Circumcision: How to decide?

As a childbirth educator, there are a couple of topics that fill me with dread when addressing a group of soon-to-be parents, and one of them is circumcision.

If you’ve spent any time at all on the internet as it relates to parenting, you may have noticed that this topic can spark some very heated discussion, so much so that it can be hard to wade through the rhetoric to find solid information. Folks hold some strong opinions on this topic—and for good reason! The decision whether to circumcise or not will carry into every day of a boy’s life. So, how to give accurate information that will help parents decide? Here’s how I do it:

There are basically 3 things for parents to consider in deciding whether or not to circumcise their baby boy:

Religious or cultural reasons

On this point, I don’t figure I have too much to contribute as a childbirth educator, though occasionally I have helped Jewish clients who did not want to circumcise to explore the idea of holding an alternate ceremony (known as a brit shalom).

Aesthetic reasons

These usually fall under the headings of: “wanting him to look like Daddy” or “wanting him not to be bullied in the locker room.” Again, I don’t feel that I can speak to one person’s sense of what looks right or wrong, and I particularly don’t need to know which of the fathers in my class were circumcised or not. But I can note that since the rate of infant circumcisions performed nationwide in the US is around 55%, there is a high probability that there will be another boy in the locker room whose penis looks like your kid’s, whichever route they choose to take.

Health benefits and risks

Since I work very hard to research and present information based on current research evidence in my classes, this final category is the one to which I can really speak. And it can be surprisingly hard to sift through the claims that are out there about risk and benefit!

The American Academy of Pediatrics has been equivocal, to be sure. Their current statement on the one hand seems to endorse the practice, and on the other hand it doesn’t. This statement can be found on their website for parents:

“The American Academy of Pediatrics believes that circumcision has potential medical benefits and advantages, as well as risks. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it, however, existing scientific evidence is not sufficient to recommend routine circumcision.

Therefore, because the procedure is not essential to a child’s current well-being, we recommend that the decision to circumcise is one best made by parents in consultation with their pediatrician, taking into account what is in the best interests of the child, including medical, religious, cultural, and ethnic traditions.”

Their longer policy statement can be found here and the very detailed and long article from the task force behind the policy statement is here.

So, according to the AAP, the benefits outweigh the risks, but not so much as to become “essential to a child’s current well-being.” Which leaves us where, exactly?

I did my best to dig for solid numbers, and came up with this handy chart to compare benefits and risks. Let’s work our way down the list together, shall we?

circumcision infographic

Yes, Circumcision is painful

First off, circumcision is painful, and medical professionals recommend adequate pain relief both during the procedure and during the healing process (which takes about a week). The choice to circumcise your baby means he will feel pain, and there is always a small risk that he will have an adverse reaction to the pain medication.

Complications can occur

Further, the choice to circumcise means incurring the risk that there will be complications to the procedure. It is basically impossible to get hard numbers on this, since there is no universal reporting standard on complications. The numbers in my chart are a good guess. Mild to moderate surgical complications include: irritation of the glans, infection, excessive bleeding, painful urination, or scarring of the urinary outlet. The much more rare severe surgical complications include: hemorrhage or having too much skin removed. Some babies will need to have the procedure redone, either because the first attempt was inadequate, or because the skin re-adhered while healing.

For a small number of babies whose parents chose to leave them intact, they will develop a medical reason (often phimosis) that will require circumcision in adolescence or as an adult.

in tact baby boy

Perceived benefits of circumcision

Now we get to one of the benefits of infant circumcision: the reduction in risk of UTI. It is important to note that most UTIs in males occur in the first year of life, but overall incidence is still low at 1%. Baby boys who are circumcised do have a three to ten-fold reduction in risk of contracting a UTI in the 1st year of life.

Sometimes a reduction in the risk of penile cancer is mentioned as a benefit of circumcision, but the overall incidence of this type of cancer is so low, that the slight reduction in risk for circumcised men is barely statistically significant.

Finally, the other major purported benefit of circumcision is the reduction in the risk of contracting HIV and some other STIs. There have been several high quality studies done in Africa that show significant reduction of these risks. Whether their findings can be generalized to the population of American men is debatable.

It is important to note that rates of contracting sexually transmitted infections are affected to a high degree by socio-cultural influences. For example, the rates of circumcision in Northern Europe are much lower than the United States, but their STI rates are much lower as well. Regardless, the reduction in risk for circumcised men would not be completely protective. In other words, parents would need to teach their sons to wear condoms.

And on the somewhat uncomfortable topic of considering one’s baby boy’s future sex life, it is debatable whether adult men who have been circumcised experience diminished sexual satisfaction and function. I’m not sure whether this could ever be definitively proven, but there are certainly plenty of people who like to argue this point.

And that’s it. The risk/benefit ratio for circumcision as it regards to health concerns. You can see why the AAP has had a hard time making a definitive recommendation in favor of circumcision. It is, as they wisely put it, a decision that parents must weigh for their own sons. If you want to read more science-based conclusions, check out The Informed Parent: A Science-Based Resource for Your Child’s First Four Years.

This guest post was written by Stephanie Spitzer-Hanks. Stephanie gave birth to her first child in the Netherlands, where the nurturing and encouragement she received from so many women there inspired her to become a doula. Now she strives to give unconditional support and evidence-based education to families so that they can be confident in making the choices that are right for them. She is an ICEA certified childbirth educator, an Evidence Based Birth® Instructor, a DONA certified birth and postpartum doula, a StillBirthday certified bereavement doula, and a certified lactation counselor through Healthy Children’s Center for Breastfeeding. On the side of all of that, Stephanie is an ordained minister in the United Church of Christ, and she serves as a chaplain at a hospital and writes and speaks about birtheology when she gets the chance. You can find out what she is up to at www.revdoula.com.

Cesarean Birth Postpartum Recovery

Whether you have a planned or unexpected cesarean section birth, the recovery can present challenges for any woman and being prepared for certain possibilities can help relieve you of added stress. After all, this is major abdominal surgery affecting nearly one-third of women in the United States and even higher numbers in some other countries; c-section prep and recovery are definitely worth thinking about and planning for, no matter what kind of birth you have in mind.

In Hospital Cesarean Recovery

If you know ahead of time that you will have a c-section, here are some things to bring and what to expect of your stay after delivery.

c section birth

What to bring to the hospital

Aside from your normal hospital bag, these few extra items might be helpful.

