Practical Postpartum Care – a brief guide for mothers-to-be, family and friends

By Nicole Drummond MRSS

When I was pregnant I found a plethora of information on pregnancy and birth but almost nothing about postpartum care. Having gone through the postpartum experience I frankly find it mind-blowing to realise no weight of attention or advice is given to our aftercare, and that we have no system or tradition in place to care for women after giving birth.

Luckily however, with various resources including our lovely doulas, my Shiatsu colleagues, and friends with experience, I learned enough to set myself up for optimum healing support after the event and I want to share that with you.
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I realise when you are pregnant there is SO MUCH to organise, learn and decide about – but trust me, this is not an area to skip. It is paramount to plan for as it will affect your long-term health. I am no expert in the area of postpartum care, but I have gone through it myself using most of the tools I describe here. There will be postpartum doulas who will be able to advise you further as well as guide you to other resources. Consider this article a jumping off point to prepare you for your healing journey postpartum – it’s an overview of suggestions that I wish I had been given up front.
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40 Days Postpartum recovery period

If there is one thing you take away from this article let it be this – organise support for post birth so you can rest for a significant period of time, at least for a month but ideally for 6 weeks. In many cultures there is a long-standing tradition of a period of 40 days, where a woman who has just given birth is supported and cared for by the women in her family and her friends. They cook for her, give her massages, they tend to the baby and even wash her hair. She sits, lies down, relaxes, naps and rests.
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Why? Well pregnancy and birth take a significant toll on your body and resources. You actually made and birthed a new human being - that’s incredible - so give your body the respect, time and space it needs to start to heal. Think of it as health insurance, not just for the immediate future but for your long-term health.

After I gave birth quite frankly I felt like I had been hit by a freight train. The flip side was that I felt very grounded, empowered and transformed by the experience - but that’s another story! I was bruised and swollen, sore, empty, overwhelmed and exhausted, for months not just weeks. Don’t worry, your superhuman strength kicks in and you do transform but I was so grateful that my partner and I had arranged for support as I certainly needed it.

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I’m not alone in this experience, there is a 40-day tradition for a reason. So how do you make it happen? Well, think about asking your partner to take holiday on top of their parental leave, call in family and friends you trust to take some time off to help you, organise a postpartum doula - you can find a way.
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Meanwhile for any family or friends who want to visit during those early days, here are some requests:

• Bring some food so the new parents don’t need to cook!
• Make tea and coffee for everyone so the new parents can rest
• Be mindful of the time. Unless you’re there to do the dishes and laundry etc. keep visits short and sweet - the new parents will be exhausted but probably too polite to ask you to leave!

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6-week check and GPs

When I had my 6-week check the doctor simply asked a broad ‘are you okay?' This left me flummoxed, as frankly it was really not the adjective I would use to describe my life changing experience! I also had no real frame of reference - I was still very sore and my world was upside down. I did have a specific problem and after an examination the doctor said I was ‘fine’. However, I trusted myself enough to push for a women’s physiotherapist, who understood immediately what the issue was, and we treated it together.

Remember GPs are not specialists in women’s health. If you don’t feel right, and don’t feel heard, then ask for a referral. Unfortunately in the UK currently only Women with 3rd and 4th degree tears will be immediately referred to a Women’s Physio, but really all postpartum women deserve a comprehensive health check after birth. Women’s physios exist for a reason – as there are common issues that can come up after birth, with or without tears, which can be resolved with guidance. Get help.

Kimberley Ann Johnson (a postnatal doula) has written a book called ‘The Fourth Trimester’ which I highly recommend, and she also does a podcast called ‘MagaMama’ on Castbox. She is passionate and very knowledgeable about women’s health. I loved the podcasts, which feature interviews with a variety of specialists - they nourished me hugely at a time when I had lots of questions and reflections.

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Wrap your belly

Post-birth your core muscles are weak, and I found it incredibly supportive and comforting to wrap my middle with a scarf. Belly binding is another ancient tradition, it is also seen as a method to help your stomach draw back in. There are different styles of belly binding or support which Doula Sophie Messenger runs through in her article.

In Chinese Medicine it is recommended to wear a Haramaki (Japanese core warmers or Hara warmer), to support your blood circulation. As the Haramaki keeps the major organs warm this enables your body to have more energy to send the blood supply to your extremities, helping to keep your hands and feet warm too - less stress on the whole system.

Importantly post-birth, wrapping your Hara also supports your Kidneys which store the Essence (Jing) which is very depleted after pregnancy and birth. It is paramount you keep this area warm to replenish and support the Kidneys during this period. I wore mine night and day. Wrapping your belly is such a gorgeous warming comfort at this tender time. 
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Healing foods

​In Chinese Medicine there are particular foods known to nourish the Kidney energy, such as walnuts, chestnuts, seaweed and seafood, nuts and seeds generally. ‘Floradix’ is also a great tonic to help nourish the Blood.

​You want to be eating nourishing and easily digestible foods at this time – plenty of warming soups, stews, broths etc. A good book which gives specific recipes, and beautiful reflections on the postpartum period, is the ‘First 40 Days Cookbook’ by Heng Ou. 

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Healing herbal kit

​To help support our healing or simply to ease post-pregnancy tenderness there are various natural remedies we can use. Homeopathic remedies include Arnica and Calendula to help with bruising and to support muscular healing. Aloe Vera, which can be taken as a drink, is very good for soft tissue repair. Calendula cream can also be applied for external tears or episiotomy cuts – please read instructions before use. There are also Bach Flower remedy kits specifically for the postpartum period.
Some women also have their placenta encapsulated and take it post-birth to support their energy levels which is something you might be interested in exploring. It’s not something I tried, but some report great results. 
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Tender Reality

After birth you will be tender and bleeding for a number of weeks. At my NCT class we are advised to get surgery knickers (regardless of whether you had surgery) as they are light and comfortable. I found them very helpful and they preserved my knickers! Get a stock of postnatal sanitary pads in ready. I was also gifted a special portable cushion with a dent in it, which I treasured as I was so sore when I sat down during the early weeks, and that really helped.

