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planning for postpartum recovery during a pandemic

There's a saying I've heard oh so often amongst the elders in Black communities after you have a baby that you need to "sit down before you have a set back", have you heard this one?

The manner in which you recover during the next three to four months after delivering your baby can affect you not only during a global pandemic but for the REST OF YOUR LIFE.

Do you have a plan in place, honey?

Pic courtesy IG thecorporatedoula

This saying could never be more true. You really need to rest, in the bed, on the bed and around the bed for the next six weeks. This "setback" would be in reference to being open to and susceptible illnesses and infections.

Research has been proven to demonstrate that pregnancy and birth dramatically affect the immune, endocrine and your psychosocial health, basically our immune system, hormones and mental health. The next three months after having your baby, most popularly known as the fourth trimester, is transitioning back into those same systems pre-pregnancy.

Postpartum and the Immune System

Inflammation that occurs after childbirth whether vaginal or cesarean sends the body into recovery mode rushing blood to areas that need healing which suppresses other functions that would normally occur outside of pregnancy or childbirth. Your immune system being one of these functions. Your immune system is not as strong and effective because you've just had a baby and your body is now focusing on healing. Almost 13 percent of the total of maternal mortality deaths in the U.S. are a result of postpartum infections.

"According to the CDC, the leading causes of death among pregnant or post-partum women are cardiovascular conditions (more than 33% of deaths), infection (12.5% of deaths), and hemorrhage (11.2% of deaths)" (CDC)

Any woman who is pregnant, recently had a miscarriage or abortion, or delivered a baby can contract an infection that could lead to sepsis. Some women are at higher risk for developing sepsis.

These include women who:

  • Are pregnant for the first time

  • Are Black

  • Have no insurance or use public insurance

  • Had a Cesarean section

  • Became pregnant with the help of reproductive technology

  • Delivered multiples (twins, triplets, or more)

Women with chronic diseases such as lupus, diabetes, heart disease, or liver disease are also at higher risk. (CDC)

It is critical for moms to continue or begin to breast or chest feed during the pandemic for the benefits it provides against illnesses such as COVID19. There has been no significant research to show that the coronavirus can be transmitted through breast milk and the mother baby breastfeeding relationship should continue. Please read more here on breast milk and COVID19 and the effects of the new COVID19 vaccine on pregnancy or breastfeeding.

Postpartum and Hormones

You did it honey, you brought a tiny being into the world and every one is overjoyed and overstimulated including those pregnancy and postpartum hormones. Let's dive into which hormones are affected and exactly why your emotions are all over the place.

  • Estrogen and progesterone levels affect your recovery the most. During pregnancy, they support the growing fetus and your rapidly changing body. Progesterone levels rise significantly early on providing nutrients to the fetus and blocks uterine contractions to prevent preterm birth.

  • Prolactin stimulates milk production, and it remains in the body for as long as you are breastfeeding. Nurse, honey, nurse. It influences behavior, metabolism, immune system functioning, and fluid regulation. Prolactin is responsible for those mood swings for occasional postpartum mood swings.

  • Oxytocin affects mothers during labor and breastfeeding and is responsible for uterine muscle contractions for delivery then moves into milk in the breasts when the placenta is delivered and it is time to nurse.

  • Oxytocin also affects your mood and social behavior. It is the love hormone which is responsible for bonding with your baby and building trust for others as well. New mothers are very defensive about their babies and oxytocin helps to curb this innate trait.

  • Relaxin is just that, it relaxes your joints and ligaments to prepare for birth. It is secreted by the ovaries, placenta, and uterine lining throughout pregnancy. In the beginning stages of pregnancy, it keeps a mother pregnant and prevents premature labor by inhibiting muscle contractions and preventing premature labor. Towards the end of the pregnancy it aids in the ease of delivery by rupturing membranes that surround the fetus before softening the cervix and vagina and loosening pelvic ligaments. It is extremely important to rest towards the end of your pregnancy and after delivery because joints and ligaments are still soft after delivery and an injury could affect joint and ligament health for a lifetime.

  • Thyroid hormone levels can change after giving birth. They react to inflammation and increase other hormones in your system that cause anxiety, irritability, rapid heart beats, fatigue, sweating and weight loss and more.

Six months postpartum is a good estimate for when your hormones will go back to normal. This is also around the time many women have their first postpartum period especially for moms that are exclusively breastfeeding and that's no accident.

Your body is amazing, honey.

Postpartum and Psychosocial Health

With all the changes that were mentioned it is expected that some new parents will be left feeling down and not feeling like their normal selves. It's a bit overwhelming just reading it, honey so imaging experiencing it. This is why as a postpartum doula I stress making a postpartum plan to prepare in case any of these symptoms occur. Mood swings, poor sleep, lack of appetite, depression and anxiety, as well as irresistible urges to cry, might all become commonplace. Fortunately, baby blues tend to subside after a week or two. When these feelings don’t go away or get worse, they may indicate postpartum depression. Warning signs of postpartum depression include:

  • Loss of interest in the newborn

  • Feelings of hopelessness

  • A constant urge to cry

  • An inability to cope or take pleasure in things

  • Loss of memory and concentration skills

  • Excessive anxiety

  • Panic attacks

  • Sleeplessness and extreme fatigue

  • Aches and pains

  • Feeling generally unwell

  • Decreased appetite

Postpartum depression is a serious condition that should not go untreated. If you observe any of the above symptoms, it’s important to contact your health care provider immediately. It has been shown that the pandemic is affecting the postpartum care and recovery on new mothers with the isolation and restrictions of social distancing. Mothers and family members should be extremely watchful of these signs and assist a new mother in anyway that you can to ease the transition. Properly masked and socially distant of course.

Cancel the snapback for now, honey, let's focus on

  • resting

  • eating well with warm nutrient dense foods such as soups, broth soups in particular to build your immune system especially during a global pandemic.

  • learning to nurse and/or pump to establish and maintain your breast milk supply throughout your breastfeeding duration

  • understanding postpartum feelings and moods and caring for your mental health

Even if you have not conceived yet there is no better time frame to begin your birthing and postpartum planning. Preparation prevents failure at times. Having a postpartum plan in place before your baby gets here will prepare you for any of these events should they arise. You can invest in a copy of our New Beginnings Postpartum Kit here.

I also offer virtual postpartum services and breastfeeding support to coach you through to postpartum success.

Rest, honey.

******This blog post is not meant to replace the advice of your medical provider. It is simply meant to keep families abreast of evidence based information.

Jada Metcalf | is a mom of two, Certified Breastfeeding Specialist, Postpartum Doula, ROSE Community Transformer, Fertility Doula and Community Health Worker in training, 2021 IBLCE candidate and a postpartum wellness business owner.

Health information on this site is based on peer-reviewed medical journals, textbooks and highly respected health organizations and institutions including the CDC (Center for Disease Control), AAP (American Academy of Pediatrics), WHO ( World Health Organization), NIH (National Institute of Health), ABM (Academy of Breastfeeding Medicine) Breastfeeding and Human Lactation, 5th Edition, Wambach Spencer)


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