The Postpartum Guide

The Postpartum Guide

Recovery from childbirth and discovery of your (new) self.

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This is not a time for keeping the house clean, “bouncing back”, or entertaining visitors who’ve come to “see the baby”. This time is about you. Your rest. Your recovery. Your time with your baby. Pregnancy pushes women to limits of human endurance. It is the most energetically expensive activity the human body can maintain for nine months, and it’s topped off with child birth. Which, no matter how you do it, is hugely taxing on your mind and body. You deserve respite. Time to heal, to slow down and find your feet as a new parent in a protected space.

Entering the world of post-birth is akin to embarking on a profound journey of discovery. Not only have you just introduced a new life into the world, but you're also navigating the transformative changes of your own body and mind. From the immediate physical aftermath of childbirth to the tidal waves of emotions and the mysteries of postpartum recovery, there's a lot to take in. As you tread these uncharted waters, it's essential to prioritise self-care. Whether it's relishing a comforting meal or indulging in a therapeutic massage, remember to take moments for yourself. And amidst the cacophony of baby cries and well-wishers, setting boundaries is paramount. This is a time of adjustment, bonding, and finding a new rhythm. Cherish it, embrace the changes, and always remember: this journey is uniquely yours.

You After Birth

The period of time immediately after birth is compounded by a myriad of both physical and emotional factors. To break down the immediate physical impacts of birth, below we focus on three major aspects; The Body, The Brain and The Bowels.

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The Body

Right after birthing your baby the umbilical cord will be clamped and cut. The baby will then be laid on your chest for skin-to-skin, a moment in time that may feel incredibly surreal. Some mothers will feel an instant and deep bond with their baby but others will not. Neither is ‘normal’ as every experience is completely unique. The benefits of skin-to-skin have been shown to include regulating your baby's heartbeat, their temperature and their blood sugar. Skin-to-skin can also be a positive initiation to breastfeeding. 

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From here you will birth your placenta and then pending whether you birthed via a vaginal delivery or a caesarean, your midwife or obstetrician will stitch up any wounds resulting from a tear, an episiotomy or an abdomen incision (i.e. a caesarean).

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The Brain

In the minutes, hours and the days following the birth, you will experience an overwhelming rollercoaster of hormones. Oestrogen and progesterone will drop while oxytocin and prolactin will rise. If you experience random highs (surges of endorphins) or moments of unexplained sadness, this can often be explained by your changing hormone levels. 

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You may also notice a direct correlation between noticeable emotional shifts and the heaviness of your bleeding. After birth (both vaginal and caesarean deliveries), you’ll bleed for a period of weeks. The bleeding you’ll experience is referred to as lochia and it’s your body's way of readjusting by expelling blood, mucus and uterine tissue. As you engage in moments that draw out emotion such as breastfeeding (where the body releases oxytocin), you’ll notice your bleeding becomes heavier. In this instance, the oxytocin causes your uterus to contract, promoting an expulsion of lochia.  

 The colour of lochia will appear a dark shade of red in the earlier days, fading to a darker brown overtime. If you notice continuous clots or excessive blood loss (for example, if you soak more than two pads in a period of 1 to 2 hours), it’s advised to make contact with your midwife or obstetrician. 

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The Bowels 

For some, the first poo after birth can be intensely overwhelming. Despite how you birthed, your abdomen, your pelvic floor and your buttocks are going to be far from excited about more ‘pushing.’ Fair enough. To help, drink lots of water and include plenty of fibre rich foods in your diet. Suitable probiotic supplements can also work wonders to reset your gut or your GP may suggest OTC stool softeners to get things moving along. The last thing you need during this vulnerable time of life is a bout of stubborn constipation. 

Some extra tips on the subject of poo; get yourself a small step for the toilet as your posture can make a big difference. Keep your knees higher than your hips, lean forwards and make a ‘moo’ sound. While doing so, you will feel both your abdomen expand and some added pressure downwards in the rectum and anus. This will assist with your bowel movement. If you’re worried about prolapse or placing any additional pressure on your pelvic floor, it can help to grab a wipe or some clean toilet paper and firmly hold your vagina while pushing. 

You’ll find some more helpful articles below:

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Postpartum Emotions

As your hormones undergo extensive change following birth, experiencing emotional surges is to be expected, especially in the first 2-5 days. The contrasting rise and fall of various hormones could feel jarring and uncomfortable to manage.

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Baby Blues 

According to The Royal Women’s Hospital, the baby blues is experienced by 80% of new mothers. The baby blues is a period of time where a new mother may feel sad, worried, overwhelmed or a little hopeless. Usually it sets in 2-3 days post birth and it can hang around for a few days or a few weeks. It’s best to contact your GP if it’s still hovering after 2 weeks, or if these feelings are causing you distress or impacting your ability to function.  


The change in hormones are a major contributor to baby blues, as is the overwhelming adjustment to life with a new baby. Eating well, reducing your coffee and alcohol consumption are advised, and it’s encouraged you find ways to catch up on sleep and get out into the fresh, open air. We know, easier said than done, but be kind to yourself and lean on those around you for support.

