You are going to have a baby, and then you are going to have to heal from having a baby. The massive unknown in that equation is all the experiences you will smooch together in your brain and label it: My Birth Story. Your postpartum recovery is a unique and important part of that story.

The birth story of your child starts when every you want it to start, and it ends when you say it ends. Most stories include the moments you thought you were labor, and have a tiny baby being held – by someone – at the end.

But regardless of the events, feelings, and choices of your birth, you will need to recover.

In our experience, the postpartum body and mind are neglected and underserved in the US. There are exceptions, and we have hopes of change. But most families are responsible for making arrangements for their mental and physical needs, all the while also learning and caring for a new person whom they just met.

The following professionals are presented for consideration with full knowledge that seeing all of these professionals may in itself become a difficult task, and therefore may also be a type of harm. So please, know that we know taking it a day at a time is a perfectly reasonable approach to your new life with your new baby. Let this short list be available to you, if and when you are at a place where you are seeking options for extended care outside of the walls of your home.  

Who to include in your postpartum recovery

1. Chiropractor, at a family-friendly office

You can start chiropractic care during pregnancy for aches and pains, and even for help if your baby is presenting breach (or head up). But chiropractic care after delivery may be viewed as a luxury. The baby is born – why keep going?

Once you spend hours and hours, sitting, swaying, rocking, feeding, and not sleeping, your body – while recovering internally from birth – is being used in many ways that are out of the ordinary. Having the care of a chiropractor can help ease your body back into the world where you aren’t carrying a small life inside you, but instead, have a car seat draped over your elbow.

And why a family-friendly office? Because you may have your child with you. And knowing you have the time to be tended to, without needing to worry if anyone has eyes on your babe can mean the world of difference. Ask them if they are prepared to help new moms make their appointments. We’ve seen strollers get pushed back and forth, pacifiers get placed back in a mouth that has just learned to pop it out, and quite a few chins dabbed when a bit of spit up slips out. Ask.

2. Massage Therapist

Your body holds onto events long after they have happened. Are your shoulders tense right now from work, or that conversation yesterday, or because you are thinking about all the things you said you would do?

Now imagine how it will remember the task of moving a child into the world? Your body will be tender, and once you feel comfortable laying on your belly, having care from a professional who can help your body to release the tension it holds will be a world of difference for your mind, as well as your muscles.

You may get weepy on the massage table and not know why. You may miss your baby while in your appointment, and both love it and hate it. Being worked on by your therapist, you might realize, will be the first time in weeks where you are being touched with restorative energy, instead of having to be the one giving stimulation, food, or peace. Massages are not just for birthdays and anniversaries. Your body deserves to have attention be paid to it after doing the critical work of birth.

3. House Cleaner

This last one might be a stretch for you, but we want you to think about hiring a cleaning service to help in your first weeks home with your baby. Your attention will be divided between learning about your new child, grieving the loss of your old life, and being wrecked with an onslaught of hormones and sleep deprivation.

A professional cleaner is not someone you will need to worry yourself over. She or he can reduce your stress if you are frustrated with keeping up with old and new responsibilities, help prevent your space from becoming an isolated cave, and offer peace of mind that you and your baby are not having your immune systems overwhelmed by housework.

If there is a time to invest in supporting your entire family, taking the cleaning stress off of everyone’s plate is a caring way to start your first weeks as new parents.

As always Doulas of Baltimore is honored so many families are choosing our in-home postpartum team to come and help in the postpartum period.  If you would like to talk with us about care options for support inside your home day or night, we want to hear from you. And if you need referrals to some of our favorite local professionals, just let us know!

 

We’ll start with the unfortunate truth: the US does not guarantee paid parental leave on a national level, and not all workers qualify for the six weeks of unpaid leave federal law mandates. According to the Washington Post, “Most Americans do not have access to paid family leave through their employer.” 

All of this means that there is no standard for when you return to work after parental leave: it could be six weeks or six months. But regardless, returning to work–for either the birthing person or partner, can be a significant transition. You may be thinking about everything from your energy levels, your schedule, pumping and/or feeding, your partner’s schedule, and how your baby will do without you. Here are 4 things to consider and plan for before you return to work. 

Know what your leave looks like and be open with your employer. 

Long before delivery you may be thinking about your parental leave options–both what your employer offers and what your ideal scenario might be. Be open with your employer and consider asking for something that might make the transition back to work easier. That might include returning part-time at first or working from home. Your employer might also be willing to be flexible in ways that they haven’t shared with you. Ask other employees or your employer directly about how others have returned to work after leave. 

