The postpartum period consists of the first 6 weeks post-delivery, over which time the body returns to its pre-pregnant state. This phase is dynamic, complicated, and filled with challenges. Women have to balance learning how to become a new mother with self-care and recovery. There are 6 key areas to consider to prepare and optimize oneself for surviving, and even thriving, postpartum. Dr. Lucky Sekhon is a reproductive endocrinologist and infertility specialist, a board-certified obstetrician, and a gynaecologist. She has particular expertise in fertility preservation (egg freezing), LGBTQ family building, and in-vitro fertilization. While Dr. Sekhon maintains a busy clinical practice, she continues to publish and present cutting edge clinical research in the field of reproductive medicine. She is passionate about educating women about their reproductive health and family building options and often volunteers at various Women’s’ Health outreach events throughout the city. We asked her about the key areas you can prepare yourself for the postpartum period. Keep reading for more according to Lucky Sekhon, leading OBGYN.
How To Set Yourself Up For Postpartum: The 6 Key Areas
A typical newborn wakes every 2-3 hours and requires feeding, changing, and to be soothed back to sleep. As a coping mechanism, it is important to try and sleep when the baby sleeps. Although sleep will be fragmented and frequently interrupted, the small increments of rest will add up. It is important to set yourself up in a way that is conducive to falling back asleep easily in between nighttime feedings and diaper changes, such as setting up the baby’s crib or bassinet near your bed for easy access. If you have the help of a partner, family member, friend, or nanny – it is wise to plan for a 3-4 hour block of time where you can have uninterrupted sleep while someone watches the baby – this may help to restore your energy and prevent chronic fatigue.
Part of recovery during the postpartum phase involves a healthy, balanced diet to provide necessary energy and facilitate healing. During a hectic day of caring for a newborn, mothers often neglect their own needs, including eating at least 3 meals a day, hydrating, and healthy snacking. It is important to plan ahead and come up with ideas for simple, healthy meals that are easy to prepare. One should avoid extreme dieting in an effort to lose pregnancy weight rapidly as this may lead to nutritional deficiencies and impair one’s ability to breastfeed. It is better to focus on a diet packed with vegetables and fruits and balanced with proteins and healthy carbohydrates. It is also important to continue taking a multivitamin to fill in for whatever vitamins and nutrients might be missing from the diet.
3) Coping with body changes
Alongside the intense emotional changes experienced during the postpartum phase, there is a myriad of physical changes taking place. It is important to have realistic expectations of body weight and weight loss post-delivery. It is very normal to still look pregnant for weeks after the delivery while your uterus very gradually shrinks back to its prepregnant size. There are many fluid shifts taking place and it is very normal to look and feel bloated and swollen. If breastfeeding, breast engorgement can be an uncomfortable new sensation. It is important to buy a supportive nursing bra that applies to gentle pressure and support. It is normal to be constipated in the first few weeks post-delivery.
If you have had a c-section, this is often compounded by the strong pain medications required. If you had a vaginal delivery, it is common to become constipated because of a lack of bowel activity from not eating during a long labor. Also, from avoidance of emptying the bowels due to painful hemorrhoids acquired from pushing and pain from vaginal tears that occurred during delivery. Sitz baths can help alleviate some of this discomfort. It is important to maintain good hydration and a high fiber diet. Use stool softening medications if needed to prevent constipation.
It is a good idea to get outside for a few minutes each day for some fresh air. From an early stage, you can get exercise by going for walks. Once cleared by your doctor, you may start the postpartum exercise. It is important to exercise your pelvic floor muscles, particularly after having a vaginal delivery. Repeating kegel exercises several times per day can help to strengthen the pelvic floor and to restore muscular integrity and tone to prevent problems with urinary incontinence and sexual dysfunction. It is important to avoid weight-bearing exercise or straining your abdominal muscles right away after delivery, particularly if you have had a
cesarean section. Exercising the abdominal muscles too early can lead to separation of the wound.
It is important to visit the doctor for a wound check 2 weeks post-C-section and to wait for your doctor to approve returning to your normal exercise routine, regardless of the route of delivery. Women who have had cesarean sections can benefit from belly bands that provide abdominal and incisional support. I am an OBGYN and a mother who had a c-section with my first baby. This was due to her being in the breech position. I found it extremely helpful to wear an abdominal binder while taking those early walks in the first few weeks after surgery. Belly Bandit is a phenomenal brand that makes comfortable, supportive, flexible abdominal binders to wear during the postpartum period.
5) Feeding your baby
How you choose to feed your baby is a very personal choice. Breastfeeding has become a very polarizing topic. While we all can have a plan to breastfeed, it is important to be open-minded and adaptable and not be too hard on yourself. Breastfeeding can be very challenging. If motivated to do so, it is good to consult with a lactation consultant (many postpartum units in hospitals provide them) who can help you troubleshoot while you are in the hospital. Lactation consultants can also make house calls and follow up with you even after you are discharged home from the hospital. Not everyone can breastfeed in an easy, pain-free way. Some women will exclusively pump to extract their breast milk and will bottle feed their infant. Others will only breastfeed. However, there are many moms who struggle from day 1 or decide to exclusively formula feed.
There are many health benefits to breastfeeding including boosting the baby’s immunity by the passage of antibodies in early breast milk, called colostrum. In order to promote milk production, it is important to breastfeed for sufficient durations and often. The breast stimulation from a breast pump can also help ‘bring milk in’. In the early phase of trying to breastfeed, production may below. In some cases, supplementation with formula is necessary to prevent newborn dehydration. It is important to treat problems early – ie. using lanolin cream on cracked nipples, seeing a doctor if any sign of mastitis, or breast infection (i.e. fever, breast pain, and engorgement).
In the first few weeks postpartum, it is important to let family/friends/hired help take care of as many households and other responsibilities outside of feeding and caring for the baby and yourself. Don’t be afraid to say NO to visitors if you are not up for it. It is important to surround yourself with support and to reach out to your friends, family, and medical professionals if you experience feelings of sadness or hopelessness. Baby blues, where you experience feelings of sadness that are manageable and attribute to the major hormonal shifts post-delivery. The sudden absence of the placenta, which was churning out estrogen and progesterone, can lead to emotional symptoms of hormone withdrawal.
More concerning is the fact that postpartum depression, characterized by profound and crippling sadness and apathy, can strike without warning, in people with no known or underlying risk factors for mental illness. Surrounding yourself with support early on and talking to your doctor about how you are feeling is key. Also, taking care of physical needs will help to combat mental fatigue and stress.