I wrote this blog post for The Daisy Foundation all about what the postnatal period is, and you can help yourself feel better during it.
What is the postnatal period?
The postnatal period is roughly those first 6 weeks following the birth of your baby during which you start to recover physically and emotionally from giving birth. And I say start because although, as we’ll see, there’s an expectation that women heal quickly if not immediately, research has been conducted which shows that women aren’t healed for up to a year – even with a straightforward, low-intervention birth.
What happens during the postnatal period?
If you’ve discussed your postnatal period with your midwives, it’s likely that you’ll have focussed on those first few days following the birth of your baby.
This conversation will probably focus on the care you’ll receive in those first couple of weeks. In the immediate days following birth you will be monitored for bleeding, bowel and bladder function, that feeding is established and that you know how to care for your baby. If you give birth in a hospital the average stay for a vaginal birth is 1-2 days, and for a caesarean section 3-4 days, although if you’re well and choose to leave you could leave hospital within a couple of hours if everything is as it should be. Therefore a lot of that initial monitoring will be carried out in hospital. Midwives will then visit you at home following an individualised care plan and then your care will be transferred over to the Health Visiting team. This will be at around day 10 but might be later if there’s a need for you to stay under the midwifery team.
As your baby gets a little older you will start to see your health care professionals less frequently – this doesn’t mean that they aren’t still there for you though, you can contact them at any time if you have concerns.
Mentally the postnatal period is important too. There’s a transition time between not being a mother and being a mother. Your body is physically transitioning and your mind is transforming too – it can be such a big event that there’s even a psychological label that can be applied ‘Adjustment Disorder’.
Why is it so important? All that matters is a healthy baby.
So what’s so important about this time? Well, it takes this long for your body to start to heal. Even with a straightforward delivery your body has been through some really big changes; growing in size, making new organs, increasing blood volume then releasing baby during delivery, getting rid of the placenta, the extra fluid, lactating…it takes a lot of hard work from your body. And that’s not to mention any other related discomforts such as Pelvic Girdle Pain or gestational diabetes! But a healing body isn’t the only thing.
You will have heard many people say ‘all that matters is a healthy baby’ when talking about birth but is this true? Does this diminish what a mother goes through in having a baby, and all that comes afterwards? Mothers matter too. The postnatal period – that first month and a half – is the time when a woman is particularly vulnerable for developing post-natal depression. So it’s especially important that a woman is supported both by healthcare professionals and other people in her life, to ensure that if she starts developing signs and symptoms of it, she’s well looked after in the most appropriate way. Around 10% of mothers (and 4% of fathers) will develop PND and it’s thought to be a number of factors coming together rather than there being just one cause. These include having previous mental health issues, feeling unsupported by partner, family and friends, having a birth they feel was traumatic, struggling to breastfeed and being exhausted. If you think that 25% of women suffer mental health issues in their lifetime, 40% would describe their birth as traumatic, and 59% don’t breastfeed for as long as they would initially hope to – highlighting a lack of support to help them breastfeed successfully – you can see that the postnatal period is a really important time to be supporting a mother.
What do women do in this time?
Having seen the importance of the postnatal period to ensure that moms are physically and mentally looked after and healing, what do we as a society think or expect mothers to be doing in the postnatal period?
When baby’s born, how quickly are you asked if people can come and have a cuddle? Pretty quickly, right? And how comfortable do you feel if someone walks into your house asking them to make a brew, or push a hoover round? You don’t, do you? I certainly don’t! So you end up making tea, and pottering about when you should be resting. And I know some of you are thinking that you’re not the type to be lazing on the sofa while people work around you but factor in soreness, tiredness, blood loss increasing if you’re too active…
And you’ve been in hospital for a few days, and not seen the outside of those walls, and you need to get something from Tesco (and admit it, you want to show off your tiny baby!) so you pop to the shops which always takes longer than you think it will. And maybe you have other children who need taking to school… Or your grandma can’t drive so you offer to travel the hour it takes to go and see her…And your workplace want to meet the new baby… It all starts adding up, doesn’t it? And very quickly instead of resting and allowing your body to heal, you’re trying to carry on at exactly the same speed as you were before you got pregnant!
