Postpartum Care – The Bigger Picture You Need to Know

Photo by Sarah Chai from Pexels

by Liz Szalai

General postpartum care has a focus on physical health, and watching out for signs of postpartum depression.

While resting up and watching out for the baby blues are very important, are there other things that need to become part of the conversation?

What else should you take into account when planning your postpartum care? 

Mental health and postpartum care 

Postpartum depression, like all forms of depression, can be hard to pinpoint a cause for. It’s thought to be a combination of changing hormones and a predisposition to mental health issues. Other factors can raise your risk, including an at risk pregnancy, a traumatic birth, and poor lifestyle choices.

But there are other challenges postpartum that we do clearly know can affect your moods. Recognising these potential mood destroyers in advance can help.

1. Sleep deprivation.

In a still not fully understood, chicken or egg sort of situation, poor sleep is directly connected to mental health issues. This includes depression and anxiety, as well as other problems like bipolar disorder.

If you already easily fall prey to sleep problems, and sleep problems then affect your mood? Note that the pattern of nighttime wakings a newborn involves, called ‘partial sleep deprivation’,  is particularly damaging.

According to a US study, ““partial sleep deprivation has a more profound effect on functioning than either long-term or short-term sleep deprivation.” 

2. Lack of control over your body and your life.

The body that grown a human (or several) for nine months is still not yours after birth. Your body will be food (if you decide to breastfeed), a couch to nap on, a toy to pull, mouth and bite, and your baby’s comfort zone. 

Also, the life you lived before went through significant changes. You can feel you don’t have control over anything, because the baby’s needs overwrite a lot of things. Part of postpartum care can be about acceptance of what is. 

3. Your relationships with your partner and family.

Photo by William Fortunato from Pexels

Introducing a new member in the family changes the dynamics of the couple. There is a lack of time for intimacy, and changes in libido. Fathers can find themselves receiving less attention, and mothers might resent that fathers get to go on with their lives with fewer changes. 

And then there is extended family. Yes, their support can be very valuable in the postnatal period. But sometimes their unsolicited parenting advice can cause conflict or stress, even though they mean well.

4. The breastfeeding debate. 

A 2019 study examines the mental health effects of decisions related to breastfeeding. They emphasise the responsibility of health care providers to support mothers through this time, not just with practical lactation issues, but emotionally.

And then there is the myth about breastfeeding being a natural easy thing, like a duck taking to water. It isn’t. Some women need lactation specialists as part of their postpartum care, or find breastfeeding is not possible. As the study points out–

–women “may also need to educate family members to be realistic and supportive of women who may have difficulties with exclusive breastfeeding. Or who decide to stop breastfeeding early, whether due to physical, emotional, or practical issues”.

Postpartum psychosis

It is also very important to be aware of the risk of postpartum psychosis. A condition that gets less press than the baby blues, it can be a very dangerous situation for both baby and mother.

Postpartum psychosis develops within six weeks of childbirth, and symptoms can consist of:

• hallucinations and delusions
• a manic mood or rapid shifts from high to low moods
• restlessness
• acting suspicious or fearful
• and acting out of character, such as endlessly chatting when usually reserved. 

The NHS suggests that postpartum psychosis affects one 500 women in the UK and should be treated as a medical emergency. 

7 Ways to improve postpartum care

1. Nourish and nurture.

By: Ella Olsson

Provide nutritious meals for your body. And obviously while a long spa day is not likely to happen, little moments for yourself matter.  A hot shower alone, or half an hour without the baby as your partner or family step in, can be crucial self-care. 

2. Move when you can.

The effect of movement in producing endorphins (happiness hormones) is now proven. Research shows that endorphins increase with exercise. It does not have to be a full workout, it just needs to be movement. A walk outside if weather permits, with or without baby. Dancing is another way to lift your spirits and help you cope with the day’s challenges.

3. Stop the comparison.

Yes, your baby needs to be monitored to ensure they are hitting necessary health and development markers. But be wary of unrealistic expectations for your baby. Don’t forget, babies develop at their own pace. So don’t compare their milestones, sleep, or eating to other babies, beyond doctor’s guidelines. 

Another minefield of comparison is our postpartum body. Like babies, every body is unique, changes in its own way. While it is important to feel good in our skin and be healthy, we have to be aware of the work our body just gone through and work towards acceptance.

A review shows that women’s view their postpartum body as a project to work on, and that this contributes to psychological distress. 

4. Use social media wisely.

Speaking of comparison, social media can be dangerous territory. New mums today have to cope with the expectations of society, and representation of motherhood in social media.

We have to be careful not to believe everything that social media says, and select people to follow wisely. A wealthy family with endless staged professional photographs of parents and child (and probably an entire team of staff helping out) is not going to make any new mother feel fantastic. 

An online presence can, however, be beneficial if used to seek support instead of being used for social comparison.  According to a US survey, 84% of new mothers felt like their social media community provides them social support. 

5. Spend time in nature as part of postpartum care.

Open the windows, or go outside, if possible to somewhere green. A study recommends connecting with nature to reduce stress and increase the feeling of contentedness.

6. Skin-to-skin contact. 

The National Partnership for Women and Families in America suggests that, “through the early weeks, skin-to-skin contact may benefit maternal psychological well-being by release of oxytocin and other hormones”. 

7. Partner time. 

And that leads to the importance of intimacy with your partner. This does not have to be sexual. But a hug goes a long way, as does a shoulder to release those fourth trimester tears.

A research review on how we self-soothe identifies crying as a significant part of the process and as a stress release.

Be honest if you need postnatal support

Again, many women find themselves facing sudden anxiety and depression, or having difficulties with their partner and family over parenting choices that leave them stressed. This can be made worse if their partner is also struggling (postpartum depression also happens for men). 

And support really helps. Research looking at data from 22 different studies on postpartum care found that in women with family dysfunction or postpartum mood issues, home visits from a nurse and/or peer support made a huge difference.

Only 15 per cent of women with peer support, for example, experienced depression, versus 52 per cent in those who didn’t have that support.

Has having kids left you feeling empty or uncertain? Talk to a therapist who truly understands. Our London-based therapists are highly experienced and rated some of the best. Or use our booking platform to find registered UK therapists for all budgets. 

Still have a question about new concerns in postpartum care? Post below.

Liz Szalai is a mother and freelance writer with a Master’s in psychology.She worked with children and young people for more than 15 years, including teaching students with learning difficulties. Find her at @lizszalaiwriter.