Post partum self-care

by | Babies and Pregnancy, Women's Health

The mantra “healthy mum, healthy bub” is never more true than in the fourth trimester – the first few hectic months after giving birth. That’s why we’ve put together an evidence-based guide to post partum self-care can trust to help you recover well and feel great as you find your own way though the ups and downs of early parenthood.

Recovering from anal fissures and tearing

Sometimes labour doesn’t go to plan and trauma to the vagina, perineum and anus can happen.1 Usually this is identified at the time of baby’s birth and stitches may be required. Other times the pelvic floor may be affected and a women’s health physiotherapist can guide your recovery. Generally, the most common kinds of trauma include tears in the skin between the vagina and anus.1 

A Dutch study found almost 70 percent of women experience pain around their bottom in the three months after birth, with one of the most common symptoms being anal fissures – cracks, tears or splits in the skin lining the anus which can be linked to pregnancy and childbirth as well as constipation and straining when using the toilet.2 Talk to your pharmacist about how to heal anal fissures.1 

Finding the right support for breastfeeding

It’s common misconception breastfeeding is a straight-forward experience. The reality is, breastfeeding, particularly in the early months, can be difficult; it’s a learned skill, like driving a car. 

While initial support from nurses and midwives in hospital can help, you may want extra advice to help with how you position baby to guide them to latch on effectively.3  This is where lactation experts and peer-support services such as the Australian Breastfeeding Association can help. Contact their 24-hour breastfeeding support service on 1800 686 268 or live chat.

See your GP if breastfeeding hurts

While breast and nipple sensitivity is normal when breastfeeding, pain is not.3-4 But working out the difference isn’t always easy, which is why sore breasts and nipples are the most common reason for calls to the National Breastfeeding Helpline in Australia.4 

If your breast feels painful, hot to touch and looks red – particularly if you have fever, chills and body aches as well – you could be experiencing mastitis.5 This condition does not effect the safety of your milk so it’s important to keep feeding as often as baby needs.4 Treatment for mastitis includes massage as well as heat packs to help milk flow before feeding and cold packs to reduce discomfort after feeding. 3 While it’s safe to keep feeding or expressing milk throughout an episode of mastitis, you may require treatment with antibiotics so talk to your GP. 3,5  

Thrush is another cause of painful breasts and nipples requiring a trip to the GP. Pain often comes on quickly then feels like it’s radiating up through the breast and may be associated with dry, flaking or shiny red skin on the nipple.5-6 Baby may also have signs of thrush around their mouth (white spots inside cheeks) or bottom (spotty red rash).5-6 Chances are you’ll both need treatment with an antifungal medicine so take bub along when you see the doctor for this extremely common condition.5-6 

Getting back to exercise

As soon as you’re feeling up to it, gentle walking for 30 minutes a day is the best way to ease back into exercise after giving birth. While The Royal Women’s Hospital advises against any vigorous exercise (running, weights, sit ups) for the first 12 weeks, multiple studies demonstrate physical and mental benefits to staying physically active in women who do not have any pregnancy or birth complications.7-8

Women who’ve experienced a Caesarean delivery may prefer to wait until after their incision has healed before walking with a pram.9 All women are advised not to lift anything heavier than your baby for the first six weeks and to discuss pelvic floor strengthening with your GP, obstetrician, midwife or women’s health physiotherapist.10

Prioritise mental wellbeing

As if having a child isn’t a massive enough life transformation, new mums face broken sleep and hormonal fluctuations as well. While this is big life stuff and plenty of women will require professional support in the form of counselling or therapy, everyone can benefit from self-awareness and asking what is needed to feel OK right now.11 

One of the most practical strategies to check in with is using the HALT acronym to ask if you’re feeling “Hungry, Angry, Lonely, or Tired”.12 As a mother caring for at least one tiny human, chances are you’ll identify with some combination of these but making an effort to eat nutritious food and stay hydrated, share how you’re feeling with loved ones, staying in touch with friends and taking naps when baby does can make a mood-boosting difference.  

When the struggle is particularly real, Beyond Blue and PANDA have resources to help with navigating early parenthood and finding your own kind of new normal:If you’re experiencing persistent low mood or anxiety, speak to your GP, obstetrician, midwife or family health nurse. For immediate support see our list of 24 hour support services or phone Lifeline on 13 11 14 . 

Related Posts

Ask for help…and be willing to accept it 

A 2019 study found mums and dads both wish they had more support from their loved ones to help with caring for bub, so make life a bit more manageable by agreeing the kind of parent who seeks help early and often.12 Partners, parents, siblings and friends usually mean it when they offer to help so take them up on it.13 Even having someone pop over to sit with baby while you take a nap and shower can make all the difference in feeling slightly more on top of things.

