If you're gearing up for a new baby in your life or you've just welcomed a new addition to your family, then you've probably already done all the research about cribs and carseats, taken the baby care classes, and set up the nursery. Even with all this research, however, caring for yourself in the postpartum period may still leave you with a lot of questions.
If that's the case, I'm glad you're reading, because supporting women during the postpartum period is literally my job. The months following birth are a sensitive time, during which women need plenty of support to properly recover, but in most cases a few simple adjustments are all that's needed to help a new mom to recover quickly.
Nutrition & Self-care
In most cultures the postpartum period is considered one of the most vulnerable and physically trying times in a woman's life, so emphasis on proper rest and nutrition is imperative. Try to get as much rest as possible, and avoid overexerting or overcommitting yourself too soon after birth. It's common for it to take several months before you feel mostly back to yourself, and that's okay, that's totally normal. You're actually considered to be in the postpartum period for the entire year after you give birth.
Ask for help if you need, from a partner, friends, family, or outsource some assistance if that's an option. You're not meant to do everything yourself, seriously, they say "it takes a village" because it actually does. We evolved in small tribes where there was built in support for new mothers, and many cultures have postpartum care built into their traditions as well. It's only in modern times that we seem to have forgotten how important this support truly is.
Taking care of yourself can often be the first thing to get left off the to-do list, when in reality it should be at the very top. Don't overlook making sure you're eating, resting, processing emotions, and managing stress in a healthy way. You don't have to be perfect, but it is important you stay healthy as possible, for yourself and for everyone around you.
After birth the main focus is to recover from a loss of Qi and blood, and to support the huge shift in hormones that occurs. Nutrition plays a huge role, since we build our new red blood cells and all the hormones in our bodies from the nutrients we absorb from our food. General nutritional recommendations for postpartum recovery in Chinese medicine include:
- Eat plenty of blood nourishing foods:
- Dark leafy greens, brightly colored non-starchy veggies, beets, berries (especially goji berries)
- Grass-fed beef, lamb, liver, bone broth, eggs
- Whole grains, such as brown rice, quinoa, oats, or barley
- Nutritional yeast or brewer's yeast
- Micro-algae, such as spirulina or chlorella
- A small amount of molasses and/or dates
- Raspberry leaf tea daily, many women drink this during pregnancy too, nettle tea is also a great option
- Unless instructed otherwise by your doctor, continue to take your prenatal vitamins
- Consider encapsulating your placenta, it can help to balance hormones and is an excellent Qi and blood tonic
- Enjoy mostly warm/cooked foods and room temp or warm beverages, avoid cold foods or drinks with ice in them
- Stay hydrated and eat nutrient-dense food frequently, don't skip meals or go too long without eating, keep easy snacks and pre-made meals on hand, ask loved ones to cook for you
- Keep protein levels up, especially if you are vegetarian or don’t eat much meat
Dealing with Bleeding & Cramping
It's normal to have bleeding last up to 4-6 weeks after birth, often with small clots and cramping that's similar to menstrual pain. Before you go into labor make sure you have lots of large pads on hand, or honestly, some women find adult diapers (yes, really) easier to use in the first few weeks after birth.
Generally the cramping starts off like moderate to severe period pains and slowly decreases with time, as the bleeding reduces as well. Cramping may flare-up during breastfeeding sessions, that's normal, but they should still reduce as the weeks pass. For some women, they don't notice much cramping accompanying the bleeding.
Bleeding or cramping can sometimes get worse or continue for much longer than usual, this is often because of overexertion or hormonal imbalance. If you have severe cramping or heavy bleeding or if you're passing large clots, call or see your doctor immediately. If there are no complications but you still have heavy or prolonged bleeding or frequent cramping, then acupuncture and/or herbal medicine may help.
Perineal Healing & Treating Hemorrhoids
It is very common to have some degree of tearing or swelling, or even just pain of the perineum, as well as hemorrhoids or similar irritation after labor. But the good news is the body is amazingly resilient and heals quite well! Especially when properly supported. Here are a few things that can help:
- Epsom bath: it doesn't get much more simple than filling up the tub with warm water and throwing in a heaping handful of epsom salt, soak for at least 20 minutes if you can. This helps to ease sore muscles and improves perineal healing. Just clear it with your doctor first if you had a cesarean and your incision site's still healing. If you don't have a bath tub or if you aren't partial to baths, a sitz bath may be a better option for you.
