Holistic Postpartum Manual: Maternal Health Manuals, #3

By Jacky Bloemraad-de Boer

From midwife and health expert, Jacky Bloemraad-de Boer, this Holistic Postpartum Manual is a comprehensive resource on how to create a healthy, holistic environment for a newborn baby, while highlighting the importance of the mother's recovery.

It aids to reduce confusion about postpartum recovery by clarifying what is needed for the mother, specifically how to support her emotional and nutritional needs and safely implements herbal advice. It extensively covers all aspects of the newborn and newborn care focussing on what is normal during the postpartum time.

 

This manual:

• Imparts practical, specific, helpful support suggestions for new mothers
• Aims to help reclaim postpartum wellness
• A perfect postpartum guide, easy-to-read has everything in it that most mother's didn't realise they wanted and needed.
• Is a holistic guide to postpartum recovery 
• Gives information to help create a healthy foundation for the baby
• Shares essential information and knowledge about recovery during postpartum
• Is packed with sound nutritional, herbal and supplemental advice
• Approaches both safe physiological information and shares traditional practices in the approach to postpartum recovery and healing
• Passes down woman-to-woman postpartum wisdom
• Provides helpful feeding/breastfeeding information
• Encourages women to tap into their innate mothering wisdom
• Helps parents feel more confident about caring for their baby
• Creates an understanding for what is happening to women's bodies during postpartum.
• Helps parents recognise what is normal in the development and health of their newborn, helping avoid perpetual double guessing
• Shares personal, informative and realistic information

 

• Language: English
• Publisher: Jacky Bloemraad-de Boer
• Release date: Jun 27, 2023
• ISBN: 9798223357124

Book preview

Physical and Emotional changes for the Mother after Birth

The terms postpartum, postnatal and fourth trimester are often used interchangeably. Cross-culturally the terms refer to the first 6 weeks (40 days) after a baby is born.

These weeks can be challenging for a new mother, with the many physiological changes occurring in her body as it returns to its pre-pregnancy state and the emotional roller-coaster ride caused by extreme hormonal changes, lack of sleep, routine upheaval and the challenge of mastering new skills - to name a few!

Establishing a good foundation during those first 40 days sets the stage for the future well-being of both the mother and her child.

The following A-Z chapters look at the specific changes that occur in a woman's body and her emotions with a focus on what is normal and what could well be challenging.

Where applicable advice and suggestions are offered throughout the manual to support healing and recovery.

Establishing a good foundation during the first 40 days postpartum sets the stage for the future of the well-being of both mother and child.

After Pains

After pains are uterine contractions which are part of the normal process of the uterus (womb) contracting back to its pre-pregnancy size. This process is called involution.

Although the uterus takes around six weeks to return to its pre-pregnancy size, after pains are usually only felt for the first few days.

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After pains are generally more intense in those who:

●  Have given birth before - this is because a uterus will stretch a little more with each consecutive pregnancy.

●  Those who have given birth to more than one baby - there will be increased stretching to accommodate twins or triplets.

●  First-time mothers that have had a fast labour also experience more intense after pains.

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After pains are triggered by:

●  The baby breastfeeding because oxytocin is released when breastfeeding, which stimulates contractions to reduce postpartum bleeding.

●  A baby's feet trample and knead the uterus when it is placed on its mother's tummy after birth. This mechanically stimulates the uterus to contract, which is a brilliant act of nature ensuring the survival of the mother by reducing excess bleeding.

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Afterpains are made more intense by:

●  Active management of the third stage (this involves giving a drug (a uterotonic) to help contract the uterus after the baby is born).

●  A full bladder.

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THERAPEUTIC STRATEGIES AND IDEAS for after pains

Empty your bladder often. After pains will be less intense with an empty bladder because a full bladder interferes with the involution process and therefore makes the contractions more uncomfortable.

A TENS machine can help with after pains in the same way that it helps during childbirth.

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Acupressure

Acupressure is a simple technique that requires firm pressure and  knowing where to apply the pressure. The main analgesic point in the body is Large Intestine 4 - Hegu found on the hand between the thumb and the forefinger.

Applying either self-acupressure or having someone do this acupressure point can greatly reduce the pain felt from after pains.

The most effective way to apply pressure to Large Intestine 4 is with the thumb on the point and the forefinger directly opposite the point on the inside of the hand then pinching them together.

The pressure on the point should be steadily applied until the after pain eases.

Herbs

Cramp Bark (Viburnum opulus)

Cramp Bark helps to reduce uterine cramping at the same time improving involution. It is a very safe herb to use.

It is best taken in a tincture because the tea is extremely bitter and some find the smell unpleasant.

Dosage:

30 drops in a small amount of water, as needed.

Most mother's find it helps to take a dose just before breastfeeding because a nursing baby stimulates the uterus to contract.

For those mothers that do not want to ingest the alcohol, which is the base of the tincture, they can place the tincture drops directly into the boiling hot tea or water to evaporate some of the alcohol content. 

