Prepare for a Positive Birth with THE BIRTH CLASS

Episode 418

Naomi | Postpartum – postpartum doula, homebirth

In today’s episode Naomi takes us through her first pregnancy and admits that she was so focussed on her birth preparation that she didn’t once think about her postpartum journey. Her birth was challenging and the newborn days were full of anxiety, severe sleep deprivation and a lot of not-knowing. Four months later she learnt about traditional postpartum care which inspired her to become a postpartum doula. Her knowledge and experience informed her next pregnancy and birth; she opted for an independent midwife and a doula, planned a homebirth, filled her freezer with nutrient-dense food and employed a postpartum doula to mother her as she mothered her baby. Naomi is wise, warm and a wonderful source of information for anyone who is pregnant and hoping to plan and prepare for postpartum.

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“Like a lot of first time parents I just focussed on the birth; I don’t think I’d even heard the word ‘postpartum’. I’d definitely heard about ‘the fourth trimester’ and how it related to the baby – making shushing sounds and creating womb-like spaces – but I was more focussed on setting up a beautiful nursery than focussing on my own needs. I was obsessively watching One Born Every Minute with my husband and we did a CalmBirth course but I didn’t consider postpartum.

“I had gestational diabetes and it put me on a path of medical management and I was immediately being pushed for an induction. I found it very difficult to push back against that advice. At 39 weeks I went in for the induction after an obstetrician warned me of the risk of stillbirth. I was getting mild contractions after having cervidil the night before and when the midwife suggested they break my waters and I asked why, she said: we want you to have this baby before the evening shift. I ended up going on the syntocinon drip and I went from having manageable contractions to them going hell to leather and I continued on before opting for an epidural.

“The epidural was magic, it took away the pain instantly but it was quite a disembodied experience; I could poke my leg and not feel anything. The midwife did a vaginal examination and I was almost fully dilated but she also noticed that the epidural had become disconnected and they didn’t have time to put another one in. The pain went from zero to 100 and I lost it; nothing was working for me. There was also a shift change and the midwife who came on was pushy, abrupt and coercive. I wasn’t being met with any compassion at all, it was all mean spirited, impatient energy. I had an episiotomy and vacuum-assisted birth and she came out and I didn’t get skin to skin straightaway, which was in my birth plan. It was about five minutes till I got to hold her and I remember saying to her: that was a rough ride.

“In those first few days I remember thinking that it must have been like it was coming back from war; you’re alive but you’re shell-shocked. I didn’t know it was trauma at the time; I would have said I wasn’t traumatised and that I was fine. My dad came to visit me and he asked how I was and I told him I felt shit. I’d imagined that I’d have this beautiful moment of meeting my daughter who I’d been dreaming of and longing for and this was this moment of yes, wonder, at this beautiful new being, but also: what the hell was that and that was not what I wanted at all. Physiologically, I knew nothing about the postpartum period at all. I couldn’t work out how to settle her on night two, she wanted to feed all the time, she didn’t want to be put down in her bassinet and I’d watched Game of Thrones on the laptop which isn’t oxytocin-inducing at all. It was a brutal shock to the system. I’d also been arrogant about my ability to cope with motherhood; my mum was a midwife in the seventies and she was the person our community came to for guidance so I’d grown up in that space and just thought I knew what to expect.

“My daughter was quite unsettled and from about 5pm till after midnight she would cry and cry. She wanted to be on the boob all the time and she’d feed to sleep but as soon as I handed her to my husband she’d start crying again. And then the mornings were beautiful; I was in awe of her, watching her unfurl but as soon as the day started to end and we crept towards the evening I just got a sick feeling in my stomach; the dread of the night ahead. I wasn’t doing anything during the day to help with the nights; I wasn’t resting, I wasn’t eating nourishing food and I wasn’t asking for support.

“I was feeling really anxious and I couldn’t work out what was going on so I googled and thought that fish oil may help so I decided I needed to go out and get some. All the baby clothes I’d bought were swimming on her so I thought we’d get some smaller newborn clothes, do all these things at the shops so off we dutifully went. We went into kmart and I felt really anxious and I felt like Michael was about to abandon me. I started looking at something and he went off to look at something else and in that moment I freaked out and had a panic attack. It was a combination of what was going on for me but also the bright lights of the shopping centre, ads shouting at you, lots of people which is not what you want in postpartum – you want dim lights, quiet voices, a calm room. I just crumbled and still managed to push through but I really should have been lying down; that’s my postpartum mantra now. It’s important to recognise that the things that work for you pre-baby – long walks, healthy salads, smoothies – are not necessarily going to work for you in postpartum. But they’re not conducive to what you’re physiologically going through in the first few days and weeks. You don’t need that pressure on your pelvic floor because even if you’re sitting, you’re still putting pressure on it.

“I was around four months postpartum when I reached that stage which is how I’d envisaged it. A friend of mine was about to have a baby and I’d just seen the book The First Forty Days but there wasn’t much about postpartum at that stage. I primarily bought the book as a cookbook but when I read it and realised that most other cultures do postpartum differently, I felt really ripped off that mothers are just discarded. I once heard an analogy that in pregnancy the mother is a shiny wrapped lolly up in foil, and when the baby is born, she’s the wrapper that’s discarded and the baby is the lolly inside.

