What to expect after your baby is born

A Postpartum Survival Guide

Let's talk about how to survive and thrive in the postpartum period. For me, postpartum life has always been blissful and magical. Nursing...cuddly newborn making little squeaks and grunts...being able to lie on my back and stomach...more nursing = bliss. It's my favorite stage by far.

nursing Inga a few days postpartum

But I know that many women struggle to adjust to life with a newborn baby. It can be a terrible shock after all that planning and preparation for the birth. You have a baby in your arms, and WHAT ON EARTH DO YOU DO NOW?

So today, let's talk about all the postpartum stuff that you wish you'd known, or that you figured out, or that surprised you, or that blindsided you. Let's talk about what to really expect postpartum for yourself, your baby, and the rest of your family. Let's share our tips and tricks for an easier postpartum adjustment.

Here are some things I've figured out:

Make a list of your postpartum responsibilities. Keep it short. 
*Everything else* other people should be doing for you. My postpartum responsibilities are:
1. Nurse the baby
2. Stay in bed and snuggle with the baby
3. Take pictures of the baby
4. Read books and putz around on the internet
5. Eat dark chocolate

I'm quite serious about #5 (but it has to be at least 70% and preferably 85% cocoa). That's really all I do for the first few weeks. I don't look after the other kids. I don't prepare meals. I don't do laundry. I don't really do anything except hole up in my room and admire my baby. Now, sometimes I feel a bit stir crazy and I have to *make* myself stay in bed.

The first recovery is probably the hardest and longest
I was really, really sore for weeks on end after I had Zari. It hurt to sit and walk for a long time. But after my other three children were born, I hardly felt like I'd had a baby. Give me a day or two, and I was almost totally recovered except for the postpartum bleeding.There's just something about having had a baby before that makes subsequent recoveries so much easier (unless, of course, you have something unusual happen like a c-section or shoulder dystocia or vacuum extraction or whatever).

Learn how to nurse lying down ASAP
This was a lifesaver. It took me about a month to master after Zari and Dio were born. But with Inga and Ivy, we nursed lying down from day one. It is seriously one of the BEST THINGS EVER.

Co-sleep
I don't care how you do it: in the bed, with a co-sleeper, or even with a crib or bassinet in the same room. The more you can stay in bed at night, the better you'll sleep. I usually get out of bed once at night--and that's to use the bathroom and get a drink of water. Otherwise I get to stay cozy and warm under the blankets all night long. I think I would DIE if I didn't co-sleep. I can't imagine having to get out of bed multiple times per night, sit in a rocking chair and nurse the baby, put the baby down and settle it to sleep, then walk back into my bed and go back to sleep. That sounds positively horrific.

Size matters
Get a king-size bed if at all possible. I feel way too crowded co-sleeping on a queen bed.

Learn about breastfeeding before the baby is born. Get help ASAP if a problem arises. 
Nursing has gone very smoothly with all four of my babies. Some of it was luck (no tongue-ties, no routine practices that undermined breastfeeding, etc.), while some came from learning as much as I could before my first baby was born. I felt really well-prepared and knew how to get help if I needed it. If you can, spend some time with nursing mothers. Watch them latch their babies on. Ask them questions. Watch them some more. It's so helpful to see breastfeeding up-close and in person.

Wait to buy nursing bras
You don't know what size you'll end up after the baby is born. Wait at least a week or two to buy your nursing bras, because you'll change sizes so much in those first weeks. You'll have crazy huge porn boobs once your mature milk comes in around days 3-4-5. Then they'll settle down to a more manageable size. You can buy your sleep bras in advance, since they're stretchy and less supportive.

Towels are very handy
I put a bath towel underneath me and the baby when we're in bed at night. It catches the inevitable fluids (leaking milk, blood, spit up, pee, poop...) and saves me from having to change the sheets every day. Because leaks happen. All the time. I also put a crib-sized mattress protector underneath the fitted sheet. If we have a big leak and need to change the sheets, this protects the large mattress pad.

Double up
So, I finally figured out how to avoid bleeding all over the bed every night. Before I go to bed, I put an extra pad in the back of my underwear. Do this maybe the first week or two, or until your flow lightens up.

Learn how to ask for help
When someone says, "If there's anything I can do, just let me know," I've become really good about saying, "Yes, actually, I really need help with ________." Don't be polite and turn down help.

Get a sling
(Or a Moby wrap, or an Ergo, or a mei tai...) I don't know how I'd survive postpartum without one, especially when my help leaves and I'm on my own with a newborn and several other little children.

Now for some crowdsourcing...

Time to share your postpartum stories (the good, the bad, and the ugly). Tell us all about what it's really like to have a new baby. Share any tips or tricks you've learned. What do you wish you'd done differently, or known beforehand?
.

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Wish-I-Had and Glad-I-Did

Things I wish I had done differently during this pregnancy and birth:

1. I wish I had done my bellycasting sooner. I had everything on hand and had planned on doing the bellycast some time during the 38^th week. Well, that obviously did not happen!

