“Birth is an everyday miracle. What is a miracle? A miracle is something that makes you pause and think.” . . . Kindreth Hamilton, Acupuncturist.
Well the workshop certainly made us pause and think! It was an inspiring afternoon thanks to our dynamic and knowledgeable speakers and an engaged and passionate audience. We learned practical, cutting edge ideas for healing and support in the postpartum time, we also talked about the larger issue of the need for comprehensive, integrative postnatal support in our culture.
We also discussed the difficulties women face in accessing comprehensive integrative care due to financial constraints and health insurance that does not adequately cover comprehensive, holistic care, including many of the modalities discussed at the workshop. We also acknowledged the void in our community with the closure of Grow, which offered a central space and was integral to supporting new families and creating networks of learning and sharing.
So where do we go from here? It was a true joy to engage in such a meaningful discussion. But we acknowledged it was just the beginning. I encourage you to continue to envision a comprehensive, integrative approach that would ensure a healthy postpartum recovery for women and create a broad base of support for new families throughout our Valley and Hilltowns. As witnessed at the workshop, we inspire each other, learn from each other and are stronger together. I encourage you to be creative and practical at the same time. Look to your circle of daily life and your area of expertise--what do you see as a next step? It will help us to answer the question: “Where do we go from here?”
“Supporting our new mothers is the basis of civilization; it needs to be multigenerational.” Ann Buscemi, CBE & Workshop Participant
And of course, I’d like to share notes compiled from our outstanding workshop speakers.
Replenish / Rebuild
A key nutrient to focus on is iron. Supplementation may be necessary and should include non-constipating formulas.
Multivitamin. Take a good quality multivitamin (not gummy vitamins) from Whole Foods, River Valley or Cornucopia. Look for one high in B vitamins.
Fish oil. Take a fish oil supplement, Nordic Naturals has a new postnatal formula.
Sugar. Avoid turning to sugar for an energy boost. Fatigue is NOT a deficiency of sugar, but rather a deficiency of quality rest / sleep.
Digestion. After birth, digestion is weak and you may want to eat differently. Warm, cooked foods should be the predominant foods rather than raw.
Probiotics. There is a major shift in the gut in the 3rd trimester. Take a probiotic that has several different strains. Eat cultured vegetables.
Wound-healing. Anti-inflammatory foods and supplements will help speed the wound healing process:
1. Bromaline, 1,000 GDU twice a day with food. Safe as long as there is no allergy for pineapple.
2. Fish oil. Quality determines efficacy.
3. Eat food in the purple/red category: blueberries, raspberries, Red cabbage, etc.
4. Eat Asian mushroom like shitakes
1. Watch the timing of when you eat. Food takes 3-4 hours to be digested. Do not eat something hard and crunchy, like a granola bar right before you sleep. Soft foods, like pureed squash or porridge are easier to digest.
2. Caffeine. The half-life of caffeine is 6-8 hours. If you choose to have caffeine, plan to have your caffeine by the early afternoon.
Chinese medicine is about prevention. After birth, the body is deficient in Qi and blood. It is of the utmost importance to rest, which is really hard to do in our culture of "Go, Go, Go." Rest can take many forms; it has to fit the life style. We live in a fractured society that is not supportive of a structured postnatal time. And many women can’t afford to pay for the supportive treatments and therapy that would help during this time.
Staying warm including eating warm foods like broths, soups, and eggs. Dress warmly, even in the summer, wear socks and warm clothing. It is believed that “Pathogenic cold” can introduce disease.
Bellybinding gives support to the pelvis.
Treatment for pain. Acupuncture treatment can give a more settled and euphoric sense of well-being. Acupuncture can treat common issues such as headache, musculoskeletal pain, insomnia and help to reduce the body’s stress response by calming the nervous system. There are many reasons for insomnia, but in the postpartum time insomnia may occur because you don’t have that internal reserve to anchor your sleep.
Replenishing the spleen is important in Chinese medicine. It is thought that blood originates in the spleen and rebuilding the spleen replenishes blood. The spleen corresponds with the Earth element. Spleen replenishing foods are naturally sweet, orange and yellowish (carrots, squash, lentils, pumpkin)– grains, root vegetables, soups, rice pudding and pumpkin soup.
Acupressure points for pain relief.
Large Intestine 4: in the webbing between the thumb and pointer finger: massage. It’s best to have the mother recline and relax for this and to have someone else perform the massage. This is “the command point of the head/face” and used for headaches, facial pain and other pain conditions when used in combination with other points.
Gall bladder 41: a point between the fourth and fifth toes, may also help a headache that is primarily on the side of the head. The GB meridian passes through the side of the breast. Use this point for breast pain, before nursing or pumping.
Gall bladder 21: the high point of the shoulder. This point has a strong descending action – use it for the let down response before nursing, tension headaches, shoulder pain and for deep relaxation.
For insomnia: moxa (artemesia/mugwort) can settle the hypervigilant state of the new mother.
Kidney I: On the bottom of the foot in the center, near the base of the pad of the big toe.
