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By day seven, the mother's partner may be back at work, and friends and relatives may again be busy with their own concerns. No wonder the new mother may feel suddenly depressed and forgotten -- her energy level is not nearly back to normal, and her emotions remain volatile. If she has additionally been entertaining well-wishers and trying to do more around the house than she should, she may be quite exhausted. A definite sign that she has been over-active is increased lochia flow, or change from serosa back to rubra (brown to red). This is an optimal time for a close friend or relative to come help with major cleaning, laundry, shopping, or running errands, or the parents may want to hire someone to assist them (a home health care provider would be a great choice for this help).
The midwife needs to make sure that the mother is well nourished and has been receiving plenty of fluids to drink to keep her milk up. It is good to make sure she has a fresh container of water by her bed and a freshly made jug of herbal tea in the refrigerator.
2 Parts Red Raspberry Leaf
1 Part Nettle Leaf
1 Part Alfalfa Leaf
1 Part Peppermint Leaf
Mix dried herbs thoroughly and use a portion to make up a half gallon to a gallon of tea. This blend makes a nice sun tea that can them be refrigerated for a refreshing iced tea to be consumed throughout the day. It provides red raspberry leaf for hormonal balance and uterine toning, Nettle and Alfalfa are high in blood building vitamins and minerals, and the peppermint leaf is good for soothing the digestive system and getting it back to normal as well as giving the tea a nice minty flavor. It tastes fine unsweetened, but if the mom would like a little sweetener, use honey. Honey is high in nutrients and digests easily. A great tea blend for not only pregnancy, but postpartum recovery. It makes a great tea blend for adding recovery tinctures to, if needed, since the flavor of the tea will help "hide" some of the flavors of the tinctures (not all of them taste good). Bulk herbs are available through Mountain Rose Herbs (see banner ads at the bottom of the page or click on the herb above. They have a nice selection of organic bulk herbs for a reasonable price).
Again, she may wish to discuss her birth. This is even more likely if it was traumatic, or the outcome was disappointing for her personally. Accept whatever feelings of resentment, frustration, or sadness she expresses. Try to supply any factual information she needs without being defensive. Pay tribute to her strengths, and downplay her shortcomings, if any.
And listen carefully to the scope of any current difficulties. Most women have no idea until they become mothers how hard they will work, let alone how much loss they will likely experience. Yes, loss -- loss of friends who don't have children, loss of income for time off work, loss of sexual intimacy, loss of personal privacy, loss of sleep, loss of career-based identity, even loss of the pregnancy! Any two or three of these losses could precipitate a crisis in the most emotionally stable woman; taken together, and combined with hormonal upheavals and practical concerns of running a household, it is hardly surprising that many new mothers suffer some degree of postpartum blues. It is important to differentiate this condition from that of postpartum depression, though. The blues tend to diminish as adjustments are made to this new phase of life, but depression typically increases as the weeks or months go by, and is marked by persistent withdrawal and inability to cope. It is important that the midwife be able to distinguish these states, and acknowledge that there are times when professional interventions is indicated.
Physical symptoms of recuperation should be tapering off by day seven. If the mother had perineal repair, the skin should be drawn together by now. Breastfeeding should be fairly well established. Lochia flow should be decreasing. This visit is primarily for emotional support. The midwife should do her best to help the mother with any problems she is experiencing, because the midwife probably won't be seeing the mother again for several weeks.
The midwife may want to bring up the topic of sex. Advise every woman at day seven to wait on intercourse until the lochia flow has stopped completely. And of course, the midwife should suggest the mother wait until she sees the midwife before resuming intercourse. This is particularly important if she has had stitches.
Over the next few weeks, if the mother reports extreme fatigue or exhaustion, continued bleeding, or sensations of pressure/dragging in her vagina when she is up and about, see her at once. All of these symptoms indicate less than optimal healing, which must be addressed promptly if she is to recover.
HELPFUL POSTPARTUM CARE SUPPLIES
MoonDragon's Postpartum Holistic & Herbal Recommendations
MoonDragon's Client Handouts about nutrition and diet for pregnant and breastfeeding mothers are available at the links below. Examples of sample diets and menus are given, including some holistic suggestions. Nutritional analysis for various foods and nutritional therapy information is also available.
POSTPARTUM CARE INFORMATION
Postpartum Care: Index
Postpartum Care: Weight
Postpartum Care: Diet
Postpartum Care: Bowel Movements & Urination
Postpartum Care: Bathing
Postpartum Care: Breasts & Breastfeeding
Postpartum Care: Perineal Care
Postpartum Care: Vaginal Bleeding (Lochia) & Menstruation
Postpartum Care: Exercise & Back Care
Postpartum Care: Sexual Intercourse
Postpartum Care: Contraception
POSTPARTUM VISITS
PostPartum Visit: Day One
PostPartum Visit: Day Three
PostPartum Visit: Day Seven
PostPartum Visit: 4 to 6 Week Visit
POSTPARTUM CONCERNS
Baby Care & Concerns
Fatigue & Exhaustion
Postpartum Depression (The "Baby Blues")
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or your family member has questions about postpartum care.
You or a family member develops any unexpected and/or unusual symptoms.
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