Mother’s Health/the New Family
While pregnant mothers often get plenty of attention, after the birth, most of this attention can be focused on the baby.
Mothers can often neglect their own health, perhaps because they don’t wish to bother others with their own problems. It takes a while for your body to adjust following childbirth. If you had a caesarean section you will also need time to recover from the effects of the operation. Caring for children can be fun and rewarding, however babies need a lot of attention during the early weeks and this can make life tiring. Some of the following ideas may help:
• trying not to expect too much from yourself. It may help to do what is essential and catch up later if or when you have more time and energy.
• asking your partner, family/wha¯nau and friends to help with housework and child care. They often enjoy being needed and
accepting offers of help may make life easier for you.
• making time to relax, cuddle and play with your children.
• resting and relaxing while your baby is sleeping.
• trying not to over-tire yourself with visitors. Visitors may like to help you by making a drink, a meal or helping around the house.
• planning time out with your partner, family and friends, leaving your baby with someone you trust over 14 years old.
• talking about your feelings, with your partner, family, friends, or health professionals particularly if you are stressed or feeling depressed.
• joining a local Plunket or parent group, which will give you the opportunity to meet, talk, share experiences and advice with others in your situation.
• Your LMC (Lead Maternity Carer) and Plunket nurse or other Well Child Health Provider are concerned about your well being along with your baby’s, so do not hesitate to discuss your own health concerns.
Out and About
You may feel isolated and lonely during the first few weeks at home with a baby. It may help to talk to others about how you are feeling. If you have made friends at antenatal classes or in the maternity unit, you may like to keep in touch. You can also meet other mothers at the Plunket clinic, or there may be a local mother-and-baby group you can join.
Early Postnatal Care
• If your baby is born in a hospital, the length of time you spend there following the birth will vary depending on where you live and the type of birth you experienced.
• Once you are at home, your midwife and later your Plunket nurse or other Well Child Health Provider, will visit you to provide
support and answer any questions or concerns. Do not hesitate to discuss your own health as well as baby’s.
E x t ra weight gained in pregnancy usually reduces naturally, particularly with breastfeeding. While you may be anxious to regain your former figure, the early postnatal period it is not a good time to start dieting. If you want to lose weight more quickly, try to get some regular exercise and reduce your intake of fatty and sugary foods. Crash dieting is not a good idea as it may reduce your energy levels. When you are breastfeeding, dieting can cause changes to the fat content of your breast milk. Doing a lot of exercise can also affect your breast milk. Eat a variety of foods. The best guide as to how much to eat should be your own appetite. In general, mothers are hungrier during the first few months of breastfeeding. It is important for breastfeeding mothers to eat regular meals and snacks to meet baby’s and your nutritional needs. You may find you are thirsty during the first few days after delivery as your body removes extra fluid accumulated during the pregnancy. After that, your body will calculate your needs, most mothers do notice they are thirstier when breastfeeding.
Folic Acid (a B Vitamin)
It has been found that in most cases spina bifida (a serious birth deformity of the spine) can be prevented if women have enough folic acid before and during early pregnancy. Your normal diet is not likely to have enough folic acid. If you are planning on becoming pregnant again or could become pregnant, you need to have the right vitamin supplements and extra foods high in folic acid such as fruit, vegetables, bread, cereals and cooked dried beans. You can talk to your Plunket nurse, other Well Child Health Provider or doctor for more information.
Skin and Hair
• Any reddish ‘stretch marks’ on your breasts, thighs and abdomen will shrink and become paler with time. Stomach muscle tone can improve with time and exercise.
• You may also find that your skin is not as clear as it was, but this will improve.
• You may find that your hair is dry and falling out more freely than usual; this is caused by temporary hormone changes and will stop in time.
After the birth of a baby it is normal to have a discharge from the uterus, which is called lochia. This usually starts as bloodstained and gradually becomes lighter and brownish. You may find that bleeding increases temporarily when you become more active. It may continue for over 6 weeks after baby’s birth. If you are breastfeeding your baby, it is likely to stop earlier as the uterus returns to normal more quickly.
• Pads are best used for at least two weeks after the birth, after that time you may prefer using tampons once you feel comfortable.
• See your doctor if you have a sudden heavy loss of blood, there are clots, or if the bleeding is smelly.
• If you are breastfeeding your periods may return in the first few months or may not return for the time you are breastfeeding.
