Postpartum is a truly unique time with both challenges and exquisite joys. Movies and TV shows perpetuate the myth that postpartum is a time of great happiness and joy, while making light of the less pleasant aspects. We don't have a lot of conversations about the reality of postpartum life, and reality and fiction rarely match up.

Postpartum can be challenging.  Mom and Dad are adjusting to having a new family member who is totally dependant on them for everything.  Mom is facing the reality if she is breastfeeding that she is the 24 hour  all you can eat buffet for baby.  Mom is also dealing with being sore from labor and birth, having bleeding and maybe leaky breasts that turn on and off at random when baby isn't nursing.  Dad is trying to figure out how best to help Mom while learning that there are some problems that he can't fix for Mom.   Both parents are navigating all this while in a very sleep deprived state, and may be getting all kind of conflicting advice about sleep, feeding, holding baby etc from friends, family and caregivers.  

Don't get me wrong, postpartum can be wonderful.  Baby is here and Dad can finally touch and hold him or her.  There's nothing to match the feelings of seeing your baby's first smile, or hear that first belly laugh, not to mention the delight in locking gazes with baby. There is a special joy in knowing someone is so dependant on you and that you can take care of them.  

There are things you can do to set yourself up to have an easier postpartum, or fourth trimester.    One of the most important things you can do is to have help available for the first 2-3 weeks postpartum.  Maybe a family member stays with you and helps with meals, cleaning and all the household duties so the parents can focus on baby and recovering from pregnancy and birth.  Some families hire a postpartum doula to help, or they have someone arrange for a meal train, and use delivery services for groceries, diapers and other necessities of life for the first few weeks.  Having some easy to prep meals, or freezer meals on hand is another great way to prep for postpartum.  Having a diaper changing station, or basket with all the diaper necesseties to keep close at hand when baby is here, as well as a snack station for mom are other ways to make postpartum a little easier, especially if you are not able to arrange for someone to always be around in the first few days and weeks.  

You get to decide what you want your postpartum time to look like.  Maybe it includes things like dates and times you will be able to receive visitors. I personally recommend that any visitors have a job do to like laundry, cooking, dishes etc as part of the visit (you could have a list of things you want help with for visitors to pick from).  Maybe there's a scheduled time for Dad to go hang out with friends, or Mom steps out to get a pedicure.  Maybe you have a list of older siblings' favorite games, movies, or places to visit for friends and family who want to help with siblings.  The options are endless, so think through what you feel you will need, and what you want.  Consider making a written postpartum plan which can help with communicating your needs and desires with others.  You can share it with family and friends who are going to be part of your support team.  Remember, it is your postpartum and not anyone else's so do what you need to do to have the postpartum you need and want.

Chiropractic care can be very beneficial during pregnancy, and a low risk way to keep feeling great throughout. During pregnancy, the hormone relaxin is at work relaxing muscles, ligaments and joints. With things more relaxed or looser, it can be very easy for the pelvis to shift out of alignment.  The Webster technique was developed specifically for pregnancy in the 1980's by Dr. Larry Webster to address this issue.

Babies will go the route of least resistance when entering the pelvis so if the muscles on one side are tight, but are looser on the other side, the baby will go to the looser side since there is less resistance.  This may cause baby to enter the pelvis with the head tilted off to the side instead of centered, or baby may enter in a posterior position with the back of baby's head against the spine. Both of these can cause a longer, more intense labor.  If baby settles into a breech position, Webster Technique is one tool that may help a breech baby into a head down position.   

Having muscles, ligaments, pelvis and spine aligned can reduce common complaints such as low back pain, or hip pain.  Regular adjustments may help with swelling, espeically swelling that is more on one side than the other.  If your baby enters the pelvis with the head off to one side, that can put pressure on the blood and lymph vessels on that side which may cause you to swell more on that side.  If things are aligned, then baby may be able to center their head, more evenly distributing that pressure.