The feedback from clients is that cramp bark works  instantaneously

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Raspberry Leaf Tea (Rubus spp.)

Raspberry leaf has a tonifying and tightening action on the uterus (womb) which is why it improves involution. As a bonus for those mothers breastfeeding, it also supports breast milk production.

Dosage:

1 tsp dried raspberry leaf in 250ml boiling water, steep for a minimum of 30 mins,  drink 4 cups a day.

WARNING! DO NOT place anything hot like a hot water bottle or heated rice sock on the lower abdomen because it can increase postpartum bleeding.

Anaemia

It is normal for women to be a little anaemic after birth but for some women, anaemia can be quite severe. Practically speaking this means they have fewer red blood cells than is ideal to adequately supply their body with oxygen.

Postpartum anaemia may result from having been anaemic during pregnancy, from the amount of blood lost during childbirth, or from giving birth to more than one baby.

Anaemia after childbirth is usually classified as iron-deficiency anaemia.

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Symptoms of iron-deficiency anaemia

Tiredness

Shortness of breath

Dizziness

Restless legs

Anaemia left untreated can result in symptoms of altered cognition and possible depression.

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THERAPEUTIC STRATEGIES AND IDEAS for iron-deficiency anaemia

Although in rare cases a transfusion is needed the preferred treatment for postpartum anaemia aims at restoring iron levels through diet and supplements.

If tackled properly, with the correct nutrition, herbs and supplements, anaemia generally takes up to 6 weeks to 3 months to correct.

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Nutrition

Iron-Rich foods

Heme-iron present in animal foods is more readily absorbed: fish, shellfish, red meat, liver, poultry and fish.

Non-heme iron foods: Nuts, seeds, dark green leafy vegetables (chard, mustard greens, kale), dried fruits, iron-fortified cereals & bread, legumes (beans, peas, lentils) and blackstrap molasses are less well absorbed and need to be either soaked or cooked and eaten in combination with Vitamin C foods (tomatoes, citrus fruits, strawberries, melons, papaya, bell peppers, broccoli etc.)

The absorption of iron is improved by Vitamin C  and so women should include foods/drinks that are high in Vitamin C when consuming iron rich foods and when taking an iron supplement. Iron absorption is hindered by tea, coffee, milk products, anti-acids and calcium-rich foods. These should be avoided for at least half an hour on either side of taking a supplement or eating/drinking iron-rich foods and herbs.  

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Supplements

Elemental Iron: 100mg a day - depending on the severity of the anaemia - is normally prescribed. Iron supplements can be harsh on the digestive system, so those women already struggling with constipation, or other digestive issues, might want to try supplements that are less harsh on the digestive system.

Examples of the more gentle iron supplements: Nano iron, MegaFood Blood Builder, Solgar Gentle Iron, Floravital Floradix, Spatone Liquid Iron.

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Herbs

Herbs are an excellent way to increase iron levels. The following herbs contain high levels of iron and can be taken as an infusion (tea) or as a tincture or capsules.

●  Nettle (Urtica dioica)

●  Yellow dock (Rumex crispus)

●  Red raspberry (Rubus idaeus)

●  Alfalfa (Medicago sativa L.)

●  Watercress (Nasturtium officinale)

●  Dandelion (Taraxacum)

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Infusion Method

Choose 1 herb or combine 2 of the herbs.

To make an infusion (tea) of dried herbs, use 1 teaspoon per 250ml (1 cup) boiling water and let the tea infuse for 15 minutes - the longer you infuse the herb the stronger it will become.

Drink 3 cups a day.

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Capsules or Tinctures

When taking any of the herbs as tinctures or in capsules, the recommended dosage of the product you buy should be followed.

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Moringa

Moringa is a herb that has many healing properties but is particularly high in iron. It should be taken in the morning because it can boost energy. Be aware that it can increase breast milk production.

Dosage

Begin with 1/2 teaspoon of powder in the morning. You can add it to a smoothie or to porridge – be sure that there are no dairy products in either – or take it in capsules, 500mg in the morning.

Baby Brain

In his book, The Postnatal Depletion Cure, Dr. Oscar Serrallach explains that one of the jobs the placenta has during pregnancy is to reprogram the mother.

He states that it is as though she gets a software upgrade, with some parts of the brain being reinforced and other parts of the brain being reduced. A pregnant woman’s grey matter volume may decrease during pregnancy, but it is not so much about the brain getting smaller, but rather about it being socially modified in order to prepare for motherhood.

Part of the brain upgrade is the acquisition of the baby radar, where mothers become intuitively aware of their child’s needs. This hyper vigilance is obviously vital for the survival of the child but if a mother is living in an unsupportive society, it can lead to sleep problems, feelings of self doubt, insecurity and even feelings of unworthiness.

