Updated: Mar 31
This long resource article was originally written this past winter for the Fourth Trimester Collective and their launch of an amazing platform for growing families. As with many of us businesses operating in the COVID 19 era, FTC is working to adapt their offerings to be even more beneficial to families navigating this uncertain time. We both felt that getting the information in this post out was essential to assist our birth givers in any way possible. Keep your eye on the Fourth Trimester Collective and what will no doubt be a helpful and essential resource for this unprecedented time.
Blending traditional ways with modern day science, we can create a postpartum that honors the individual’s path to wellness.
UPDATE 03.29.19: This post was written pre- COVID19 and therefore some of this may not be feasible at the moment. Please see my upcoming video series collaboration with several genius women for resources on childbirth and postpartum education in time of the coronavirus pandemic.
In the west, it’s hard to escape the bounce-back ‘influencer’ culture that touts getting back into pre-baby clothes the fastest or hopping back in the gym to grab those ubiquitous before and after selfies. All of this glorifying creates a toxic and unrealistic environment that leaves new parents feeling isolated, different, and often ‘not-good-enough’. If we want to shift the maternal health crisis, we need to recognize that we have lost our way when it comes to how we care for people during this short period of time in their life. Instead, let's consider the opposite approach - a time to be supported through warmth, rest and replenishment. It is paramount that we embrace it with some thorough and thought-out planning.
To do so we need to dissect the pillars of care and see how they will fit in our everyday life. First, we might stop and take the time to understand what our own ancestors did during their postpartum period. What did their “village of support” look like? How long was this window of time? What foods did they eat? How were they supported? Then move deeper and look around the world and you will find that there is much that overlaps & aligns with a slow, birth-giver centered postpartum. Each culture might have different foods, herbs and wares but there are so many similarities that understanding these universal principles can shed light on how we can align with these time-tested approaches.
As a Holistic Nutritionist that specializes in postpartum care, I work to treat the whole person using food and herbs first. Robust, mother centered care that is focussed from day one on meeting the needs of a newly-born mother first. The pillars of care are well covered in phenomenal books that have helped the movement to reclaim postpartum. (My website has a list of these books if you are interested in reading them). Here, I am reshaping this framework a bit to blend traditional ways with the modern demands of life after baby. I am hoping to encourage deeper consideration so we can adjust our mindset and embrace the intensity of this time.
Rest and Restore
Photo by Dana Tentis
Make the commitment for Deep Rest - notice I didn’t necessarily say Deep Sleep. That, of course, would be glorious - but alas new babies aren’t in agreement! Making this conscious commitment is going to look different for everyone. Too often we regard sleep as an indulgence and luxury, at times it’s almost a division of the HAVES and the HAVE NOTS. First off, staying in bed after baby is one of the ways we reclaim postpartum. Prioritizing this sacred time to heal and bond with baby is paramount and should not be considered a luxury. Rather, we should recognize that adequate sleep is just as important for overall health and even more so when we are healing from birth.
We work towards Rest & Restore by using this lovely framework:
Sanctuary Space: Generally this is your bedroom stocked up with most things at arms reach including a breastfeeding station, access to water, reading material, self care items.
First week postpartum, staying in bed one full week almost ALL of the time. This means not getting out for anything but bathroom visits and midwife visits.
Second week ‘touching’ the bed. This means more sitting up, some very light stretching in the bed to keep up circulation, very light self-massage.
Third week is ‘near’ the bed. We are staying out of the main, high activity spaces in the house (kitchen, living room) and remaining under the radar as much as possible. This translates into still being in bed quite a bit but perhaps you’ve gone for a very short walk to stretch your legs or sat and soaked in some sun. This timeframe is among the hardest as often the energy is returning to the birth giver, being still has gotten old, and the tendency to want to commence regular activities is strong. Please consider resisting this. Just like the digestion needs to be nurtured and slowly awakened, so does the body. I often hear from new parents that their bleeding has increased a bit during this time - this is the body screaming that you are doing too much too soon.
