Having a baby is joyful, transformational, exciting, challenging, and disruptive, all at the same time. While there are many resources for pregnancy and birth, there aren't nearly as many for the “fourth trimester” - the several months just after birth. We think this feels a bit backward since the fourth trimester is such an important yet physically and emotionally demanding time for a new mom!
After giving birth, a mother’s body goes through physical, mental, emotional, and hormonal changes that set her up for motherhood in the long term but can also lead to fatigue, depression, and anxiety. Their partner’s life is also turned upside down also and most are not fully prepared for how to handle it. Knowing what to expect, and having a strategy for dealing with these changes can be incredibly helpful. A postpartum plan can help parents prepare for this new stage of their lives in the best way possible.
We believe that parents need more support in postpartum, so we're digging in on all things postpartum care - including why postpartum care is important and how to create the perfect postpartum plan to ensure that the transition into parenthood is a smooth one. From preparing for parental leave to deciding who can visit the baby (and when), we'll walk you through how to create a healthy environment for your newly expanded family!
Ch-Ch-Changes! What Happens in a Mom’s Body After Giving Birth?
Matrescence is a term to describe the journey of the physical, emotional, hormonal, and social transition to becoming a mother.
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Understanding the normal changes that occur postpartum is key to preparing for the postpartum period. Without solid preparation, all of these changes happening simultaneously can lead to a whole lot of stress and overwhelm which can have a major emotional impact, like mood swings, depression, and anxiety. Having resources and support lined up ahead of time can be a real game-changer!
1. Physical changes
Physical recovery looks different for each woman based on her length and nature of labor, the type of delivery she had, and many other variables. However, many postpartum women experience breast engorgement or tenderness, postpartum bleeding, mild pelvic pain and postpartum contractions, hemorrhoids, constipation, discomfort in the perineal area (if she had a vaginal birth) or in the abdomen (if she had a cesarean delivery). So if you experience any of those you can rest assured that they’re normal! Not fun, but normal.
Many experts recommend a 5-5-5 rule: 5 days in the bed, 5 days on the bed, and 5 days near the bed to give mama a solid two weeks of focused intentional rest. It can be tough to make this happen with all of the other priorities in life, but it is much more feasible if you prepare for this intentional rest in advance.
2. Emotional changes
Research shows that the architecture of women's brains actually changes during and after pregnancy in ways that last for at least 2 years. Gray matter in the brain shrinks in areas involved in processing and responding to social signals. In addition, due to hormone shifts, activity increases in the areas of the brain that control empathy, anxiety, fear, and social interaction. This essentially happens as a way to “rewire” the brain to allow women to respond to their baby's needs or to detect threats in their environments.
This change can feel confusing and emotional for a mama, or it can show up as increased anxiety. She may feel like her identity has changed and may feel a disconnection with those formerly close to her, especially from those who may not relate to her experience.
Emotional changes can also be exacerbated by a labor and delivery experience that didn't go as expected, birth trauma, or complications with mama or baby following birth.
A woman's psychological health is quite vulnerable after birth, so it is important to provide a source of emotional support and to know the signs and symptoms of serious conditions like postpartum depression.
3. Hormonal changes
A woman's body goes through significant hormonal changes after birth and in the early postpartum period.
Immediately after birth and in the week following delivery, estrogen and progesterone both plummet. At the same time, oxytocin surges to compensate for the initial drops in progesterone and estrogen and prolactin increases to encourage milk production. These dramatic hormonal changes can feel like a rollercoaster, affecting a woman's mood and emotions, and also her physical state. Women often feel bouts of sadness, cramping, fatigue, night sweats, and more. Again, not fun, but normal.
4. Spiritual changes
The link between a mom and her baby (the mother-baby dyad) is intangible but widely experienced. For some, it can feel like they are still in the same body. A mom might feel the same feelings as their child or anticipate their needs with seemingly telepathic abilities. Accepting and embracing this is key for everyone in the family, as they learn to trust mom’s instincts above all else. Some women even find they’re more intuitive in other areas of their life also, so don’t be surprised if you’re suddenly a better mind-reader!
Additionally, with the fear and anxiety centers of the brain expanding, learning to have trust and faith that everything will be ok is more important than ever. It can be a fine line between trusting those intuitive instincts that something is wrong, and remembering that fear and anxiety is often disproportionate during this time. Each family has to find this balance for themselves.