  • Nice shampoo and lotion. Your favorite shower items can be a nice way to treat yourself.
  • Clothing. Definitely do not pack anything restrictive that could cut into your incision area. Maternity pants, sweats, and robes are all good options. These high-waisted panties have great reviews for c-section comfort and a bit of support.
  • High fiber snacks. Many women report some degree of GI pain and discomfort following surgery, and constipation is not uncommon. Having some fibrous foods on hand to eat during your stay can aid in normalizing your bowels. Pack some easy snack items to munch on between meals. Apples, oranges, pears, berries, nuts, and dried fruit are all good options. Remember to drink as much water as you can!
  • Slip-free shoes. Slippers with rubber soles or flip flops will be handy when you go for laps around the floor and to the bathroom. It may be difficult to regain your balance post-surgery because you use all those core muscles that are currently on the mend. So make sure your shoes have good grip.
  • Fabric wrap for your waist. Purchasing a belly band or bringing some stretchy fabric to wrap snugly around your waist can really help with added support when you are moving around post-surgery. Even coughs and sneezes can be quite jarring to your incision area, so having that core stabilization is nice. It also helps to encourage your abs to come back together after separation during pregnancy (diastasis recti). Holding a pillow tight around your stomach when coughing or sneezing can also help ease the pain, but having a wrap or belly binder allows you to have support and free up your hands for holding your new baby.

What to expect post surgery

Hospital policies vary but a three or four day stay is most common. Recommendations for getting up and walking will vary based on the type of anesthesia you were given as well as how your body responded to it, but it’s not uncommon for the staff to have you up and walking around after approximately 12 hours. If 12 hours post-op falls in the middle of the night they will probably keep the catheter that was placed for surgery inserted and wait until the next morning. Some hospitals don’t suggest getting up to walk until 24 hours following surgery. This is something to discuss with your doctor to decide what is the best course of action for you personally.

Mobility After Cesarean Birth

The reasoning behind getting you up and moving as soon as is safe is to encourage good blood flow to your extremities and prevent clots. Walking will also help with digestion, but will likely wear you out, so don’t overdo it. Taking a lap around the floor every couple of hours is probably sufficient.

While you’re still in the bed you’ll likely wear cuffs around your lower legs that occasionally pump up with air and squeeze tight. These compressions lower the risk of blood clots when you are less mobile.

pospartum recovery cesarean

Gastrointestinal Issues

Some women may feel very gassy and bloated. This can make it uncomfortable to try to pass gas as well as cause discomfort to your incision area where the muscles used for bowel movements are still healing from surgery. Answering questions about whether you’ve passed gas or had a bowel movement yet can be embarrassing but the staff needs to know your GI tract is back up and working to ensure you don’t have any complications there.

Your first bowel movement can be a nerve wracking event. The act of pushing can be painful to your healing muscles so you’ll be given stool softeners beginning right after surgery to help minimize the amount of pushing required. Many women report the anticipation of pain during a bowel movement was much worse than the actual pain experienced while some women do experience severe discomfort.

Anesthesia, surgery, narcotic pain relievers, and decreased mobility can all contribute to constipation so it’s important to take the stool softeners regularly, drink plenty of water, eat wholesome fiber rich foods, and be as mobile as your energy and pain level permits to help alleviate possible GI issues.

Uterine Recovery

Following all types of birth the uterus needs to contract in order to expel any remaining blood or tissue inside of it. Some women report no noticeable afterbirth pains (the uterine contractions that occur after baby is born), while others experience such strong ones that they equate them to labor pains.

Whether yours are mild or strong, they serve a purpose. It’s important for your uterus to begin the process of shrinking back down to its pre-pregnancy size. The nurses will need to assess the size and firmness of your uterus but palpating your abdomen. This is typically a fairly uncomfortable assessment whether you’ve had a cesarean or vaginal delivery. They have to press down hard to accurately assess the size of your uterus as well as how firm it is.

A shrinking, firm uterus is what they are looking for, whereas a ‘boggy’ uterus could indicate a problem requiring medication to help it contract more. The act of pressing down on it through your abdomen can help it along as well, and while they don’t usually have to press down very long it can be painful. The nurses will use this time to assess your level of bleeding as well. We recommend this afterbirth tincture.

Postpartum Bleeding

Many women are surprised to learn that following a c-section you will still have very heavy vaginal bleeding, just like vaginal deliveries. This lasts for about 4-6 weeks and the protocol is the same—no tampons allowed, only big absorbent pads. Your caregiver will likely provide some large mesh disposable underwear to use after delivery. These are a great option for the first few days following birth as they typically don’t irritate your incision site or put any pressure on that area the way some underwear elastic can—basically they are glorious! Stocking up on these as well as large overnight pads (these are our favorites) is a good idea since you’ll be changing them frequently the first couple of weeks.

Passing some heavy clots is fairly normal. The rule of thumb is generally if you pass a clot smaller than your fist, it’s okay. Anything larger—call your doctor.

preparing for cesarean

Cesarean Incision care

Following surgery, your incision will be covered with a bandage that usually isn’t removed until the next day. Your incision will either be closed with sutures (dissolvable or non-dissolvable), staples, steri strips, or surgical glue on your abdomen. Staples and some types of sutures will need to be removed by your doctor a few days after you’re discharged. Before being discharged you will be given incision care instructions specific to your type of closure.

Keep in mind that your incision will look very different immediately after surgery than it will eventually. Most incisions will shrink down considerably and flatten to a thin line. Itching and tenderness around your incision is normal but annoying, anything more severe than that would warrant a call to your doctor. Try this spray or salve for expedited healing and scar reducing.

Advocate for Yourself at the Hospital and Home

Recovering from surgery, adjusting to new motherhood, getting the hang of breastfeeding—the first few days after a cesarean can be stressful and overwhelming. It’s important to make your needs known to the staff. If they don’t know your wishes, they can’t follow them. It’s your job to advocate for yourself and your new baby. Be open and clear with the hospital staff and expect the same from them—you’ll both benefit from respectful and clear communication. Never be afraid to request a new nurse if you aren’t receiving the care you feel you need or even if your personalities are not meshing well.

You never get the first few days with your new baby back again and they’re too precious to have marred by having someone around who puts you on edge, this goes for visitors and family as well. While well meaning and excited for you, visitors and family often end up putting more strain on mom than support. If friends want to come see the new baby make them earn the visit! Have them hold the baby while you take a shower or nap. Fold a basket of laundry while you chat. Fix some lunch or start a freezer meal in the oven for you. Have older kids? Ask friends to take them to the park for a hour and let them peek at baby when the come to pick them up.

You might be surprised at how eager people are to help when given specific tasks! But if the thought of a house full of people fills you with dread then don’t put yourself through it. Ask your partner or a supportive family member or friend to spread the word that you aren’t ready for visitors yet but appreciate everyone’s well wishes and put a sign on the door with the same sentiments.

what to pack for hospital

Breastfeeding after a Cesarean Section

The first few days, your breasts produce a nutrient-dense, antibody-rich yellow liquid called colostrum. Colostrum is nature’s first perfect food for baby and provides all the nutrition, immunity, and vitamins your baby needs. Colostrum usually transitions to mature breast milk within 2-6 days of delivery. It’s not unusual for milk production, or ‘coming in’, to be delayed following a cesarean due to the use of IV fluids and other medications such as Pitocin. Once this occurs your breasts will be much larger and you may experience some engorgement. The best remedy for the discomfort of engorgement is removal of milk from the breast by the baby. Your baby will signal the amount of milk she needs your breasts to make and your supply will normalize. There are wonderful breastfeeding resources to be found here.