I encourage my clients to get regular chiropractic care, especially when experiencing issues with lower back pain, swelling, hip pain and pelvic pain.  Having everything balanced and in alignment can lead to an easier labor, and birth.  

For clients in Manhattan, Junction City, St Marys, Chapman and the surrounding areas, Nichols Chiropractic, Flint Hills Family Chiropractic,  Alternative Health Care, and Premier Chiropractic and Wellness in Manhattan have chiropractors certified in Webster Technique.  
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It seems everywhere I turn, there's another article or "expert" recommending the newest supplement, superfood or diet that everyone should be taking or doing. I am amazed at how quickly the next thing comes out!  If you are thinking about adding in some supplements to your daily nutrition, there are some things to consider.

Why do you want to take this?  What benefit do you hope to get?  Sometimes you may read someting online or in a magazine that makes you think you would benefit from adding a supplement.  Perhaps your midwife has suggested you add a supplement.  You should understand the reasons for taking any supplement and what the benefits are so you can monitor to see if you are actually getting the expected benefit from a supplement.

Are there reasons not to take the supplement? What are the potential risks? There may be reasons not to take a supplement.  For instance, if you have a sea food allergy, Spirulina is something you should avoid.  Another reason may be that a supplement may have a serious interaction with a medication you are already taking.  Adding a baby aspirin to your daily nutirtion regimin may not be wise if you are already taking garlic since they both have blood thinning properties.

What supplement dose is appropriate for you?  Flouride can be beneficial in small doeses, but high doses of floride can cause several issues including heart arhythmias.  Selenium is another supplement you can take too much of, causing hair loss among other effects.  Be aware of the proper dosing and remember, too much of a good thing can have damaging effects.

Have you discussed using the supplement with a health care provider?  It is important to talk with your health care provider about your supplements.  Some over the counter supplements can interact with prescription medicines.  For instance if you are taking Levothyroxine, there can be risks to taking an over the counter decongestant.  In pregnancy, some supplements may not be wise to use, or only used in the last trimester.

Can you get the supplement benefit through nutrition changes or tweaks? The best source for nutrients is from whole food sources.  If you are experiencing low iron levels, you may want to try eating liver, spinach or more red meats before adding a supplement.  Selenium can be found in Brazil nuts.  Broccoli has more calcium per serving than milk.  Consider if dietary changes or tweaks will provide the nutirients you want to add through a supplement.

How will you know if you are getting the benefits you are looking for from the supplement?  If you are supplementing for something measurable such as taking iron to raise hemoglobin levels, having labs drawn is one of the more accurate ways to know if you are getting the benefits.  Keeping a journal of how you are feeling, and what changes you are observing is another way to determine if you are benefiting from a supplement.

Supplements can be great, or they can be detrimental so do your research before adding in something new.  

Planning for birth should start as soon as you learn you are pregnant. Here are my tips to make life easier when you are close to your due date.

1.  Do not share your due date.  Sharing that info only sets you up for pressure as your due date approaches, and the pressure only increases if you go past your due date.  Those who know the due date may ask you why you aren't getting induced, if you and baby are ok, if there is something wrong ect.  One idea I suggest is to give a due window like sometime in June or July instead of a definite date.  I think this is the most important thing you can do to make life easier as your due date comes, and potentially goes before baby arrives.

2.  Do not listen to birth stories.  Birth stories are like fishing stories, they get bigger, scarier and more dramatic with each retelling.  If you want to hear birth stories, source them from people you trust or read a book with birth stories such as Ina May's Guide to Childbirth by Ina May Gaskin.  

3.   Do not tell everyone when labor has begun.  Sometimes labors are start and stop, or they may take longer than people think they should.  You may start getting questions asking if everything is ok, what is the delay, and so on.  Decide beforehand who needs to know your labor has started, and who you want to tell that you know isn't going to make it public.

