Postpartum

I am writing this from our oldest granddaughter’s house where I am staying to help her after the birth of their 2nd baby; he will be a week old tomorrow!  She is married to a Navy man who is away at a school on the other side of the country. 

It has been awhile since I have been with a mom 24 hours a day postpartum.  As a birth doula, I am usually more on the outside checking in periodically or going to help with breastfeeding occasionally.  Being here has been a good reminder of the importance of help and support during the 4th trimester (the weeks following the birth). 

I tell clients that the new mother should not be doing any cleaning, laundry, cooking or childcare in the weeks following birth.  She should really only be taking care of her personal needs and feeding baby. Much of the first few days should be spent in bed with someone bringing her food and drinks throughout the day.  My granddaughter is a very independent headstrong woman and gave me a look when I went over my instructions as she prepared to head home from the hospital with her mother and sister there to help her.  

I came back several days later to take over so her mom could return home. Amira started asking to go to Target with me. She said she was going stir crazy and that she would take it easy the rest of the day.  I reluctantly gave in and off to Target we went with baby covered up in the stroller to keep germy people away and her 3 year old helping push. We hadn’t been gone long when I could see she was moving slower and finally admitted she was ready to go home.  She returned to rest and nap while I got dinner ready. She has been more willing to let me do the laundry, housework, and cooking as she has learned the limitations and exhaustion of mothering two children. And I learned an important lesson too: the more I tried to stop her from going to the store, the more she wanted to. By going with her, I was there to help, she got out of the house like she needed, and the situation helped her realize her limitations.

There is a very fine balance in taking over and helping out.  Here are some things to remember if you are helping a family member or friend during their 4th trimester:

• If you are from out of town ask where they prefer you to stay, in their house or at a hotel.  Honor their choice.
• Ask about normal household routines and stick to them. This is not your house.  If you change things, it will just make it harder when you leave.
• Learn the workings of machines in the house and where things are kept.
• If the mom’s partner is home, discuss what they would like to do and what you can help with.
• When mom sits to feed baby, make sure she has something to drink and a snack if desired.
• If in a 2-story home, make sure there are things needed to change baby on both levels,  or have a basket that can easily be moved from place to place.
• If it isn’t done yet, help set up a comfortable place for mom to feed baby.
• Ask mom what she wants to eat, don’t decide for her. 
• Do not interfere with parenting of older children; follow parents’ wishes.  
• Ask before giving drinks or snacks to children. Find out their bedtime and meal routine and let parents handle them unless you are asked to help.
• Spend time with older siblings doing special things. Need to get some things from the store?  Make it a special outing with older kids. Let older children help with meals. Make some cookies together or take them outside to play
• Have things to occupy yourself (books, knitting/sewing, your laptop to do some work or write emails, etc.) several times during the day to give the new family time and space to bond.
• Encourage mom to spend some time outside. Babies can be outside too, just dress them appropriately for the weather.
• Be supportive of the parents’ choices with feeding the baby and such. If they ask, you can offer suggestions/expertise, but remember the final choice is theirs.  If it has been awhile since you have cared for an infant, familiarize yourself with current best practices. Just because something might have been done one way years ago does not necessarily make it the best or safest way.  If you are a grandparent, consider taking a grandparents’ class.
• Don’t expect to hold baby much. Instead, enjoy watching the parents nurturing and getting to know baby.
• Offer to watch/hold baby while parents shower or nap, but don’t push it if they decline.  Being overly protective of baby is normal.
• Do familiarize yourself with signs of postpartum depression and anxiety. If you see any, encourage mom or partner to have a discussion with a care provider. Help make the appointment and offer to accompany if appropriate.

If you are preparing for your own 4th trimester, here are some things to keep in mind when making your all-important postpartum plan. 

First of all, discuss who you will have helping during this time. Family member, friend or would it be best to hire a postpartum doula?

• Will they be supportive of your parenting choices?
• Will they stay in your house or at a hotel?
• Do they understand their role is not sitting and holding the baby?
• Do they have any limitations that will make them unable to do what is needed?
• Will you and partner feel comfortable having them do these things?
• Consider hiring a postpartum doula. They have the expertise and knowledge to help you through this time and prepare you to carry on when they leave.

Discuss, write out and hang in an easy to see spot:

• Directions for older children’s routine.
• If any animals are in the house, routine and care for them.
• Directions on washer/dryer running and preferences
• Food/cooking preferences
• If the house has any odd things such as where light switches are, how keys/garage door/ heating or cooling etc
• Garbage/recycling pick up
• Where keys are
• Directions and supplies for cleaning

The 4th trimester should be respected and prepared for as much as we do the first 3 trimesters, labor and birth.  How parents are treated and cared for has a great impact on the health and mental well-being of the entire family. Additionally, when good care is provided, signs of physical problems or of postpartum depression and anxieties are noticed quickly, allowing for early care and lessening their negative effects.