Parenting journal: Postpartum

I have a post all ready about life with a newborn but it occurs to me that first I should make a postscript to my pregnancy journal and say something about recovery in these first weeks. Already we don’t talk enough about the realities of pregnancy and birth, and then once the baby comes out it’s as if the mother just rests and then goes more or less back to normal (or, if you agree with the magazines, she transforms from attractive young woman to ‘mom’ who is inherently unattractive and uninteresting!!!). So I want to share how this part of the process is going for me. Be warned, I’ll be explicit (but not overly explicit… I think?). 

At its simplest, the postpartum period involves two major processes:

• recovering from labor
• learning to parent (which often includes learning to breastfeed)

But that much is obvious. For myself, I would break it down even further:

• recovering from labor, which means:
  • regionally specific comfort and healing from the trauma of pushing and vaginal delivery
  • general rest and recuperation from the strenuous endurance workout that is all of pregnancy and labor
  • emotional/mental transitioning from pregnancy to parenthood

• learning to parent, which involves:

• • dealing with sleep deprivation and disruption of circadian rhythms
  • learning to breastfeed and coping with the accompanying sensations
  • tending to the physical needs of lactation, e.g., increased hunger and thirst
  • adjusting to the existence of our baby and recognition of our new roles as parents
  • coping with intense emotions around love and responsibility
  • coping with the fallout from continued hormonal fluctuations affecting mood

In other words, we may call it simply “recovery” but I find it to be an intensive, multi-layered process of healing and transition, encompassing my emotional being as well as my physical body. And although I am affected more strongly than Erik — he, after all, mostly gets to skip over the labor recovery and the physicality of breastfeeding — many of these aspects of recovery/transition do apply to him as well, and therefore he also needs care during this period, even while he devotes nearly all his energy to looking after me and Owl.

tired!

Let’s take these pieces one by one.

First: physical recovery from labor. As I said in my last post, this process began immediately after birth, with my doctor stitching up my rather severe (third-degree) perineal tear. I also had what I will describe simply as a hemorrhoid situation, brought on by the hours of pushing and all that downward pressure. To address these issues, I was given thick absorbent pads, disposable stretch mesh underpants, numbing spray, witch hazel pads, ice packs, washcloths, a “peri” bottle (a squeeze bottle for rinsing the perineum), a sitz bath, and ibuprofen.

partial bathroom arsenal

The ibuprofen also helped with the overall soreness and aches I felt in my whole body for the next two days. Sanja, one of our favorite nurses, commented, “It feels like you’ve been hit by an 18-wheeler, right?” A friend told me after her delivery that she felt “destroyed.” Both descriptions are apt; I’ve never been so exhausted in my life.

four doses daily

Amazingly, though, there was very little active pain, and after the first week, healing progressed more rapidly. Slight bleeding continues for weeks, along with mild, twinge-y uterine contractions, but I had minimal swelling, painless regular pees and poops, and no incontinence (though I did buy special undies just in case).

Probably the most annoying and impactful aspect of my physical recovery was that I was unable to sit down for more than two weeks. Between the perineal tear and the hemorrhoids, I just had a constant feeling of downward pressure that made me, if not actually uncomfortable, incredibly tense and anxious every time I sat on my butt. Cushions did not help, whether regular or donut-shaped. Sitting on a ball did not help. Mostly I didn’t mind, but not being able to sit did have ramifications for my comfort while writing (not a big deal) and for my chosen position for breastfeeding (sometimes frustrating — more on that later).

Later I will need to think about things like exercise and regaining core strength, but for now, forget it!

As to emotional recovery from labor, it doesn’t compare to the emotional impact of Owl’s presence, but I mention it because I was surprised there was any emotional component to labor recovery at all. I thought that once she came out I’d be so happy to meet her that I wouldn’t think much more on pregnancy until maybe much later, but that wasn’t the case. I enjoyed being pregnant — mostly — and found it strange to lose that state so abruptly. Immediately after Owl was born I felt as if there were phantom kicks in my newly flattened belly, and even now, it sometimes gives me a pang of loss to feel my abdomen and realize it no longer contains any life but my own (well, and my microbiome, I suppose). Pregnancy was a nearly ten-month period of gradual adjustment to carrying a new life within me, and it’s only natural to feel something when that process comes to an end so suddenly. I haven’t had too much time to ponder this but it’s just worth noting that these feelings exist.

not pregnant anymore

I am not sure how much Erik is affected by any of the aforementioned processes, by the way. He did have some body aches after Owl’s birth, probably from hunching non-ergonomically by my side for so many hours and the exertion of holding up my leg. But these next processes affect him more directly.

So: parenting. The sleep deprivation is real. It’s not just the lack of sleep that’s hard but the adjustment to a schedule that is now 24 hours rather than one that follows the rhythms of day and night. But I’ll be saying more on that in my next post.

Breastfeeding can be hard. People don’t always talk about this because they want to encourage breastfeeding and because it’s thought of as the most natural thing in the world. Well, natural it is, but there’s a learning curve and it doesn’t always work out for everyone. Fortunately it does work for us and the benefits are indeed great, but there is still an adjustment, especially in the first days.