4. Be prepared.  Attending a good childbirth education class will help you be ready.  I am not referring to the classes the hospital does that have a heavy emphasis on how to be a good patient and what to expect at the hospital.  If you are planning on having your baby at the hospital, they can be a good supplement to childbirth education.  Bradley classes, Birth Bootcamp and Hypnobabies are among the many good classes out there.  Many have shifted to an online format which makes them easily accessible to everyone. 

5.   Practice the exercises, coping mechanisms and whatever else the childbirth education classes recommend to be prepared for birth.   It will be much harder to draw on the skills, coping mechanisms and comfort measures if you haven't practiced them.  Being familiar with them is not the same as having experience actually doing them.

6.   Plan some fun activities to do to savor those last few days and weeks before your family grows with the birth of your baby.  Sometimes the anticipation of baby arriving pulls focus away from savoring the last days or weeks before things change with birth.

7.    Plan on your pregnancy going past your due date (you can read more about how accurate due dates are here).  If you plan and expect to go past your due date then it's no big deal if baby hasn't come by the due date, and a bonus if baby has arrived.

8.     Trust your body.  Your body doesn't need any help and there isn't anything you have to do to go into labor.  You won't be pregnant forever.  Your baby and body know the perfect timing for birth.

9.  Dial in your self care.  This will look different for everyone.  Ideas to get you thinking include buying that book you really want to read, getting a massage, taking naps, or watching that movie you've been meaning to get to.

10.  Consider handing phone duty off to a friend, partner or other family member you trust until baby arrives.  You may find you have lower stress letting someone else screen phone calls and text messages for you instead of having to interact with everyone who contacts you.

I hope you find something on this list that helps you have a less stressful time as your due date approaches, and perhaps passes.  Please share any ideas you have, you can leave a comment below. 

Update:  A reader recommended making ahead freezer meals and easily made meals you can pop in the oven or crockpot after baby arrives.

As a doula, I saw a big disconnect between the current evidence and recommendations and the care that was actually given.  I had a client who wanted delayed cord clamping.  The American Academy of Pediatrics and World Health Organization were recommending it.  My client asked her doctor to delay cord clamping and he refused, stating it would harm the baby by giving it too much blood. That incident had me wondering what the doctor was doing, if anything, to stay current on evidence based care.  I watched as mothers were not allowed to eat even though the evidence did not support that.  I witnessed parents being coerced into making decisions to appease medical providers and I witnessed medical providers giving an "informed consent" talk that did not fully cover all the risks of whatever the provider was asking the parents to consent to.

What finally tipped me into a full on drive to become a midwife was my sister's birth.  She lived in an upscale suburb of Detroit.  She was an athlete who had a very healthy, normal pregnancy. During her labor, she and her doctor agreed that a cesearan section was the best way for baby to be born.  I was present when the doctor discussed the risks of cesearan section.  She did not tell my sister she was at a higher risk of a postpartum hemorrhage or discuss risks a c-section may pose for future pregnancies.  Ten days after her baby's birth, my sister experienced a postpartum hemorrhage.  She nearly died sitting in the hospital emergency room waiting to get adequate care.  She was asked what she did to cause the hemorrhage in way that left her feeling she was somehow to blame.  After emergency surgery, she was sent to the ICU where the medical providers searched Google in her room to tell her she should dump her breast milk for the next 24 hours.  Had they contacted the hospital's lactation consultant, they would have gotten the correct information that the breast milk was fine for baby.  She was not allowed to see her baby, hold her baby or nurse her baby until she left the ICU 3 days later.  She was traumatized by how she was treated.

That was when I decided that no woman should ever have to experience the medical care my sister did. No woman should have to sit bleeding out in an emergency room, waiting for care.  No woman should be made to feel that they somehow intentionally caused a hemorrhage.  No woman should watch a medical provider search Google for the wrong answer.  No woman and baby should be seperated after birth. The fastest way to start the change to compassionate, respectful, evidence based care women need and are entitled to is to beome the one providing the care.  That is why I am a midwife.