If you are formula feeding, your period is likely to return in the first 1-3 months. The first periods are often irregular and may be heavier or lighter than your usual period as your hormone levels settle to their pre-pregnant state.
• It is important for early detection of cervical cancer to have regular smears. Talk to your midwife or doctor about smears and when your next one is due.
• You may feel bruised and sore around the perineum (the area between the vagina and rectum) even if you experienced a
• If necessary, your midwife can advise on treatment to relieve perineal pain, and on the best position to adopt when lying or
Having Sex Again
• Many women do not enjoy sex for some months after the birth of a child. You may feel tired and be sore from the birth. Caring for your baby and perhaps other children places demands on your time and energy.
• It is important to talk to your partner about your feelings and help him understand that he is not being rejected if you do not
feel like sex.
• You may decide as a couple to find other ways of sharing your love, e.g. cuddling or a massage can be relaxing and loving.
• Sex may be uncomfortable at first, especially if you have had stitches. Lubricating jelly or a different position may help. If sex continues to be painful, talk to your doctor.
• Some breastfeeding women find that milk leaks when having sex. This is quite normal, it may help to have a towel handy.
• It is possible before your periods begin again to ovulate and to become pregnant. Breastfeeding can delay fertility, but is not
a reliable method of avoiding pregnancy.
Remember, that once you start having sex after the baby’s birth, you may become pregnant before you have had a period. You can discuss contraceptives with your midwife, doctor, Plunket staff or other Well Child Health Provider.
Postnatal exercises may feel like the last thing you want to do. However, they can be done easily and quickly when washing up, feeding the baby, standing in a queue or talking on the telephone.
Pelvic floor muscles
These support the bladder, uterus and bowel and may become weakened during pregnancy. This can cause some women to
wet their pants when laughing, coughing or exercising.To help strengthen your pelvic floor muscles, try squeezing and tightening your bottom (anus), vagina and bladder openings (imagine you are stopping yourself from passing urine.) Squeeze and hold for a few seconds, relax and then repeat 5 times more. Practice the pelvic floor exercises several times a day. If you experience problems talk to your midwife. You may need to be referred for physiotherapy to help you strengthen these muscles.
To help strengthen your abdominal muscles kneel on all fours and, keeping your back flat, pull your tummy button in towards your spine. You should feel the muscles at the side of your abdomen tightening but your back should not move. Keep breathing normally. Repeat this eight to 10 times.
Care of your back
Take care with lifting, lift bending your knees rather than your back. Be careful doing exercises after the birth e.g. ‘cycling’ with both legs in the air, sit-ups or lifting both legs together while lying down are best avoided at present.
• After having a baby, changes in your hormone levels may cause you to feel tearful, irritable, depressed and tired. You may find you are very tired from looking after baby around the clock especially if you have older children.
• Some mothers fall in love with their babies immediately, but for others it takes a little longer. Both responses are normal.
Maternal feelings grow as you get to know your baby.
• If you are worried about your feelings towards your baby, or fear that you or your partner might harm the baby, seek help
at once. Talk to your midwife, Plunket nurse or other Well Child Health Provider, or ask one of them to help you contact other professionals e.g. a social worker. These professionals will understand and can help you.
The ‘Baby Blues’
Between three and five days after your baby’s birth, you may experience mild depression, feel tense, or tearful for no particular
reason. This is common and often known as the ‘baby blues’. It is caused by postnatal hormone changes. It usually lasts for a few days and does not need treatment.
Postnatal depression affects about one in ten mothers, and can occur at any time during the first year. The risk is greater for mothers who have had severe ‘baby blues’, who have suffered from depression in the past, who do not have good support, or who have experienced a recent stressful event such as a trauma, bereavement or illness. Feelings of anxiety, irritability, having
difficulty sleeping and a reduced appetite may occur before starting to feel depressed. Mothers with postnatal depression often
experience feelings of hopelessness and inadequacy that do not seem to improve. Some women may feel angry and irritated
and do not understand why, others may feel tearful, alone, guilty and unsupported. Each woman’s experience of postnatal depression is different. Cultural background may also affect a woman’s experience of postnatal depression. Often mothers suffer in silence thinking they are a ‘bad mother’ and feel they have to cope. Most do not realize they are depressed. Postnatal depression is an illness.
How do you know if you have postnatal depression?
One way is to ask yourself if any of the following describe how you are feeling:
• I have been unable to laugh and see the funny side of things.
• I have not looked forward with enjoyment to things as I used to.
