Postpartum Care Planning: Part 2

May 20,2024 Blog

Postpartum Care Planning: Part 2

Practical Tips for Rallying Available Support

If you are just dropping in to our discussion on Postpartum Care Planning, welcome! I encourage you to read Part 1 and then return to this page for some practical tips to utilize in your fourth trimester planning experience.

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Kimberly Ann Johnson, in her book The Fourth Trimester, suggests that there are 5 Universal Postpartum Needs [6]:

An extended rest period
Nourishing food
Loving touch
The presence of wise women and spiritual companionship
Contact with nature

While each of these are not specifically discussed below, I would encourage any woman preparing for postpartum to consider each of them as part of an optimum healing.

The following suggestions are meant to help you consider how you can be best supported and safe as you move through pregnancy and make plans for your growing family post-birth.

Medical: Questions to ask your OBGYN or birth provider:

Consider asking your birth provider the following questions as part of your postpartum care planning process. My personal opinion is that a birth provider who cares about your holistic wellbeing will have answers at the ready for each of these questions.

Length of care and contact: How long will I be under your postpartum care? What things do I call you about versus my Primary Care Physician (PCP)? How do I reach your office or on-call nurse?
Warning signs of postpartum distress: What are some physical postpartum warning signs to look for, specifically regarding mastitis, blood clotting, hemorrhaging, blood pressure, mental health, etc? Which concerns warrant a trip to the ER and which should I simply call about first?
Referrals: Who do you recommend for other professional care such as pelvic floor therapists, postpartum nurses or doulas, mental health care (specifically for perinatal mental health), lactation consulting, chiropractic care, etc?
Partner Support: What can my spouse or partner do to support my recovery in postpartum? Do you have any resources on this topic?
Nutrition and Activity: What kind of nutrition choices support a healthy postpartum as I recover? What kind of activity do you suggest at each stage of healing?

Mental/ Emotional

It is no secret that the mental and emotional health of a woman immediately postpartum can be tenuous at times. While not all women experience mood disorders, it is certainly a time of heightened risk. Many women and their partners may not know what to recognize as a red flag. These are some basic tips for postpartum mental and emotional health:

Make sure your main support person (usually a spouse or partner) is aware of the warning signs surrounding perinatal mental health.
Know that you may be at higher risk of a Perinatal Mood or Anxiety Disorder (PMAD) if you have a history of mental health concerns.
While the “baby blues” are largely normal and will pass in a few days or weeks following birth, extended or heightened periods of sadness, anxiety, or intrusive thoughts may be pointing to a PMAD. Use this resource to help yourself know the differences and when to seek help.
You can also use this brief discussion tool as a quick check-in with your partner or someone you trust to screen for PMADs throughout your postpartum experience.
Identify a mental health professional that you would want to work with PRIOR to postpartum period. Maybe even call them to ask some questions about how they work, their philosophy and training, etc. Once you are “in the weeds,” it may feel too overwhelming to identify a counselor you may deem a good fit. Even if you never end up calling them for counseling, you can have the number handy. Maybe you even identify 2 or 3 options just in case you have trouble getting in to see them.

Note: ChristianWorks offers free counseling services (both in-person and virtual) for any expectant parent or someone parenting a child under 36 months of age.

Relational

We know that there is inevitable strain on partner relationships with the massive transition into parenthood. In fact, John Gottman, relationship researcher and creator of many couples’ counseling models of therapy used today, found a whopping 67% decline in marital satisfaction in the first three years of a child’s life [6]. But the good news is, Gottman also found that 2 short counseling sessions about potential conflict and parenting topics helped ease this decline [6].

But if for some reason counseling is not manageable for you and your partner, I recommend having in-depth discussions surrounding each of your expectations for your relationship following the birth of the child. Also, what will the roles and responsibilities look like for each of you as Mama recovers physically? Talk about these openly both before and after your child arrives.

In a strong relationship, a “relationship bubble” of clear expectations and mutual support can positively support and impact the postpartum and parenting experience [6], creating a safe-haven for the couple midst stressors of the newborn phase.

Identify your strengths as a couple. How you will ideally problem solve disagreements?
What practical help will you need from your partner?
Who can your partner turn to for emotional and practical support as he transitions into fatherhood?
How will you each manage the potential lack of connectedness or feelings of isolation in early postpartum as you are likely not participating in your regular social activities?
Discuss how to manage inevitable sleep deprivation and how to help one another get basic needs met as often as possible.
I HIGHLY RECOMMEND using one of the postpartum planning resources at the bottom of this page to discuss when (and who) you would like to come over after the baby is born to visit or help during the postpartum period. Doing this as a couple can assist in considering what each of you anticipate needing during these days and weeks.

Note: ChristianWorks offers free couples’ counseling services (both in-person and virtual) for couples who are expecting a child and couples who are parenting children under 36 months of age.

Basic Needs and Community Support

In postpartum, you ideally will need you and your family’s basic needs covered while you recover. Again, postpartum planning tools (see below for examples) are fantastic at helping you walk through the logistics of this, so I will not list all the topics we could discuss here. These are simply the biggest suggestions I have for rallying your community. Remember, you may not know who is willing to help you unless you simply ask; and as you build this community of support, you are building a community that you can continue to maintain throughout your whole parenting journey, not just postpartum [1].

