Postpartum is the time period after giving birth. It is a natural time the body needs to recover from pregnancy and delivery. There are three distinct phases of postpartum.
1) EARLY POSTPARTUM – Uterine Cleanse Phase (0-1 Month)
Early postpartum is from birth until 30 days. During this phase the uterus clears out any leftover pregnancy matter and fluids and heals up the walls of the uterus. Replenishing lost fluids, blood and energy is vital as soon as possible after giving birth and throughout this entire phase or else breastmilk will not get a strong start. Rest is necessary for the uterus to perform necessary tasks during this phase.
2) MIDDLE POSTPARTUM – Uterine Strengthening Phase (1-12 Months)
Middle postpartum is from one to twelve months after giving birth. During this phase the body continues to replenish from lost fluids, blood and energy and, if the uterus received a full cleanse during phase 1, starts to regain its strength.
3) LATE POSTPARTUM – Uterine Circulation Phase (13-24 Months)
Late postpartum is from thirteen to twenty four months after giving birth. During this phase the body focuses on circulation and boosting energy.
SIGNS OF INCOMPLETE POSTPARTUM RECOVERY
-Heavy bleeding . Associated with Uterine Fatigue and/or Uterine Stagnation.
-Yellow lochia . Associated with Excess Heat.
-Lochia extended past 30 days . Associated with Uterine Stagnation or Uterine Fatigue.
-Early menstrual return. Associated with Uterine Fatigue.
-Late menstrual return. Associated with Blood Deficiency and/or Uterine Stagnation .
-Unhealthy menstrual return. Associated with Uterine Stagnation.
-Low breastmilk. Associated with Blood Deficiency and Uterine Stagnation.
-Hair loss. Associated with Blood Deficiency.
-Aching teeth. Associated with Blood Deficiency and Dryness.
-Lack of support
-Incomplete postpartum care
-Cold foods and drinks
-Lack of follow-through to ensure healthy menstrual return
-Lack of medical and public health awareness of postpartum needs
Medical treatments include monitoring and issuing antidepressants for depression. The word postpartum itself seems to be heavily associated with patient depression. Additionally, the doctor may offer a variety of birth control options for extended lochia, heavy bleeding, postpartum contractions and other issues that arise.
In Traditional Asian Medicine, Postpartum is seen as the second Golden Opportunity in a woman’s lifetime – a chance to enhance one’s health and life. It is a time to care for and nourish the body to the utmost extent possible. (More Information: 7 Times a Woman by Lia Andrews)
-Depression / Emotional Overwhelm / Disconnect
-Pelvic Floor Prolapse
-Late Postpartum Menstrual Return
-Early Postpartum Menstrual Return
Postpartum Recovery is the return of the postpartum body to full pre-pregnancy state and function within the six week period after giving birth extended on until the return of a standard healthy menstrual cycle.
POSTPARTUM RECOVERY CHECKLIST
1. Full uterine cleanse.
2. Uterus organ and ligaments return to normal size and position.
3. Neighboring organs (colon, bladder, intestines) must return to normal position and function.
4. Stretched vulva, perineum and vaginal canal skin tissue must regain tone and shape and heal from tears and sutures and scar tissue.
5. Water retention or swelling must disperse.
6. Pelvic or spinal bone injuries should be assessed and addressed.
7. Blood and fluid loss during labor and delivery must be replenished to allow for the body to recover energy, heal and produce breastmilk.
8. The birth experience, labor and delivery should be emotionally processed.
9. The Matrescence transition into motherhood should be acknowledged and supported.
10. Return to sex should be painless.
11.Menstrual return should consist of 3 consecutive months of standard healthy cycles — 4 days menses, pain free, red color, no side-effects, 28-30 day cycles
If any of these items is not satisfied then there is an incomplete postpartum recovery. Due to insufficient medical care for postpartum mothers there is a pandemic of mothers who have not ever fully recovered from their postpartum and deal with a variety of issues that effect quality of life. Sadly, it’s more common not be fully recovered than to have had a full postpartum recovery.
Wide-scale and immediate steps should be taken on both the micro and macro scale (each pregnant person, birthworker, doctor and medical structure) to adopt these guidelines and put them into immediate use for current and future care.
Steps must also be taken to identify past mothers who are not fully recovered from their postpartum time periods (no matter how long it has been) and to take steps to correct remaining issues now.
HOW DOES IT WORK?
Steam appears to help clear out leftover pregnancy matter which may reduce risk of infection, help make the uterus go back down to size faster, help the other organs return to their normal position and function. Additionally, the introduction of steam helps with circulation which disperses water retention and swelling of the skin. For steam users this has reported not only in pain reduction and seeing the vulva return back to its shape in record time but also getting into their pre-pregnancy clothes faster. Steam also might help to clean birth injuries and sutures preventing them from infection and helping to prevent the formulation of scar tissue.
With all the benefits that postpartum steam users report, there is no question that postpartum steaming is used universally all over the world. Postpartum steam use spans all cultures worldwide. Though the domination of western medical care does not use steaming (and therefore it has not been a standard treatment for postpartum care for many years) a great effort should be made for all birthworkers and nurses to receive adequate training in steam therapy to re-introduce it into wide-scale care as soon as possible.
Steam therapy can also be used in several first aid situations during labor and delivery and the immediate postpartum – stalled labor, retained placenta, urine retention, pre-eclampsia and general pain relief and relaxation.
WHAT TO EXPECT
1) In early postpartum, many steam users feel immediate relief that improves with each steam session. It is common to have discharge after steaming (lochia, mucus, clots, bleeding). If someone has not done any postpartum steaming and their menstruation has not returned yet, it is also often for them to have post-steam discharge. Depending on the discharge, steaming must sometimes stop for a day or two until it is resumed.
