Three ways proper postpartum care with the support of doulas can build a nation of happier, healthier mothers.
The postpartum period of pregnancy also referred to as “the fourth trimester,” has been historically underlooked within the field of obstetrics in the United States. For many expecting mothers and those in their communities, the focus of preparing for a new birth focuses on the health of the pregnant woman only in regards to the coming bundle of joy. But the health and wellness of the mother after birth, especially in those critical first 40 days, is equally important to the health of the baby as it is to the mother. In order to have the emotional capacity to care for an infant, mothers should feel as physically and mentally fit as possible so that their infant receives the best possible care. Most developing countries have a healthcare infrastructure with resources to support this—unfortunately in the United States, this is not the case.
Maternal mortality rates in the US are generally higher than any other developing country, and each year the numbers get worse. This unsettling statistic is due in part to this country’s shortage of maternity care providers per woman: according to research by The Commonwealth Fund, the US and Canada rank on the low end with only three providers per 250 births. As a comparison, in Sweden there are plenty of childcare workers to choose from. Mothers-to-be are provided with free and subsidized prenatal care including group support, breathing lessons, and group therapy with other soon-to-be moms, and postpartum care is part of the national healthcare package.
Why the disparity?
In a society as economically and socially developed as ours, how can this be so? If we begin to look critically, much can be attributed to our lack of country-wide health care, the lack of maternity coverage in private healthcare plans, and the grave disparity between expectant mother’s economic well-being in regards to race (postpartum complications and mortality are significantly higher in lower-income Latinx, Black, and Native American communities). There is also something to be said for the lack of post-pregnancy home visits made by OBGYNs, nurses, and midwives in the US: according to a study through the Henry J. Kaiser Family Foundation in 2017, all developed countries apart from the US ensure at least one postpartum house visit by a caregiver that is covered under national insurance. (Some US states provide this through Medicaid, but not all.)
Why are postpartum visits so integral to the birth cycle?
Historically, postnatal visits are beneficial for both the mother and the baby. Having postpartum aid from a doula or a community health worker allows for:
- A lower rate of postpartum depression in the mother
- Easier time breastfeeding and ongoing lactation support
- Proactive and preventative care that results in lower health care costs in the long run
- Physical and emotional support for the mother, the mother’s partner, and the newborn
As a doula agency focused on ensuring support and continuity of care before, during, and after birth, we believe in guiding expectant mothers through pregnancy and into the postpartum period, healing them as they transition into this next beautiful—but demanding—stage in their lives.
Below are three ways in which we as a country can center our efforts in creating opportunities to “mother the mother” during the fourth trimester.
- Community care: “It takes a village”
The common phrase “it takes a village” may have originated from the Kijita proverb Omwana ni wa bhone, which translates roughly to “regardless of a child’s biological parents, its upbringing belongs to the community.” In the US, a nuclear family may not be able to provide holistically for a mother and a newborn recovering from birth, simply due to lack of hands on deck. In the doula and CHW industry, our goal is to assemble a village prior to birth, so the new mother does not bear the burden of healing herself while adjusting to motherhood.
In China, the first forty days post-birth is called Zuo Yue Zi or “The Sitting Moon,” where the woman is encouraged to rest as much as possible. Family members surround her with help through cooking, cleaning, and ancillary newborn care. In Eastern societies this type of care is often readily available if multiple generations live under one roof. Our mission at Holistic Family Doulas is to promote this type of natural community care that the nuclear family may not be able to provide. In doing so, we offer a la carte postpartum services that include culturally sensitive emotional support, day services like meal prep, light cleaning, and childcare, and night services like feeding so the healing mother can sleep.
We have also had the honor of being trained by midwives and health practitioners experienced in Eastern medicine that have turned us on to other healing practices such as belly binding, Reiki and Reflexology, vaginal steam, herbal baths and the importance of nourishing the mother with warming foods and teas.