Family meals: Have a close friend (or yourself) set up and manage a meal train for you, the details of which you can determine for yourself on the to honor your desires for either space or connection from your support system while also receiving nourishment. Try an online meal train to keep the stress of scheduling minimal.
Household management: Who will manage the household tasks, and/or keep your other children on schedule? Is there anyone you’d like to stay with you for a week or two that you trust for this role?
Identify these crucial areas of support: DLR: Do, Listen, Relief
- Do: Who in your support system are the doers? These are the people who love acts of service and staying busy. Task them with keeping your kitchen clean, running errands, or dropping off older children at baseball practice.
- Listen: Who is a seasoned mother you admire? Who are your friends in the same postpartum grind? Call them; text them; reach out to them with all the questions you may be embarrassed about. They have been there.
- Relief: Who just brings a sense of calm or humor? This is the friend who may not be a mother yet, but reminds you of the outside world. This is the friend that takes up zero social energy, but helps relieve you of the newborn bubble when you need an adult conversation and to relax in a social atmosphere.
Consider your personal plans to return to work and options for parental leave. Do not stress if the plan that you make during pregnancy is not the plan you choose to maintain. In the United States, 1 in 4 women return to work at only 10 days postpartum, and only 12 percent of Americans even have access to paid parental leave [6]. This unfortunate trend largely sets women up for disappointment in their goals for experiencing a nurturing and healing postpartum journey. While many of the details surrounding your return to work may feel out of your hands, do not be afraid to speak boldly with your partner and support system about creative ways you can obtain as much time postpartum as you can for both yourself and your child.

Resources to help you create a postpartum care plan of your own:

Kimberly Ann Johnson’s Postpartum Sanctuary Plan (The planning tool begins on page 18)

Postpartum Support International’s Postpartum Care Planning Tool

Postpartum Support International’s bimonthly, virtual Postpartum Planning Class

References:

Barimani, M., & Vikström, A. (2015). Successful early postpartum support linked to management, informational, and relational continuity. Midwifery, 31(8), 811–817. https://doi.org/10.1016/j.midw.2015.04.009
Chien, L.-Y., Tai, C.-J., Ko, Y.-L., Huang, C.-H., & Sheu, S.-J. (2006). Adherence to “doing-the-month” practices is associated with fewer physical and depressive symptoms among postpartum women in Taiwan. Research in Nursing & Health, 29(5), 374–383. https://doi.org/10.1002/nur.20154
Eberhard-Gran, M., Garthus-Niegel, S., Garthus-Niegel, K., & Eskild, A. (2010). Postnatal care: A cross-cultural and historical perspective. Archives of Women’s Mental Health, 13(6), 459–466. https://doi.org/10.1007/s00737-010-0175-1
Entsieh, A. A., & Hallström, I. K. (2016). First-time parents’ prenatal needs for early parenthood preparation-A systematic review and meta-synthesis of qualitative literature. Midwifery, 39, 1–11. https://doi.org/10.1016/j.midw.2016.04.006
Fahey, J. O., & Shenassa, E. (2013). Understanding and meeting the needs of women in the postpartum period: The Perinatal Maternal Health Promotion Model. Journal of Midwifery & Women’s Health, 58(6), 613–621. https://doi.org/10.1111/jmwh.12139
Johnson, K. A. (2021). The Fourth Trimester Journal: Practices and reflections to Honor your journey into Liu, Y. Q., Maloni, J. A., & Petrini, M. A. (2012). Effect of postpartum practices of doing the month on Chinese women’s physical and psychological health. Biological Research For Nursing, 16(1), 55–63. https://doi.org/10.1177/1099800412465107
Mott, S. L., Schiller, C. E., Richards, J. G., O’Hara, M. W., & Stuart, S. (2011). Depression and anxiety among postpartum and adoptive mothers. Archives of Women’s Mental Health, 14(4), 335–343. https://doi.org/10.1007/s00737-011-0227-1
Postpartum plan for new parents. 4th Trimester Project. (2023, August 14). https://newmomhealth.com/toolkit/postpartum-plan-for-new-parents-toolkit-old-version/
Postpartum plan. (n.d.). https://www.postpartum.net/wp-content/uploads/2023/04/PP-Plan-Updated.pdf
Postpartum planning for expectant parents. Postpartum Support International (PSI). (2024, January 15). https://www.postpartum.net/postpartum-planning-for-expectant-parents/
Razurel, C., Kaiser, B., Sellenet, C., & Epiney, M. (2013). Relation between perceived stress, social support, and coping strategies and maternal well-being: A review of the literature. Women & Health, 53(1), 74–99. https://doi.org/10.1080/03630242.2012.732681
Savage, J. S. (2020). A fourth trimester action plan for wellness. The Journal of Perinatal Education, 29(2), 103–112. https://doi.org/10.1891/j-pe-d-18-00034
Stuebe, A. M., Kendig, S., Suplee, P. D., & D’Oria, R. (2020). Consensus bundle on Postpartum Care Basics. Obstetrics & Gynecology, 137(1), 33–40. https://doi.org/10.1097/aog.0000000000004206