In this video Caitlin and Diana discuss postpartum. They cover;

Immediate postpartum; what to do about bleeding in the days after
Healing any perineal tears
Tips to make that first dreaded poop easier
Nutrition
Exercise once appropriate to do so
Sleep, both yours and the baby and managing expectations
How to organise a support team and ask for what you need

**Find transcript below

In this video Caitlin and Diana discuss postpartum. They cover;

Immediate postpartum; what to do about bleeding in the days after
Healing any tears
Tips to make that first dreaded poop easier
Nutrition
Exercise once appropriate to do so
Sleep, both yours and the baby and managing expectations
How to organise a support team and ask for what you need

Caitlin; Lets talk about the early days postpartum

Diana; Ok, so you’ve had a baby

Caitlin; I have

Diana; I didn’t mean you, but

Caitlin; Yes I have! The royal you- you!

Diana; So hypothetically, you’ve had a baby, you’re back at home, there are certain things you want to do to take care of yourself, okay? So this is where we’re just going to focus on yourself and and mom, and we’re going to leave the baby topic for another time. So when you’re home, you want to make sure you’re resting enough. We say at least two full weeks of full rest. That means mum doesn’t get up for anything other than going to the bathroom and getting that baby and that perineum out in the sun. And we’re going to talk more about that. So that, also mum doesn’t life anything heavier than the weight of your baby. So say your baby was 8 pounds, then you don’t carry more than eight pounds. Say your baby was five pounds, then you don’t lift anything heavier than five pounds, okay? That means mum is mostly lying down, not sitting up, and after those two weeks mum can start to move around a little bit. There are several things you want to focus on, we’re going to talk about bleeding postpartum and your uterus, we’re going to talk about peeing and going to the toilet,

And we’re going to talk about taking care of your perineum.

So, youre bleeding. The first days after having your baby your bleeding is going to be pretty heavy. More like three times a very heavy period, thats probably going to be more for the first 24 hours.

Caitlin; Thats a good reference point because you can be like; how much is too much, thats a good reference point.

Diana; yep, and so after that, your period, or your bleeding which are called lochea, not period, because they’re not periods they’re not hormonal. They should be about a heavy period which is slowly going to reduce and be more like a light period and stay like that for quite a while. It can be like that for up to six weeks, in some cases eight weeks and that would still be normal.

So what is the loch? The lochea is your bleeding that are coming from the wound left behind by the placenta. So say the placenta is about this size, of your face, then your wound would be about this size. So thats a big wound right thats why you need to rest so much.

When your wound shrinks down after birth what it is trying to do is compress the capillaries left open by the wound, and like compress them and stop bleeding. But obviously its not, its not completely compressed, so some bleeding is going to happen

So after a couple of days, let’s say about three days, you probably won’t need adult diapers anymore. Or mega pads and disposable underwear, which is what you’re going to get in a hospital. If you’re home, adult diapers will be fine. And, it’s going to slowly go away, it’s going to move from very heavy bleeding with quite a bit of clots, you can have clots up to the size of a goose egg, and don’t let that scare you, it’s not dangerous, it’s actually good that it comes out. You might pass out when that happens, because your blood pressure might go down, but it’s not dangerous as long as your bleeding isn’t excessive. If you do have excessive bleeding, you want to make sure that you pee, that your bladder is empty, and because at some point, lets say your uterus is shrinking down, and your bladder is filling up, then they’ll compete for space, and your uterus won’t be able to contract, and then you can start bleeding more, and have postpartum haemorrhage.

So excessive bleeding would be defined as blood that doesn’t stop, or a big big gush of blood at once. If that happens, as I say, you want to pee, so your bladder is empty, you want to make sure your baby nurses so you stimulate your nipples, because when you stimulate your nipples it’s going to cause your uterus to shrink down and stop bleeding, and if that doesn’t work you want to massage your uterus and ask your healthcare provider where your uterus is after births o you can feel it and know where it’s supposed to be and what its supposed to feel like, and if its not there, if its not hard as its supposed to be you can massage it, and that will cause your uterus to contract and stop bleeding. If that doesn’t work you’ll need to call your midwife or your doctor. So, that’s more or less the information about the uterus, as I said, fifteen days resting, also because your uterus takes about 12 days to go back to its normal size, your uterus was about the size of your fist, and through pregnancy it stretches about the size of a watermelon, and in 12 days its going to go back to the size of your fist. So a lot is going on in those first two weeks and you really want to make sure you give your body the chance to recuperate, to repair any tissues that were injured in the process of birth, and you want to give your body the chance to make new blood that you might have lost through childbirth, and also your overall being might be a little shaken up after you’ve had a baby.

