Precious Postpartum, Pt.1

Whenever my father used to get emphatic about something (and when I was a kid, he would get emphatic about things like learning how to change a tire or how to type well…I’ve learned to type, but I still can’t change a tire), one of his eyebrows would go up, his eyes became quite intense, and his voice was both a little louder and more forceful.

I am my father’s daughter, and I can feel myself doing all of those things when I start talking about things that are really, really important to me. And one of those things is the kind of care mothers need to give themselves during their postpartum period. I know it doesn’t help much to get all lecture-y to a Momma who is trying to keep a baby alive while she’s exhausted, so when I feel that eyebrow go up, I usually take a deep breath, chill out a little, and let my love come through more than my conviction about how important postpartum care is–but it really is so very important! This is going to be the first in a series of blog posts about this precious, exhausting, beautiful and precarious period right after you birth your baby. I’d like to set the foundation for my recommendations for mother-care first, by using this space to remind you of all the incredible ways your body has transformed during your pregnancy and birth.

I’ve had a good number of women tell me that the idea of a whole new human growing in their belly felt surreal and was almost difficult to believe until they actually gave birth and saw the baby. Just that amazing fact is probably enough to warrant rest and recovery after birth: you grew a whole ‘nother human being. It’s tremendous.

Growing that human, though, means a lot of other things, as well. Your organs were scooched around to accommodate the bulk of your baby in their amniotic sac bubble. I love this animation of how a mother’s innards shift and move through a pregnancy. While things got rearranged, they were held in place by your uterus, and then when you brought your baby into the world, that bulk was no longer there to support them. The first time you stand up after birth, you’re going to feel this. Your belly is still loose from expanding around your baby, and your muscles have to shrink and re-orient themselves all over again. That lack of support means you need to move gently and let things rest as they find their previous, pre-pregnancy balance. There’s a lot of unseen, unfelt activity during those first few postpartum weeks, and staying mostly in bed is what allows that work to happen efficiently.

Besides the movement of your inner organs, your pelvis itself has completely transformed. I recently heard a midwife get a bit emphatic herself as she said “the pelvis is a joint.” and I think that’s such an important point. We usually think of our joints as elbows, knees, or where our legs connect to our hips, but not always so much when we consider the bony pelvis. But the pelvis is made of three distinct bones, and as your body produces the relaxin hormone before labor, it opens and moves in new ways. If we’ve had a prenatal together, I’ve shown you my model pelvis, and I’ve likely had you sit on your hands so you could feel your sitz bones moving around when you turned your legs in different directions. There was a lot of opening, wiggling, and twisting going on when you gave birth, and now your pelvis is going to return to its normal shape so that it can continue to do its amazing job holding you up so you can do little things like walk with balance.

If you gave birth vaginally, I’m sure you were already quite aware of your cervical dilation, and the relief in hearing you were fully dilated and could finally start to push your baby out. In order to get to that point, all of the muscles in your uterus had to move about. At the beginning of your labor, your cervix was long, narrow, and tight while the top of your uterus was fairly thin. When you began pushing, the structure was quite opposite: the bottom of your uterus became paper thin, stretchy, and wide open while there was a thick pad of muscle at the top to give you good strong pushes. It’s a pretty dramatic shift.

And then there’s your placenta. Man, placentas are cool–and should probably get their very own blog post. I’ll try to stay brief here by just reminding you that in addition to growing a whole separate human, you grew a whole separate organ, and that organ is bigger than most of your other ones. It’s an amazing part of your accomplishment! When you release your placenta, though, it leaves its mark. Your placenta had open blood vessels that were embedded in the open blood vessels of your uterus. When you had a little contraction right after birth, your uterus shrank down a bit, and the tightness kind of pushed your placenta away so that you could get that out. I hope you got a good look at your placenta; they are typically the size of a paper plate, and that is how big the space is in your uterus with those open blood vessels. As you continue to contract a bit (and starting to breastfeed helps with that!), your uterus will shrink down to roughly the size of a grapefruit. This means the placental site–with those open blood vessels–becomes more the size of your knee cap. That shrinking will pinch off most of the blood vessels, and that’s really important. Pinching those off and getting them closed is what keeps you from hemorrhaging after birth. They still ooze a little for several weeks; this is the source of your lochia, your after-birth bleeding.

Once your uterus has shrunk down, and that placental site is knee-cap sized, it does form a bit of a scab. If your entire knee got scraped and scabbed over, how would you treat it? I know that I would baby it a little bit, being careful with movement and activity to let it heal. Jostling it at first would break the scab open, cause more bleeding, maybe some of the protective scab would fall off (blood clots, anyone?) and prolong the healing process. Can you please just picture the same thing happening inside your uterus? We honor that healing process by being gentle and restful for a couple of weeks, and still taking it generally easy for a month or two.

Once you’ve birthed your baby, there is still the massive hormone shift that begins milk production. You are using energy and resources to create that beautiful milk, and the hormones themselves are going to have both a physical and emotional impact. It is not a small part of your transformation, but a large piece of this overall picture.

I’ve spent a lot of time on this one concept, and many of my readers will find it all to be familiar information. Please just keep referring to this list as a reminder of the incredible transformation you’ve undergone in so many areas. As I spend some time talking about the importance of rest, emotional care, and shifting family dynamics during your postpartum period, this is the foundation for why it’s all so vital.

And I’ll do my best to keep the love in my voice and tell my eyebrows to calm down.

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