Some women have no additional difficulties breastfeeding following a cesarean than after a vaginal delivery but some find positioning difficult while their incision area is still tender (we love this breastfeeding pillow for keeping off your incision). Utilize the lactation consultants at the hospital as much as you need them while there. It’s a great idea to have an outpatient lactation consultant’s contact info saved already prior to delivery in the event you need more assistance following discharge. Ask friends who have had fulfilling breastfeeding relationships with their children for references to check out before you’re home with a new baby, sleep deprived, and probably pretty emotional.

The International Cesarean Awareness Network has some great info available regarding breastfeeding after a cesarean that can be found here. Kellymom.com is a great breastfeeding resource website in general and wonderful article about breastfeeding after cesarean can be found here.

Recovery at home after Cesarean Birth

recovery postpartum cesarean

photo via @littlewhale3

Bringing a new baby home is an exciting time for everyone, but don’t forget to take care of yourself as well. Your baby needs a cared for mother as much as she needs to be cared for herself. Accept offers of help! People love to feel useful but may not know how best to help or are hesitant to step on toes. Give them direction and don’t be afraid to set boundaries when it comes to having people over. Physically, you’ll need to take it easy for a while. It’s often recommended that you not to lift anything heavier than the baby or drive for 2 weeks. After that, follow your body’s cues and rest as much as possible.

The best way to encourage a speedy recovery is to allow your body the time it needs to heal. Rushing the process can result in setbacks that will only prolong it. Once you feel up to it, which will vary for every woman, light exercises like walking can be beneficial.

Medication After C Section Birth

The types of medications prescribed for pain will vary from doctor to doctor and patient to patient. Ask someone (like your partner) to keep track of what time you take your medications as trying to remember on a sleep deprived brain is probably not the best plan. Many people recommend taking the meds on a strict schedule the first few days regardless of whether you’re in enough pain to feel you need it yet. This is suggested to prevent the pain getting ahead of you and then having to wait for the meds to kick in. Some people prefer to begin a slow weaning process off of the meds sooner if they don’t like the way they feel on them.

Pay attention to your reaction to the meds and to your pain level and make the best decision for your body. Don’t hesitate to call a nurse or doctor if you are concerned about any symptoms. There are many post-surgery symptoms that while totally benign, can alarm you if you haven’t experienced them before. Reach out for information when you need to.

Some women report referred pain in their shoulder during recovery. Not all women experience it, and it seems to be worse for patients who had general anesthesia vs. spinal anesthesia. The pain is due to irritation of the diaphragm, and trapped gas. Anti-gas medication and walking will help. The more regular you can get with your bowels, the sooner the pain will subside.

advanced maternal age

Bed comfort for Cesarean Mamas

Keep that wrap handy for when you get in and out of bed, to help with support. Wrapping before you get up and lay down provides stability and a little bit of comfort. Feel free to even keep it on for a while so you don’t have to constantly adjust it. Some women find it difficult to get up from a flat lying position in bed. Roll on your side first and push up with your hands to prevent straining your abdominal muscles. If this is still too uncomfortable try putting several pillows behind your back and rest or sleep in a reclined position. Your pelvis will be working to get back in its pre-pregnancy position and can ache after delivery. Try sleeping with a special pillow between your knees and ankles to help alleviate some pressure.

Night Sweats

There are lots of hormonal changes that take place right after delivery, and your body is also getting rid of a lot of excess fluid it carried while pregnant as well as any intravenous fluids given before, during, and after surgery. All of these factors combined might have you waking up at night to find the bedding and your clothes completely soaked. For the first couple of weeks, some women sleep on an extra sheet folded in half, or a towel so they can remove it midway through the night to have clean linens beneath them. Others suggest having clean pajamas handy for a quick middle of the night change. Remember to keep drinking a lot of water. It sounds counter-intuitive to replace excess fluid you are losing through sweat, but remember how much water is going toward milk production, so it’s necessary to keep things functioning well, and restore balance.

Mobility After A Cesarean Birth

For some women, stairs prove to be tiring and awkward to navigate the first couple of weeks. If possible, you might consider setting things up at home so that all the supplies for baby and for yourself will be mostly on one floor. Then stay in that area most of the day minimizing the need to navigate the stairs repeatedly. For other women the lure of being in their own bed on the second floor is enough to make it worth it. Just don’t hesitate to ask for help going up and down, even just having someone walk along beside you can be reassuring.

Keep in mind that your center of gravity has drastically changed and your body is still adjusting to that as well as healing from surgery. It’s not uncommon to feel off balance and it’s better to have help nearby just in case. Consider having pillows handy on both floors should you need to squeeze one against your abdomen while coughing or sneezing. Plan to give yourself plenty of time to recover, should it happen sooner than you planned—it will be a pleasant surprise! Be gentle with yourself.  All women are different. There is no ‘right’ amount of time for recovery. There are no hard and fast rules for a healing timeline. Listen to your body, introduce things slowly back into your routine, and ease into motherhood.

cesarean stitches

photo via @chan_askins

Emotional Recovery after Cesarean Birth

Take time to evaluate your feelings about your cesarean experience. Mothers with planned cesareans have the opportunity to consider this beforehand but may still find themselves overwhelmed with conflicting emotions after the fact. Mothers who had an unexpected cesarean may feel blindsided and it’s important to take stock of all of these emotions and know that they are all valid.

It’s ok to feel disappointed in the way your baby was born. If you had planned for or envisioned things going differently, it’s completely normal to be sad it didn’t work out that way. This does not take away from the love and joy you have for your child. You can be deliriously happy that they are here and still be upset about how they came. Birth trauma may sound like a dramatic way to describe it but it’s not uncommon for women to experience varying degrees of trauma after a cesarean birth whether it was planned or unexpected, or especially if it was an emergency situation.

Your Feelings Are Your Own

Birth is a highly emotional experience and any emotions you have towards your child’s birth are valid and you are not alone in feeling them. Perhaps your cesarean was calm, you felt respected, and things went smoothly—this is the hope for all women experiencing a cesarean. Many women feel at peace with their sections and might not understand why others are seemingly devastated by theirs. Other women are deeply saddened by having had a section and cannot fathom why someone would choose to have one unless necessary.

When speaking with other mothers or mothers-to-be, be respectful of others’ experiences and perceptions of their experiences. Just because you loved your c section doesn’t mean another woman is wrong for disliking hers. Just because you hated your experience doesn’t mean another woman is wrong for liking hers. Evaluate and process your own feelings towards your cesarean and reach out for help.

Find others who can be supportive of your journey of processing your cesarean. The International Cesarean Awareness Network provides support, education, and advocacy for women experiencing cesareans and interested in VBAC (vaginal birth after cesarean.) ICAN can be found online here as well as on Facebook and Instagram. They have local chapters across the world which can be located on their website. Many of their chapters have individual Facebook groups and hold in person meetings for support. Talking to other women who have experienced a cesarean is an invaluable resource for processing your experience as well as planning for a cesarean section or a VBAC.

