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Postpartum Care

Why Didn't Anybody Tell Me: There Is No Postpartum Care

Ever heard of a sitz bath? There is one thing I wish I had known before I left the hospital with my first baby — that once you leave, there is no postpartum care. Yes, you have a checkup at six weeks, but it's after most of the discomfort has passed. The shock of what has happened to your body may not have passed.

By the time I got back to my OB at six weeks, I'd figured out that my tailbone was probably broken from childbirth and was told — by a doctor I had really liked — a broken tailbone is a broken tailbone. As in, there's really nothing to do except let time heal it. It was discouraging. I had mistakenly been looking for a little help. In those crucial early weeks of nursing and bonding with my child, sitting was unbearably painful. I quickly bought a doughnut ring to sit on and became very choosy about chairs, but it didn't change the fact that I had to sit down to feed my baby every other hour, and that discomfort, even with all of the meds and padding, made nursing my infant feel something like torture. I wasn't fully healed until five or six months postpartum. This might be why many women shell out for those seemingly overpriced gliders. No price is too high for a little comfort at that stage.

A friend of mine was discharged postpartum only to have her newborn readmitted a day later for jaundice. In their city hospital, all the rooms with space for parents with newborns were full. This new mother had to sleep in the waiting room and sit there during the day in between nursing and pumping for her newborn. During this time, her stitches came out and she contracted an infection, so she had to be readmitted and treated. She said that recovery was far more painful than labor itself.

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While her story is unusual, it seems fairly common that the pain new mothers experience is overlooked or unseen by the medical community. Care between mothers and newborns is not well coordinated. In the hospital, you'll be given some info about postpartum bleeding — called lochia — and a nurse might talk to you about the baby blues or postpartum depression. Once home, you can call your doctor or clinic for some advice, but in between figuring out your new baby, nursing, and being physically limited, you may not have the wherewithal to get yourself to the doctor. I found it strange in retrospect that the baby's health is checked every week or two in the first months, whereas your own body is supposed to magically take care of itself. Yes, it does heal, but it's better to inform yourself beforehand and be prepared.

Ask your friends, doula, or physician what you might need to care for yourself after you leave the hospital. You might find yourself in significant pain, especially while sitting, either from bruising during labor, from healing stitches, or painful hemorrhoids. You may have strong contractions, called afterpains, or have trouble using the bathroom from a stressed bladder and perineal muscles. You may pass blood clots as your uterus heals or be so sore and tired that you experience deep body aches. If you've had a C-section, you may not be able to hold and lift your baby well or without pain. Your body has a lot of healing to do even while you are giving much of your energy to the newborn.

In many cases, rest, pain medications, and frequent baths will be most important. The time it takes to heal is one reason people talk of organizing help or meals after baby arrives. Instead of thinking, "I can do this," think, "I'll take all the help I can get." Don't minimize your pain. Make sure you communicate about how you are feeling with your spouse and with your doctor. Take time getting back to your usual speed. I think I took my first walk outside the apartment a full week after my first labor. I was pushing a stroller, confused by the actual sunlight and roaring traffic and investigating dogs, all of which seemed dangerous to my child. But it wasn't — she slept through the noise and sidewalk bumps, and so we just kept going.

We walked a lot in the early months, with a sling or the stroller, and while it was slower than my solo pace, it was also refreshing to feel my legs stretch and gather strength, week by week. The body I knew returned but very slowly, and my memory of that painful recovery still shadows my experience of having children.

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