Prenatally, we tend to focus on mom and how she can optimize her health for her benefit and the benefit of the baby. However in the postpartum period, our culture seems to completely focus on baby and mom’s well-being is forgotten. This attitude is also reflected in postpartum medical care in the USA. Generally, the baby goes for their first pediatrician visit just a few days after birth, but mom’s first visit with her OB isn’t until a whopping 6 weeks after the delivery!
Thankfully, recently there has been more media attention to this problem (see this great guide in the New York Times). The American Academy of Pediatrics has even recommended that new moms be screened by their child’s pediatrician for postpartum anxiety and depression. In my and many others’ opinion, this is a positive step, but more support for new moms is needed. Until healthcare systems in the USA begin providing appropriate levels of support to new parents, you must develop a plan for your postpartum health during pregnancy. After the baby is born it will likely feel much too overwhelming.
Postpartum Changes
Many physical and emotional changes can bring uncertainty to the post-delivery recovery process. Physically, constipation, urinary incontinence, breastfeeding difficulties, incision pain and pelvic floor pain can be present. Emotionally, mood fluctuations can be quite normal, but often women need support in determining if their emotions are normal or are a cause for concern. The earlier postpartum mood issues are identified, the more effectively they can be treated. The bottom line is this: if you aren’t sure if the symptoms you are experiencing are normal, seek help from a therapist, midwife or your OB and they can tell you. Ask for as much help as you need.
Below are some categories of experts I recommend familiarizing yourself with. Find a local practitioner, reach out to them in the third trimester (or earlier!), and keep their contact information handy in case it’s needed. You shouldn’t be expected to do it all on your own and many times even with lots of support from friends and family, an expert’s experience and care can make a huge difference.
Resources:
Mental/Emotional Health:
I recommend finding a therapist who specializes in treating postpartum mood disorders. It’s best to establish a relationship with a therapist before giving birth so that you are not overwhelmed with the task of finding someone while you are taking care of your new baby. Have one session with them during your pregnancy so they are familiar with your history, and you can make sure you feel comfortable with their approach. Keep in mind, new dads/partners often experience anxiety and mood issues after the birth as well- it may be helpful for them to follow the same approach.
See The Seleni Institute, The Motherhood Center and Postpartum International for articles and information.
Pelvic Floor Experts:
In Europe and many other places, pelvic floor muscle rehabilitation is standard care for new moms, whether they delivered vaginally or via c-section. It can help with urinary and bowel problems as well as abdominal muscle separation called diastasis recti.
In NYC, I like Beyond Basics PT, Shift Integrative Health and The Functional Pelvis. Even if you aren’t in NYC, check out their websites for lots of informative articles. I also recommend reading Heal Pelvic Pain by Amy Stein, MPT.
Lactation:
If you choose to breastfeed, know that most moms do have issues at some point! It’s a very good idea to have a lactation counselor available for questions- both for initiating breastfeeding and how to stop once it’s time.
See La Leche League to find a local support group, and here in NYC I recommend Boober, Leigh Ann O’Connor and The New York Doula services.
Newborn Care Specialists:
Commonly known as baby nurses, these are experts who provide in-home care focused on the baby, so you are able to get more rest.
The New York Doula and British American Household Staffing both are highly recommended.
Postpartum Doulas:
As compared to a Newborn Care Specialist, who focuses on taking care of the baby, a postpartum doula focuses on taking care of you. Many are also lactation consultants so can help you with breastfeeding, but also will help with preparing healthy meals and whatever else will make you feel nourished and taken care of.
I recommend The New York Doula, Baby Caravan Doulas, Kin Doulas, and Amber Star Merkens.
Books:
The First Forty Days– an excellent collection of recipes and tips for preparing for the period immediately after childbirth, this is also a guide on good self-care practices throughout pregnancy.