Birth is hard. Birth is beautiful. Birth is transformative. Take the time to take care of yourself and be proud of what you’ve accomplished and experienced for your new baby.

This guest post was written by Austyn Smith and a very special thanks Laura Shawver and Elizabeth Quinn who provided lots of great information while writing this post.

Resources

  1. Hamilton BE, Martin JA, Osterman MJK, et al. Births: Final data for 2014. National vital statistics reports; vol 64 no 12. Hyattsville, MD: National Center for Health Statistics. 2015. https://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf
  2. Althabe,Fernando; Belizán, José M.;  Betrán, Ana P.; Gibbons, Luz; Lauer, Jeremy A.;  Merialdi Mario. The Global Numbers and Costs of Additionally Needed and Unnecessary Caesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage. World Health Report. 2010; Background paper, 30. Health Systems Financing. World Health Organization. 2010. [January 22, 2017]. http://www.who.int/healthsystems/topics/financing/healthreport/30C-sectioncosts.pdf
  3. Basar, Birsen; Cift, Tayfur; Olmez, Fatma; Ustunyurt, Emin; Yilmaz, Canan. Shoulder Tip Pain After Cesarean Section. Journal of Clinical and Diagnostic Research. Ausust, 1, 2015 [January 22, 2017]. Bethesda MD: National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4576593/

Best High Waisted Panties for Post-Baby Bodies

Note: My body looks nothing like these models and I actually tried to get some real-life pictures for you but failed miserably! You’ll just have to trust that these undies look amazing on me and my post-baby pooch!

After giving birth, for most women their tummies just aren’t the same as they were pre-baby. Even when (if!) you lose all the pregnancy weight, you are often left with what I fondly call my postpartum pooch. Due to this pooch, I’ve become a diehard fan of high waisted pants that hold everything in and don’t cut into my belly. Lucky for me, high waisted pants are in style! If you’re curious, my favorites are these jeans and these leggings.

Once I started wearing high waisted bottoms every day I realized just how annoying it was to have a low rise bikini panty and began my search for high waisted underwear that don’t look like granny panties. When I told one of my close friends that I would send her a list of my favorites she said that compiling a list would be a public service to moms everywhere and that I should share it with the world, so here we go!

Most Flattering – Knock Out

high waisted panties

The Knock Out brand is my absolute favorite and my latest discovery. They offer high waisted underwear that feel supportive without looking like granny panties AND without squeezing you so hard you have diarrhea (side eye at girdles and some types of Spanx).

Most Support: My favorites are these high waisted bikinis which come in black or nude. I recommend sizing up one for reference I wear a medium in Hanky Panky and a size 10-12 dress and order a Large in these. They also come in plus size.

Thongs: They also offer this style in a comfy and supportive (HIGH WAISTED!!) thong if that’s your thing. I have one nude and one black thong for the rare outfit that looks better without a VPL (visible panty line).

Light Support: They also offer a high waisted option with a little less support—just thin stretchy lace on the top instead of multiple layers of fabric. These are insanely comfortable but I did put a hole in the lace with my thumb pulling them up so just be careful there! They come in a lot of colors if you’re the type that likes variety in your underwear drawer! They also come in plus size up to 3X.

Most Comfortable – Hanky Panky

hanky panky high waist plus size

Hanky Panky is known for their skimpy one size fits all thongs but they’ve actually expanded their line quite a bit and have some lovely high waisted options worth trying out. While they aren’t quite as high waisted as the Knock Out brand, they cover the parts that matter if you know what I mean. I like them because they are super stretchy, look sexy on and off (as in they don’t look like huge granny panties when they come out of the wash) and they come in tons of gorgeous colors and patterns.

Bikini: My go-to from Hanky Panky is the Retro line specifically the Retro V-kini. It’s super comfy, doesn’t squeeze you and make love handles and doesn’t roll down. It also comes in plus size up to size 24! I’m in love with the leopard print because why the hell not!?

Thong: I also have the Retro thong for those rare occasions when I need a thong. They are actually crazy comfortable (as far as thongs go) and offer the coverage you want with a post-baby pooch. They also come in plus size. I’ve been lusting after this rose pattern!

Most Feels Like You’re Going Commando – Spanx

spanx high waist panties

My days of squeezing into Spanx are long gone but they do have a newer line of underwear that’s less supportwear and more just supportive. It’s called the Spanx UndieTectable line. My favorite style is this one and it comes in a handful of different colors. The only caveat here is that the sizing is way off in my opinion. I typically wear a medium in underwear and I wear an XL in these to keep them from squeezing me into a muffin top. Luckily Amazon has free returns so you can try a couple sizes if you want. They also make a plus size option in tons of fun colors.

For That Time of the Month – Period Panties

thinx period panties high waist

I finally invested in some period panties from Thinx (this link will get you $10 off!) this year and love the hi-waisted option. When I bought mine the side panels were made of lace and they’ve since changed the style to be mesh but I’m assuming the fit is the same.

I ordered mediums and they fit but I wish I’d gotten large because there’s a tiny bit of muffin top with the mediums. They also go up to size 3XL.  

I’m totally a period panties loyalist now (also a menstrual cup loyalist!)—it’s so nice to not have to worry about a leaking tampon overnight (or during the day) and I especially love them for the last day or so of my period when I’m really just barely spotting and don’t want to deal with panty liners. I could see them being really helpful for pregnancy as well when you’re producing so much extra cervical fluid.

* This post contains affiliate links and if you click a link I will receive a few cents at no cost to you. As always all opinions are my own and I have personally tried all of the products mentioned and use them daily!

How to Practice Self Care as a Mother

Upon becoming a mother, I really worried about being a good one. I wanted to fill my child’s life with happiness and comfort, to teach him, feed him, love him, and float from one blissful moment to the next. I’d read a lot books, talked to friends, babysat, and I felt ready. I naively thought the best way to achieve these high expectations was to give everything I had to serving the baby. Isn’t this how “good” mothers do it? After months and months of striving for these unrealistic expectations, I hit rock bottom. One day I found myself in a blubbering mess while on the phone with my boss (poor guy). I couldn’t stop crying. I felt like my soul had been sucked out of me and a hollow robot shell was left going through the motions. Worst of all I was filled with resentment toward my baby and husband, like this was somehow their fault. I knew something was wrong but had no idea how to fix it. The only reasonable explanation I could come to is that I wasn’t cut out to be a mother, and I wish I’d known beforehand.

Valuing Self Care as a Mother

It took several more years of life experience to learn the invaluable lesson and secret to enjoying motherhood and life—The value of self care. In order for me to become the best version of myself I needed to invest time in, and practice loving myself.