Visit this website if you are interested to read more about Dr Oscar Serrallach's interesting work with postpartum women -> The MotherCare Project

Read more about postpartum depletion in the Nutrition chapters.

Baby Blues

Due to a major shift in hormones, the disruption in routine and lack of sleep, up to 80% of new mothers experience confusing mood swings starting around day 3 or 4 postpartum. This often coincides with the full-breast milk coming in for those mothers that are breastfeeding and is commonly known as the baby blues.

The symptoms of the baby blues can occur for a few minutes up to a few hours each day but they should gradually lessen and completely disappear within two weeks after birth. If they do not then the mother may need professional help.

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Symptoms

●  Weepiness or crying for no apparent reason

●  Impatience

●  Irritability

●  Restlessness

●  Anxiety

●  Insomnia (even when the baby is sleeping)

●  Sadness

●  Poor concentration

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If you are concerned about PMAD then please go to the Postpartum Mood and Anxiety Disorders (PMAD) chapter to learn more.

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For some women the baby blues may go on to develop into postpartum depression, which is currently referred to as Postpartum Mood and Anxiety Disorders (PMAD). If symptoms persist after two weeks postpartum then professional care should be sought.

Belly

The pregnancy belly takes some time to firm up after birth even though the uterus (womb) will contract back to its pre-pregnancy size by around six weeks postpartum.

For most women it can take months to regain something resembling their pre-pregnancy abdomen. The return of muscle tone depends on previous tone, exercise, the number of pregnancies and the amount of adipose tissue (body fat).

In some traditions belly binding is used to aid recovery. Bengkung belly binding is an ancient Malaysian method of wrapping the hips and belly with a long muslin cloth (17 metres). The constant gentle pressure encourages the natural release of blood, fluids and air. It supports the stretched and relaxed muscles creating a holding effect.

Bladder

The bladder tone is somewhat compromised after birth which can make it more difficult to urinate directly after birth. This can be due to:

●  Temporary swelling after a vaginal birth which tends to be more common after an instrumental delivery (ventouse or forceps).

●  An epidural during labour which can cause an altered sensation in the lower body for up to 8 hours.

●  Sometimes women are reluctant to urinate when they have a tear/rupture (with or without stitches, also known as sutures) because they are fearful of the possible pain it might cause.

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To ensure that the bladder function is normal after birth and also because the uterus cannot contract (involute) efficiently with a full bladder, a woman is expected to urinate within 6 to 8 hours of birth.

If a woman is unable to pass urine within 6 to 8 hours after the birth the midwife or doctor will empty her bladder by using a urinary catheter.

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Very rarely, a permanent catheter will be placed until bladder function returns to normal.

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Frequent urination postpartum

Once a woman has urinated and it becomes clear that her bladder is functioning as it should, it is natural for her to experience a frequent urge to urinate in the first days after birth. This is a way for the body to get rid of the excess fluid, which built up during her pregnancy. It is completely normal and usually doesn't last longer than 3 or 4 days post-birth.

Although it can be tiresome, women should not put off going to the toilet this is to avoid a bladder infection and it is especially important to empty the bladder just before breastfeeding because the action of a nursing baby stimulates the uterus to contract and a full bladder not only gets in the way of the uterus shrinking but it will also be more painful for the mother. 

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THERAPEUTIC STRATEGIES AND IDEAS to support the bladder

There are some things that may encourage that first urination after birth.

●  It may be easier to urinate under the shower; especially if the reason is due to fear of a tear/rupture making it painful to urinate. The warm water will both relax her and dilute the urine concentration which will reduce stinging

●  Alternatively, she can use a plastic squirt bottle (per-bottle), with warm water to squirt over her perineum during urination this too can relax and dilute to reduce stinging -  > more about this in both the Episiotomy and the Perineal Tears chapters

●  The tinkling sound of running water sometimes stimulates the urge to urinate

●  Placing hands or feet in cold water can trigger urination

●  Walking around might help

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Essential Oil

3 drops of peppermint oil in the toilet bowl can help a mother to urinate. The vapour’s cause the urethra (tube running from the bladder to the outside) to dilate (relax and open) making it easier to urinate.

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Herbs

Drinking peppermint tea may help a woman to relax and it has the added benefit of being a diuretic, which means it will encourage urination.

Peppermint, in any form, should not be used after the first hours post birth because it interferes with breast milk production.

Bladder Infection

Bladder infections are quite common postpartum, especially for those women that have a history of bladder infections. There is also an increased risk of bladder infection when a bladder catheter has been placed during and/or after birth, which means that those mothers that have had a C-section and those that had an epidural have a significantly increased risk of getting a bladder infection compared to those women that have had a non-interventive vaginal birth.

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Diagnosis

The diagnosis of a bladder infection is based on the analysis of a urine sample but it may be tricky to obtain a urine sample that is not contaminated with lochia (postpartum bleeding) in order for it to be accurate, this means that sometimes a diagnosis is made based