The importance of postpartum rest

Brin Tucker looks on as her children, Lyla and newborn Kai, sleep. Photo by Michael Whigham, father.

Mothers are the ultimate superheroes. We can do it all.

We comfort, discipline, raise good citizens, make money for our families, manage schedules and get healthy food on the table (and all of these things in just the right amounts). And, of course, we birth our babies and get right back up, no worse for the wear.

Right?

Unfortunately, this unrealistic set of expectations can have disastrous consequences, as American women struggle under the weight of postpartum depression. We want to be superstars from day one, perhaps to prove to ourselves and to others that we are ready for motherhood and its many demands. But what if being a superstar means letting oneself rest, being vulnerable and accepting help?

There are so many prescriptions when we are pregnant; we are full to the brim on how to take care of our babies after they are born. A pregnant woman can hardly walk down the street without a barrage of advice, well wishes and birth stories from townsfolk. Our parents, in-laws, doctors and midwives counsel us on breastfeeding, vaccinations, safety and sleep.

All of this, and yet very rarely do we get much counsel on how to take care of ourselves after the baby is born. What an incredible responsibility the newly birthed mother has, and what a gift to her child she is. The only thing the newborn baby cares about is being close to the mother.

Most of us who have been new mothers would agree that if we allow ourselves the luxury, the only thing we care about in those first postpartum weeks is being close to the baby, without interference from other responsibilities. This intense desire to be close and protected during this very vulnerable time serves a purpose; within that quiet time, we can better establish this very important relationship, and allow ourselves time for necessary physical recovery.

Most midwives and delivery doctors don’t have much to say on the subject of postpartum rest beyond a vague injunction to sleep when the baby sleeps. How much rest is necessary? In many countries of the world, women are expected to rest – off their feet, in bed, close to baby, with people to care for them – for anywhere from a week to a month.

When postpartum women return to “normal” too quickly they risk a host of complications: heavy bleeding; breast infections; and postpartum depression, which affects American women at a rate of 10 to 15 percent. Mary Lawlor, a certified professional midwife with an office in Brattleboro and a birth center in Swanzey, has been delivering babies in Vermont, Massachusetts and New Hampshire for nearly 30 years. When she started her practice, she knew that rest was important, but she didn’t know how important.

“I remember when I had my baby, many, many years ago now, that all I could do by the third day was cry,” Mary Lawlor explained. “That’s all I could do. Because no one was taking care of me; nobody was paying attention to me; nobody was telling me to rest; nothing. And I was just crying. That’s all I was doing. And I’ve seen that a lot.”

At first, Lawlor had her clients rest in bed for three days; as time went on, she realized through her observations during home visits that people generally started doing well at a week postpartum.

“What’s really interesting is that when you read about the postpartum time, you hear about how you’ll be sore, that you’ll be weepy, that you’ll get depressed. That’s the kind of description that people have of what it’s like after the birth.

“And instead, when people are well cared for and protected, they’re very happy for the most part. Not 100 percent of the time, but 90 percent. That’s really true. It’s just wonderful to watch that. That time after birth is supposed to be nice, not miserable,” adds Lawlor.

She now recommends – or rather, insists – that her clients remain in their bedrooms, with their babies, for a full week after the birth. In the second week, postpartum women can rest elsewhere in the house, but they are still to be resting, with someone else caring for older children, cooking, doing the dishes, doing the laundry and so on.

In Lawlor’s opinion, this rest time is not only about recovering from the physical experience of birth, though that’s certainly part of it. But the postpartum rest that she requires is also about the physiological, emotional and hormonal transition into parenting.

“(The postpartum time is) supposed to … ultimately connect you to your child, and to support the physiological, emotional and hormonal transition from being pregnant to being a parent. That state of being needs every bit as much protection from disruption as giving birth does.

“The only way to actually achieve that is to keep somebody in their bedroom. Because even in their living room, they’re called on to come out and pay attention to the world in a way that they’re not in their bedroom.” Lawlor compares the situation to that of a wild animal, so that we can fully understand the intensity of the experience.

“I tell people it’s kind of like being a wolf in the back of the cave. The wolf would never be out in the yard or the woods the day after the birth … It wouldn’t make a bit of sense. But we do that to women all the time. All the time. In order to have the protection that you need, you need to be in a space that really is separate from the world.”

In South Korea, it is standard for women to go into a kind of confinement after birth. Many years ago, women would stay home for at least three weeks, cared for by their mothers. During this time, there were special foods the woman was to eat, as well as other practices to observe, such as staying very warm.

Now in Korea there is another option for women who can afford it; many women leave the hospital and go right to a “sanhu joriwon,” which is a postpartum resting place. A cross between a hotel and a hospital, these facilities specialize in creating a healing environment for postpartum women.

According to Jennifer Chung, a South Korean mother and English school director, “They (Confucianists) believe that your bones and joints are pushed out of place (from birth) and your body takes at least four weeks to regain full energy.” Chung adds that 90 percent of women still adhere to these postpartum practices.

One certain challenge with a full week of postpartum rest is financial. Many women are not in a position to rest to the degree recommended, because of finances or lack of family or spousal support. However, changing the expectations we have for ourselves and others can go a long way towards creating a birth-positive culture that supports women and infants.

Though it doesn’t replace a partner providing around-the-clock care, friends and community members can offer meals, cleaning and child care for new mothers. Instead of another brand-new onesies set or wipes warmer, gift the new parents with meals for the freezer, take-out coupons for a local restaurant or housecleaning services.

No new mother needs to be a superstar – there will be plenty of time for that as her children get older. Right after the birth, she just needs to be cared for.

Abigail Healey is a freelance writer, gardener and mother who lives in Brattleboro. Read more of her writing online at www.leviandfamily.com.

More Information on the Benefits of Postpartum Rest:

• Monadnock Birth Center: www.monadockbirthcenter.com, 603-352-5860

• It Takes a Village, postpartum support network in Brattleboro: It Takes A Village-Brattleboro on Facebook

• Sanhu Joriwon photos from a husband’s blog:

project365ki.blogspot.com/2012/04/3101-engawa-sake-nigiri-sushi.html

• “Why Are America’s Postpartum Practices So Rough on New Mothers?” by Hillary Brenhouse: www.thedailybeast.com/witw/articles/2013/08/15/america-s-postpartum-practices.html

• “Mothering the Mother: 40 Days of Rest” by Svea Boyda-Vikander: birthwithoutfearblog.com/2012/10/21/mothering-the-mother-40-days-of-rest/

• “Korean-Chinese Postpartum Rituals” by Mrs. High Heels: www.hellobee.com/2012/08/28/korean-chinese-postpartum-rituals/

• “A Time To Heal – A Look at Postpartum Reovery:” theleakyboob.com/2010/12/a-time-to-heal-a-look-at-postpartum-recovery/

• “Stop Acting Like ‘Bouncing Back’ From Labor is Even Possible” by Tracy Moore: jezebel.com/stop-acting-like-bouncing-back-from-labor-is-even-pos-1168230225