I received quick validation as I first started trying this out. I had an obligation fall through one morning and found myself with 2 hours of unexpected free time. I initially started running through my to-do list in my mind and then remembered I was going to start trying more self-care. It was a beautiful sunny day (sometimes a rare occasion in Portland, OR) so I called my good friend to see if she wanted to join me in a walk. She did. We walked and talked and connected on so many levels. I came home completely energized, and felt so good that I wanted to do something for someone else. I thought of my friend *Jenni who just had major surgery and I decided to make her dinner. I surprised her later on and she was so grateful. I was full to the brim. I learned that self-care does not breed selfishness (as I had feared), but rather it breeds a greater capacity to love.

The airline safety advice to secure your own oxygen masks before helping children is a good analogy. If you you pass out while helping your child, due to lack of oxygen, you are no good to anyone. The same goes for motherhood and self-care. You can’t give from an empty bucket; and if you are trying to, what you are giving out is low quality and pretty useless. This is a great children’s book about filling your and other’s buckets.

I adopted this new affirmation from Melody Beattie. “I am a gift to myself and the universe.  Nurturing self-care delivers that gift in its highest form.”  

So, how can a mother invest in herself and still be a useful, productive woman, wife, and mother? I have a few suggestions.

Things to keep in mind when first starting out

self care as a mom

Drop the guilt

Guilt serves one purpose, to alert us when we’ve done something wrong so that we can make restitution. That’s it. It is not helpful to let it creep in where it doesn’t belong and tell us lies about not being enough, or that we are selfish for leaving the children to do something for ourselves. Dismiss the guilt and stick to your guns.  Write down some positive statements and read through them at the beginning of your time. Like these:

  • When I take care of my needs first, I am a better mother.
  • If I fill my bucket, I will be refreshed and ready to face my responsibilities with more energy and joy.
  • I am teaching my children that my needs are important. When they are parents they will understand that investing in themselves is worthwhile.

Start with some ground rules

Boundaries are your friend. Set some for the children and for yourself. These are the rules I follow.  

  • No bothering mom allowed. If my kids disturb me during my “quiet time” they get to lay in their beds for the remainder of the time. More on how to occupy children during Mom’s Time later.
  • Set daily and weekly appointments with myself and treat them as such. If I receive an invitation or am asked a favor that overlaps my scheduled time, the answer is usually no. I have an unbreakable appointment…with myself!
  • No to-do lists allowed. No running errands. I am only allowed to do things that rejuvenate my soul. I keep a list of ideas handy (more on that later).
  • No “vegging out” on social media. Not only is it a time trap, but comparison to social media “perfection” can be a quick recipe for depression. Right now, I need something to recharge me.

Learn to say no

We all love to be “team players,” help out friends, and volunteer ourselves. These are all good things, but they have to be done in balance. I think of the balance as a pendulum. On one side is service to others, and on the other side is selfishness. It can take a lot of practice to understand what it feels like for the pendulum to rest in the middle; a nice balance of meeting my needs and helping when it would fill my bucket to help. I remember the mantra “Just because I can, doesn’t mean that I have to.” I also like to Brene Brown’s philosophy to “choose discomfort over resentment.” It can be uncomfortable to say no to making 60 cupcakes for the PTA fundraiser that’s tomorrow, but if you will be aggressively whipping that batter with resentment, it’s better to decline.

Ask for help

This can be very hard for someone who is used to being a “people pleaser.” Guilt may creep in, but remember the purpose of guilt? To remind us when we’ve done something WRONG! Asking help of people is not wrong. In fact, accepting help provides an opportunity for others to show their love for you. Let one of your friends drive a carpool, or come and fold your laundry when you are sick. Let them love you and your children.

How to logistically make time for self care

babysitting self care

Make a plan

Childcare:  If you have young children at home, it can be tricky to get some time, but can also be the phase with the most urgent need for self care. You might need to get creative. Here’s some suggestions:

  • Set up a babysitting co-op with some friends. Sit down together and assign a few days a month for each of you where you will watch everyone else’s children for a few hours at a time.  
  • See if your community or rec center offers babysitting. Some will give up to a few hours at a time for a small fee. Remember, no errand running allowed!
  • Take advantage of gym time. Many gyms offer a few hours of childcare at a time while you exercise. Use the extra hour after you are done working out to sit in the hot tub or sauna, take a long leisurely bath, do a mediation, or even just sit in the lobby with a magazine or book.
  • Swap with your partner. Choose one night a week that you have “off.”  Hand off all responsibilities to your husband, while you go have some fun for a few hours. He gets another night for himself. This has worked great for my husband and me. I sometimes choose Saturday morning instead of an evening (because I’m usually exhausted by 4pm). That’s awesome too!
  • For some daily peace, instigate quiet time. I have been doing this for years. Right after lunch, the kids know they go up to their rooms for an hour. I usually pull out some activities that are reserved only for quiet time, so it’s exciting for them (books, puzzles, building toys—things that occupy their minds), and they have to play quietly.

They know they have to stay inside their room and I come to get them when their time is up. I get an hour to myself to take a quick nap, read, meditate, connect spiritually, or work on a hobby or project. It’s the perfect break I need to recharge and then I’m ready to see my kiddos and tackle the afternoon. This can also be particularly helpful when you have a new baby. You can even do it a few times a day in smaller doses.

Give yourself an allowance

It makes quite a difference to have money set aside that is just for you. Add it into the budget. Buying something nice for yourself is an act of love, and it makes you feel really good. It is much easier to say “yes” to fun activities, lunch dates, or nights out with friends when you have some money set aside for that exact purpose.  

Get to know yourself

  • Make a list of things that bring you joy. If you are not used to having this time to yourself, you may find yourself wandering around wondering what in the world to do with your time. Take some time beforehand to write down a list of things and activities you love to do. You might have to think back to before motherhood!
  • Think about your personality and your needs. Are you energized by being with people (extroverted) or does that drain you (introverted)? What phase of life are you in? What do you want and need the most right now?  Some good girl talk? A massage? To sleep for 3 hours? A combination?

sleep when baby sleeps

List of ideas for Self-Care

  • Gather a support group of friends that can have “real talk,” and get together regularly. I credit this one thing for my emotional health the past several years, and those girls are my most prized gifts. Our get togethers are safe places where there is love and acceptance, healing and support.  
  • Keep it well rounded. Make a list of physical activities you enjoy, things that uplift you spiritually, and things that are healing emotionally.
  • See a therapist regularly. Even if it’s once a quarter. My college psych 101 teacher stated, “Even the healthiest person will benefit from seeing a therapist.”  
  • Meditate. Listen to guided meditations, long or short. Light a candle. Do it while some tea is steeping. Indoors or outdoors. Meditation classes can also be fun.  Keep a list of affirmations handy. Statements about you as a woman, a person, a mother.
  • Yoga. It doesn’t have to be a physically challenging class (unless that’s what you want!) to be effective. Even some gentle yoga stretches or poses can rejuvenate your body and soul.
  • Listen to an uplifting podcast, book on tape, or music.
  • Take walks in different environments. Get to know your city. Find a peaceful garden, a country road, or a neighborhood with stunning houses.
  • Schedule regular massages.   
  • Take a bubble bath. Add some bath salts or essential oils, light some candles, play some music, read a book. Really use your senses as you soak.
  • Sleep. Make your nap really restful with cozy blankets, temperature, clothes, lighting, and quiet. You’ll awake completely refreshed.
  • Create something. Draw, paint, sew, decorate, write. A friend once said she tries to do one thing everyday that cannot be undone (by the kids!). It makes her feel like she accomplished something.  
  • Discover a new hobby. Take a class, go to a craft store, take up a new sport, make some plans.
  • Do things that enliven your senses. Light aromatic candles, use essential oils, discover new music/soothing sounds, gaze at beautiful or interesting art, snuggle with fluffy blankets or buy a new sweater. Taste new flavors at a restaurant, sample new drinks—seasonal flavors are fun.
  • Write. Start a self care journal. Record your recent thoughts, dreams, and ideas.  Include things you are grateful for.
  • Ask yourself, “What do I need to do to take care of myself today, or for this moment?” Truly listen to yourself, and trust the answer that comes.