Diet of the Mind: I mention later in this writing that diet is an ugly word in our house. However, a diet of the mind is more about restricting what we spend our mental energy on. A slow postpartum might mean only checking your phone a few times a day instead of the constant scroll. It might mean not watching or reading the news for a bit. It might mean skipping over that loud, violent movie. The raw vulnerability during this time can linger, we want our hearts and minds filled with beauty, calm, and tenderness.
Practice Yoga Nidra: No poses required! This ‘yogic sleep’ illustrates why rest can be ALMOST as good as sleep (almost). Studies have shown that 30 minutes of a yoga nidra practice is equal to 2 hours of sleep. While not perfect, the guided nature and gentle attention to breath will help move the body from fight/flight (sympathetic nervous system) to rest/digest (parasympathetic).
Horizontal Days: I love this phrase from Chrystal of Feminist Oasis as it’s just the most perfect visual. Once we move out of the first 21 days postpartum, we must still be slow and remain horizontal as much as possible.
In the immediate postpartum, this might seem nearly impossible. Feeding every 3 hours makes long stretches of sleep nearly impossible. Perhaps there also may be older siblings in the picture adding another layer to manage. Or maybe babe is fussy, gassy or glued to boob. What I am saying is that the above isn’t always feasible but that doesn’t mean it is not a worthy endeavor and care plan to strive for. Instead work to create a support system that understands this goal so that the road to feeling more rested, balanced and grounded becomes attainable.
Some thoughts if they work for you: Let the person breastfeeding sleep while the other stays awake (practice safe sleeping), sleep in shifts, sleep bank to help offset sleep debt (sleep every chance you get even if you don’t necessarily feel tired), enlist the help of loved ones and trusted professionals (hire a postpartum doula, night nurse), let people wait on you. Why? It's not to spoil you, although you deserve that, your body vitally needs this deep healing.
This all might feel strange but it's an excellent way to kick off your Fourth Trimester.
Resist the urge to DO the things, to FIX the things, to CLEAN the things, to ENTERTAIN the visitors. Lack of restful sleep for new parents is no laughing matter, we casually joke about it but the cumulative effects of not getting relief are dangerous. The issues with sleep deprivation are well documented but just in case you are unaware, “the greater the sleep debt, the less capable we are of recognizing it: Once sleep deprivation — with its fuzzy-headedness, irritability, and fatigue — has us in its sway, we can hardly recall what it's like to be fully rested. And as the sleep debt mounts, the health consequences increase, putting us at growing risk for weight gain, diabetes, heart disease, stroke, and memory loss.” (Harvard Medical School)
To restore means to bring back. Part of matrescence is realizing our body is ours again. Well somewhat ours again - if we are breastfeeding, we now have a new (and beautiful) demand on our body. The truth is our body is indeed different - that part does not need to be fully restored. Embracing the evolution of being a newly-born parent means restoring some autonomy and restoring a baseline for health.
Photo by Autumn Wells of Autumn Bliss Photography
Replete and Remedy
You often hear people say that they were their most healthy when they were pregnant. Great! Growing a baby is indeed demanding on the body and paying attention to what we put in it and do to it only benefits everyone involved. When we enter this new journey after baby, so much of the focus gets shifted from pregnant person to this new little sweet squish - it’s not just society that does this, new parents sacrifice their own health to meet the demands of this intense timeframe. We are, afterall, ‘the parent’ and it’s our job to put our kids first, right? Right!? Well, sort of. The adage you can’t pour from an empty cup is so often used in mothering circles as a call out for “self care”. The reality is we can and we do…….mothers are badass like that. But it is costly and expensive to the body, mind and spirit. If we don’t stop and remedy this, we cannot sustain.
"If a new mom isn’t allowed to fully recover from the demanding requirements of pregnancy and birth, the aftereffects can last for years. I’ve treated women who were still depleted ten years after their babies were born.” Dr. Oscar Serrallach
Food has been used for healing since the dawn of time. When we talk about Postpartum Nutrition, we are really talking about providing conditions so there is active repair & replenishment in the body - we are looking to replete and remedy the demands that have been laid on our body. Once again we can look back on our history and see that these food rituals are a staple across many cultures except the fast paced US where we are told to keep taking a prenatal vitamin at our measly SOLO 6 week check up. Instead of understanding the postpartum body, the emphasis is placed on getting back on your feet the fastest for some non existent badge of honor.
