The Girlfriends' Guide: Postpartum

Erin Baird, Certified Nurse Midwife
Rachel Gagen, Pediatrician
Adrienne Griffen, Founder and Executive Director, Postpartum Support Virginia

Our Girlfriends' Guides are always one of our favorite panels; we give you the info that you really want and need to hear...unfiltered and as real as it gets!! Our most recent Guide was on everything postpartum, from body changes to hormonal changes to how to get support and stay healthy as a new mom.

First, we talked about physical changes. Erin noted that literally everything changes during birth: our back shape, our nipples...our pelvic floor muscles end up with a mind of their own! (pee, anyone?!) Regardless of whether you have a vaginal delivery, a C-section, an epidural or a non-medicated birth, all of our bodies go through these changes, and we all recover at different rates. Recovery is completely unique to YOU, and can take from a few short weeks to much longer. 

Let's talk breasts! Rachel noted that 98% of moms have breast tissue and CAN breastfeed. The other 2% can still allow baby to attach and bond. Even before milk 'comes in', it's so important for baby to learn to suck, as they will first get that "liquid gold" of colostrum. Sucking also stimulates hormones, registering in the brain that the baby is here and that will then stimulate milk production. Everyone's rate at which their milk comes in will differ; it usually takes a few days but it can range from immediate to a few weeks' time! Also, if you have had IV fluids in labor, it can affect swelling in the breast tissue, making them feel more full than they actually are before milk is fully in. She also noted that if you feed on demand, rather than scheduling feedings, it allows your body to meld with the baby and you may not really experiences any 'full' or 'tight' feelings in the breasts. This is important and helps to lessen the risk of things like plugged ducts, engorgement and mastitis...if you've ever had any of these, we all know how much we want to avoid it!!

Any kind of breastfeeding questions or problems, all of the panelists encouraged us to ask for help!I Most often, there is someone who can help sort things out and encourage breastfeeding success, if that is how the mother has decided she wants to feed her baby. From issues such as a 'lazy eater', to tongue-tie, to breastfeeding depression...there are resources, and if it's not what you expected, get help! 

Vaginas. They swell, they stretch, they feel like they're falling out of our bodies!! Erin notes that yes, they DO stretch, and quite a bit at that, so it takes a while for them to go back to normal. Even at the 6 week appointment, there may still be a lot of extra 'room' down there. 

Lauren asked the panel if they received much info about postpartum during pregnancy, and if so, from whom. The overwhelming answer was that they found information themselves, from books or online. Adrienne noted that she had no idea what would happen to her body! She compared it to a wedding...we tend to focus so much on the wedding and the big day, but sometimes forget about the entire marriage that comes after it, and that that needs to have much more preparation! The same is true with birth vs. actually raising a baby...having a birth plan can be important, but we need to be preparing for what happens when the baby is actually here. Everyone agreed that we need to talk about it more...much more. And that everyone's body, everyone's experiences are unique...Don't make a rule of your own experience!!

Switching gears to the mental and emotional side of postpartum....Adrienne noted that she had seen the same frustrations everywhere. Lack of support from medical providers in asking the hard questions, and mothers unsure of where to turn if they don't feel right or aren't enjoying motherhood like they thought they would. A woman will usually see her care provider at least30 times during a normal pregnancy and first year of a child's providers need to be asking mothers, 'How are YOU doing?' They send us home and we don't see the doctor again for 6 weeks...audience members agreed that that though terrified them! These things must change!! 

Adrienne shared that Perinatal Mood and Anxiety Disorders affect 1 in every 5 women. Hormones, a change in social and family circles, expectations...there are so many contributing factors. Going from work to home with a baby, even if just for maternity leave, can be extremely isolating. Some mothers are high on hormones and almost floating after giving birth, others are extremely low and feel very different than what they expected. Even if someone looks put together, or 'OK', she could be in despair. Erin encourages new moms to bring a support person with them to appointments, so she can ask the other person how mom is REALLY doing. 

80-85% of women have the "baby blues", a period of time after birth usually lasting 2-3 weeks. Can feel up and down, weepy then happy, etc. If it lasts longer than that or becomes worse, that can be more serious; PPMD can also affect new dads. Erin notes that if you've made 2 excuses for how you feel, then you need to talk to someone.

If a new mom cannot sleep, she needs to get help! 

Other external contributing factors include:

  • -previous history of anxiety/depression
  • -if the # of pregnancies vs # of live births aren't equal
  • -Traumatic birth - if mom feels it was traumatic, regardless of how it went in others' eyes.
  • -Social changes (staying home, new friends, new lifestyle, etc.)
  • -Financial concerns
  • -lack of support/isolation
  • -health of baby
  • -low income/immigrant status

Some internal contributing factors:

  • -Type A personality
  • -needing control
  • -unrealistic expectations

Having survived postpartum depression and anxiety, Adrienne said that these were the biggest helps during the dark days: going on anti-depressants and getting sleep!!! Some combination of the following 4 things will help all women going through this feel well again:
1) self-care
2) social support - validation!
3) talk therapy/counseling
4) medication

Rachel noted that medication gets a bad rap, but explained it like this: if you were diabetic, would you deprive your body of insulin? No! So why deprive your mind of what it needs if it truly needs it? Erin explained that we all have a bucket of serotonin that stabilizes our moods, and that when we deliver that baby and then the placenta, that bucket takes a hit. Some people have a bigger bucket than others, so that 'hit' can affect each person differently. Medication, when needed, can help to slow the depletion of that bucket's levels. 

So how can prepare for this? Adrienne shared some great ideas:

  •   -have a plan so you can sleep!
  •   - pump for one bottle/day so partner can feed!
  •   -extra hands - accept help!
  •   -fill a prescription if needed (she filled her Zoloft prescription to be prepared)
  •   -make meals ahead of time
  •   -figure out child care for older children ahead of time, so you can rest.
  •   - make a list of what YOU need to feel helped. Everyone is different. 
  •   -let others know how you can feel rested and most cared for - time out, time alone with baby, whatever it may be. 
  • Have a Realistic Postpartum Plan 

Some closing thoughts:

  • If you are experiencing any pain or problems at all 'waist to knees' after birth - even weeks or months after, please see someone! You were pregnant for 10 months; it can take a while to recover!
  • Have someone you can text or call without words. If you're too overwhelmed to speak, they'll know and be able to come help immediately. Erin recommends having a 'code word' so if you get to that place at any point, you just have to send or say that word, and your person will be there to help. (she had a friend whose word was "sassafras".) 
  • Rachel recommended some great resources on breastfeeding and postpartum support...all resources are linked at the end of this post!

The panelists agreed wholeheartedly on two things: 
1) Everyone has a different experience. Physically, mentally, emotionally. 
2) There is no such thing as a perfect mom!!!

KellyMom                                                                                                                                Postpartum Support VA
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Alisha Meador

Alisha Meador is mother to 2 wonderful and wild little boys. She has an obsession with all things British, is an aspiring writer, amateur yogi and pretty decent backyard homesteader. She is so thankful for this motherhood community.