Think about childcare after parental leave, and then come up with a back-up plan. 

You may have come up with the perfect childcare solution: you are returning part-time to work and a friend or family member is baby-sitting on the other days. In 2022, that might be problematic because of changes in school openings due to COVID. Or, the caregiver might have to quarantine after a COVID exposure. Problems could arise simply because they are not as reliable as you would like them to be. Whatever your childcare plan involves after you return to work, come up with a backup plan. If you have a family member caring for baby, what happens if they are sick? 

If you are working from home, remember that you are still working and taking care of baby is also full-time work. Although working from home can make it easier to care of baby, you should still try to have a secondary caregiver available. Some of our clients have utilized our postpartum doulas while working from home to ease that transition. 

Figure out priorities and roles for when return to work after parental leave. 

You partner may have taken little or no time off after baby arrived. But, your transition back to work is still a transition for them as well. Take time to figure out each of your priorities and roles. If you are not a morning person, consider having your partner take care of baby’s or the family’s morning routine. This way, you can get ready for work in the way that you need to. Discuss who will pickup baby or kids from caregivers, daycare, or school. You may have figured out a postpartum plan of who was cooking and cleaning, but you may need to revisit those plans if both partners are back at work. 

Don’t be afraid to acknowledge your emotions and ask for help. 

The postpartum period can be difficult: you are adapting to a new family member. If you gave birth, you may be experiencing physical changes in your body as well (link to blog). You are going to have a lot of emotions–from being excited about being back at work to sad that your baby is someone else’s care. Don’t be afraid to acknowledge that whole range of emotions and understand that they are all OK. If you being feeling overwhelmed when you return to work after parental leave, ask for help, whether from your partner, family, friends, or other loved ones.

We spend nine months getting ready for baby to arrive–both physically and emotionally. But the actual birth experience portion of your journey is relatively short. After birth, your body continues to change for many months. Here are some of the changes you can expect in the moments, weeks, and months after birth

What will I experience immediately after birth?

Immediately after birth, a care provider may place baby directly on your chest. This skin-to-skin contact helps regulate baby’s body temperature and calms baby. But it can also help your uterus contract to reduce bleeding. Bleeding may still be taking place from where the placenta was attached to the uterus or from any tears. A care provider might provide medication to slow or stop that bleeding, perform a uterine massage, or stitch the perineum. You might also shake, have contractions, feel weak, or be sore (you did just work very hard). 

How long does it take to recover from childbirth?

How long it takes to physically recover from childbirth depends on what happened during birth as well as the birthing person’s activity level. If you had tearing, an episiotomy, excessive blood loss, or a cesarean birth, it may take you longer to recover. In the days and weeks following birth, your body will feel different. You may be exhausted, bloated, and sore. The change in hormones can cause mood swings, sweating or hair loss. Pregnancy and childbirth also stretches ligaments and muscles, so your abdominal and pelvic floor muscles take time to tighten back up. If you had a c-section, remember that it is major surgery. You shouldn’t lift or over-exert yourself. Take the time you need to recover, listen to your body and be gentle with yourself

What are the emotional changes I’ll experience after birth?

Our brains are a part of our bodies, and the physical changes to our brains can alter our emotions. The change in hormones that happens in the postpartum period can make you feel happy, excited, positive, overwhelmed, sad, possessive, or disappointed. These are all normal. Making a plan for how family and friends (link to last blow) can help reduce stress. Prolonged and severe depression can also happen after childbirth, and if you (or your support network) are worried about a Postpartum Mood Disorder (PMDD) or Post-traumatic Stress Disorder (PTSD), talk to your care provider. 

What physical changes are not normal?

If you have any physical or emotional changes that concern you, talk to your care provider. They can help you determine what is normal and what isn’t. You should also talk to your care provider if you have vomiting, flu-like symptoms, fever, heavy bleeding, difficulty urinating, leg pain, vaginal itching, dizziness, shortness of breath, or racing heart. 

Can I recover more quickly after childbirth? 

The most important thing to do after giving birth is listen to your care provider. They can help you understand what you went through and how long it will take to recover. Make sure you prioritize your needs for rest, nutrition, and mental health. Many women feel physically recovered from childbirth around 6 weeks, but for most, it may take longer. 

A postpartum doula can provide education and support, and assist with newborn care, breastfeeding support, or anything else that can help ease the transition when a new baby arrives. 