Learn to set boundaries and stick to them

Babies are lovely and people will want to see them. But it’s not your job to entertain well-meaning relatives. Decide in advance how you’d like to receive visitors and let them know whether unexpected drop-ins are an option. Clearly communicate your preferences regarding visit duration, frequency, limits on group sizes and any specific rules about hygiene (handwash before holding, no visitors with colds). If it all sounds like too much, explain that you’re only doing virtual visits for the moment and fire up Zoom. Remember, it’s your family so it’s your rules!

References

  1. Bužinskienė D, Sabonytė-Balšaitienė Ž, Poškus T. Perianal diseases in pregnancy and after childbirth: frequency, risk factors, impact on women’s quality of life and treatment methods. Front Surg. 2022 Feb 18;9:788823. Accessed August 13, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894587/
  2. Ferdinande K, Dorreman Y, Roelens K, et al. PWE-001 Anal problems during pregnancy and postpartum: a prospective cohort study. Gut 2017;66:A126. Accessed August 13, 2023. https://gut.bmj.com/content/66/Suppl_2/A126.1
  3. Westerfield KL, Koenig K, Oh R. Breastfeeding: common questions and answers. Am Fam Physician. 2018 Sep 15;98(6):368-373. Accessed August 13, 2023. https://pubmed.ncbi.nlm.nih.gov/30215910/
  4. Tawia S, Haines N. The impact of the National Breastfeeding Helpline in Australia: an evaluation of caller satisfaction, wellbeing and breastfeeding. 2023. Breastfeeding Review, vol. 31, no. 2, Australian Breastfeeding Association, 2023, pp. 6–13. Accessed August 13, 2023. https://search.informit.org/doi/10.3316/informit.193939244072787.
  5. Amir L, Baeza C, Charlamb J, et al. Identifying the cause of breast and nipple pain during lactation. 2021. BMJ, vol. 374, n. 1628. Accessed August 13, 2023. https://www.bmj.com/content/374/bmj.n1628
  6. Tommelein, E., Muyldermans, J., & Moerman, A. Diagnosis and treatment of thrush during breastfeeding: An overview of recommendations in national and international guidelines. Laktation und Stillen. 2020. 32(4), 26-30. Accessed August 13, 2023. https://researchportal.vub.be/en/publications/diagnosis-and-treatment-of-thrush-during-breastfeeding-an-overvie
  7. Brown WJ, Hayman M, Haakstad LAH, et al. Australian guidelines for physical activity in pregnancy and postpartum. Journal of Science and Medicine in Sport. 2022. Volume 25, Issue 6. (511-519). Accessed August 13, 2023. https://www.sciencedirect.com/science/article/pii/S1440244022000688
  8. Liu N, Wang J, Chen D-d, Sun W-j,Li P, Zhang W. Effects of exercise on pregnancy and postpartum fatigue: A systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2020. Volume 253, Pages 285-295. https://www.sciencedirect.com/science/article/pii/S0301211520305273?casa_token=YQR6yHlocigAAAAA:Eda8ddeUcltCphpCh64ywnik30M2WqvVS4h-_giNgYmOBeIAj5oOSe_PSc84LnerX1dJZSA#sec0080
  9. Pregnancy birth baby. Recovery after a caesarean. May 2022. Accessed August 13, 2023. https://www.pregnancybirthbaby.org.au/recovery-after-a-caesarean
  10. The Royal Women’s Hospital. Exercise. [nd]. Accessed August 13, 2023. https://www.thewomens.org.au/health-information/pregnancy-and-birth/your-health-after-birth/exercise-after-birth
  11. Holopainen A, Hakulinen T. New parents’ experiences of postpartum depression: a systematic review of qualitative evidence. JBI Database of Systematic Reviews and Implementation Reports 17(9):p 1731-1769, September 2019. Accessed August 13, 2023. https://journals.lww.com/jbisrir/Fulltext/2019/09000/New_parents__experiences_of_postpartum_depression_.3.aspx?context=FeaturedArticles&collectionId=5&casa_token=aFCdmOpQnP0AAAAA:vm3HEVBF_bKHxtpStLVGQ8Dq1C6zWPshkFhn4LIBGYlsYQAA27bPn743oWLiQ5yA3sBzTzTjmHlUoIkapWdGaA
  12. Cleveland Clinic. Four stressors on your recovery. May 24, 2022. Accessed August 13, 2023. https://health.clevelandclinic.org/halt-hungry-angry-lonely-tired/
  13. Nkwoma Inekwe J, Lee E. Perceived social support on postpartum mental health: an instrumental variable analysis. Plos One. May 5, 2022. Accessed August 13, 2023. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265941