The modern American approach to postpartum care is lackluster at best.
It starts in the hospital with medical staff not knowing how to educate mothers about the signs and symptoms they should look for postpartum. There are even stories of women returning to the hospital postpartum complaining of symptoms and being turned away only to find out that their conditions are serious and life threatening. Medical staff are there to support you, but in the overwhelm and the confusion postpartum overlooking symptoms isn’t uncommon.
Once we’ve left the hospital, the idea that women can “resume normal activities” is taken to heart with new mothers getting right back to a schedule of cleaning and cooking, and then returning to work six to twelve weeks later. Our grandmother’s grandmother would be shocked.
Women are wearing ‘going to Target the day after giving birth’ like a badge of honor when really it’s a representation of how our society doesn’t respect the birth process.
Taking proper care of yourself postpartum is the best way to protect your current health, reduce your recovery time and even protect your overall longevity and vitality.
The Modern American Woman and the Postpartum Period
Western women push themselves hard. We have a societal impetus to do all the things. We hold down a job, while raising our kids, keeping a home and trying to maintain a social life so we can have other adults to talk to. So perhaps the idea of trying to do it all the day after giving birth isn’t so hard to understand – it’s just a matter of getting back to the grind.
But what is actually happening to your body in the postpartum period?
First, you just ran a biological and physiological marathon. You have every right to be exhausted. And now, if you’re breast feeding, you are going to have to wake up every two hours to feed your new baby. It’s not going to be easy to get that energy back if you are also cleaning the house and running errands.
You’re bloated and constipated so while you may want to eat, you’re uncomfortable. You’re constipated because the muscles in your pelvic floor don’t know what to do with themselves. Mostly, they’re in shock which is why you’re also having troubles urinating.
And you’re bleeding…
If you’re bleeding an appropriate amount it looks like you’re having your period. This is called lochia and is your uterus shedding the lining you’ve accumulated over the past few months. Most practitioners will caution that this will continue shedding for the next six to eight weeks.
Add that to having a huge, gaping wound that no one can see. This is important and it’s something Rochelle Matos, the childbirth educator who provided my birthing classes emphasized. This wound is in our uterus, one of the most vascular organs in our body and it’s about the size of our face. The placenta has been attached to the side of our uterus for nine months helping filter blood for our baby. It detached after the birth leaving this wound.
No one can see it so it’s easy to forget it’s there. However, if we had a wound this big on our leg do you think people would let us be up, moving around doing stuff around the house, let alone running errands? Heck no.
Rochelle also points out that since this is an internal wound we can’t just accidentally chip off a corner of a scab and have it heal over. If we disturb the healing process the body scraps what it’s done and starts anew. This is why bed rest is important – you have to let your body do its job.
Traditional Postpartum Care in the Modern Era
Birth centers and some practitioners have seen this trend of getting back to the grind and what it’s doing to women and are determined to change it. The addition to your postpartum care that will make the biggest difference is bed rest.
Traditionally, Chinese women rest for 4-5 weeks postpartum. Family members, usually grandmothers take on the tasks of everything but feeding the new baby to let the mother recover. This allows time for a mother’s qi and blood to build back up and start flowing sufficiently again. Ideally, the mother is also eating a diet rich in qi and blood building foods, is being protected from illness and other stresses and may be being treated herbally.
I was being treated in the Western midwifery model and my midwife recommended one week of strict bed rest followed by one more week of “house arrest” – I could only use the stairs once a day which meant I rarely left the apartment. I am very Type A, so this was difficult but with my husband’s help that first week we made it work. And let me tell you, bed rest helped.
How do we know?
A woman’s menstrual cycle/bleeding is the best diagnostic tool a Traditional East Asian practitioner has available.
The lochia postpartum is no exception. The midwives at my clinic know this too – if you start bleeding again after your flow has slowed, you did too much and should go back to resting. Using this philosophy, they have noticed that their mothers have stopped bleeding by their two week check up.
You read that right. Two weeks of bleeding versus the six to eight weeks of expected discharge women are cautioned to expect.
Why is this?
The Traditional Chinese Perspective
A quick primer on TCM (Traditional Chinese Medicine):
Qi is so much more than just energy. It’s how the body functions, how well your blood is oxygenated, the action of things that is supposed to happen in your body.
Blood is the yin to qi’s yang. It’s the more substantial and nutritive functions of your body.
Jing is our essence. We receive it from our parents, nurture it with food and drink and use it up over the course of our lifetime. It is difficult to replace and once our essence is depleted, we’re gone.
The organ systems
Any organ system mentioned in TCM is a collection of processes that relate to a particular topic or element. In this case I’ll be talking about the Spleen and Kidneys. I have italicized and capitalized them to differentiate them from your physiological organs.
The most important thing to understand going forward is that TCM describes the processes of our body through a metaphor of nature (and sometimes politics.) Think poetically, not literally.
While there are many patterns (see more on pattern diagnosis here) that women experience postpartum we all have qi and blood deficiency with blood stasis. At this point in our recovery we need to focus on building our qi and blood and gently moving it. We can do this with acupuncture, herbs, diet and rest.
Our Spleen is in charge of our blood and rebuilding it. It is also responsible for keeping things up – preventing hemorrhage and prolapse. So if in the postpartum period we decide to use our energy to do the dishes or vacuum instead of giving our Spleen time to recuperate after the marathon we just ran, it’s going to have a hard time keeping the blood its trying to make in our bodies.
If you remember from my first fertility post I talked about the Kidneys being our foundational energy, and that if we push past the qi and blood that our Spleens can provide, we start to recruit qi and jing from our Kidneys. This directly impacts our future vitality and longevity.
This is ultimately why bed rest is so important: we need to protect our Kidney energy.
The Second Golden Opportunity
Dr. Lia Andrews and Shuqi Zhuang refer to the postpartum period as the ‘second golden opportunity’ with the first and third being the menstrual cycle and menopause respectively. These opportunities are times women can either ravage or rebuild their Kidney energy and other aspects of their and have a dramatic impact on their overall well-being.
In her book ‘7 times a woman‘, Andrews outlines a postpartum recovery plan that supports a new mother through community support, instructions on abdominal binding, lactation support as well as detailed dietary guidelines to help rebuild your system.
Your postpartum period is a chance for you to heal and grow. I know that you want to be supermom. I do too. But the best way for you to be there for your growing family is to take care of yourself. You can’t pour from an empty cup, mama. Take this time to build yourself up so that you can be healthy for your children, your grandchildren and maybe even beyond.
Interested in including TCM as part of your birth or postpartum care plan?
Disclaimer: I am an acupuncturist in the state of Minnesota, and the information falls within my scope of practice in my state. However, unless I have directed you here as your homework I am probably not your acupuncturist. The information in this post is for general purposes only and does not constitute medical advice. As always, check with your own acupuncturist or primary care provider before making any lifestyle changes. This post does not create a patient-practitioner relationship and I am not liable for any losses or damages resulting or relating to the content in this post.
Resources and links
Rochelle Matos – http://www.withlove.mn/
Dr. Lia Andrews – 7 Times a Woman
Jessica Gustafson is a licensed acupuncturist in St Paul, MN specializing in women’s health and fertility. She loves working with patients through the Health Foundations Birth Center on Grand Avenue in St Paul as well as doing home visits in the Twin Cities area. Check out the services page for more information!
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