Postpartum tips.

What can you do in advance to make the postpartum period easier?

Even though a lot of my readers have given birth more times than I have, I do still get a fair amount of traffic from search engines, and I was thinking that this post might be helpful for the pregnancy newbies out there in the world.  Let me preface this by saying that I've never given birth in a hospital, and never had any birth-related surgery -- no Cesareans, obviously, and also no episiotomies or stitches.  So I can't help much with those specifics -- maybe my readers can.

That said, here are some things that I swear by.    Have them in your house before you give birth.  Depending on how long you "get" to stay in the hospital after birth, some of these things aren't applicable to mothers who'll be coming home from the hospital, but others are.

1.  Install a handheld showerhead-on-a-hose in your shower.  I cannot stress this one enough.  It is not expensive or complicated, and it will make a real difference.  New mothers bleed, sometimes quite heavily, for several days after birth.  Often there are tears, episiotomy wounds, or stitches, and those areas must be kept clean for proper healing.   The easiest way to keep the perineum clean is to step into the shower several times a day -- as in "every time you go to the toilet" -- and quickly wash with plain warm water.  The shower is better than a bath because it is quicker, you won't have to sit your poor sore bottom in a hard tub, and it is easier to adjust the water temperature.  Also:  Perineal wounds sting when urine touches them.   They won't sting if you've got water running over them.  So go pee in the shower for a couple of days.

2.  Consider skipping the maternity maxi-pads for several days, along with all underwear, unless you absolutely must appear, wearing pants, in front of company.  Instead, if you're not opposed to disposable paper things, have ready some disposable underpads.   "Depends" brand should be in your local drugstore, in the adult continence section.   Sometimes people call them "chux pads."   The size I like best is about the size of a large hand towel or a pillowcase.  Anyway, put them under you in bed, or sit on them in a chair and cover yourself with a blanket or wear a long skirt hiked up in back.  It's not glamorous, but it will keep you dryer and cleaner and allow air to get to your wounds, and it won't stick to them either.  If you don't like disposable stuff, old towels or cloth diapers will also do the trick. 

 Look, here I am 3 1/2 years ago after MJ's birth, sitting in the rocking chair on some towels.  I'm not ashamed.  

 

3.   Tops and nightgowns and maybe a "sleep bra" that make it really, really easy to get at your breasts from both directions:  down from the neck or up from the bottom.   Yeah, if you're wearing a t-shirt you could just pull it up, but that's surprisingly difficult when the hem of the shirt is pinned between your body and the baby.  You're home, modesty and fashion aren't all that important; ease is.  Avoid buttons and snaps and look for fabric that can be simply pushed aside.  The "crossover" style for sleep bras and sleeveless nightgowns is pretty easy, and what I am wearing now (this site looks like the same kind of nightgown, though I've not bought their products).  An inexpensive and comfortable support option that I have used before is the Hanes Barely There Microfiber Crop Top which is stretchy enough to extract a breast from top or bottom but is still reasonably supportive, at least when it's new.   I think the best nursing opening, at least for ease of access, is found in tops made by the Swedish designer label Boob.  They are not cheap, but I want to show them to you so you know what I'm talking about when I say these are the easiest-access tops. 

4.  Hand mirror.    It's nice to be able to see how you're healing up.  Like I said in an earlier post, it doesn't look as bad as you think it will look.

5.  A generous supply of acetaminophen or ibuprofen and some rice bags or other heating pads:  those afterpains are a bitch, pardon my French. Rice bags are marvelous and it's good to have several in assorted shapes and sizes if you can manage it, but at minimum have two tube-sock bags, which don't have to be sewn, just knotted.  You heat them in the microwave until hot and they stay warm for a long time.  The weight of the rice keeps them in place, and as they cool you can squish them around to mix the rice up and bring the hotter rice out from the center.  You can also wedge them behind your back and give yourself a little heated lumbar support.   (Note:  a few handmade rice bags with instructions would be a great thing to give an expectant mom at a baby shower or blessingway.   Don't use fancy fabric, certainly no metallic thread, and remember that the eventual fate of all rice bags is either to get wet and mildew or to be eaten by mice.  Such is the circle of life.)

6.  Cheap plastic dishtubs are very useful.  Scatter them around your house.  Put them by your chair to receive wet diapers so you don't have to get up.  Ditto by the bed at night.  During your postpartum bed rest, use it instead of a breakfast tray; a tub doesn't look as nice but provides valuable secondary containment for your cup of coffee or jar of water.  If you're doing the diaper-free/"elimination communication"/"natural infant hygiene"/"infant potty training" thing, a plastic dishtub makes a great infant potty, especially for boys, as it is a large target; put a cloth diaper or a paper towel in the bottom for quick and easy cleanup, or else just rinse it out when necessary.  (Don't use the same tub for your breakfast tray.)