Another part of your body that could potentially be injured in the process of labor is your perineum. But as I have mentioned in previous topics, just the fact that you had a vaginal birth doesn’t mean that’s why you’re having perineal issues. The perineum is there between the vagina and the anus which can be injured in the process of labor, but also the hormones that influence our pelvic floor can be cause for all of that to feel quite weird, painful, sore, swollen, it also has to do with how your labor went, how that baby was born, but if you did tear you want to make sure that you keep your legs closed most of the time, but you definitely want to make sure that you get some air and some light on the area, because bacteria grow where it’s warm, damp and dark, so if you open up your legs, have a window where your neighbours can’t see you, get some sunlight in that area, then it is less likely that you will get an infection and its also more likely to heal better. And then, you can apply ice if its uncomfortable, you can also do cold sitz baths, or warm sitz baths, whatever feels better. It’s most likely you’re going to have some burning when you pee, because even if you didn’t tear, some micro tears might have occurred in the area, they might not bleed or be visible or anything, but the pee is quite salty, sour, so it can burn when it goes through so you might want to pour water over your perineum as you pee over the urine and have it be less painful. Then you can also use some compresses, we always like to use fenugreek compresses in the area, because they help with swelling and they are antibacterial so that helps quite a bit. If you’ve heard the word ‘padsicles’ they’re amazing. And then at some point in the week following the birth, you’re going to want to go to the bathroom, and that can be quite scary because after having a baby, the last thing you want to do is pushing, especially if you have stitches. You may feel as if the stitches are going to burst; I promise that doesn’t happen, but it might feel like they will burst. So one tip- or two tips- one is, have patience; really take the time, have baby be with someone else and you take a full hour to decide to poop. And make sure you’re eating enough fibre and drinking enough water because after the baby comes out and your intestines fall basically back into your abdominal cavity, they can freeze up because of the sudden ample space, it might take them a while to start working right again. So you can be quite constipated. So, get a lot of finer, drink a lot of water, and then when you actually need to go to the bathroom it might be very helpful to wrap some toilet paper and put some pressure on your perineum or over your vulva, to hold the stitches in place, hold your vulva in place as you go to the bathroom, because then you know its not going to explode, okay?

Cait: yeah, because you can logically know but if you feel it, that it won’t, its so much harder so you can think, I’m physically holding it, it’s okay. Just that kind of reassurance.

And bidets are amazing, I actually chose my new house when I was pregnant because it had a bidet, because I knew I was going to need it postpartum, so, they are great, if you don’t have one you can also use a sprinkle bottle or something like that to clean instead of wiping, especially if you have haemorrhoids, or if you tore you might not want to be rubbing or irritating the area. And having haemorrhoids is very common through pregnancy, its very likely that they’re going to get worse during birth, and then in the days following the birth and then they will slowly shrink down. You can always lie on your belly, putting a pillow on where your belly used to be, and then lying in that position you can ice them a little bit using witch hazel for them, because that will help move around the blood that gets stuck there, and help with the swelling a lot.

I guess some tips I can give you, for postpartum recovery, would be to drink a lot of water, eat good food, make sure- I know its hard when you have a baby because you just want to order pizza every single night, but it might be an idea to put some veggies on that pizza, drink a lot of water, skip the Coca Cola, and make sure you’re drinking enough because after the birth you’re going to be sweating a lot, you’re going to be peeing a lot, you’re going to be getting rid of the extra liquids in your body. You want to make sure you’re not dehydrated- you’re going to be nursing and thats going to take a lot of liquids out of you. And make sure you do get up once in a while just to help your uterus empty, but not too much because you really do want to be lying down or resting, you can use a belly binder to help hold your uterus in place, that might feel really good, in some countries that’s traditional, here in our Guatemalan country we do that, we don’t recommend you use a bellybinder for more than seven days, but seven days is good, you want to make sure that someone else is taking care of everything else at home, you don’t want to be the one thinking of ‘oh, I need to do this, do I need to do the laundry, do I need to wash diapers, so make sure you have some help, and also consider taking placenta capsules, using your placenta for medicine, and yeah as I said before, try to keep your legs closed.