Around 3.7 million babies are born each year in the US, but we are the only developed country with a rising maternal mortality rate. And that rate is worse for marginalized groups. Black women are three to four times as likely to die of pregnancy and birthing complications as white women and disabled people have a significantly higher risk of dying from pregnancy and childbirth than their able-bodied counterparts. Here is the important statistic, though: 60% of maternal deaths are preventable. Understanding the disparities and providing equity in healthcare access can decrease maternal mortality. To help increase awareness for maternal health, the American College of Obstetricians and Gynecologists (ACOG) recognizes Maternal Health Awareness Day every January 23. 

Here are some resources for expectant parents to improve maternal health.

Routine Prenatal Visits are Vital for Your Maternal Health and Baby’s Health

ACOG recommends that you schedule a visit with a care provider as soon as you know you are pregnant. Then, go to all of your visits, even if you feel fine. A prenatal care provider can include an OB/GYN, a family care doctor, a nurse practitioner, or a midwife. The March of Dimes has an extensive guide to prenatal care visits and what to expect. 

Understanding Pregnancy Helps a Health Pregnancy

Our belief is that education, collaborative provider partnership, and unwavering nonjudgmental support can make pregnancy and childbirth one of the most fulfilling and transformative experiences of your life. Understanding pregnancy can help people know what to expect, what to look out for, and how to stay as healthy as possible. For example, preeclampsia is a leading cause of maternal mortality, but many people may not know their risk factors. ACOG has an infographic with preeclampsia basics and an FAQ about staying healthy before and during pregnancy. At Doulas of Baltimore, our Childbirth Education Classes help you feel informed and make confident decisions. 

Postpartum Care Should Be an Ongoing Process

While a lot of focus is placed on the time leading up to childbirth, ACOG has recognized that the postpartum period is important. For parents, this should mean planning and thinking about healthcare, feeding, care, and important decisions (link to last blog) before baby arrives. ACOG believes that postpartum care should be an ongoing process that is individualized for each birthing person. This is especially true for people who have other health conditions that may impact their postpartum health. March of Dimes has an overview of what to expect during postpartum healthcare visits. 

Each pregnancy and birth is unique. By helping parents understand childbirth and the postpartum period, we can hope for healthier families and babies. 

Being pregnant and preparing for birth can feel overwhelming enough without considering what happens when you bring baby home. But postpartum planning before baby arrives can save you a lot of stress when you will want to be resting and recovering from delivery. And, you might have postpartum brain fog that makes thinking about your options (not to mention making decisions) hard. At Doulas of Baltimore, we think of the first three months at home as the fourth trimester. The postpartum period comes with its own challenges and joys. Here are some basic questions to consider before you go into labor that will make your postpartum life easier. 

What will your home look like?

Because nesting is very real, you may have already set up a nursery or room for your baby. But realistically, this isn’t where baby will be spending most of their time. For the first six months, the American Academy of Pediatrics recommends baby sleep in your room. But where does baby sleep during daytime naps? Do you want to have a dedicated changing table, setups in different parts of the house, or a moveable station? Where will be the best place to feed baby during the day and at night? Consider the layout of your living space and the setup of cribs, feeding or pumping stations, and changing tables. 

What does everyday at home look like? 

A baby changes things: we know this. And postpartum planning involves thinking about the details of how things have changed. Who will feed baby when they wake up at night? Who will change baby? Who will cook meals? Who will walk the dog? Who will take big sister to school? Who will go to baby’s appointments? Who will clean and tidy the house? 

Who can you go to for extra support? 

While everyone might want to meet your new baby, that doesn’t necessarily mean they can provide the support you need. Consider which friends and family can provide practical support, like buying groceries, cooking meals, walking the dog, or taking care of siblings if you are at the hospital longer than expected. 

Who are the care providers you need?  

With care providers, there are the basic people you need to have planned out, and others that you may want to think about having lined up. While you’ve been dealing with an OB, midwife, and/or doula before birth, afterward you’ll need a pediatrician. You may also want a postpartum doula or lactation consultant. If you are concerned about postpartum depression or emotions after birth, you may want to find a mental health provider before delivery since they can have Before you leave the hospital, you’ll need a carseat installed, and we recommend having it checked by a Child Passenger Safety Technician (CPST) or “car seat tech”.

What does post-parental leave look like? 

There is unfortunately no standard for parental leave, so consider when parents will be going back to work and what happens then. Do you have a nanny, babysitter, friend, or grandparent who can care for baby? Will you need a daycare? 

 

This is just a short overview of questions that we see new parents considering as they bring their babies home. Over the next months, we will be going more in depth on these questions and providing guidance and advice for the postpartum period.