Saturday, January 4, 2014

Top 5 Things Every Postpartum Woman Should Have... (And no, I'm not talking about breastpumps, breast pads, and nipple cream)

During pregnancy, a woman’s blood volume nearly doubles, as it works and grows to support the growing baby inside of her. Is this not a miraculous thing? As women, we often focus on our expanding bodies...beyond an expanding waistline, to expanding hips and breasts. (On those days when we feel oh-so-big, we need not forget that it is not simply the addition of fat, but fluid and blood expansion.)

The “work” of labor and delivery is truly LABOR- hard labor in all aspects- emotional, mental, and physical. It is arguably the equivalent of running a marathon...that you have not trained for...which you have no idea if it is a 5k or a full marathon. To labor and give birth is to use every muscle fiber in your body (which you will likely feel the day afterward!). I have had moms whose shoulders ache, whose thigh muscles throb as if they have been doing repetitive squats, and who have broken blood vessels in their eyes from the physical exertion that it took to birth their baby. This is not to portray birth as scary...this is to speak to the challenge that is birth and the power that is the female body. In additional to the exertion of the body, blood loss during delivery further depletes the woman's body.

After delivery, the body shifts from growing life intrauterine, to continuing to sustain and grow that life outside of the body, by way of breastfeeding. The task of producing rich breastmilk is further taxing. For all these reasons, the body may be deficient postpartum.

If the female body can grow, birth, and sustain life, what are we doing after such an accomplishment, to nurture that body? In our culture, we do not always hold this time- the postpartum period- in reverence. We fail to see and treat it as a sacred time. Yes, a baby has just been born. But so has a mother.

So, with all of that said, here is a list of the top 5 things every postpartum woman should have, some material comfort items, some not.

1) Depends/Disposable adult underwear
Yes, I know. It's not the coolest, sexiest, most attractive garment, but I promise you, it will be worth it. The first couple of days when bleeding is heavier, it is so nice to not have to worry about pad placement and ruining your underwear. Go to the bathroom ---> take off--->toss in trash--->replace. It's comfy, it's hassle free.

2) Frozen witch hazel pads- they feel like heaven on your bottom and perineum after you have given birth, particularly if you have stitches for a vaginal/perineal tear. It's cold and soothing, and helps to reduce swelling. Take a heavy absorbancy sanitary pad, and moderately fill it with witch hazel. Be careful not to drench will become a solid ice block in the freezer. Curve it slightly upward (as the curve of the body when it's in the underwear) and place it in the freezer. You can stack several.

3) Rest- I'm not talking about rest in the immediate hours after giving birth. I'm talking days. Weeks. I tell my moms for the first 3 days, stay in the comfort of your own space- your bed. Stay nearly naked (refer back to #1), skin to skin with your new baby. Rest. Nurse. Rest some more. Bond. Limit your visitors. You see? These things are interrelated. You're nearly naked, looking like a beautiful mess of a new mother, why have company over? We also need to keep in mind that company also brings unwelcome company- germs.
What more important task do you have than to establish breastfeeding, provide nutrients and antibodies to Baby, and get to know your new baby? You can do it all by resting and staying close to each other!

4) Nourishment- in the immediate days after birth and through the postpartum period, the body needs to be nourished and replenished. Hot teas, infusions, broths, and hearty soups are staples for this. In our house Glen makes a wonderful homemade broth from our leftover bones. It can be made from beef bones, or a turkey or chicken carcass. It's simple to make and nourishing to the body and mind. Best of all, you can do this ahead of time and freeze in large quantities. It's also easy enough that anyone- including Dad- can do it. Recipe at the end!

5) Time- I've learned, by being a midwife and 'practicing' in a country other than the U.S., as well as being the midwife to many women from various cultures and beliefs, that here in our (American) culture, the postpartum period isn't always held in high regard and provided Time.

Just yesterday (Friday), as I was leaving a 24 hour postpartum home visit, I said to mom, "Just in case you were considering it, please do not go to church on Sunday. Stay home. Rest."
Mom (who is from Guatemala) looked at me like I was crazy! " I stay home," she said. "In my culture, we do not go anywhere for 30 days after having baby." I was in awe. This is not the norm. Perhaps it should be.

Ever heard of the 4th trimester? It refers to the time from birth to the end of a baby's third month. At birth, the brain of the human infant is still immature (compared to other mammals). Human babies are fragile and vulnerable, depending on the constant care of their mother. At birth, they have innate reflexes and abilities- breathing, sucking, swallowing, pooping. As the end of the 4th trimester nears, they become increasingly more able- regulating their body temperature, interacting more, nursing less often, etc. Shouldn't this vulnerable, dependent time of the newborn tell us something important about the 4th trimester for the mother as well?

Indeed, I think so!

So forget about breastpumps, breastpads, nipple cream, and the various other gadgets and 'nice-to-haves' for now, and consider this simple, short list. Let us not forget about the 4th trimester for both mom and baby, and all the ways in which we can comfort, nurture, and support them both.

Nourishing Bone Broth

One big pot of water
2 tablespoons vinegar (helps to draw the minerals out of the bones)
. Can be substituted with lemon juice.
3 carrots, peeled and coarsely chopped
3 celery stalks, coarsely chopped

1 large onion, coarsely chopped
1 bunch each of parsley and thyme
2 Bay leaves
8 peppercorns
Marrow Bones- we only use organic, hormone-free animal bones such as beef bones, whole turkey, or whole chicken. You can either use a whole chicken with the meat still intact, or use the remaining carcass, after you have already eaten the meat for a previous meal.

• If using a whole chicken, cut off the wings, remove the neck and cut both into pieces. Remove the gizzards from the cavity. Like mentioned above, an already eaten off of chicken or turkey carcass is fine. Throw it in!
• Place marrow bones or chicken and pieces in a pot with water, vinegar, and all vegetables and herbs.
• Bring slowly to a boil, and remove the scum that rises to the top.
• Reduce heat, cover and low simmer for 6 to 8 hours.
• Salt and pepper to taste, or wait until consumption
• Strain the stock into another large pot. Remove the bones and any meat pieces with a slotted spoon. You can save the loose meat to be used for chicken/turkey noodle soup, etc.
• Cool in an ice bath (or, as my husband does during the wintertime, sticks it in the snow outside (this is not my favorite, as I tell him he's going to attract all the wild animals!), and refrigerate until the fat rises to the top and congeals. Skim off the layer of fat. Refrigerate up to 3-4 days or freeze for future use.