In later postpartum, in the months following birth…

There are five things that I think are very important, which are, nutrition, making sure that you’re having a good diet, that you’re eating enough, that you’re eating in the proper times, that you’re not living off of junk food and chocolate. Making sure you’re exercising, making sure you’re moving enough, obviously the first couple of weeks after birth you’re not going to be doing any exercise, but eventually you want to get into a routine of exercise, and I know thats very hard to do with a baby, but it makes all the difference. And then, the other one is sleep, which is a big one. It’s hard getting good sleep, good quality sleep, getting enough sleep, in my prenatal course we go a little deeper into these topics. The next one would be getting some time for yourself away from being a mom. This is going to make you happier and if mom is doing okay, baby is going to be doing okay, too. And then you want to make sure that you have enough support. That you have a support system in place, already from the pregnancy for the postpartum because it is that hard.

So lets go a little bit more into that, what might it look like to get a support team, because surely people want to help, but there is a difference between, lets say, someone actively helping you, and supporting you, versus someone kind of wanting to be there, to hold the baby, but its not serving you, so what does a good support system look like.

I think a very important thing would be for mom to be able to define that, some moms might need some more help getting free time for themselves, some moms might really need that, maybe they have a job they really love and they want to be able to focus on that even after baby comes, some moms want the space to be created for them to really be with their baby and not have the distraction of work and other things. Some moms might really want to be able to keep an open channel of communication, to be able to talk with the partner or whoever is with her, about how hard to raise a baby, just opening those channels of conversation, also knowing how to ask for help, knowing how to establish a good support system, and for sure making sure that you have that space to be held and thats usually the role of the dad, that needs to be created and also reaching out to other friends and moms and other women who might feel the same way you feel or might have gone through the same things is really important, often if you’re the only one in your group who has babies, it might be really hard to find spaces for moms. Being a new mom can be hard, and I think getting a doula would be a good idea, making sure that if you have problems breastfeeding that you’re going to have someone to go to, make sure that if you’re having sexual problems after having a baby that you’re going to have someone to talk to about it, making sure that if you’re struggling with depression after your baby is born, that you have somebody to talk to about it thats not going to dismiss you, making sure that your parter knows that this is a very vulnerable time, and make it very clear to him, or her, how to support you through this process, even if you don’t know it right now, to be able to say ‘okay, thank you for what you’ve been doing so far but this is how I need you to help.’ And making sure that you’re also aware that this person in your life is also struggling, and changing their entire world for this little baby.

Cait; I think thats important too because, we feel so much of it because we experience so much of it obviously, but for sure if there is a partner, that partners whole life has been turned upside down as well.

And for us it starts in the pregnancy, but it happens for them all at once, once that baby crowns. SO as a family you need a support system, and you also need that support system to make sure you’re eating well, to make sure that youre having the time to exercise, that you know what kind of exercise you need, to make sure you sleep enough, quality sleep, make sure you get some time for yourself.

Not to get too far into it but what advice would you give to people who are struggling to do the crib sleep, or -

I think the main thing is to not be set on a way of doing things, there are a lot of different ways to skin a cat, um, several right ways to skin a cat, so what I am trying to say is if you decided you were gonna put your baby in a cot to sleep, and that isn’t working, its okay to change and try new things. Don’t let media scare you, bedspring is safe, cosleeping can be done safely, and it often helps a lot of babies who are very anxious about being alone and sleeping alone. These babies have never been alone in their entire life before, and you suddenly putting them in another room, in another crib, or even in the same room but another bed away from you causes a lot of anxiety, and what do they do- they communicate, and how do they communicate? They cry. A lot. I think just being flexible and being okay with it not going exactly how you thought it was going to go can go a long way. I think also placing more realistic expectations on your baby. As soon as they’re born we expect them to behave a certain way and act a certain way and do a certain thing, and not do another certain thing, and it might just not be the child you got.

Cait. Yeah. Exactly, we expect babies to be able to regulate themselves from the get-go, its like this instant dash to independence or something;

Diana: yeah, we’re reaching thirties and we still don’t know how to regulate ourselves

Cait: exactly and why do we expect our babies to do that, like we probably don’t sleep through the night, even before babies I probably wasn’t sleeping through the night and its just these crazy expectations on babies that, anyway we probably shouldn’t go too far into that because we’re talking about mum but anyway I just wanted really add that sleep bit for a little bit because that is such a big source of stress, and so much can make you feeling like you’re failing you know.