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Recovery Expectations

You found out about the hard work of labour, now you are finding out about the hard work of mothering. Often women just think about what life with a newborn will be like and forget that they will also be healing and recovering from a birth. The focus can be on the new baby and the new mother is forgotten. In many cultures around the world the new mother is honored and cared for. The first 40 days is used to help the mother heal so she can meet the needs of her baby. There are some things to think about as you prepare for your healing period.

There are many changes in the uterus and vagina after birth. Normally the uterus is about the size and shape of a pear. It can be felt as low in your pelvis and firm. After the birth of the placenta, the top of the uterus is at the level of the belly button. The uterus will remain this size for about two days and then it continually gets smaller. In about five to six weeks, it has regained its pre-pregnant size. The regeneration happens very quickly except at the placental site. Complete healing of the placental site takes up to six weeks or more.

Vaginal discharge is experienced, whether it is a vaginal birth or cesarean. This is called lochia. It is much like a menstrual period and can be experienced for two to six weeks after birth. Lochia comes from blood and tissues that have built up in the uterus during pregnancy. It will gradually slow down and turn from a bright red colour to lighter pink and then brown. There may be clots that are passed around day 3 after birth. If you notice an increase of red blood you body is telling you to slow down and rest.

In vaginal births where tearing has occurred the mother usually experiences swelling and pain. The tearing may be repaired by the use of stitches depending on the severity. If this is the case they will dissolve over the course of a week. For a mother who has not experienced tearing, the vaginal lips can still appear slightly swollen. Although the vagina stretches significantly to accommodate the birth of the baby, immediately after birth, it will return to normal. The perineum, the area between the vagina and anus, may also be sore due to a tear during labour or if an episiotomy was done.

Restoring strength and tone to the abdominal wall muscles. The abdominal wall will remain soft and flabby for a while after birth due to the rupture of the elastic fibers and the prolonged distention of the uterus. It makes the perfect resting spot for your new baby, who was nestled on the inside and now can nestle on the outside. It usually takes several weeks for the abdomen to return to its pre pregnancy appearance. For some women, the abdominal wall may have separated and will remain lax. Therapy and gentle exercises can help with healing.

Endocrine system and hormonal shifts. After giving birth, estrogen and progesterone, which are released by the endocrine system, significantly lower. During pregnancy, the body produces these hormones in abundance. It takes around three days for hormonal levels to return to their pre-pregnancy state. The body experiences a shift with the sudden change in hormones, impacting the mothers mood, body functions, digestion and ability to sleep. Due to major shifts in hormones after birth, mothers may experience mood swings. In the first week postpartum women may have lots of energy and are joyful and happy because of the high of the birth. However, in a few days the joys of birth can turn into the ‘baby blues’ and or a sense of melancholy. This is due to the physical and mental stress of birth, a breakdown of tissue components and a withdrawal of estrogen and progesterone leading to an imbalance of electrolytes and hormones. If the feelings of being sad and low continue mothers are encouraged to seek help and support.

Establishing a good milk supply and successful breastfeeding. The same hormones that initiate contractions in labor help to initiate breast milk. Within 24 hours after birth, the breast produces colostrum, a golden yellow liquid that is full of antibodies that serve as the newborns first immunization to disease. Breast milk has the proper amount of sugar, fat, water and protein for the baby’s growth. Not only is breastfeeding good for the child, it is also great for the mother as well. Suckling on the breast creates a rush of oxytocin in the mother’s body. This hormone helps the body secrete milk. Suckling also helps in contracting the uterus and protects the mother from hemorrhaging.

Benefits of herbs, nutrition, love and pampering during postpartum. One way to use herbs is an after-birth tea. It increases circulation, cleanses the womb, increases breast milk, balances hormones, relieves pain and gives the mother an overall good relaxed feeling. Fathers like it as well.

To make the tea, grate the ginger and add it and the cinnamon sticks to a large pot of water. Bring it to a boil and then add the star anise seed. Let it boil for 25 minutes. Add oranges and lemons and turn it on low for 10 minutes. Add the rest of the ingredients, turn off the fire and let it steep. Strain, add honey and enjoy.

Herbs can also be used as a bathing treatment. The after-birth bath aids in the healing of the uterus and perineum. It also helps with circulation. It is relaxing and soothing and allows a mother to rest comfortably.

Eating nourishing foods is essential to the recovery of a mother during her postpartum period. There are many foods that aid in the healing. Some of the best foods for the recovering mother are those that have high vitamin and mineral content including whole grains, vegetable soups, cooked greens, root vegetables and pure clean water. Bone broth makes a great nourishing soup base or just drink the broth throughout the day. The brewer’s pregnancy diet can be continued after birth. Motherfoods by Hilary Jacobson has lots of good information on eating a lactogenic diet to help with breastmilk and healing postpartum.

Note on cesarean recovery. Major surgery takes months to heal. Problems that can arise at different stages in the healing process include bleeding, infections adhesion's, pain, stiffness, and numbness around the surgical site. As with an episiotomy, you should follow the rules of good hygiene regarding your stitches. Keep the wound clean and dry, and don’t fuss with it. As you heal you may consider seeing a massage therapist who specializes in scar tissue. If you have more severe or persistent pain, speak with your physician. Numbness should go away as your severed nerves heal. You may, however, feel some itching sensations in the process. Mild exercise, such as frequent moving about and walking and stretching, is important even in the earliest phase of healing, because it reduces the chances of adhesion's forming which is a common long-term complication of c-section.

Be gentle with yourself as you are healing and bonding with your new baby. Ask for help and support as you journey through the postpartum period. Remember that you are important, and worth being taken care of. Your baby and you are in this together.

Be well!

Mothering the Mother: The Importance of Postpartum Care by Rev. Pilar (Ma’at) Grant

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