Pathway to Pregnancy, Part III: Postpartum & the 4th Trimester

hand and baby foot

by Julie Johnson, L.Ac.

In this final installment of our series, The Path to Parenthood, we will discuss the POSTPARTUM period with a focus on self-care for mamas.

So. You are having a baby!

Your approaching due date brings with it much anticipation and excitement. The to-do list is bursting with supplies to buy (Diapers! Breast pump! Baby Bjorn!) and tasks to complete (Paint nursery! Hang mobile! Decorate with butterflies/dinosaurs/giraffes/something adorable!)

For many new parents, the nesting instinct comes on strong: Let’s make sure that we have everything we need to meet our little one’s needs and welcome him/her into the world. It’s fun and easy to focus on these details, because the fun part of having a baby is, well, the baby!

 What may not make it on to your to-do list, however, are preparations for postpartum self-care that go beyond enlisting Grandma for baby-sitting help or asking your best friend to bring over a few meals in the early weeks.

Many mothers invest heavily in self-care before and during pregnancy, making significant dietary and lifestyle changes, engaging in stress-relief practices, and scheduling regular pre-natal massage and acupuncture treatments. But let’s face it: much of this self-care is ultimately intended to benefit our child’s health and wellbeing. Once our infant is outside the womb, we instinctually shift to an “other-oriented” focus and our own needs are pushed to the backburner.

While this approach is common in our society, I encourage women to make self-care a continued priority. As an acupuncturist, I frequently meet women who are one, two, or even several years postpartum who tell me that they still haven’t recovered their pre-pregnancy energy level and mood. Fortunately, acupuncture and herbal medicine can be wonderfully effective for restoring vitality even at this stage, but it saddens me knowing that many women fail to receive even the most basic postpartum care that could nip these problems of ongoing fatigue and depression in the bud.

The 4th Trimester: Protecting Mama & Baby

In our culture, we tend to think of labor and delivery as the “finish line” of pregnancy, when, in fact, the process is not yet complete. As soon as we deliver our child, our body must begin the process of healing tissues and rebuilding resources. That healing process is hindered if we are overextended and undernourished, which can easily happen if we invest our energy in activities beyond tending to our infant and eating nourishing foods.   Trying to clean the house, run errands, jump back into your normal exercise routine, and entertain family and friends while snatching a quick protein bar snack in between may fit your image of being a “super mom,” but it robs you of the rest and rejuvenation you need and deserve.

No matter what the circumstances or duration of the labor, delivering a child into the world is a monumental feat of physical and mental endurance—often the largest of a woman’s life—and the need for a full and deep recovery cannot be understated.   Physically, a new mama has likely endured some combination of sleep-deprivation, long hours of contractions, breathtaking pain, a large volume of blood loss, surgical intervention, and utter exhaustion (or all of the above). And this marathon comes at the end of pregnancy when her resources are already low from nurturing her child in utero.

Simultaneously, at her time of greatest vulnerability, a mother has also received into her care her tiny infant, infinitely more vulnerable than she. A baby’s first few months outside the womb are now being referred to as the 4th trimester, a term that casts this transitional period as an extension of pregnancy, highlighting an infant’s vulnerability and need to stay close to mama’s body wrapped in a protective cocoon of care and gentleness.

Traditionally, this cocoon of protection was also extended to mothers, and it is still standard in many societies to create a time of rest and rejuvenation for the mother lasting anywhere from 20 to 40 days after labor and delivery. This transitional period for a woman is seen as critical for her to recover her strength. Recognizing that a mother’s return to full vitality is essential not only for her long-term health but also for the health of the baby and the strength of the family as a whole, these cultures place a high value on ensuring that a new mama’s need for rest and nourishment are met.

Postpartum Self-Care: Sanctuary

The first line of defense in building your cocoon is enshrouding yourself in a restful sanctuary, free from the demands of the outside world. Sleep can be difficult to come by in the early days, but a next best second is staying still and quiet in a protected space with your baby bundled on your chest. Ideally, you won’t venture out into the world for anything more than your baby’s first pediatric medical check-up, and you won’t be required to entertain guests of any sort (including family). In the early days, the best guests are those who come by only to drop off food, assist with household chores, or cradle your little one while you nap or refresh yourself with a hot shower or bath.

The message here is to give yourself the gift of as much rest and freedom from obligations as your heart desires. During those early and precious first weeks and months postpartum, allow yourself the luxury of conserving your energy. As a practitioner of Chinese Medicine, I urge my patients to be gentle with themselves when they are recovering from any taxing situation, whether that be a nasty head cold, a surgery, or even years of over-work. I encourage them not to “spend” that first burst of energy they feel by over-doing it with exercise or activity, but instead to put that energy “in the bank,” saving it up until they have ample reserves.

