Saturday, June 1, 2019

Planning for Postpartum

When Kevin and I first decided to take the leap into human-making, I never would have expected to become so captivated by the postpartum period. There's so much that feels compelling. For one, pregnancy actually garners a fair amount of attention and support. The support is kind of uneven and the attention not always wanted, but there's energy in its direction. I'd already observed with other friends that they seemed overlooked once the baby arrived and we would even talk about that. Some of them felt really OK with the level of energy going towards their children. Some felt newly invisible.

The more that I learned and observed, the more I kept circling back to a feeling that potentially more than pregnancy, labor, or birth, but the postpartum period is the hard part. And the magic part. The messy, quiet, and pivotal part.

The Fourth Trimester and The First Forty Days helped me understand cultural practices that used to cocoon mother and child in this sacred window. And, like Ina May's more nuanced histories, helped me understand that we didn't completely lose all the support simply because of "the patriarchy." Some postpartum practices, like Chinese women being kept indoors under their mother-in-law's care for the first forty days, were at times very oppressive. Women balking at some of these older rites was, at times, for good reason.

But we might not have understood what we were losing.

I started looking at the struggles of the postpartum period alongside older cultural support practices and also in the context of current messaging: bounce back! Get your life back! Get your body back!

And all these accolades to women who returned to work or exercise or travel practically minutes after giving birth.

And some women who had no choice but to return to much of their life that was outside of the world of a new baby.

In some conversations, I noticed a lot of resistance from other women about the possibility of needing recovery time after giving birth. I asked a friend her take on it. She said, she felt like most of us struggle with limits. My understanding of the postpartum period is that by investing in it up front by doing as little as possible-- resting, eating nourishing food, nursing your baby, bonding, and staying quiet-- there is the potential for very long-term resiliency. But it means slowing down for a period. That is very, very hard for many of us.

I also think some of our collective resistance to fully caring for ourselves, setting up support, asking for and receiving help, and allowing for this healing time is due to lack of information. And a fear to meet our own limitations. From what I can tell, birth has the potential to fully empower women, which is also why it can feel counter-intuitive that the aftermath might be so quiet and internal. One notable piece of information is that after a woman births, no matter how she births, when the placenta exits the uterus it leaves behind a wound inside the uterus. Among the reasons that care providers urge postpartum women to be so conservative in their movement and energy output in the early days is because there is a literal, but not visible, wound healing. You wouldn't run to the store or try to resume yoga if you had a gaping wound on your thigh, but because we don't see it and it's not commonly spoken of, a wound in our uterus, a very central internal muscle for women's health, women push themselves.

I have a lot more to say about this period, but so much of it right now is speculation. It feels to me like one of those critical moments that can deplete or restore a woman long-term. Given that we're such resilient creatures, I think women can "bounce back" quickly after birth and maybe not notice many side effects in the short term. Again, this isn't backed, but I would like there to be studies! I think the moment of consequence might be menopause. I'm strongly suspecting that what happens to women postpartum has great bearing on their experience of menopause. I think it has something to do with restoring hormonal balance, among other things.

I want to be a powerful, strong, older woman. I want to use the postpartum period to my benefit.

And I know I can only parent well if I'm well, so I want to use the postpartum period to restore my energy and vitality fully.

It feels like an opportunity.

Based on my reading and research, I selected the practices that felt most important to me. Some of them have to do with balancing hormone levels but some of them feel important for more obscure reasons. They just feel right.

  • Pretty early on, I booked placenta encapsulation.
  • A friend of mine set up a postpartum meal train (and I'm SO EXCITED AND GRATEFUL!).
  • During pregnancy, I began osteopathic manipulation with a DO at my practice. I'll go at least once more in the first five weeks after having given birth to help put everything back in place while relaxin continues to loosen my system.
  • Also during pregnancy, I had two pelvic floor physical therapy sessions. I learned perineal massage and had some myofascial work done to prepare for birth. After birth, I'll have at least one or potentially more sessions to make sure my pelvic floor is fully healed. This is some of the most important work to address very common, but unnecessarily so, issues like incontinence. Most women will face some disruption to the pelvic floor and neighboring organs. Pelvic floor physical therapy is standard postpartum care in France and helps women navigate the common, but unnecessary, post birth issues. We don't need to be martyrs. We should all get this care.
  • I found a steam care specialist who advised me on appropriate herbs and a protocol for postpartum vaginal steaming. Depending on how the birth goes, this will likely begin on day 2 and continue for 30 days.
  • I asked one of the wisest women that I know, who is also one of the most talented myofascial body workers, to bind me postpartum. We'll also do myofascial work.
  • I plan to "lay in," meaning I'll stay in bed with my daughter for at least a week. If we can, we'll stay in bed or near it for about a month.
  • Last, I'll have a blood panel check my hormone levels regularly in the ensuing weeks and months post birth.