Learning to love and care for yourself leads to the best version of you.  It’s a very worthy and worthwhile investment. Best of all, you’ll find an increased capacity and love for your family and others.

Your Immediate Postpartum Plan for Emotional Birth Trauma

Emotional Healing from Birth Trauma

Emotional healing is more long-term than physical healing. Long after your scars are gone and your pain level has returned to normal, you may still be turning the birth story over and over in your mind. If you felt uncared for, if you felt that you weren’t listened to, if you felt that your care providers betrayed your trust, and you were ignored as a person while the birth of your baby took priority, then you experienced a traumatic birth. It doesn’t matter if someone else had a ‘worse’ experience than you—trauma is subjective, and the only perspective that matters is yours.

When I was recovering from my older daughter’s birth, my recovery included self-help techniques as well as actual therapy from a qualified therapist. I am not a therapist, I’m a Self-Advocacy Coach. I cannot diagnose you, but I can tell you about the facts and symptoms around common postpartum mood disorders, and you can use the language of experts to articulate your needs if you decide to seek professional help. Below are descriptions of common postpartum mental illnesses, and tips to address them.

Postpartum Mood Disorders/Mental Illnesses

breastfeeding station

“Baby Blues”

  • 60-80% of women experience “baby blues,” and the clinical definition is moodiness that coincides with breastmilk developing — something that usually happens between the 3rd and 5th day postpartum.
  • While there’s crying, irritability, and sadness, it coexists with the ability to experience pleasure and peace.
  • Most cases only last a few hours to at most a few days, and can usually be kicked with a nap or a pleasurable activity.

Postpartum Emergency

  • This is “Postpartum Psychosis,” a condition the media sensationalizes. It only occurs in 2 in 1000 deliveries, and the biggest risk of harm is actually suicide of the mother.
  • Make sure you seek emergency medical attention and/or hospitalization if you are
    • Suicidal
    • Psychotic (hearing voices, feeling paranoid, having delusional beliefs)
    • There is actual risk of harm to your baby
    • You cannot tolerate being left alone
    • You feel you can no longer cope
    • You are unable to perform important daily activities, such as eating, dressing, or getting out of bed.

Postpartum Depression

  • Postpartum depression includes physical, as well as emotional symptoms. Pay attention to your ability to enjoy life, as well as your connection with your newborn.
  • I want to direct you to the best resource on the web: Postpartum Progress
  • But I also want to remind you that having a newborn is stressful, you’ve just had a traumatic birth, and you may be experiencing disappointment when some of your expectations of motherhood aren’t coming to fruition.  
  • The important thing is that if you think you’re experiencing postpartum depression is that you get help.

Post Traumatic Stress Injury/Disorder

This is perhaps what you came looking for when you wanted to learn about emotionally traumatic birth experiences. The whole diagnosis in the official diagnostic manual is fairly complicated, but the symptoms for post-traumatic stress disorder can be grouped in roughly three parts:

  1. Intrusive memories, thoughts, flashbacks and/or dreams of the event.
  2. Avoidance of reminders, or a general sense of emotional numbing.
  3. Physiological over-activity, as manifested by angry outbursts, hyperactive startle response (fight-or-flight reactions or panic attacks in response to environmental cues that remind you of the trauma), or constantly being on guard.

Category one symptoms are why you’re here: you’re ruminating on the events of the past. But that alone doesn’t justify an official diagnosis. Be aware that avoiding reminders in category two may include avoiding your child—and other types of emotional numbing may include overeating and alcohol abuse. Category three symptoms may be summed as “feeling jumpy” or “paranoid.”

Remember, not all women who experience traumatic birthings go on to develop PTSD. In this case, I think this advice from the book “This Isn’t What I Expected” comes in handy: No list of symptoms will ever replace a careful, individual diagnostic assessment from a professional.

recovering from birth trauma

Exercises for PTSD “First Aid”

If you suspect that you are experiencing symptoms of PTSD, I suggest you try the following grounding exercises, to remind yourself that you’re not actually being threatened right now. They’ll help you believe you’re safe:

EXERCISE: BE LIKE A MOUNTAIN

Sit up at the edge of a chair, with your hands on your knees and your feet flat on the ground. While your body will be well supported like this, it will still engage your body’s vestibular system, which maintains your balance, and thus return your awareness to your body.

Or, do Mountain Pose (Tadasana). First, stand with your feet together, or hip width apart (whichever is more comfortable for you.) Tuck in your tailbone and push your shoulders down and back so that your back is straight. Keep your arms relaxed at your side, and spread your fingers out. Breathe deeply from the belly. This will also involve your vestibular system, as well as awareness of breathing, and should help you realize that you’re in your body and not just a mind floating around.

EXERCISE: NAME THINGS YOU CAN SENSE

There are two versions of this exercise, too.

1.) When you feel yourself hitting resistance or disassociation, name five things in different colors. Name one red thing, one orange thing, one yellow, one green, and one blue.

2.) Or, you could engage all of the senses. Name to yourself five things you can see, four things you can hear, three things you can touch (and touch them!), two things you can smell and/or taste, and one deep, cleansing breath.

This guest post was written by Kate Ditzler. Kate is a Self-Advocacy Coach who works with women who dream of saving the world and are struggling with aspects of their life situations and expectations. These women learn to identify, validate, and speak up about their emotions and needs so that they can live their most expansive lives, coming away with strategies, skills, and sisters for their world-changing role.  She has a Master’s Degree in Public Policy, and her big mission for her work in the world is to solve the problem of feeling unseen, unheard, and unsupported for all women.

Her company is Practicing Empathy, and she has free gifts, such as a checklist to evaluate the extent of your emotional birth trauma, as well as a one-page summary of the federal laws that cover pregnant workers.