Postpartum Self-Care: Sustenance

Equally important is mom’s postpartum sustenance. As in any period of convalescence, nourishing herbs and foods are essential to replenish nutrients, build blood, and overcome fatigue.

In China, the use of herbs to accelerate postpartum healing is common “grandmother wisdom,” and a new mom can rely on the family matriarch to cook up medicinal teas and nutrient-rich, herb-infused postpartum soups.

Though you may not have a Chinese grandmother to move in and lavish you with care for six weeks, there are lots of strategies for making sure you get the sustenance you need for postpartum recovery. Freezing broths and soups in advance can be a lifesaver and don’t be afraid to send out specific recipe requests to friends and family. Most importantly, it’s a great idea to make sure your kitchen is stocked with the building blocks you need for nourishing recipes!

In terms of food preparation, from a Chinese Medicine perspective you can go a long way just by following a few simple principles:

  1. Favor warm, cooked foods

This principle applies to all foods, including vegetables, fruits, and beverages.  That means steering away from cold sandwiches, salads, raw fruits, and ice water, and instead choosing options like baked root vegetables, stewed fruit, steamed greens, and warm tea. The reasoning behind this principle is that warm, cooked foods are easier on the digestive system and require much less energy to break down (thereby saving energy for the healing process), whereas raw, cold foods require more energy and also extinguish the body’s “digestive fire.” Good choices include baked squash and sweet potatoes, stewed apples and pears, steamed greens like chard, kale, and spinach, and fresh herbal teas made with herbs like nettles, raspberry leaf, and red clover.

  1. Favor mushy over dry

This principle is an extension of the first principle but deserves special mention. It means ditching the breads, crackers, and protein bars in favor of cooked grains and soups. One of the most popular convalescent foods in China is congee, which, at its most basic, is porridge made from a grain (commonly rice, barley, or oats) cooked for longer than usual and with extra water. The extra water and longer cooking time helps the grains break down more, thus enhancing digestibility. Along these same lines, soups of all sorts are wonderful for promoting healing and rejuvenation, especially when prepared with a base of home-cooked bone broth or veggie stock. This principle also applies to any dried fruits, nuts, or seeds, all of which are much more easily digested if they have been pre-soaked in water or cooked into other foods. Good choices include red dates, figs, goji berries, black sesame seeds, pumpkin seeds, almonds, and walnuts.

2. Start with easily-digestible animal protein

While reaching for a cheesesteak first thing might be just the ticket for some women, many do much better starting with gentler forms of animal protein like bone broth, butter and ghee (melted on vegetables or stirred into congees), whisked eggs stirred into soup (egg-drop soup), bits of meat cooked into soup and stews, and warm milk with spices (turmeric, cardamom, ginger). As your energy returns, heavier meals with meats and cheeses may become easier to assimilate.

Herbs and Chinese Medicine for Postpartum

 In a perfect world, every new mom would have the opportunity to consult with a Chinese Medicine practitioner and receive a custom blend of postpartum herbs to help her heal!

We particularly recommend that you seek help if you are experiencing any of the following:

  • Postpartum depression
  • Exhaustion
  • Poor milk supply
  • Mastitis
  • Increased sweating
  • Excessive bleeding
  • Uterine prolapse
  • Urinary tract infection
  • Hemorrhoids

For your herbal medicine, we recommend finding a practitioner who specializes in women’s care and who does phone consultations, so you can stay cozy at home in your sanctuary! At Well Woman Acupuncture, we will happily mail your herbs to you if you don’t have someone to pick up your herbs or if you live far away.

Once you are ready to venture out of the house, acupuncture is a wonderful addition to your self-care routine that will work synergistically with your custom herbal formulas to optimize your recovery time. Consider biweekly acupuncture treatments to promote uterine healing, alleviate back and hip pain, facilitate a smooth milk supply, and boost your overall energy and mood. Weekly treatments may be indicated if you are experiencing any of the complications listed above.

And don’t forget that acupuncturists can work wonders for your little bundle of joy too! When treating infants and young children, we use special Japanese tools that we gently tap and brush along the skin to stimulate certain acupuncture points and meridians. Kids are super responsive to this treatment, so be sure to give us a call if any ear infections, digestive troubles, or sniffles come your way!

Our Favorite Postpartum Book

The First Forty Days: The Essential Art of the Nourishing the New Mother

This lovely book serves as guide for the modern day mother wishing to navigate her postpartum recovery armed with traditional grandmother wisdom. It is full of self-care strategies and tips, suggested must-have pantry items, and a terrific collection of nourishing recipes ranging from Beef Bone Broth to Miso & Burdock Soup to Spiced Vanilla Egg Custard. The perfect gift for a mama-to-be.

Have postpartum self-care tips that you’d like to share? Post your comments below! And, as always, don’t hesitate to include us as part of your self-care network. If you are unsure if acupuncture and herbal medicine are right for you, contact us to schedule a free 15-minute consultation. We are here for you!