All of these plans and protocols are pretty explicitly geared at me using this pivotal time to shore up my own health and longterm vitality so that I can parent to the best of my ability. My insurance only covers the osteopathic manipulation. I think all of these practices should be studied, so they could responsibly be prescribed as standard postpartum care. I'm able to do these practices thanks to support from my community, family, and most importantly, Kevin.

Another way Kevin and I tried to think through postpartum is to think about our own tendencies and patterns when we're sleep deprived and freaked out. I'm doing everything I can think of to support myself to hopefully navigate this period as well as can be hoped for. And a lot will fall on Kevin. We've had a lot of conversations about how each of us handles sleep deprivation (he's way better at it than me) and what we tend to do when stressed. Conversely, we've tried to think about what helps both of us feel like we have some sustenance or nourishment to ride out a stressful period. Knowing what helps each of us, we're going to try to make room for one another to do what we gotta do.

Living through these phases of life like pregnancy, birth, and postpartum is reminding me of how seasonal needs can be. I don't believe that I'm meant to live into postpartum as I lived into my energetic early thirties. I think I'll face other phases of seclusion and shoring up as well. I feel like I have an opportunity here-- to go in and allow for a quiet rest and strengthening with my daughter. I think it will ready us to reenter the world whole.

I'll report back.

Prepping for labor

We joined a practice that doesn't offer epidurals (unless you require transfer and surgery) so they request that you prep for labor. We'd planned on it anyway and signed up for a great class with Cat LaPlante and Carrie Sarlo-Randazzo at the Village. We got fantastic information about the general arc of labor, ways to move and support both comfort as well as the baby's descent, and best of all, ways that Kevin can massage me. Win.

This experience and many prior and since spurred Kevin and I to talk about what support feels like to each of us. We're very different characters. If Kevin were the one giving birth, he'd probably either want me to be totally silent or read aloud super obscure Stoic philosophy. However, I'm chatty. Our practice recommended hypnobirthing materials. I listened to a podcast and looked into it a bit-- from what I can tell, it's an amazing network of resources and feels very similar to yoga affirmation mantras. And it caused me to realize something else about myself. I have a history of being gaslit, meaning I had pivotal experiences where I was told that what I experienced wasn't real, or wasn't what it felt like to me. It's taken me years to really trust myself and my own perceptions. I realized that due to those past experiences, cliche affirmations don't work well for me. I want verbal communication and I want it to be very specific. When I get that, basically, a narration of reality that affirms my own experience, I feel safe.

This is a pretty foreign way of operating for Kevin, but he's a champ, and we've been working on it. He's been writing up a list of all the things he's seen me accomplish so that he can remind me of them if I need encouragement. He's working on affirming what I'm experiencing first and being verbally connected to me so I feel like everyone around me is checked in and on the same page.

I put this in a birth preferences sheet for my practice-- that's basically a "birth plan" but perhaps with more allowance for the reality that birth can't be planned. My midwives were very responsive and grateful to know what communication style made me feel the safest and therefore the most relaxed. They agreed that for many birthing people, less information or communication is preferable. Knowing this about myself is helping me ask for what I need.

I mentioned in other posts that I'm also deep in both Ina May Gaskin and Spinning Babies rabbit holes. Ina May is a plethora of wisdom on all sorts of things, but mainly, the miracle of the birthing body. She's reminding me to keep my mouth loose and make low noises and filling my imagination with all the possibility of birth.

Spinning Babies is reminding me to move, move, move. This is another request that I put in my birth preferences document-- to get suggestions and encouragement in moving frequently during labor. My midwives responded really well and I'm excited to get their support!

Kevin and I packed bags for two nights at the birth center, and they're in the trunk. He installed the car seat and I got it inspected. We've made a document on who to text and when, like our friends who will come watch the cats when we go to the birth center, and a list of who to contact after our daughter has made her arrival-- we don't want to forget anyone.

The main thing that has me stumped is snacks. Easily digestible, high energy food tends to really help people in labor-- and those supporting them. Kevin has a bunch of energy bars. I'm not good at food prep. It's on the list.

Apart from that, we're trying to make room. Just time and space to sink into the sort of twilight feeling of waiting for birth. I'm starting to feel that labor isn't just the hours leading up to the arrival of the baby-- it starts way earlier. Things get softer and fuzzier. There's a quiet. A sinking. A loosening and deepening. Going with that, so labor can unfold.

I'll report back.