Reflexology, which activates pressure points in the healing body, helps balance in the body in the form of massage. Reiki, an Eastern energy healing, is popular for decreasing pain, eliminating fatigue or nausea, and can allow you to fall asleep more easily. Postpartum belly binding keeps inflammation and bloating and bay, helping uterus tissue heal better. Here is more helpful information about these healing services, all of which our agency provides.
- Healing and restoring the sacred pelvic floor
The pelvic floor, or the thirty muscles that attach your pelvis, sacrum, and hip bones, is the root of our sexual, urinary/bowel, and reproductive health— in less words, the pelvic floor is the root of life, and a root that is strong, healthy, and rehabilitated with care is one that will provide you with the resiliency to be the best mother you can be.
Think of your pelvic floor as a small trampoline of muscle. The trauma that a mother’s pelvic floor goes through during birth is not negligible: pelvic muscles stretch and weaken to become loose and malleable for a baby to pass through, and after birth mothers will need to heal and care for the area to build up strength for it to restore. As doulas in the community, we have forged connections with skilled pelvic floor therapists and bodyworkers that help support the realignment of the uterus and the ligaments that have been stretched during the birthing process.
Believe it or not, even women without complicated birthing experiences can suffer from pelvic floor dysfunction postpartum. Twenty percent of mothers who deliver vaginally and 16% of mothers who deliver via c-section suffer from postpartum incontinence. New mothers may suffer from leaking bowels, burning sensations, vaginal flatulence, and the increased risk of a bladder infection due to the aftermath of birth. And rather than prioritizing rest, Western culture has normalized dysfunction by telling moms they should simply wear pads while exercising.
Prolapse is another postpartum injury common in the first 40 days after giving birth, and occurs in the form of a cystocele (when the bladder prolapses into the vagina), or rectocele (when the rectum prolapses into the vagina). There are varying degrees of severity, and a plethora of natural treatments, for healing and rehabilitating a prolapse in the pelvic floor. Holistic physical therapy care along with our Mayan belly massages can help both healing scar tissue from a cesarean and restoring the pelvic floor. Holistic Family Doulas can show you how to administer a self massage as well as provide you with a handout to begin a self care practice at home.
We also offer vaginal steams as relief for the entire pelvic floor, which are known to regulate menstruation and ease aches and cramps. We use castor oil packs, a cloth soaked in castor oil, which is placed on the skin above the liver and uterus to enhance circulation and promote healing, in our reflexology sessions. Castor oil packs are great for women experiencing reproductive health issues such as endometriosis, fibroids and cysts, PCOS, etc.
We also can help you incorporate breathing exercises that help your body, mind, and spirit.
- Newborn care support
Especially for first time mothers, shock can come in the form of one tiny swaddled baby whose survival still depends on your tired body’s ability to keep it alive. Postpartum mood disorders are exacerbated by feelings of emotional overwhelm and exhaustion, and the peace of mind that comes from an expert’s support is a gift to both the mother and the baby. A doula is able to tune into the mother’s needs while supporting her confidence to tap into her instinct, empowering mothers to care for their baby in ways that feel most natural to them exclusively.
For those mothers who choose to breastfeed, a doula can serve as both a coach and a technician to guide you towards the optimal way to nurse your baby with confidence by offering lactation services. Postpartum care can also take the form of newborn care and education, which includes but is not limited to learning how to navigate situations such as the first newborn bath and bottle, learning massages that help your infant to relieve gas, finding remedies and suggestions for colic that work for your baby, and comprehending and conquering your infant’s sleeping pattern.
The truth is, no amount of preparation can prepare mothers for the first forty days of motherhood. But having someone at your side coaching you towards that inner instinct all mothers have, someone whose role is to strengthen your own special connection to your baby, makes all the difference. Proper doula postpartum care should be a requirement for all new mothers, not a luxury.
Are you looking for a postpartum doula?
If you’re a new parent living in the Chicago area, we’d be honored to support you and your family as you transition to this new stage of life. Whether you’re pregnant and navigating your options for a natural birth, would like to become pregnant, or looking for that crucial support after the birth, Holistic Family Doulas is here to help.