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Postpartum Adjusting
Adjusting After Baby Arrives

As an obstetrician, I find that most couples spend countless hours anticipating and preparing for the birth of their child. They read books on childbirth, take birthing classes together, work on creating the ideal birth plan, and perhaps hire a doula or labor coach. Far less effort may go into preparing for the weeks following a delivery, and couples may be quite unprepared for the realities of life with a new baby. Many women have a romantic image of caring for a baby, imagining peaceful days beaming down at their beautiful new child. While the fulfillment and joy that comes with having a baby is undeniable, many women soon find themselves overwhelmed.

Physical changes as the body heals from a delivery, hormonal shifts, sleep deprivation, and an entire change in daily routine can make the first few weeks post-partum seem less blissful than anticipated. Loss of independence and a sense of control, while being on call 24 hours a day to a completely dependent little being, is a hard adjustment for most women. It is not uncommon for me to hear from a tearful new mother within days after leaving the hospital, sharing feelings of being overwhelmed at home. In fact, 50–80% of new mothers experience what is called “baby blues,” a temporary condition that often begins in the first post-partum week. It is characterized by feeling anxious, irritable, tearful and having moodswings. While some of the exhaustion and anxiety that occurs within the first few weeks is inevitable, there are strategies that may ease the transition.

1) Sleep whenever possible. Take naps when the baby sleeps, go to sleep earlier than usual, consider letting the baby sleep with you at night while you are nursing. If exhaustion becomes overwhelming, consider pumping your breast milk and letting someone else give the baby the first night’s feeding. If you bottle feed, invest in a bottle warmer that will let you keep some formula by the bedside and avoid an unnecessary trip to the kitchen at night.

2) Minimize nighttime disruptions. Encourage the baby to fall back asleep at night (rather than assume nighttime is another play time). Keep a night light on—don’t turn on an overhead light when attending to the baby at night, feed the baby quietly and only change the nappy if absolutely necessary. (This is where I found disposable nappys extremely helpful.) Keep voices low and avoid stimulating the baby.

3) Reduce domestic demands. This could include having other people/family members help with food preparation, house cleaning, laundry and entertaining.

4) Limit visitors. It is hard enough to adjust to the constant demands of a new baby, let alone to entertain a parade of well-meaning friends. If friends want to visit, encourage them to bring food for you that can be heated up for meals. If you are too tired to have friends over, it’s okay to say so.

5) Continue good nutrition, vitamins and adequate fluid intake. Your body needs more calories to create breast milk than it did to grow your baby, so continue to eat well and drink well. If you are not a big dairy consumer, then take a daily calcium supplement. Breastfeeding itself is an exhausting activity.

6) Physical activity and fresh air can help. Getting outside with or without the baby for short periods of time can be very refreshing. Take a short walk, use a sling, baby carrier or stroller to visit a park with the baby. There are post-partum exercise and yoga classes that will allow mums to bring infants to class as well; these are usually fine to begin after the first four to six weeks post-partum.

7) Look for support from your partner, your family and friends. If you receive offers to help, then think of what would truly be helpful. Could it be an hour or two of babysitting, having the laundry done, or having groceries brought to you?

8) Join a mum’s group, or create your own. Give yourself permission to voice the difficulties and frustrations of having a newborn in front of a supportive group of women in the same position. It is reassuring to hear that other mothers feel similarly. I have seldom seen a new mother breeze through the first few weeks.

9) If you have a history of depression, have access to help. Post-partum depression occurs in 10% of mothers, and is more common in women with a history of depression. If you have had a history of depression, you should have a plan in place for a therapist and/or psychiatrist to turn to in the event you become depressed post-partum. If you are not already in therapy, I recommend finding a therapist or psychiatrist in the last trimester of pregnancy, so you will have someone to call if the need arises after the baby is born. If you have been depressed during pregnancy, continue care with a professional in the weeks post-partum.

10) Be flexible. You may have set expectations of what life would be like after the baby was born. Your baby may look and act differently than you expected. If your baby has special health concerns, is fussy or colicky, it may be especially difficult. Try and let go of preconceived notions, and don’t force unrealistic expectations on yourself.

11) Prioritize. Your household will probably become more chaotic than you would like, rooms will be messier, and meals may be quite simple. Give yourself permission to let things be, and decide with your partner where you would like any extra ounce of energy to go.

12) Get help. There are professionals who can help you during the post-partum weeks. Some doulas provide in-home care post-partum, and I see ads in the local papers for similar services. New mothers sometimes hire babysitters to be on call at night to help with feedings, or housekeepers to keep up with the cleaning, cooking and laundry. If you have family members who offer to help, make sure they will be easing your burden rather than creating new demands on you.

13) Be kind to yourself. Take a little time to meditate, listen to your favourite music, or indulge in a professional massage. The first few weeks are times when you are expected to do a tremendous amount of giving. Allow yourself to receive a little, too. By attending to your own needs, you’ll be better able to enjoy this special time in your life.
Laura E. Stachel M.D. Obstetrician & Gynecologist