preferred couples to have had intercourse so that women could let him know if they were having any difficulties in that area (rather than waiting until their next annual visit). He typically recommended waiting until after the lochia stopped...his reasoning being that he didn't want anything going into the uterus while there was still an open wound. But would semen be able to travel against the flow of the lochia? And even if it did...semen actually has antibacterial properties! http://informahealthcare.com/doi/abs/10.3109/00365597309133666?journalCode=uro

Misty Pratt said...

I knew you could get emotional after birth, but I don't think I was prepared for the "crazies." Although I may have had PPD, I think in speaking with a lot of women, my prolonged blues are actually quite common. I had insomnia, even though I was exhausted. I had panic about my baby's well being, and my ability to care for her, and I cried ALL DAY LONG!! I think it has taught me a lot about what I would do differently second time around - I would get more support. I would hire a postpartum doula, and call every single one of my friends to ask that they come over and keep me company on the days my hubby worked. Instead of hiding my feelings away, I think I would let them all air out :) If we could only have our second baby as our first...but I guess then we'd never learn anything! :)

AngShoe said...

Wish I would have read this prior to birth. I prepared so much for the home birth that I didn't eventhink anything post could go wrong! Pregnancy was beautiful and a healthy, happy time, I thought PP would be also.
I had my wonderful!!! HB, but had to go in for stitching on my 4th degree tear and stay over night :( then 2 days later went to pediatric appt and baby had lost 14% body weight so was sent to pediatrics in hospital for 48 hours to BF and supplement!!
It was a VERY hard time for me. I was in so much pain, mentally and phisically. My body wasn't producing milk and I felt like a failure. Ended up after 12 days of trying to BF, breaking down and giving up on it. Was a very low point in my life. I knew breast milk was best, but I just could not handle it any more, no fullness after that long.
With all I went through, my big baby boy is 5 months old and very happy and healthy. I learned a ton from his birth and if there is a next time I hope to be much better off.
Thank you for this post and all of it is so true.

Liz said...

nice how you assume every woman reading this is using a midwife *roll eyes*

how helpful
you forgot to talk about afterpains also

The Smiths said...

Liz, I don't see how this wouldn't apply with a hospital birth. I have had both and this info was applicable to either. I think the midwife references were just her experience. I read lots of articles about "doctors" and I just insert "midwife" where necessary.

Great article. Post partum does sort of take me off guard after a terrific labor and birth. And yeah, after pains and baby blues are biggies.

Julia said...

Big thanks for sharing so honestly-it's a rare thing in our culture to talk about our vulnerability after birth. There is a beautiful book called Mothering the New Mother by Sally Placksin. It's full of beautiful honest accounts of post partum, like yours, and loads of traditional stories froma ll over the world about how women elsewhere in the world are treated after birth.

www.newbornmothers.com.au

Mama Birth said...

Thanks for the thoughts and comments.

Man- I could do a whole post on afterpains. Can't say I have a magic way to make them go away though. And it wasn't an issue for the first baby for me. Wouldn't want to scare people out of having more than one!

Ruethee said...

Amen!

Carmen said...

What a great post! It always makes me sad when I see women out and about 1 week after delivery. It took a good 8 weeks for me to feel completely normal again. In fact, I spent the entire first week and a half in bed more or less. I didn't even go downstairs until week 2 (although my midwife said wait until week 3).

I wrote a post with tips on having a more comfortable birth and postpartum period here if you're interested.

http://www.clusterloveblog.com/2011/06/tips-to-have-more-comfortable-birth.html

Jessi said...

Wonderful tips.

Yes Depends are great PP. Also good for labor - put them on when contractions start and no worry when the water breaks or if you're pushing on the way to the birth place and some poo is released too!

My husband is from Egypt and in their culture when a woman has a baby she does nothing but nurse the baby for 40 days and her mother, sisters, cousins, etc. all take care of and feed her (and any older kids). We DO need that nurturing!

Ashley said...

Another thing you didn't mention was night sweats. I actually managed to lose ALL my pregnancy weight in the first two weeks thanks to oozing it out overnight. We were changing sheets at 2 am, I was sleeping on towels, a few nights I even woke up to shower it was so nasty.

I'm not looking forward to that again.

mmmmmcupcakes said...

It is important to point out (because a lot of women do not know this) that the main reason you should abstain from sex for at least 6 weeks is because of risk of infection. Yes, it can be uncomfortable too, but regardless of how your baby was born, cesarean or vaginally, your uterus has a very large open wound that is healing, where the placenta detached. Things being inserted into the vagina postpartum can transfer bacteria through the cervix and into the wound. This is why you're also told not to overexert yourself and to slow down if you start bleeding bright red again--you have started opening the placenta site again.

Liz, how is it rude to say "midwife?" There are SO many different providers for the pregnancy period and it's unreasonable to preface every statement with "your obstetrician, nurse practitioner, registered nurse, nurse midwife, direct entry midwife, certified professional midwife, osteopath, naturopathic DO, or any other prenatal care provider"

thefullmontessori said...

I hemorrhaged after delivery, so my midwife had me stay home for four weeks. It was THE BEST thing that ever happened to me. I didn't have to justify being in bed, I didn't have to see people, I just focused on my baby. In Mexico they have the "cuarentena", which literally means "forty days", in which mom and babe stay together at home and don't see people. LOVE IT!

Katie Purves said...

You said to wait until it's too late but I read on anyway. (We're trying for our first)
I love your blatant honesty. I didn't find it at all 'off putting'
I now have some real information to use.
Thank you!!

Mari Cascia said...

Love this post! For me, the bleeding lasted longer after each delivery. It lasted for about 2 weeks after my first 3 children, but I just had number 9 and it is now more like 6-8 weeks total. I agree w/ waiting for at least 6 weeks to have sex. At least for me, I wasn't as sore the longer I waited.

Natasha Clarke said...

Thanks for the great post, and reminders for me prepping for baby 3 coming soon! Couple of questions: Aren't Depends uncomfortable? What oils and how much (how much hibeclens as well) did you add to your peri-bottle solution? Thank you!!

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