Postpartum Recovery From a Vaginal Birth

How to take care of yourself postpartum after a vaginal birth

I often hear women talk about how unprepared they were for their postpartum recovery period. I, myself was completely shocked that there even WAS a recovery the first time around. I thought you just pushed a baby out and then it was all over. I had never really heard anyone talk about it and I somehow hadn’t thought to read about it while I was pregnant. Recovering from birth is definitely something that needs more attention and emphasis as women prepare for labor and delivery. The better informed a mother is, the smoother recovery can go. Here’s some things to expect about the postpartum period, and how to aid your recovery from a vaginal birth.

Perineum care after vaginal birth

First things first—90% of women tear during a vaginal delivery. Ranked from level 1 through level 4, the degree of tearing is directly proportionate to the length of recovery time. This perineal trauma is a very common complaint after delivery, and can leave mamas feeling sore anywhere from a few days to several weeks (the average length of discomfort is one month). There are several things you can do postpartum to alleviate perineal pain.

Take a postpartum herb bath every day for a week

Postpartum herb baths can be taken immediately after birth (along with baby) and as much as you like after that. I liked taking one every day for a week. My husband would prepare the herbs in the morning so it would be a concentrated brew by the evening and I’d start my bath with the baby (they love it and it helps with umbilical cord healing!) and then my husband would take the baby after about 15 minutes so I could lay back and relax until the water went cold. I largely credit my perineum repair to these baths.

Purchase small herbal sitz baths

For a sitz bath, you’ll need a convenient toilet insert that allows you to soak your bottom in several inches of water without taking a full on bath. You essentially fill a gallon bag with warm water and connect it to the plastic insert that sits right in the toilet seat. It fills quickly and you can soak for up to 15 minutes. These are so helpful, because they keep things clean, and also alleviate swelling and irritation, especially if you have stitches or hemorrhoids. It’s recommended to use these every time you use the bathroom for the first few weeks to aid in recovery.

Use a peri bottle

Many hospitals give these bottles out post-delivery. Prior to going to the bathroom, fill a peri bottle up with warm water. Spray it on your perineum as you are urinating to lessen the sting. Pat yourself dry rather than wiping (I used cloth diapers to pat with instead of toilet paper).

Squeeze your glute muscles when sitting and standing from the toilet. This will prevent your skin from pulling on the stitches.

vaginal birth crowning photo

Purchase a donut to sit on for a few days

These allow maximum comfort as you don’t have to put any pressure directly on your perineum. There will be lots of sitting and lounging the next few days, so this purchase is worth it, especially if you have several stitches.

Use an ice pack or cold compress

Do this a few times a day for the first 24 hours or so. This can help with inflammation. Make sure that you have a layer between the ice and skin so they do not come in direct contact. These cold pads are a great option as well. 

Spray your perineum with bottom spray

This is a glorious cooling blend of herbs and witch hazel and it seems to work wonders. It helps with swelling, pain, and itchiness for both perineal pain and stitches as well as hemorrhoids. Plus it has an inverted spray mechanism meaning it sprays easily even when held upside down. Trust me when I say you will want a bottle for each bathroom in your house!

Night sweats after giving birth

There are lots of hormonal changes that take place right after delivery, and your body is also getting rid of a lot of excess fluid it carried while pregnant. These two things combined, might make you wake up at night to find the bedding and your clothes completely soaked. For the first couple of weeks, sleep on an extra sheet folded in half, a towel or a sheet protector. Keep clean undergarments and pajamas handy for a quick middle of the night change. Remember to keep drinking a lot of water. It sounds counter-intuitive to replace excess fluid you are losing through sweat, but remember how much water is going toward milk production, so it’s necessary to keep things functioning well, and restore balance.

After pains also know as afterbirth pains

Your uterus will contract for about a week, every time you nurse the baby, and these contractions (yes they feel like labor contractions!) tend to get more intense with each subsequent delivery. This is nature’s way of shrinking things back to size, and also encouraging the excretion of blood and tissue it no longer needs. Try to think of it as a good thing! I LOVED this tincture with herbs that ease these pains and would put a little under my tongue each time I felt the pains coming on! If the pain gets to be too intense, ask your care provider about taking some tylenol. After about a week or so, the after pains should subside.

Postpartum bleeding

You’ve enjoyed nine months of period-free bliss…now get ready for a massive comeback. Plan on bleeding for about a month to six weeks as your body gets rid of all the protective tissues you used to cushion and grow the baby. After about a week of heavy bleeding, you should start to taper off a bit in the amount you are excreting, each week losing less and less. Your caregiver might give you some large mesh disposable underwear to use after delivery. This is so convenient as you’ll be leaking all kinds of fluid for a while after delivery.

There are also very large overnight pads available that provide maximum coverage—I like these natural ones that don’t stick to you and keep you feeling dry. You’ll change these often and soak a few pads per day.

Passing some heavy clots is fairly normal (even the size of a golf ball or bigger in the first few days). The rule of thumb is generally if you pass a clot smaller than your fist, it’s okay. Anything larger—call your doctor.

Hemorrhoids after baby

A byproduct of pushing or acquired during pregnancy, hemorrhoids are inflamed veins in or around the anus that can become itchy, irritated, and swollen. Most hemorrhoids will go away on their own within a few weeks. In the meantime, try these tips.

Witch hazel tends to do wonders. Use TUCKS pads, which are medicated cooling pads with witch hazel. When you have a bowel movement, use a pad to wipe, and then throw it away or flush them. For added relief, you can put a few pads in your underwear and leave them for 15 minutes or so. Stay well stocked with a container in every bathroom and a pack in your purse.

Constipation after giving birth

Constipation can exacerbate the problem. It’s normal for things to get a little backed up for a while after delivery and that first BM can be downright scary. Being sedentary, stressed, and fatigued also worsens the situation. Ask your doctor what kind of stool softener works best (some hospitals send you home with some). Colace is often recommended and is safe to take while pregnant and nursing or take a milder step by drinking Smooth Move tea. Keep in mind the longer you put off having a bowel movement, the bigger the problem will be, so try to go often. Take your time, and relax. Use a hand with a warm cloth to put counter pressure on your perineum to ease the pain while pushing. Push gently. Don’t force it or strain.

vaginal waterbirth

Drink lots of water

With the hormonal changes going on, night sweats, and especially if you are nursing, dehydration is a threat. Drink way more water than you think you need. The large majority you are drinking will go to making milk, so keep large cups with straws filled all over the house—at your nursing station, by your bed, near the couch, in the kitchen. Drink, drink, drink.

Get your fiber

Eat high fiber foods like vegetables and fruits. Berries, nuts, salads loaded with crunchy vegetables, and whole grain foods all are high in fiber. Pour some flax seed (soaked in water) on your food or in a smoothie, and if you can stomach it, prune juice does wonders! Try to keep the sweets and packaged foods to a minimum. Stay clear of other constipating foods for a week or two while you normalize: cheese, bananas, chocolate, white flour, and fried foods all promote constipation. If needed take a fiber supplement.