Quite frankly, nutrition is an area that many allopathic doctors aren’t up to the latest in understanding - many receive an average 15 hours of nutrition education in their entire MD education. While this is slowly changing, many do not have an understanding on how to live optimally never mind the idea of replenishing the body after it’s been taxed through pregnancy and even more while breastfeeding.
After gradually growing a human, we experience drastic swings that are unlike any other time in life. To replete and remedy the body, new parents deserve a repletion protocol that is unique to them. Using healing foods that our ancestors perfected combined with modern day knowledge of nutrition & science is the cornerstone of our practice at Small Batch Wellness.
The truth is that I do not advocate for one type of ‘diet’ over another. It’s a bit of a bad word around this house and if we were speaking about postpartum specifically, we definitely would not be talking about any other diet other than the one of love, nourishment, healing and rest. In school, we (Holistic Nutritionists) are taught to advocate for a robust eating style that is rooted in plants (60%-85%) and utilizes properly sourced animal protein to complement. While we might have a discussion about reasons, there is plenty of room for vegetarians and vegans if that’s your jam though. Simply put, promoting low-inflammatory, nutrient-dense options, that are rich in good satiating fats (and later in postpartum diverse ferments). There aren’t any tricks to this. Anyone selling a meal replacement powder or package simply does not understand how food as medicine works.
More specifically to postpartum, new mothers need to be warmed - this is true whether it is January in Maine or July in the south, the drastic changes create a vulnerability to all parts of a person that requires foods to be warming, well cooked, easily digestible and nutrient rich.
Let me say that again for the people in the back as this is that important. The backbone of postpartum nourishment, repletion and healing begins with using the framework of warming, well cooked, easily digestible and nutrient rich food. These are some of the universal principles seen across a myriad of cultures. We ‘warm’ a mother to rebuild their blood, support sluggish digestion, aid in absorption, ease more fluids into the body, assist the process of involution.
Here is the thing that many people (including many healthcare providers and ‘coaches’ miss), just because something is nutrient dense and may help optimize health, it doesn’t mean it is appropriate for the postpartum state.
Frozen smoothies, raw salads, iced drinks, dry granola, may all be deemed beneficial however, simply put, they are tremendously hard on digestion. The postpartum, breastfeeding body demands more nutrients than a pregnant body; then layer in settling organs, hormonal swings, poor absorption (gut health), nutrient poor food. Lastly, we also want to be aware of what foods do in our body - do they inflame, bloat, cause gassiness? Do they over do the spiciness (warming doesn’t mean super spicy), are they laden with gmos, glyphosate, and chemical ‘food stuffs’? We are leading mothers astray when in reality this is a finite and short period of time to instead provide gentle and supportive conditions to create balance and repair.
All of this being said, I can’t miss the opportunity to provide some clear starting points to focus on. Generally, the holistic approach would be to use food and herbal support as a starting point to address what the body needs. However, for the reasons mentioned above there are other factors at play here making it wise to consider supplementing micronutrients (vitamins & minerals).
By no means does this all need to come in supplement form, this is meant to encourage self education and self-advocacy on what is best for your postpartum body. Understanding the role of Iron, Omegas, Folate, Vitamin D3, Magnesium, Calcium Zinc, and all the rest of B vitamins and why they are vital. Under the guidance of your Midwife, RD or Nutritionist, consider additionally supplementing DHA, Vitamin C, Vitamin D3, K2, B Complex, Probiotics, Desiccated Liver (iron)...and yes, it is indeed wise to stay on your prenatal vitamin as well. While this doesn’t cover all of the bases and should be individualized, this is a starting point.
I would also be remiss if I didn’t mention the importance of three more things. Hydration, good fats and plant medicine (herbal support). To way oversimplify, hydrating with both water and electrolytes (try my electrolyte drink here) is the gas that makes your engine go. Fats are how the medicine gets in, we need to absorb all the goodness we are putting in the body and our herbal friends work to balance it all out.