I didn’t realize until fairly recently that you can’t just pop a baby on your breast and have them eat. There is a procedure to it. The baby has to latch on properly, which means they need to be properly positioned over your nipple to create suction without discomfort to the mother. When you’re first starting out it can take awhile to get the hang of this, so until then you endure a lot of painful chomping. It’s amazing how much it can feel like they’re biting you even when they don’t have teeth! And as you probably know just from other activities, anytime you pay a lot of attention to these sensitive parts they get, well, more sensitive. I felt in the first week or so of feeding that my breasts were constantly feeling about the worst they had ever felt during PMS — which is thankfully not that bad but it’s not super pleasant either, especially since I was also recovering from labor.

Because I was so uncomfortable sitting, we opted to feed Owl from a side-lying position — lying on my side in bed — which is a great position in many ways (not least because I can rest while I feed her!), but it’s also so difficult to learn that several of the nurses, and my doctor, basically told me not to even bother. Fortunately some of the other nurses were not daunted, and thanks to their help, we figured it out eventually. But at this early stage, while Owl doesn’t have as much neck control, side-lying requires that Erik position her (rather than me doing it) — and if she’s feeling fussy, “position” is a very active verb! This means less rest for Erik, but it also makes feeding more of a partner activity. This is more tiring in the short run but I suspect we’ll look back on it as a positive feature of these early days. Middle-of-night feedings can be very isolating for new moms, but because of our side-lying feeding I’m not feeling that way. 

I’ve also discovered that breastfeeding can be very emotional when it’s not going smoothly. For me as Owl’s mother, there’s just a really strong visceral reaction to seeing her distressed, knowing that she’s hungry and I’m unable to feed her. Thankfully whenever we have latching problems we’re always able to get her on eventually — even if it takes maybe 10 to 20 minutes of her crying in the middle of the night — but to see her wailing her heart out with her mouth actually on the nipple and just unable to make that connection… I actually cried several times. Sobbed, really. It wasn’t logical, it was just my instinctive reaction to seeing her so desperate. (After all, she doesn’t know she’s not about to starve.) I can only begin to imagine how deeply upsetting it must be for moms who have more serious difficulties with nursing.

On the plus side, though, when breastfeeding goes well, it’s really unexpectedly nice. I feel proud that my body can feed my child (and can leave her happily “milk drunk” as they call it!). I like having her close to me, and she enjoys it too. And besides bonding, the process also releases prolactin and oxytocin which are mood-enhancing and assist with deeper sleep; a feeding session often leaves us both in a state of deep relaxation. I really feel bad that Erik doesn’t get to benefit from these hormones because I’m quite sure that I’m resting better because of them!

The last thing I’ll say about breastfeeding is it’s tremendously physically taxing. I had heard this but I’m still surprised by this every day. They say you have to eat 300-500 extra calories per day while lactating; I also read that metabolically it’s the same energy expenditure as walking 7 miles in a day. It may look restful and it may even be relaxing, but it is hard work, and as such it requires extra food, extra liquids, and extra rest — all of course on top of whatever rest and sustenance I already need for basic labor recovery.

As for the emotional transition to parenthood, that’s actually a little hard for me to dwell on right now, so I will leave it for a future post. For now I will just say that for a week-plus I cried once a day and mostly just at the thought of how much I love her. (See, I’m already tearing up just writing this.) These days I think the hormones are settling down a bit because I only cry once every few days! Obviously the emotions are real but the hormones are also very real and they make everything more overwhelming. It was very disconcerting for me to realize that although I’ve never thought of myself as a heroic person, I would endure anything for Owl, take any number of bullets for her, whatever — this isn’t a choice, it’s just pure instinct. She is the most important part of me now and if that’s not an emotional transition I don’t know what is. It’s all been so organic I don’t exactly feel shocked by it — it seems as natural as breathing — but it’s definitely there, a big thing that I will probably be coming to terms with, well, for the rest of my life maybe!

Anyway, so that’s how these first two and a half weeks have been. A lot of physical sensations, a lot of feelings, a lot of newness to adjust to. I started writing this post last week and I concluded then, “Actually it all makes me rather glad to be hunkered down at home even if I’m not doing the traditional Chinese monthlong confinement. Why deal with the outside world when the inner world already presents me with this much to cope with?! I am tremendously lucky to have Erik and my family and friends rallied around as support. This is not an experience that anyone should have to go through alone.”

Worth it.

Now that a few more days have passed, though… I have been noticing that my recovery, much like Owl’s growth (now and in utero!), doesn’t happen in a clean gradual line, but in fits and starts. For my first week postpartum I felt as if nothing was improving, and then almost instantly on day seven I started to feel like I’d turned some kind of corner. The same thing happened on day seventeen, just recently, so that some of what I wrote earlier in this post already feels dated! I pretty much woke up feeling astoundingly better, and the next day Erik and I even left the house together with Owl and had a (very short) walk, and that night we were able to sit down and have dinner together for the first time since her birth. (Curiously enough this coincides with Owl also looking much fatter and being a lot more alert during the daytime. Hmm.)

It felt wonderful to get outside, although I can feel that things have changed a lot in my body and will require, beyond just basic recovery, some active re-learning of my body mechanics. I don’t know if delivery actually changed my body that much, or if I’d gotten so used to a pregnant body that I’m now having to adjust to not being pregnant. Probably both. If my current rate of recovery continues, I expect that I’ll soon be done with this more acute stage, but getting back to something resembling normal is going to take much longer, and I’ll have to be careful not to overdo it by jumping back into active life before I’m fully ready.