And that’s not to mention the physical things that you need to learn as well! How to care for baby when they’re here; how to recognise their feeding cues, sleeping cues, if they’re over-stimulated, if they need their nappy changing… parenthood is a learning curve and a steep one for you, dad and baby! It’s like walking into a CEO job of a Fortune 500 company knowing you’ve lied on your CV about your A levels – you know you can do it but you’re scared of being found out anyway!
You can see, then, that when a mother is in a vulnerable state anyway any anxiety she has over how she’s parenting (the so-called mommy wars!) could overwhelm her and link into her emotional state and possibly contribute to her PND. Part of this comes from the expectations she has of how life with a newborn is. Perhaps she’ll feel like she’ll ‘bounce back’ like magazines insist on celebrity mothers doing, or carry on her life exactly as before because it looks to her like everyone else is. Perhaps she doesn’t expect the constant feeding, or short bursts of sleep to continue for more than a week or so. Perhaps she doesn’t fully understand the sheer relentlessness of looking after another person who relies on you for everything. It’s easy to look at a snapshot of other peoples lives and think they’ve got it together while you’re in 2 day old clothes and haven’t washed your hair for a week and feel like you’re failing. That your baby is broken. But if we can change your expectation that you have of a newborn and the way your new life is going to be, then it’s a great way to help stop that feeling of helplessness that you’re not doing things ‘right’. One of the overwhelming things we hear from new mothers is ‘I didn’t know it would be like this’ and this is what we’re here to help you with.
What did women used to do?
It’s interesting that as life generally has got faster-paced and more demands placed on us, that the demands placed on a new mother have increased, with a shift in what she would be expected to do and how others would support her.
In a practice called ‘churching’ a woman in the UK would be set apart from their community for 5-6 weeks (or 40 days) while they tended to their new baby and healed, with help from other close women – usually family or neighbours. The timings differ slightly depending on which variant of Christianity they were but at the 40 day or 6 week point they would be reintroduced to their community with a blessing at their church. Although this was primarily a religious ceremony, the 40 day timing linked closely with the time it takes for a mother’s body to have that healing process, and this time frame is seen over and over across different cultures.
This tradition has fallen by the wayside in the UK due to a number of factors; the decline of Christianity, the medicalisation and masculinisation of birth and the birth world, migration of labour creating more fragmented communities, changes to the working patterns of women…many things, but increasingly women are trying to carve back this time for themselves to be looked after.
What happens around the world?
I’m willing to bet that you’ve either said or heard about a woman in a different culture giving birth in a field then getting right back to the work they were doing, right? It’s a trope trotted out frequently but actually it doesn’t have much basis in truth. Most pre-industrial or traditional cultures all honour the 40 day period after a woman has given birth, with additional support being given to her and her family. Nobody is compelled to feel like they have to get right back into the swing of things, and they’re honoured and celebrated for bringing new life into the world.
China – zuo yuezi – sitting the month – a big focus on the warm, nourishing food for the new mother to eat and replenish herself with, as well as practical support
Korea – no cold or hard foods, and no going out into cold weather. New moms are looked after for 21 days but sometimes this increases all the way up to 100!
Latin America – la cuarentena (quarantine) – Approved food, no sex, no hair washing, lots of rest!
Now it’s clear that times have moved on and there’s very few women who would consent to following the full confinement to the full extreme – I definitely couldn’t go without washing my hair for more than a couple of days! But it’s interesting that universally there is an acceptance that time cherishing the mother after a baby is born is really, really important for so many reasons. The way in which we look after the mother and allow her the space she needs to recuperate and to learn how to be a mother shows how we understand and appreciate the newborn baby. And in some respects having that protected time without having to worry about too much of the outside world can make the intensity of life with a newborn seem easier as your focus is on them and not a hundred other things.
Make a plan
When you’re pregnant and planning for life with a baby, think about creating a postpartum plan. After all, we spend time planning our births, planning what car seat and pram we’ll use, what nursery they’ll attend – isn’t planning to protect your wellbeing equally as important? Think about who can help you in the early days, and what they can do that’s practical and will mother the mother; think about what external support you might need and where you could go for that; think about if things aren’t going so well and you need help urgently – what might that look like and have you got people who know what to look for?
Most of all – take care of yourself, and enjoy that lovely new baby.