2. Ditto on taking artistic pregnancy pictures. I have weekly pictures of my growing belly, but nothing more aesthetic.

3. Next time, I will be more pro-active in treating my perineum and vaginal area after the birth. I had some pretty serious swelling and pain, and I realize now I should have started ice packs and warm herbal baths right away. I didn’t do any of these things until the fourth day after the birth.

4. Made sure our camera was on the right setting (5 megapixels). It was on a very low resolution when Eric snapped the picture of me and Zari immediately after she was born. I am sad because it is too grainy for anything but a very small print. I don’t suppose there’s a magic way to remedy this...anyone?

Things I am very glad I did:

1. Read Jack Newman’s Ultimate Breastfeeding Book of Answers about 2 times from cover to cover, and watched several video clips on his website. I firmly believe that educating myself before the birth enabled breastfeeding go without a hitch. Knowing exactly what a good latch looks and feels like, and how to get it right, made all the difference.

2. Bought a fetoscope. Eric and I enjoyed listening to the baby’s heart beat, and when I had occasional “hmmmm, I haven’t felt the baby move in a while” moments, I could reassure myself that the baby was fine. The best $13 I ever spent. I didn’t use it all during labor though, nor was I planning to. The thought crossed my mind once, but as the intensity mounted, I didn’t think of it again.

3. Had a 12-day "babymoon" before I allowed any visitors (my mom) to come. It was a magical time, with just me, Eric, and the new baby. We spent most of the time upstairs in our master suite. Eric brought the laptop up, and we ate our meals on my sewing table. Church members supplied most of our dinners during that time, so Eric only had minimal cooking duties. Then, right when I was starting to feel a little stir-crazy, my mom arrived. It was perfect.

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Some Numbers

Weeks gestation (from known date of conception): 36
Pounds gained during pregnancy: 26
Pounds lost immediately after the birth: 13
Pounds lost at 4 weeks postpartum: 16
Day my milk came in: 2-5 (the colostrum started turning milky the evening of day 2, but my milk was not in full force until about day 5)
Days of postpartum bleeding: 8 or 9
Average length of a nursing session: 45 minutes
Average length between nursing: 3 hours
Time between Zari’s birth and the birth of the placenta: 2 ½ hours
Total length of labor: 10 hours
Length of pushing stage: 2 hours (or 3 if you include the hour of “nudging”)
Zari’s weight at birth: 7 lbs
Weight at 8 days: 6 lbs 14 oz
Weight at 19 days: 8 lbs
Zari’s length: 19 ½” (nurse’s 8-day measurement) or 20” (my measurement)
Duration of my “babymoon”: 11 days
Number of meals provided by church friends: 9

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Some thoughts about a four-letter word

PAIN.

I hesitate to even write this post, because it gives pain a privileged position in childbirth. We all know how pain and birth are talked about: birth as the most excruciating pain a woman will ever endure, pain management in labor (a euphemism for drugs), getting a pain-free labor with hypnosis...

But now that I have been there done that, I feel the need to share my experience of pain. Not because it was awful or excruciating, but because it was one of many, many sensations that made up the entirety of labor.

Before my labor began, even before I became pregnant, I knew that I wanted to experience labor in its fullness. I wanted to feel every sensation, pleasant or not. I firmly believed—and still do—that by numbing myself to the painful parts of labor, I would also miss out on the bliss and the ecstasy as well. I wouldn’t be pain-free by taking drugs or having anesthesia; I would be sensation-free. I didn’t like that idea.

I wasn’t wedded to the idea that labor had to feel a certain way. I didn’t expect pain, but I also didn’t expect its absence. Honestly, I expected to feel a great many sensations as I labored, and I knew that pain might be one of them. I loved reading stories of painless births, ones that take a woman by surprise because she doesn’t realize she is in labor, or the ones where a woman experiences bliss and waves of pleasure. I listened to Marie Mongan’s Hypnobirthing CD and read her book. The CD was incredibly useful for relaxation during pregnancy and helping me sleep when nothing else could, but I resisted her assertion that if you relax the right way, you will not feel pain. I think that often is the case, but I didn’t want to be so dogmatic about my own labor and feel that I somehow failed if I experienced a sensation as painful.

My contractions felt like sharp, intense menstrual cramps, all entirely in the front of my abdomen close to my pubic bone. I can only say they were “like” menstrual cramps because cramps for me don’t come and go like contractions—they are a slow, dull, relentless ache, almost in my pelvic bones. The contractions became more intense and more painful as labor progressed. Pushing brought on a different kind of pain. I think the ferocity of the contractions and the uncontrollable urge to push made the sensations a bit more difficult to integrate. All I had to do during the labor contractions was relax and let everything happen, keeping my body totally loose. During pushing, however, I HAD to actively participate even though I sometimes didn’t want to, because it was so intense.

The funny thing about pain is that it fills any given space. It’s like a gas—no matter how small the amount, it will completely fill the volume it occupies. That’s why I hesitate to say something like “it was the worst pain I have ever felt.” Heck, even a paper cut, at the moment it happens, can be the worst pain ever!