- Sitz bath: you can get these at most drug stores, it goes on top of your toilet bowl and allows you to put warm liquid in the reservoir and sit to soak your perineum. You can just use warm water, but I usually recommend using an herbal soak that's specifically formulated for postpartum healing, such as Angelica Herbal's Soothing Herbal Sitz Bath, it's particularly effective when used with the Rhoid Relief.
- Witch hazel: witch hazel is a common home remedy that soothes irritated and swollen skin and promotes healing, you can find bottles of witch hazel water at most major drug stores. Fill a spray bottle with witch hazel water and spray it directly onto a pad, don't soak it all the way through because you still want it to be somewhat absorbent.
- Peri bottle: this is a small plastic bottle made for rinsing off the perineum. Fill it with warm water and gently spray your perineum over the toilet, the warmth of the water is soothing and it helps to keep the area clean. Especially after you use the restroom it helps to rinse residual urine off that may cause irritation.
- What about ice? I actually don't recommend using it. A lot of holistic practitioners will recommend ice as a natural way of reducing perineal pain and swelling, but in Chinese medicine ice isn't often recommended because it can drain energy from the body. Especially when used on the perineum, ice will leach energy directly from the kidneys and make it even harder for the body and metabolism to recover from labor.
Pregnancy, labor, and pain medications can all contribute to constipation and hemorrhoids, here are a few things that can help to move things along:
- Eat nuts/seeds
- Especially shelled hemp seeds, they are traditional in Chinese medicine for postpartum constipation
- Chia and flax seeds also help, add to smoothies or oatmeal
- Stay hydrated - especially if you're breastfeeding your water intake needs to be much higher than usual
- Prunes really do work
- Plenty of fiber from whole food sources (such as fruit, whole grains, leafy greens, non-starchy veggies)
- Take a magnesium supplement, such as Natural Calm
- If cleared by your doctor, light exercise such as walking can help
There are usually two main issues when it comes to breastfeeding, behavior and supply.
When I say behavior I mean how and if your baby latches, positions that work best for you, schedules, routines, and if you need to pump or supplement with formula. If you or your baby's breastfeeding behavior is frustrating, confusing, or non-productive, then lactation support is an excellent resource you should consider.
I usually refer patients to a local lactation consultant who makes personal assessments of each woman's individual needs. Some hospitals offer lactation consultations, but access may be limited. La Leche League is another great resource for moms to get breastfeeding support from other moms, online or in person.
When it comes to the other issue of breastmilk supply, low supply can be caused by nutrient deficiencies, an endocrine/hormone imbalance, or some women are prone to low milk supply and it's not always known why.
Talk to your OBGYN if you have concerns about your supply, they may want to take a look at your prolactin levels or check your thyroid function just to make sure everything is working properly. Make sure you're eating regularly and your diet is full of nutrient-rich foods, refer to the list at the top of this article. Acupuncture and herbal medicine benefit low milk supply better than any other modality I've found, usually 2-4 treatments and drinking Milk Support Tea daily is all that's needed to boost supply substantially.
Mental Health Support
Postpartum depression and/or anxiety is incredibly common, you are not alone. If you have a feeling something is off, reach out and ask for help now. You may feel shame or frustration that you have to deal with these uncomfortable feelings, but I promise you the relief you'll feel from getting help will outweigh the discomfort you experience by asking for help.
Talking therapy can be incredibly helpful, especially during such a significant transition. You may have mental health coverage through health insurance, though it doesn't come standard. If you you need, here are some resources that may offer support:
- If you are in crisis, you can call the National Suicide Prevention Lifeline (1-800-273-8255) 24 hours a day or if you'd rather not speak on the phone you can text MHA to 741741 to speak with a trained crisis counselor. You can also call 911 or go to your nearest emergency room.
- Mental Health America
- Postpartum Support International
It's also important to also visit your doctor/OBGYN as well, sometimes hormonal or endocrine imbalances can effect emotions. For example, thyroid imbalance commonly can contribute to anxiety and/or depression.
Acupuncture can also be helpful adjunct therapy for reducing the symptoms of depression and anxiety, as well as balancing hormones. If you'd like to work together, schedule an appointment or send me a message.