7.  Please have someone in your family (a 6-year-old is a good candidate) be in charge of keeping a quart of drinking water within your reach at all times.  Ice and a splash of juice would be a nice touch; anything to encourage you to drink more of it.   And stock up on one-handed snacks:  your favorite crackers, cubes of cheese or maybe string cheese, washed grapes or berries or perhaps clementines, hard-boiled eggs.  Pieces of dark chocolate.  Have a plate ready.  Have someone put a plate by your bed.  You should not have to get up to forage, and it's nice if you don't have to wake up your sweetie who also needs his sleep.

8.  When friends or acquaintances offer help, especially when they offer in advance as your due date approaches, get their phone numbers.   There is more that can be done than just bringing meals.  In particular, I recommend asking, "Can I call you to come over and sit with me for a couple of hours in the first few days after the baby is born?"  A list of people who have said "yes" to this question is priceless.  Because this is what will enable your exhausted spouse to take a nap.  Or go for a run, or take a trip to the grocery store or hardware store, some time in the car alone with the radio on, a little psychic space.    Meanwhile, the person who has come to "sit with you" can fetch your water, attend to getting snacks for your children, grab a diaper for you from the changing table, that sort of thing, and generally make sure that you and the baby survive for two hours while your spouse is away or resting.  If your spouse can't take much time off work -- some cannot take any -- then please line up someone to help you more intensely.  The same if you are expecting multiples or a particularly difficult recovery (e.g. if you anticipate a high-risk cesarean or other surgery along with the birth).

Note:  It's smart to identify someone who could help intensely even if you don't expect to need it.  When our first was born in a difficult labor that left both of us debilitated, my sister-in-law, who was on break from college at the time, flew in on short notice and basically -- thank you Lori, we are eternally grateful -- saved our lives.  If you lack available family members or friends, this service can be purchased -- Google "postpartum doula."  

* * *

I've deliberately not gone into the large topics of Preparing For Successful Breastfeeding and Stocking Up On Meals, all of which are worthy of separate posts and also are available in many other resources on the web.  So, saving breastfeeding/meal stocking advice for another time, what tips do my readers have to share for getting through those first couple of weeks?  Especially for taking care of yourself and making sure you can recuperate?

Comments

[Amy F]

Wow, that's a whole lot of useful info. I too bemoan the lack of postpartum info out there. So many birth stories and belly pictures, but no one posts photos of the 4-days-pp belly which can be really scary if you aren't expecting it.

I've been stuck with a baby in the NICU but not checked in myself for 3-7 days with the boys, so I have a weird combination of postpartum hospital/homebirth experience. My favorite blood-catching approach is to buy a pack of Depends and use those until they run out (4 or 5 days), then a couple days of granny underwear with a prefold inside, and by then I'm down to a medium cloth pad. I'd usually sleep with a hiked up nightgown on a chux pad.

[Barbara C.]

If you give birth in the hospital, they give you these mesh spanky panties that really breathe. You also receive ice packs over your maxipad. After about 24 hours of ice packs, you graduate to spreading Tucks pads along your maxi pad. They also give you a Sitz bath if you have a lot of stitches.

There are other tips I give for the hospital like keeping track of when you're due for meds and ask your nurse 30 minutes before, pack lots of simple snacks to eat one-handed, request extra fruit with your meals to stash for later, and bring a book or two you can read one-handed.

When my milk comes in it REALLY comes in. Last time I slept at night with my breasts hanging out and cloth diapers bundled underneath. It offered some relief between nursing periods.

When we moved to a multi-level house, I just made sure to have two of everything, one for each level: bouncy seats, diaper-changing areas, articles of baby clothes.

I'm fairly lucky in that my parents come to stay for four or five days when I give birth. They're with me all day to help out with me and the kids while DH is at work, and then head to their hotel for a break at night.

[bearing]

re: ice packs, my homebirth midwives make these frozen herbal compresses of comfrey root and goldenseal. They're for the first 24 hours and they are really nice. I only needed to use three of them this time around before the swelling and pain subsided.

[Lisa]

Thanks for this great advice! Some of things you mentioned had never occurred to me.

[Sara]

Our doula brought me pads soaked with witch hazel and then frozen. They were lovely.

[Alicia]

I had a small tear that did require a couple stitches along with what the midwife called a "skid mark" on the right--and I have to disagree and say that it looked every bit as bad as it felt, and I was NOT prepared for the appearance. Sitz baths, calendula gel (which had the added benefit of preventing maxi-pads from sticking, and a squirt bottle that I virtually emptied on my perineum during every voiding were lifesavers.

I appreciate several of your tips and will hold them in mind to make our second pp trip better than the first. Thank you!

[Barbara C.]

I also forgot about the squirt bottles they give you in the hospital (although you can buy them at most drug stores). You fill with warm water, squirt, and then pat dry with t.p. instead of wiping.

I always take two or three. I keep one in each bathroom at home, and then I use one for rinsing the baby's hair for the first three months or so.