The pain I felt in labor was clean and finite: as soon as it was over, it was over. Completely gone. I calculate that I spent far more time feeling pleasure during the rest periods, than I did feeling pain during the contractions. Except for a few short moments when I became discouraged during pushing, I never felt like I was suffering or in distress. Just very focused on the task ahead of me.

A few times during my labor, I was able to alter the sensations from being painful to pleasurable. During the early morning hours while I was leaning over the kitchen countertop and breathing deeply, I started smiling and making my face look blissful. Another time, soon before I started pushing, I said to myself mentally, “breathe in comfort, breathe in relaxation” (a phrase from the Hypnobirthing CDs). Both times, the pain altered itself instantly into a rushing kind of pleasure, kind of like the dizzy tingly feeling you get before you faint.

One of the best ways I have found to approach labor pain is with this acronym:

Progress
Anticipated
Intermittent
Normal

Labor pain indicates that your body is working. You know it will come and then it will disappear completely (unless you are having back labor because of a posterior presentation, but that is another story). It is not a signal that anything is injured; instead, it comes from muscles working incredibly hard and from tissues stretching and expanding—as they are meant to do.

Pain was one of many sensations I felt during labor. It was strong when it was present, but it did not dominate the experience. Almost all of the time I was able to integrate it without judgment. Instead of thinking oh no this hurts, I am suffering, make it stop, I was able to think this way: another contraction, the pain is building, inhale, exhale, sway my hips, the pain is ending, now I can rest. I had awareness of pain without labeling it as good or bad. It just was.

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Some reflections

A week ago I gave birth to my daughter, a glorious culmination of years of research and preparation. Here are some reflections on the labor and birth:

1. Nearly everything I had specifically visualized about the birth came to pass. I was careful not to put time restrictions on my birth affirmations. For example, I would say to myself, “my birth will go smoothly and at just the right pace” rather than “my labor will last 5 hours.” Here are some of the affirmations and visualizations I used. I didn’t ever write them down or say them out loud; I would just let them play through in my mind:

- My body will go into labor when the baby is ready.
- The baby will get into the perfect position for birth: head down, chin tucked into her chest, her back facing my stomach, and the umbilical cord tucked safely out of the way.
- I will move my body to help the labor progress smoothly and to help the baby get into the best position.
- I will feel joy, anticipation, and excitement as my labor begins.
- My husband will be exactly what I need him to be during labor. He will be calm and collected, and be able to watch me labor without feeling fearful or anxious.
- I will embrace every sensation of labor, without judging them. I will also let go of the sensations once they are finished.
- I will take one contraction at a time, and will remember that “I can do anything for one minute!”
- My cervix will thin and open at just the right pace.
- I will enjoy the rest periods in between contractions.
- I will ease the baby’s head out with my hand as it emerges.
- I will give birth to my baby kneeling down, cradling her head and body with my hands as they emerge.
- After the baby’s head is born, her head will rotate and her shoulders will slip out easily with the next contraction.
- My uterus will clamp down quickly and firmly after the birth.
- My placenta will release cleanly and all in one piece. After the placenta is out, my uterus will continue to clamp down.

2. I hate to give my birth experience a label, because it’s not just one of many ways to give birth. It is THE true standard of normal. There were no outside influences to disrupt or derail the physiological process. Just pure, raw, spontaneous, instinctive birth. This is a tricky thing to say without slipping into Mommy War mode: My birth was better than yours. Nah nah nah boo boo. The kind of birth a woman has is sometimes beyond her control, so I do not mean to say that a person is any less or more of a woman if she birthed unassisted, or via cesarean, or with an epidural. This is not about personal judgments. However, a spontaneous, autonomous birth is an unparalleled experience and should serve as the standard against which we judge and measure all other births. How can we know if a birth practice is healthy or harmful unless we know what birth REALLY looks like, stripped of all interference?

3. Giving birth seems like a dream. If there weren’t a beautiful little girl nestled on my chest (okay, and a sore bottom too), I would almost think it never happened. I wonder if the endorphins I felt played a role in making the memory hazy and distant. I have had a few times where I remembered the birth physically, in my body, almost as if I were reliving the sensations. Once I felt the endorphin-induced buzz. Another time I relived the sensations of pushing. What makes these windows of clarity appear?

4. While preparing to birth unassisted was definitely a difficult path, birthing the way I did was the easiest possible way. There was nothing any person or institution could have done to make it better or easier or more satisfying. I am willing to do the hard work of preparation and planning. I am NOT willing to make the labor unnecessarily difficult!

5. A perfect birth does not occur by accident. It is something you work for. I poured almost four years of my life into preparing for this birth. I have the luxury of being a PhD student in American Studies, which means I could choose my course of study. I focused on...big surprise...childbirth, and my dissertation is about unassisted birth. I have read hundreds of birth-related books, journal articles and birth stories; trained as a doula; apprenticed as a midwife; attended many home and a few hospital births; read tens of thousands of entries on various internet birth groups. I educated myself about variations of normal. I examined the assumptions I held about birth and found that many of them needed changing.

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