Mama Roasting—after cesarean to help heal the scar—30 minutes back and forth on the scar.
Uterine prolapse. Directly related to lack of Spleen-Qi. Acupuncturist will “needle the top of the head,” creating a pulling up action in the body. Take ginseng and astragalus to strengthen muscle tone. Ginseng and astragalus can be added to chicken broth. One classic formula for Spleen Qi- deficiency is Bu Zhong Yi Qi Tang (Astragulus and Ginseng Combination).
- Congee rice porridge with apricots and almonds.
- Be sure you are eating enough fats and foods.
- To increase milk flow, stimulate Small Intestine I, the outside of the pinky finger in the outer corner where the nail meets the skin, by tapping with a fingernail. Do this before pumping and before nursing.
- Gall bladder 21 (the high point of the shoulder) can also stimulate let-down and increase milk flow.
- Stomach 36. To find this acupressure point, place your hand horizontally across your knee. At the lower edge of your hand, on the outside of the knee there is an indentation. That is stomach 36.
Realize that you are not going to return to normal, but that you will find a new normal.
Women are led to believe that pain, discomfort, and incontinence are normal during pregnancy and will naturally resolve after birth. Women have no preparation for a resolution to pelvic diaphragm problems after birth. In contrast, women in European countries have an expectation that their pelvic symptoms can be resolved and they are routinely offered pelvic strengthening and healing exercises as part of regular medical care.
You don’t have to be in pain during pregnancy or after having a baby! Physical therapy can:
- Alleviate back pain
- Abolish urinary stress incontinence
- Address pain with intercourse
- Strengthen the pelvic diaphragm.
Postural strain in pregnancy can cause:
1. Increase in the lumbar curve due to the weight of the baby.
2. Mid-back and shoulder pain due to increase weight in the breasts
3. Increased pressure on the pelvic diaphragm
4. Hormonal changes on the joints and ligaments
Postpartum postural strain is caused by:
1. Carrying and lifting the baby
2. Feeding and sleeping positions
Birth can cause soft tissue injury:
3. Hemorrhoids from labor and delivery or constipation
First exercises after birth:
1. Ankle rolls and wrist rolls to relieve edema
2. Gentle breathing and relaxation; breathe in for a count of 4, breathe out for a count of 6.
3. Gentle pelvic tilts
4. Gentle stretching
5. Get to a state of relaxation.
After six-week follow-up with care provider.
1. Tissue repair: women may have adhesions from tears, episiotomies or cesarean scars; scar mobilization can be addressed with myofascial release technique
2. Postural re-education is a key factor in pain relief and pelvic floor healing.
Urinary stress and Incontinence.
1. Urine leakage during normal activities, or during sneezing and coughing
2. Trouble starting a urine stream
3. Trouble with frequent urination (more than every 3-4 hours during the day and up more than once at night.
1. Don’t race against a neurological response!
2. Learn behavior changes to lessen the occurrence of accidents.
3. Learn techniques to strengthen the pelvic muscles.
And finally, remember: Strengthen the abdominals from belly button to pubic bone.
Never do sit-ups!! Never!! There are safer, more effective ways to strengthen your core!
Casey Zandona, LCSW
It’s not unusual for new mothers to, at some point, hate their babies. It’s normal and it’s okay. Normalizing negative feelings in the postpartum time is a first step in allowing women to acknowledge and talk about their feelings without judgment. We are presented with an idealized view of postpartum emotions through social media sources like Facebook. Baby blues is very common, about 50-70% of the population.) It typically begins the 3rd or 4th day after birth and can last for as long as two weeks. If Baby Blues lasts beyond the two weeks and feelings of sadness and depression are interfering with the person’s capacity to function, it is an indication to seek professional help for these symptoms.
Risk factors. There are several factors that may put you at a higher risk for postpartum mood disorders. Among them are:
- Previous mental health diagnosis
- Family history of mental health diagnosis
- Sleep deprivation
- Unplanned pregnancy
- Relationship problems
- Baby with health problems
- Low socioeconomic status
- Environmental stressors
- Lack of support
There is a resistance to getting therapy for postpartum mental health. It means admitting the upsetting feelings and being willing to talk about them as opposed to being overwhelmed by and defending against them through denial, for instance. It’s important to normalize the negative feelings that occur in the postpartum time in a nonjudgmental way. If it’s difficult for the mother to get help for herself, appeal to her love of her baby. Babies whose mothers are suffering from postpartum mood and anxiety disorders do not typically receive optimal stimulation or support and may experience delayed development.
In seeking help, it may be necessary to sit with her as she makes a phone call. Simply providing the name and number of psychotherapists may not be sufficient support for her.
Realization through Psychotherapy.
Postpartum is a transformative time. Psychotherapy can support mothers through mourning the loss of her pre-child life and missing such things as spontaneity and socialization. With the therapist, a mother can make meaning of her new identity, work through and understand the meaning of self-doubt, guilt, and shame that typically emerge in the postpartum time, and ultimately create space to learn about herself and her baby so both can grow and develop.