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Postpartum Depression (PND) or Postpartum Anxiety (PNA)

To differentiate between PND and PNA; Depression is usually distinguished by ongoing (lasting more than a few weeks) feelings of flatness, disconnection, lethargy and hopelessness. Anxiety on the other hand, is characterised by feelings of worry, restlessness and panic. A mother experiencing anxiety may start to catastrophize an outcome before it actually happens. 

 

Differentiating between a bout of the baby blues and PND/PNA, can come down to timing, or the duration of the depressed periods. If your depressed mood extends past a few days – 2-3 weeks, worsens, or causes you distress and impacts your ability to do the things you want/need to do, it’s imperative you tell someone and/or call your GP. Experiencing a low mood or anxiety does not make you a bad parent, but could indicate that you need some support with your mental wellbeing.

 

It can be helpful to remind yourself that you are not alone. 1 in 5 new mothers will experience Postpartum Depression (PND) or Postpartum Anxiety (PNA). The best way to help yourself is to let others help you. 

 

If a feeling of shame surfaces, perhaps write down everything that is challenging you right now. Seeing the words in a physical form may release a sense of empathy. In moments like these, you need to back yourself. Understand that having a baby is exceptionally challenging and it’s to be expected to feel overwhelmed or low as you adjust to such extreme change.

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Both PND and PNA are serious but treatable issues that require immediate support. There are a range of support options available to you (e.g., counselling, psychology, psychiatry, medication) that will be individualised depending on a range of factors (e.g., symptoms, stage).

While you’re in these deep waters, it can be helpful to try to:

-       build a community of support around you

-       look after your physical and mental health (e.g. fuelling and moving your body, staying socially connected, sleeping (when you can), engaging in calming or relaxing activities)

-       Focus your time on things that bring joy 

-       Eliminate unnecessary angst.  

Experiencing either PND or PNA is no easy feat but you have an ocean of support around you. 

 

If you are unsure of whether you need to seek help, there are a range of mental health checklists (dependent on your stage) available at PANDA. These checklists won’t diagnose you but they will ask you questions based on possible symptoms of postnatal anxiety and/or depression. This can help you to better understand what you are experiencing, and assist you to get help if needed. 

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Further resources:


Postnatal Depletion 

Postnatal depletion is another common byproduct of postpartum life. It’s something to look out for as it can wreak havoc during a vulnerable time of life. 

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Postnatal depletion is not the same as being ‘burnt out’, or ‘sleep deprived’, or ‘depressed.’ In the postnatal context, postnatal depletion is a period of time where your body and mind are literally ‘emptying' or becoming ‘reduced.’ Every cell in your body is trying to recalibrate and adjust to life with a baby, however due to the weight of change endured during pregnancy and birth, this adjustment phase can have some hefty implications.

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How will you differentiate if you’re suffering from postnatal depletion vs postnatal depression or postnatal anxiety?

  • If you are feeling exhausted, yet you’re still able to ‘feel joy’ when moments in life bring goodness - this is likely depletion. Those who suffer depression will find their moods very ‘flat line’ and feeling joy and happiness will not be easy.
  • Sleep is another good indication. If you are up during the night and able to fall back to sleep quite easily, again, this is likely depletion. Those with depression, despite utter exhaustion on a physical and mental level will find it very hard to reduce the noise in their brain, keeping them awake for up to an hour or more, before they’re able to fall back asleep.

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Further resources:

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Caring For Your Body

Postpartum is a time for TLC and becoming your own personal cheerleader (and boundary setter). Your body has achieved some serious feats whilst growing and birthing a baby, so it’s important you give yourself time and space to heal.

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After a Vaginal Birth

As your cervix dilates to 10cm, it’s no surprise to learn that a woman’s body is wonderfully intuitive and behaves with such reactionary physicality during birth, and the vagina, in many cases, is the MVP. While some women will birth without ‘injury’ or assistance, others will experience tears or require an episiotomy (a controlled cut in the perineum to allow space for the baby to be born). This is common and you will heal. 

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Even for those who don’t experience any tearing or require stitches, your vagina will still be quite swollen and sore. Keeping it iced and clean are some of the best things you can do for yourself during this time. 

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As you could be sitting down for long durations in those early weeks feeding, you’ll inadvertently place continuous pressure on your downstairs region. To alleviate swelling, try gentle movement (for example slow walks around the house) or sitting on a ‘donut shaped’ pillow. Something else that may help is to feed in the Side Lying position, which can support rest and pelvic floor recovery, plus be very calming for your baby.

How to care for your perineum

If you experience a tear, an episiotomy and/or you require stitches, it’s normal to feel sore and tender. You potentially have broken skin, fluid retention and bruising surrounding an incredibly intimate area of your body so be sure to go easy. Icing your vagina using cool packs and/or a specific type of maternity pads with inbuilt cooling can be hugely effective quite quickly. 

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For women who have stitches, paying extra attention to hygiene via adequate washing of your perineum is critical. Due to the position of your wound and the expulsion of lochia, the area surrounding your perineum and your vagina can be more prone to bacterial build up. 

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Regularly changing your pads, regularly changing your underwear and showering at least once a day in the first few weeks post birth are simple and e