Incontinence

Your pelvic floor has been thrashed. It will recover, but all your muscles have been stretched, pulled, and potentially torn. Pregnancy hormones have thinned things out, and it takes a while for elasticity to come back. While you wait, you may find you have a lot of incontinence when laughing, sneezing, coughing, or making sudden movements. Repeat to self: “This is normal, this is normal, this is normal.” Be patient with yourself. Wear panty liners, or better yet, purchase some of these disposable protective underwear to wear at the beginning or reusable ones that are a little cuter! 

Kegels will be the very best thing you can do for your pelvic floor, and you can start these as early as the day you deliver. Slowly pull up your pelvic floor muscles as you “zip” up your lower abs. Progressively tighten the muscles and then slowly release. Do these periodically. Every time you nurse do a few reps (you’re not going anywhere anyway) and you’ll be sure to get in some good exercise time.

Breast tenderness

The first few days, your breasts produce a nutrient-dense, antibody-rich yellow liquid called colostrum. This is so so good for the baby. It provides protection, immunity, and vitamins. Your regular milk supply will come in within 2-5 days of delivery. At that time, your boobs will get HUGE which lasts for about 24-48 hours before the swelling goes down little by little. Naturally, that can be very uncomfortable. Use special warm compresses or a warm shower to aid with discomfort while being careful not to stimulate the nipples (especially in the shower) as that will just cause you to produce more milk.

Breastfeeding Challenges

There are so many potential breastfeeding challenges, it requires a post of it’s own, but I will mention three big ones here. breastfeeding challenges

Thrush

Thrush occurs when there is an excess of yeast production in mother or baby. If a woman had a yeast infection close to the time of delivery, thrush can be passed on to the baby during birth. Baby will have a white coating inside her mouth, and also a very red and irritated rash in her diaper area. Thrush can be tricky to treat as it is easily passed back and forth from baby to mother through breastfeeding. A woman can then get thrush on her nipples, which will be very red, and feel like they are on fire. Nursing will be extra painful, like knives are stabbing your areolas when the baby drinks but it is safe to continue nursing. You may want to try a nipple shield to help with discomfort.

It is treated by a prescription from your doctor or also by an over the counter medication called gentian violet (read up on it here). These ointments are rubbed on affected areas several times a day. Take great care in sanitizing everything that comes in contact with breastmilk, breasts, and baby’s mouth (toys, pacifiers, breastpumps, bras, shirts, etc). Avoid sugar and inflammatory foods while trying to treat thrush, as yeast thrives in sugary environments. Read more about thrush prevention, symptoms, and treatment here.

Blocked Ducts

A blocked milk duct is easily identified when there is a hard and painful lump in a breast. This indicates a milk duct has become blocked and milk has backed up. This can lead to further problems, so try to deal with it at the first sign. Get in a hot shower and massage the area to loosen up the lump. Nurse frequently on the affected side, while rubbing the duct. The baby can help to excrete the blockage. Raw cabbage leaves also tend to draw the milk out and help with engorgement. Prevent blocked ducts by ensuring a proper latch, that the breast is drained completely after nursing, and that both breasts receive equal nursing time. Using a Milkies Milk Saver can help relieve pressure on the non-nursing side as well.

Lecithin is a supplement that’s often recommended to help unclog milked ducts. According to Kellymom, “the usual recommended dosage for recurrent plugged ducts is 3600-4800 mg lecithin per day, or 1 capsule (1200 milligram) 3-4 times per day. After a week or two with no blockage, mom can reduce the dosage by one capsule. If there is no blockage within another 2 weeks she can reduce it again by one. Mom may need to continue taking 1-2 capsules per day if stopping the lecithin leads to additional plugged ducts.”

Mastitis

Mastitis occurs when a blocked duct goes undetected or awry. An infection forms from the blocked duct and unused milk. A red spot or two will appear on the outside of the breast that is hot and tender to the touch and mother will start to get flu-like symptoms—fever, chills, muscle achiness. Call a doctor at the first sign of infection, as mastitis can progress very quickly. An antibiotic prescription will often be prescribed and clear things up fairly quickly, but make sure you are nursing frequently on the affected side or pumping frequently to alleviate the pain and clear out the old milk. Lecithin can also help with mastitis, see above.

General soreness

You’ve just been through a fantastic physical feat. Your body is going to be sore in many places you didn’t realize you were even working. Holding the baby constantly, combined with nursing can also add to your muscle fatigue. Shoulder, neck, and back muscles are commonly tense, and arm and leg muscles might feel sore and tender. A postpartum massage or chiropractic adjustment can feel divine soon after delivery. Even if a partner offers a 15 minute massage here and there it can do wonders. We also love to use a tens machine for sore muscles.

Take it extremely easy physically for the next little while. Even if you start to feel energized or better physically, do not overdo it with housework or errand running. Force yourself to keep a low profile. If you do venture out, make short trips. If you decide to go for a walk, aim for refreshment rather than fitness, and keep the distance short. There is plenty of time for that in the future. Plenty!

when to call the doctor

When to call the doctor postpartum

Be on the lookout for any of these symptoms postpartum. They could indicate further problems. Call a doctor if you have:

  • A fever of 100.4 degrees F (38 degrees c) or higher
  • Soaked more than one sanitary pad an hour or passed a large clot (bigger than fist) or bleeding increases or turns bright red after having been brown for a few days
  • New pain, swelling, or tenderness in arms and legs
  • Vaginal discharge with a foul odor
  • Painful urination, frequent urge to urinate, or are unable to urinate
  • New or worsening belly pain
  • Cough, chest pain, nausea or vomiting
  • Headaches or vision changes
  • Feelings of depression, have hallucinations, suicidal thoughts or thoughts of harming the baby.
  • Sore breasts, accompanied by red spots/streaks, breasts that feel hot to the touch, cracked/bleeding nipples or areolas.

Simple ways to take care of yourself postpartum

  • Take frequent naps, seriously.
  • Nourish yourself for healing. This is an amazing book on food for the first forty days after giving birth.
  • Take time each day to yourself to read, relax, listen to music, or do something you enjoy.
  • Shower frequently and enjoy a postpartum herb bath nightly.
  • Get fresh air.
  • Schedule regular time with your partner to connect, even if only for 15 minutes.
  • Limit visitors.
  • Lower standards for house cleanliness and home cooked meals.
  • Talk with other women who can relate to your situation.
  • Ask for and accept help when you need it.

The way you care for yourself during this time will greatly influence your recovery speed. Besides, with a new little one, there will not be many opportunities for rest in the near future, so take advantage while the help is there and treat yourself to a good immediate recovery.

This post was co-written by Austyn Smith and Bryn Huntpalmer.

Sources

  1. Abraham, S., Child A., Ferry J., Vizzard J., Mira M. Jan. 1, 1990. Recovery after Childbirth: a preliminary prospective study. Medical Journal of Australia (152). [January 22, 2017]. http://www.ncbi.nlm.nih.gov/pubmed/2294386
  2. Royal College of Obstetricians and Gynaecologists. July 11, 2014. [January 22, 2017]. http://rcog.org/uk/en/blog/perenial-tearing-is-a-national-issue-we-must-address/