Chinese medicine would advise against any application of ice or cold packs to ease swelling, as you don’t want an Invasion of Cold in the body at this time as it will hinder healing. Instead take a warm bath with Epsom salts or have a vaginal steam to put warmth into your body and support the blood circulation to the area.

Obviously always listen to your body. You will discover advice from health professionals (midwifes, nurses, health visitors and doctors) can really vary - and even contradict each other - on some topics and you will need to use your personal discretion when it comes to your health and that of your baby, or at least that was my experience and that of my friends too. 
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Yoni Steaming

Another old tradition which has become more mainstream recently is vaginal steaming, or ‘v-steaming’. It involves sitting over steaming water mixed with herbs for 10 minutes or longer, to support the healing of your vulva and pelvic region.  

Sounds a bit ‘out there’? Well I’m sure it will be commonly known and a normal practice in the coming years. You can learn how to do it at home in a more or less DIY fashion. There are especially made steaming stools or boxes and herbs that you can buy online. I did try this and found it very powerful. 

There is a long list of reported benefits for postnatal women. Kimberley Ann Johnson recently ran some clinical trials which verified the effectiveness of vaginal steaming and the rate of healing recovery in women. Check out the results here   

Note: DO NOT PRACTICE WHILST PREGNANT. Also do your research before trying steaming at home.

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When to Exercise

The NHS has a guideline for exercise, and it is just that, a guideline. I wasn’t ‘ready for light exercise’ at 6 weeks, it was more like 5 months for me and the comparison made me feel concerned. We are all individuals. I would encourage you to listen to your body and do what it needs (though remembering definitely just to rest for the first 40 days). Now is not the time to push yourself hard, go gently. Heal.

If like me you have a ‘tummy gap’ after pregnancy, which a women’s health physio can diagnose, and you are finding it isn’t closing on its own (as it can) there are various different Pilates exercises you can do but I can recommend this one in particular

Obviously always listen to your own body. Definitely don’t do stomach crunches as they will do the opposite of what you want. There are various postnatal Pilates groups out there to support you as well. 
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Bodywork ​

Bodywork therapy will aid your healing enormously. Especially if you found the experience of giving birth very shocking, intense and/or traumatic. You need support to process and release the event. Specialists who can help you include:

• Craniosacral Therapists – find a specialist in releasing trauma who works with mothers and babies
• Cranial Osteopaths – who work on both mother and baby
• Shiatsu home visits – no need to leave your own home to be treated! 

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Breastfeeding consultant ​

If you are breastfeeding and experience pain, then get a Lactation consultant in asap. Don’t wait, it really should be painless – which I found hard to believe as when I started it was so painful! But my daughter had a tongue-tie and as soon as that was cut then for me breastfeeding was a comfortable bonding experience.

A lactation consultant can help you learn how to latch the baby on as well as do a tongue-tie assessment. The NHS no longer staff this specialist area unfortunately, so you have to go private but it’s worth it if you want to breastfeed and you will be saving money on formula in the long run.
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In Chinese Medicine it’s considered that it takes 2 years to recover your energy levels after breastfeeding (it’s also said to take 1 year to reach a BASIC level of physical and energetic recovery after pregnancy). Why? Well breastfeeding continues to deplete your Jing - just another reason to be gentle and kind to yourself in the early years as well as resting whenever possible. You will be giving out on every level as well as steadily healing.
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If you experience nipple pain I can highly recommend ‘Hypercal’ cream on your nipples as an incredibly quick healer, as well as Jelonet gauze dressings, which you simply cut to size and place on your nipple. Those are the two things that allowed me to keep me breast feeding in the early difficult days. 
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Light relief 

After all that information you might be looking for some light relief? Well there is plenty of good humour out there on parenthood to lift you and keep you sane.

I have a fond memory of being sleep-deprived and delirious in the middle of the night, in the first month of our daughter's life, and reading this article which is a funny guide to ‘Mum Forums’ by Emily Jane Clark. I read it out loud to my partner and we both ended up crying with laughter in our manic state (maybe you had to be there?)
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To conclude 

​I hope you find some useful information in the above. I will not have covered everything as it is a large field, but these aspects were all pertinent to me. Please always remember to check and do your homework, no one size fits all, so make sure the suggestion is right for you. Let me know if you find any of the material useful as it’s lovely to have feedback.
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Otherwise, I wish you good luck in those early days and send you lots of love! Take care of yourself as well as your little one. 
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Links to Local Services 

​Local practitioners and services recommended for women based in Norfolk, UK.
 
Breastfeeding Consultants

• Jan Edye - Breastfeeding Norfolk
• Sian Aldis - No Milk Like Mamas

Both consultants run breastfeeding support cafes locally as well as offering private consultations. 
 
Therapists

• Andrew Cook - Craniosacral Therapist specialising in trauma and he works with Mothers and babies 

• Felicity Hancock - Cranial Osteopath – for Mother and baby 
• Shakura Meddings and Cat Westwood - Shiatsu Home Visits  

 
Women’s Health Physios  

• Lucy Eggleton
• Rosie Taylor – Also runs pilates and yoga for postpartum women under Well Fit Mumma

 
Yoni Steaming

• Tuesday at Wombon

 
Birth Doula's

• Rachel Graveling – Also runs a birth group every 2 weeks from home
• Siobhan Ridley 
• Doula uk website – to find postpartum doulas

 
Placenta encapsulating 

• Cherished Placentas (recommended by colleagues)