In the spirit of keeping it real, I’d like to also say that postpartum eating can be cathartic and can be an essential part of feeling more like yourself. I’d like to acknowledge and validate that. While we are focussed on healing and resting, sometimes eating that damn piece of pizza is what needs to happen because that heartburn that’s been kicking your butt has finally subsided. Enjoy it! You deserve it! You won’t fall off the postpartum nutrition train if you feed your soul as well as your belly. There is no food police. Sure there is still some navigating that needs to happen especially when breastfeeding ( i.e. limited high mercury fish) but nourishing yourself isn’t JUST about nutrients. Just like in pregnancy, our cravings sometimes provide insight into some micronutrients that are lacking so talk about it with your healthcare professional if it’s a constant craving.
It is also worth noting that a person in their 4th Trimester would be cared for differently than one 6 months postpartum and one 6 years postpartum. Yes, postpartum depletion lurks and lingers until it is addressed in the body. All stages can be equally depleted but addressing repletion might look slightly different.
Receive and Reclaim
The art of receiving is not necessarily a simple, straight answer. Many of us feel uncomfortable or awkward having people help us. Why do you think that is? For some, it’s a part of their genetic make up, Type A personality. For others it makes them anxious to have people in their personal spaces. For others, it’s a loss of control. In the last 2 -3 generations, society has shifted to become a nuclear family instead of multiple generations living under one roof. We no longer mirror what our ancestors and scores of other cultures have done throughout the ages. Our built in support is no longer immediately present in our day to day lives so visitors often feel more like guests that need hosting and entertaining. Newsflash, this is not conducive for an environment of healing and bonding. Honestly, aside from a fascinating anthropological discussion and a full on therapy session, bottom line will be getting our head around accepting help from trusted, loved ones. Knowing and acknowledging in advance the areas that might trigger this is one way to get moving through it.
Receiving help can look like anything from having a tray of food being brought to you in bed. Having someone in your house putting dishes away (probably in the wrong place). Taking up a neighbor's offer to walk the dog. Have a postpartum plan on your fridge or counter to make some of the ways they can help clear and obvious. (Reach out on my website for a simple worksheet to use).
Moving deeper into healing, it could also be going to support groups, having a lactation specialist offer guidance, hiring trusted professionals to take some of the load off. It can look like talk therapy (yes, please everyone consider this), a relaxing massage, coming to grips with pelvic floor challenges, or sharing a birth story.
Making clear boundaries can be quite a challenge when we are doing something different than our parents and grandparents did. If you are inclined to elaborate, gently explain that it is important as new parents to make your own way, own your decisions, get some time under the belt, and learn lessons. This does not mean going it alone, this means harnessing the good intentions of people and limiting everyone else's agenda except your own. Let them know that you are looking to be supported AND empowered. Most people want to help and giving them clear and specific ways combined with strong, clear boundaries is a recipe for receiving in a way that feels more comfortable for everyone.
An important element in receiving is compassion for self - often an elusive part of ‘self care’. It is loving-kindness that needs to be cultivated here. When we understand that we vitally need to and deserve to receive this type of care, we can do so with more grace.
Receiving feels more like active and empowered versus passive and accepting. We can then begin to reclaim the precious window of time. The power is in the education of the postpartum planning, the power is in the confidence this education brings, the power is in a radical awakening of loving kindness.
Maternal health is suffering. Mood disorders are running rampant. We have a society of depleted, isolated and longing mothers looking for connection. We can shift this conversation by normalizing deep, birth-giver centered support. If you are a grandparent or elder, support our birthgivers with their choices even if it looks different than in your day. It is our job as a society to embrace and hold up our newly-born parents - let’s just assume that they need help. Collectively, we can cultivate generational healing and reclaim this sacred time.
About the author:
Meg, founder of Small Batch Wellness is a Holistic Nutritionist who specializes in postpartum care. Established in 2015, Small Batch Wellness works locally and virtually with clients in all stages of healing and repletion to facilitate deep nourishment. Meg blends her knowledge in modern-day, evidence-based nutrition with Ayurveda & folk herbalism to create a protocol specific to the birthing person. Meg will provide in-home (bedside) meal services combining nutrient-dense foods and herbs with time honored ancestral approach to postpartum.
Find her @smallbatchwellness | smallbatchwellness.com