• I have blamed myself unnecessarily when things went wrong.
• I have often been anxious or worried for no good reason.
• I have felt scared or panicky for no good reason.
• Things have been getting on top of me lately.
• I have been so unhappy that I have difficulty sleeping even when my baby is asleep.
• I often feel sad or miserable.
• I have been so unhappy that I have been crying.
• The thought of harming myself or my baby has occurred to me.
(Based on the Edinburgh Postnatal Depression Scale by JL Cox, JM Holden, R Sagovsky.)
If you think some of the above points sound like how you are feeling a lot of the time, you may like to get support and help from your doctor, Plunket staff member or other health professionals. The good thing is that these feelings are not here to stay. You will get better gradually with the correct help.
Some suggestions that may help you to cope with postnatal depression:
• talk with people you trust and feel will help and support you. They may be your partner, friends, family, doctor, Plunket
staff or other Well Child Health Provider. Also discussing what community supports are available to you.
• accept offers of help that you feel comfortable with. For example: regular phone calls, visits, help with housework, meals, looking after baby to give you some time out.
• keep your workload and expectations of yourself manageable, e.g. the amount of housework, paid work or volunteer work you do.
• take each day one at a time. You may find you have good days and bad days. It may help to divide jobs up into smaller parts.
• have things to look forward to in the morning and afternoon, e.g. time for you and baby to play, cuddle and talk. Also planning something special each week.
• eat well, even if you are eating small, frequent meals.
• make a time to relax, rest and sleep (if you are tired).
• find ways to relax, e.g. listening to music, reading.
• get some exercise, e.g. leaving baby with a trusted friend or family member and going for a walk or taking baby for a walk.
• write down how you are feeling.
• read books and pamphlets on postnatal distress.
• discuss with your doctor your options for care and possible medication for the illness.
The arrival of a baby brings many changes to a family. Family members will have their own feelings and reactions to the baby. Talking about these feelings can bring the family closer together. As with any time of major change there are stresses involved and it is important that you allow time to adjust to your new family roles.
• Children value having a good relationship with their Dad, whether they live with them or not.
• Being a father plays a very important role in helping your child to develop and grow. By providing a positive influence you will
enable him to feel good about himself, be confident and do well. A lot of what a child learns from his parents will follow through into his everyday life helping him be happy as a child and then as an adult how to relate to other adults and how to be a parent himself.
• Children thrive on attention. Try to spend quality time with your child playing with him, talking to him and as he grows listening to his ideas and feelings. Making time to spend with your child will help develop a special relationship with him and enable you to be there for him. This may help your child feel he can go to you when he needs help.
• Sometimes it may seem like baby’s mum knows a lot or has become very busy with baby and you might feel left out. It may
help you to be involved too, and talk about your feelings with her.
• It is not uncommon for some parents to become overwhelmed with their new role as a mother or father. It may help if you both talk about how you are feeling and share ideas on how to cope. This can also feel worse if you are tired or stressed. It
is important to understand that this is a vulnerable time and baby’s mother needs care and to feel valued as an equal.
• You may have your own dad, other male figure, family or friends around to talk to about your feelings– parents need support
for families and parenting to work.
Having a new baby may have caused some financial problems. If you are having budgeting problems, your local Citizens
Advice Bureau may be able to help you find a budgeting service. You can also ring Inland Revenue for benefit entitlements 0800 227 773.
Time for yourself and your partner
• Broken sleep and the demands of parenting can put a strain on your relationship. It is important to talk about concerns and problems.
• At times you may have differing opinions and ideas on parenting; these may have come from your own childhoods.
Discussing your feelings and ideas may help.
• It can help to occasionally have some time for yourself and for you and your partner to be together leaving your baby with a
trusted adult (or trusted teenager over 14 years old).
The Arrival of a Second Baby
Coping with a new baby and a toddler or older child can be very demanding. Until now your older child has been the centre
of attention. They may now think you are spending all your time with the baby and feel jealous. You can often find it hard trying to divide your time and attention. If you are tired after a wakeful night with the baby, facing a busy toddler in the morning can be
hard. Remember you are not superhuman. Sometimes, the baby or toddler has to wait. These ideas may help:
• talk to your older child about the new baby during pregnancy and about who is going to look after him when you have the baby.
• giving him a present from the baby may help make him feel special.
• teach your toddler how to cuddle, touch and talk to the baby safely while you watch them. Toddlers and older children