5. Relational changes
A new baby can really strain a marriage and other close relationships. Many couples just aren’t prepared for the stress, the sleep deprivation, and the amount of time and attention the new baby takes. Many men aren’t prepared for their partner to suddenly have zero time or attention for them, and it can be hard for a woman to relate to her partner when she has had such a physical change and connection to the baby. The last thing you want is severe marital conflict on top of all the stresses a new baby brings, and yet it’s inevitable as you both adapt to this new identity, reality, and relationship. Knowing the relationship stress is inevitable and temporary can help, along with having a solid plan on how to address it.
The Postpartum Care Plan: Learn the Basics
A postpartum plan is a practical approach to help prepare for the transition into parenthood. It involves planning out activities and strategies to ensure that both parents and baby are safe and well taken care of.
1. What is a postpartum care plan?
Put simply, a postpartum plan is a set of preferences for the early weeks and months after a new baby arrives. It typically includes a family's predetermined choices around all sorts of decisions like parental leave, feeding, sleep, visitors, household chores, self-care, and more.
2. Why make a postpartum care plan?
Having a plan helps to prepare for so many things in life, from weekly meals to what you're going to do while on leave. A postpartum care plan helps to make sure that you and your partner are on the same page when it comes to key aspects of postpartum recovery, household responsibilities, visitor policies, and more.
A postpartum care plan also sets you up to have tough conversations before the baby arrives, which is helpful since you'll likely be tired and have less capacity to think clearly after birth.
A postpartum care plan can also help both partners know the difference between what is normal and what's not, so you can quickly identify risk factors that may require additional resources or care from a healthcare provider. For example, persistent pain, excessive bleeding or postpartum hemorrhage, or signs of perinatal mood and anxiety disorders (postpartum depression, postpartum anxiety, postpartum rage, postpartum psychosis, and more) should all be addressed immediately.
Your plan will definitely not go exactly as intended but having some guardrails outlined can help make deviations feel more manageable and less overwhelming, which ultimately supports mental health.
Create Your Personalized Postpartum Plan
Ready to create your postpartum care plan? Here are some topics you'll want to consider:
1. Consider who you would like to welcome into your baby's life
You will likely have family members and friends reaching out immediately wanting to meet your baby. While visitors are typically well-intentioned, they can quickly become overwhelming. Even if you are a person who likes company, you may feel differently in the first few weeks of postpartum when you are sleep deprived and un-showered. It helps to anticipate who is nearby that may want to visit so that you can talk through when you'll be ready.
You may also want to anticipate any events that will happen in the first few months following the birth so that you can set expectations with the host that you may or may not be able to attend.
2. Set healthy boundaries
In addition to deciding who you will invite into your lives in the early postpartum period, think about how you would like people to engage with you, and then set realistic expectations with them. Perhaps you want to limit visits to a certain length of time or time of day. You can also request that anyone visiting also support the new mother in some way (e.g., fold laundry, bring a meal, play with an older sibling).
Per the First 40 Days approach, it is entirely appropriate to expect visitors to perform some kind of service for the mom or family, even if they don’t even get to see or hold the new baby. Explain in advance to loved ones that the best way to love the new baby is to care for the mom, and be prepared to do housework and be prepared to not even see her or the new baby if that moment isn’t right. Help them understand that if they cannot agree to that they may not be welcome during that early time. Our cofounder Joe made a spreadsheet with good times to visit he sent to their loved ones to sign up for a shift, and then gave them a certain job based on when they came and what was needed.
3. Think about the kind of family and friend support that would benefit you
Speaking of boundaries... Not everyone wants meals or visitors, but people will reach out, so be prepared with what YOU want, not what they want. Be specific and clear about what would actually be useful, like taking your toddler to the playground, taking your dog for a walk, leaving groceries on the porch, or driving you to an appointment so you don't have to deal with parking.
4. Reflect on the best way to divide household tasks
Talk through what each partner expects in terms of baby and household responsibilities. You probably have a cadence of who does what prior to the baby's arrival, so how will that change? Who will grocery shop, meal plan, do laundry (there will be a lot more!), pay bills, etc. How will this change when one or both parents return to work?
If it is accessible, consider what professional help you can hire, even if it is as simple as grocery delivery. You can also ask friends and family to help with household tasks, like folding laundry while they visit.
To take this to the next level, consider implementing some degree of the Fair Play system of household management. This has been revolutionary for many couples and is easier to start before having children, and is a major game changer for a couples’ quality of life.