2) In the middle postpartum steaming can be used to help painless return to intimacy, softening scar tissue, resolving bleeding issues, fending off early menstrual return, resolving extended lochia, resolving prolapse, hemorrhoids and urinary incontincence; and support with nursing. This is also when cesarean deliverers start steaming. 3) In the late postpartum steaming can be used to help with hormonal balance, healthy menstrual cycle returns, reducing heavy/painful menstruation and late menstrual return.
STEAM THERAPIST RECOMMENDATION
A trained steam therapist should be part of every birth team and available to a birthing client whether in a hospital or homebirth setting. The most practical way to make this happen is to have someone on the birth team (midwife, doula, nurse, doctor, partner, family member) trained in steam therapy for labor and postpartum. If no one on the birth team is trained, a steam therapist should be brought in to be a part of the birth team.
Postpartum steaming is not a do-it-yourself home self-care treatment, nor is it something that can be learned through youtube turtorials or the Steamy Chick userguide. Peristeam Hydrotherapists go through extensive training and work with their client from 36 weeks pregnancy until two years postpartum adapting the steam plan and herbs according to the many changing needs during this time.
To reduce chance of birth injury and complications and to ensure a complete postpartum recovery a steam client and practitioner should work together starting the last month of pregnancy on until two years postpartum. This starts off with weekly consultations during the end of pregnancy which switches to daily consultations after 40 weeks and during the early postpartum. After 30 days postpartum monthly visits should continue until two years postpartum.
-Womb Cleanse Care Guidelines (rest, no plugs, warmth, nourishment, no inversions)
-Identify and Avoid Uterine Fatigue Triggers
-10pm Bedtime. Between 11pm to 3am the liver works to clean and generate blood. If you are awake at this time, it is more difficult for the liver to perform these functions
-Vitamin S Guidelines
-Take a pause from regular routine
-Optional Abstinence (if desired)
-Pelvic Muscle Strengthening Exercises
-Womb Cleanse Food Therapy (Warm nourishing foods like soups and hot cereals. Eat/snack often. Do not cut calories. Avoid cold foods/beverages.)
-Blood Deficiency Food Therapy Guidelines (Blood tonic herbal formulas, focus on digestion and absorption, protein/iron/B vitamins/vitamin C.
-Eat last meal by 6pm or earlier allowing digestion a chance to rest at night, which frees up the liver for cleaning and generating blood.)
-Food Therapy for Lubrication (fruit, gelatin, goji berries, tapioca, chia seeds, oatmeal, boba, okra, nopales, aloe vera and other foods that have a natural gel in them)
Peristeam Hydrotherapists are instrumental starting ASAP after delivery. They can use steaming in several first aid situations (placenta retention, urine retention, infection, preeclampsia) and have herbal first aid tools to stop heavy bleeding. Steaming should start ASAP after giving birth in order to decrease swelling, help the organs return to function and jumpstart breastmilk production. It is recommended working with the Peristeam Hydrotherapist up until 2 years postpartum to ensure full recovery throughout the postpartum stages. Peristeam Hydrotherapists do daily check-ins for the first 6 weeks postnatal and then do a six week checkup to make sure that the Postpartum Recovery is complete.
If someone has a homebirth they will have several appointments with the midwife within the 6 weeks after giving birth – perhaps 8-10 visits. It will be determined by their midwife.
Even if someone has a hospital birth and works with an obstetrician a midwife should be scheduled for in-home visits. The bare minimum would be one visit in the first week after giving birth and another at the six week checkup. They should also be contacted if any issues arise.
Postpartum support from an entire team is necessary at this time so that mom and baby can focus on feeding, sleeping and recovering from the birth.
Absolutely no housecare or cooking should be the responsibility of a postpartum mom for at least 6 weeks after giving birth. Food preparations should be made ahead of time with pre-made/frozen meals, delivery service, meal train, take-out and/or support people that will be in charge of mom’s nutrition and other members of the family. Housecare and laundry should be scheduled for someone outside of the primary home to take care of twice a week for the first two weeks and then weekly afterwards. This can be a friend, supportive family member or hired housekeeper. This should not be the responsibility of the partner as they also need to be present for welcoming baby, supporting new mom at this time and adjusting to new sleep schedules.
If possible, this should be arranged during pregnancy so it is already in place at the time birth takes place.
Abdominal massage should be done starting one week postpartum and continuing weekly for the first six weeks.
PELVIC FLOOR PHYSICAL THERAPIST / OCCUPATIONAL THERAPIST
An appointment with a Pelvic Floor Specialist should take place at six weeks. Physical training should start at this time and continue until one year postpartum.
SEXUAL WELLNESS COACH
A couple therapy appointment with a sexual wellness coach is recommended before returning to intimacy. Things will be different and in order for a pleasurable (not painful) experience both partners should be able to communicate and have steps to be able to have a healthy, pleasurable experience.
An appointment with a healer or somatic experiencer is recommended at six weeks postpartum or earlier if necessary/desired to process the birth experience and all the life transitions taking place. Doulas and midwives are also really great for these types of conversations and sometimes have support groups that you can join.
Monthly acupuncture appointments (or more frequent if the acupuncturist recommends) should start at 1 month and continue through 2 years postpartum.
SCAR TISSUE REMEDIATION
Recommended if there is any scar tissue remaining at the six week checkup.
Recommended for constipation.
The body needs as much time as it took during pregnancy and nursing to recover from the increase in blood, fluid and energy necessary for those tasks.
If the body does not receive what it needs during each phase, postpartum recovery time may take longer or be incomplete.
The body will naturally pause menstruation for some or all of the recovery process. This can be called the postpartum menopause.