Musings of a Midwife: Planning for the Postpartum

Published on: January 15, 2022

Last month’s issue looked at the taboo of postpartum dissatisfaction—the bewildering paradox of loving your baby but in some ways disliking what your life has become and the guilt that comes with it. This month, Midwife Emma looks at steps you can take to prepare yourself emotionally, physically, and practically for the early weeks as a mother, and hence take control of your postpartum.

By Emma McNerlin

When you are expecting a baby, it’s hard to see or think beyond the labour and birth. We midwives and childbirth educators call this ‘the labour wall’. Much of your focus is on ensuring that you have bought the necessary things, packed the hospital bag, read all the books, and made the big birth plan. The anticipation of meeting your little one after nine long months and the preparation and hope for their safe arrival leaves little room or headspace for thinking of what life will really be like with a newborn. 

I wonder whether, if you glanced over that labour wall at the ‘postpartum you’, you would like what you saw, and if it would be everything that you had expected? Becoming a mother is a new beginning and also an abrupt ending (even if only temporary) to the ‘you’ that was before. You were a whole person with a full life before motherhood. Where does that ‘you’ go in the haze of feeding, burping, changing and entertaining this gorgeous, new, full-time job you birthed?

Friends who have gone before you into this brave new world might tell you that it is hard at times, but you will tell yourself “well, surely not that hard”. No one wants to spend the last weeks of their pregnancy worrying that they will never sleep eight hours straight again and that their life will not be their own. Even if it is true (spoiler alert: it’s not true), it’s not like you can do anything about it, right? There is no way around it, only through it, so it is important that you can lean on those closest to you, especially in the early weeks. 

Following birth, it is quite normal for mothers to have a biological drive to do everything for their baby. Your brain physically changes to play this beautiful trick on you. Partners can feel excluded, or on the other hand, they might be quite relieved to see you taking to motherhood like the proverbial duck to water. From experience though, once the newness and novelty of newborn care starts to wane, you will want and need your partner to be able to take over, sometimes to just give you some space, and they will need practice to build their confidence as a parent.

There is no doubt that a baby will change your relationship. You get to know each other all over again, this time as parents. Spending some time discussing a practical plan for the postpartum can help you and your partner to communicate openly about your expectations for what life will be like. You might be surprised about how different your perceptions and expectations are. Never assume that you are on the same page; your partner will potentially bring different experiences and beliefs on what their practical role will be.

When I had my son, I recall silently seething at my husband for not helping, whereas he was waiting for me to ask for help. He was also mightily surprised that the newborn was in our room and not in the lovely, relaxing nursery that I had nagged him to finish in the last weeks of pregnancy. We had obviously assumed different things about life with a baby. So my advice is to preempt those conversations before the lack of sleep and postpartum hormones are in the mix and tempers can fray.  Obviously if the plan is to breastfeed, much of the physical parenting—especially in the first month or two—will fall on the mother. So spend some time thinking about what you will need from your partner for this time and beyond. Be as specific as possible with this. Think of it as a ‘pre-nup’ for the postpartum if you like. Sure, it takes all the romance and wonder out of it, but at least you have each identified what you need and expressed it. Open and honest communication helps you to prepare and to avoid resentment and distance from expectations not met. 

For some new families, employing a nanny from birth is a key component to the postpartum plan. Do not be surprised if you are reluctant at first to allow your nanny to help with baby. Many of us did not grow up with nannies or domestic help, so it can take a while to get used to having one around. Also, on a biological level, your brain changes in pregnancy and postpartum to heighten your attachment and protective instinct, so you really do not want to share your baby with anyone.  Give it some time, and in the meantime, the nanny can be a great help with household chores and cooking to allow you to focus on your baby.

You may also choose to have family come and stay with you in the postpartum to meet the newest addition and lend a helping hand. If you have a good relationship with your families, this can be a wonderful experience. However, also consider that the early weeks with a newborn pass by in a haze. Getting to know your baby and establishing your feeding takes time and can be intense. Make sure family are aware of that, and also set the expectation that they need to give you space when you need it and not require too much entertainment from you.  

All the baby books will tell you that breastfeeding is the most natural thing in the world; however, it doesn’t come naturally to all. It is a skill that takes time and patience. The key elements to get it right from the start are lots of skin-to-skin contact and access to the breast for feeding on demand. Getting the latch right and making sure baby is actively sucking and swallowing throughout the feed are important, too. It can feel like you are feeding constantly in the first few weeks. This all helps to establish your milk supply, but it can be overwhelming. Pain and trauma to the nipples is never normal, so do not suffer! Fixing small issues stops them becoming big issues. The solution is often a simple one. If you are determined to breastfeed exclusively, be sure to tell your loved ones that suggesting a bottle before getting breastfeeding support is not helpful and can undermine your confidence. There is lots of wonderful support for breastfeeding in Bangkok in the form of lactation professionals, doulas, and midwives, so make contact with them early on to get off to the best start with your feeding. 

Of course we can’t forget to factor in the hormones. In the last weeks of pregnancy, your estrogen and progesterone are at the highest levels they will ever be. Within the first week of postpartum, they will plummet to levels similar to menopause. While they will gradually return to normal levels, this sudden crash can cause baby blues, which manifests as periods of irritability, low mood, tearfulness, anxiety, and restlessness. Awareness of this, being able to recognize the symptoms of baby blues, and talking with your partner, your family, or friends can really help. Symptoms persisting beyond two weeks and worsening can be an early indication of postpartum depression, which affects 15% of women.  When you make your birth plan, you can also make a mental health plan for your postpartum. Ask yourself if you are the type of person who can easily ask for help, and if so, who will you talk to? Tell that person before baby arrives that you might reach out, and that if you don’t reach out, ask them to check in with you. Make a list of all the support services that are available locally and groups that you can join. BAMBI New Moon postnatal group is a great soft landing for new mums with support from midwives and postpartum professionals. Contact the Bumps team for details of meet-ups. 

Pregnancy and postpartum is the ultimate life reboot; you are forever changed by the arrival of a baby. Priorities change, relationships evolve, and new friendships are formed. Change is not without challenge, but by acknowledging and normalizing the emotions that go with sometimes mourning and missing the life that was before while still loving your baby, and by talking about the practicalities of life with a baby with your partner and friends, you can ensure that they are in the best position to support you as you grow in confidence as a mum. One day you will realize as you strap on your baby carrier and skip out the door that despite all the hard work, you are the expert on your baby, and you will once again have space and time for yourself and your needs. 

Photos from Canva.

About the Author

Emma McNerlin is a UK trained and registered Midwife, First Aid Instructor, and owner of Bumpsy Daisy Café and Community; a cafe and parenting community centre for new and expecting parents offering birthing classes, hypnobirthing, First Aid workshops, and baby classes.


The views expressed in the articles in this magazine are not necessarily those of BAMBI committee members and we assume no responsibility for them or their effects. BAMBI Magazine welcomes volunteer contributors to our magazine. Please contact editor@bambiweb.org.

 

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