5. Plan to get enough rest and sleep
It might sound funny knowing how much newborns tend to keep you up at night, but establishing a plan ahead of time for how you will handle nighttime wakings (e.g., if mom is breastfeeding, dad can be the one to get baby back to sleep so you aren't both up for the entire wake period) is helpful for maximizing rest. You can also discuss how you might snag some additional nap time during the day (e.g., you can alternate taking baby for a contact nap in a carrier while the other stays home for a nap).
6. Plan to nourish and hydrate mom’s body
Along with pregnancy, postpartum is among the most nutritionally demanding times in a woman's life. Expect that she will be HUNGRY, especially if breastfeeding. But she needs to be nourished, not just fed. Prepare as many nourishing freezer meals ahead of time as possible, pick out recipes in advance that are quick and easy to make or to ask friends and family to make for you, and stock your pantry with nutrient-dense foods and snacks like bone broth, meat sticks, and nuts and seeds. Check out Serenity’s breastfeeding station survival kit.
In addition, it is important to stay hydrated. Make sure she has a large water bottle that it's easy to drink from with one hand (e.g., an insulated tumbler with a straw). Good quality electrolytes (we like LMNT) are also helpful because water alone won't hydrate.
7. Consider the different support options available for breastfeeding and bottle-feeding
Think about how you prefer to feed your baby and then consider what support you might want to have in place to make that journey as smooth as possible. For example, you may want to line up an experienced lactation consultant, invest in a great breast pump with extra parts, or research a formula in advance. If planning to breastfeed, it’s always helpful to plan for help from a lactation consultant and local La Leche League groups.
8. Give yourself permission to take care of your physical and mental well-being
Plan to allocate time for yourself and your needs - decide what are your non-negotiables when it comes to self-care and then decide together how you will commit to maintaining a minimum of self-care practices. Prepare to allow someone else to care for your baby so you can have a break or time with your partner. It can be helpful to get used to having a babysitter very early so both you and your child learn that some time apart is ok.
9. Establish a relationship with a mental health practitioner
Just about every postpartum woman we've met would agree that they could have used more mental health support during the first several months postpartum (and much longer for many women).
But it will be hard to establish a new relationship during the postpartum period, and finding someone you really click with is key. So if you don't already have a trusted mental health practitioner, consider finding one now. A couple of sessions to talk through any questions, tensions, or anxieties you may have can be hugely beneficial.
10. Carefully consider what works best for you in terms of returning to work
Your formal maternity leave policy might be outlined by your employer, but you may have the option to take additional time off without full pay or benefits or return part time. You are also always allowed to ask even if it isn’t spelled out in the policy, many employers can be more flexible on this than one might think. It is also helpful to consider what you'd like life to look like when you return. You might want to consider asking for a flexible or remote work arrangement, you might want to understand what options you have for pumping at work, or you might want to request opting out of work-related travel for a period of time. If your partner gets leave as well, you could consider taking some of it together and some of it separately to spread out the amount of time one of you is home. Finding the right childcare can be hard and stressful, so it could also be great to do this ahead of time to add more ease to what will already be a tough transition.
11. Plan for Dad’s needs
One in ten dads suffer from depression/anxiety after a baby is born. While new mothers are often the focus, dads can have their own identity crises and opportunity for spiritual awakening during the postpartum period.
Make sure to discuss how dad would like to be involved to help bond with the baby (e.g., dad has one skin-to-skin contact nap each day or dad gives one bottle each day if mom is breastfeeding). Discuss dad's self-care needs too, maybe it's important to get a workout in a few days a week or to meet a friend for a hike once a week. See more ideas on this in our cofounder Joe’s blog “Lessons Learned 9 Months Into Fatherhood.”
12. Consider hiring a postpartum doula or other professional support
I promise you no one has ever regretted hiring professional support during this critical time. If you have the means, a postpartum doula can be a real game changer! This is even more important if you feel like you may be lacking in support (for example, you do not have family nearby, or your partner has a very short paternity leave or travels frequently). We appreciate that hired support comes at a cost that isn't always accessible to everyone, but it's worth exploring your options to see what might work best for you. Sometimes you can find a doula in training that is available at a lower cost, or even just a local teenager to come help clean, do laundry, prep meals, or watch other children can really help.
A postpartum care plan is a key component of helping your postpartum experience be as smooth and stress-free as possible. We hope this guide will help you to create your own so that you can have an empowered postpartum experience!
The following are some resources that we found helpful in preparing a postpartum care plan and preparing for the postpartum period. We wish you all the best!