“I’d heard of doulas but I very much saw it as a woo-woo thing. When I read about postpartum doulas and what they did and how they helped, I realised it’s what I needed and what I wanted to do. It took a few years for me to train as a postpartum doula but it started with that lightbulb moment that people could actually help you in postpartum; it was an entirely different paradigm.

“When I had my food delivery service, I did a mix of foods including chicken broth, red date and goji berry tea, lactation cookies, pate (which is actually my grandma’s recipe) and sauerkraut, so I was making things that were nutrient-dense and suited for postpartum. In my cookbook I took the principles of warm, warming, cooked and easy on the digestion, my goal was to include recipes that I and my clients enjoy eating. Many of them are freezer friendly because there’s a lot you can’t prepare for in postpartum but you can definitely fill your freezer.

“Having a meal train, considering a weekend where friends join you in the kitchen to batch-cook and when you make a bolognese during the week, double it and freeze half. It doesn’t need to be an overly complicated process; you can build-up your freezer stash over six to eight weeks.

“When I started considering having another baby, I went to therapy to process my birth trauma. I knew I wanted an independent midwife, a doula and a postpartum doula. I knew I wanted to spend money on massages and acupuncture and all of the things because I’d learnt so much, I’d listened to other women’s stories, but it meant we needed to plan for it financially. Four to six months prior to when we started trying to conceive, I started a postpartum fund and put a certain amount in there every week. I started looking into independent midwives, I went to a homebirth meetup because I wasn’t one hundred percent convinced of it at that point. I soon realised that hospitals didn’t feel safe to me anymore, I read the statistics, understood that home births were as safe as hospital births but also had less intervention. I was doing the physical preparation and I was also getting my brain in the right space.

“The last few weeks of pregnancy were a head fuck and Jerusha, my doula, didn’t tell me what to do but she asked the right questions and she knew how to support me. My midwife, Jo, was doing home visits and they were leisurely and a completely different experience to being in the hospital and she was with me from 14 weeks pregnant to six months postpartum.

“I was 41+6 and Jo came and told me she was happy to do a stretch and sweep if it’s what I wanted. She came over and did a vaginal examination and I was 3cm dilated. I’d been having period-pain like cramps for several weeks and I would wake up each morning so disappointed. She reassured me that it was all happening and by 8pm that night the contractions were really on. I texted Jo and Jerusha and told them what was going on and I was lying in bed, watching a movie and I would wake up to the contraction and pressing a comb into my hand.

“At about 4:30 am my waters broke and things ramped up instantly. Michael texted Jo and told her I was coping well but in hindsight, I should have got on the phone to Jo because she was happy to see what was happening. I remember thinking I was really far along and within no time I was bashing my hand into the doorframe. At 6am I asked Michael to call everyone because I was scared and it felt really full on. I was labouring in my bathroom and my parents turned up to pick up Margot and around that time I felt like I needed to poo. My parents left and Michael came in and he could see the head. Jo was 40 minutes away and Jersha was on the way but my mum was down the road. Mum came back, washed her hands, I was focussing really hard on a butterfly clip of my daughter’s, Michael was going to catch the baby. He came out, it was all very quickly, and Michael caught him and my mum pulled the nuchal cord off, Jo was the calming voice on the speaker phone. I staggered onto the couch and lying down and that’s when Jerusha walked in.

“I was on the couch, he latched on, Michael brought me chicken bone broth and vegemite and avocado on toast. It was incredible, the most amazing experience of my life; painful but so powerful and empowering. I felt like I could do anything.

“It was so special to have a dedicated postpartum and so informative for my own practice. I had a postpartum doula and she had beautiful, motherly energy. My husband had three months off work because it was covid and one of his work contracts fell through.

“I was stretched by my daughter’s behaviour and her aggressive love for the baby, I had a lot of mum rage and I found it difficult to contain my emotions around that. I still went through all the hard stuff but I was also supported and I knew what was normal biology for infants, we coslept and that made a massive difference to my sleep deprivation. I wasn’t worried about putting him down when he was drowsy but awake, or he’s feeding earlier than ninety minutes. I didn’t have any apps or panic googling (although that’s partly just a rite of passage) and he was also quite a settled newborn, but I was also a lot more settled, too.”

You can enjoy Naomi’s cookbook for just $19 with the code ABS at checkout.

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Topics Discussed

Birth trauma, homebirth, postpartum cookbook, Postpartum doula, Postpartum preparation, Two births

Episode Sponsor

This episode is brought to you by The Birth Class, my online childbirth education course.

Featuring 10 audio lessons with perinatal health specialists, you can listen from the comfort of your home when you’re relaxed and receptive to new information. The Birth Class is a conversation starter between you and your birth partner that informs, encourages and empowers you to journey towards labour with knowledge and confidence.

In The Birth Class you’ll be guided through every stage of labour and birth, including:

– the powerful role of your hormones to prompt contractions and moderate pain
– what to expect from each stage of labour; from the first contraction to birthing your baby and the placenta
– practical breathing and sound skills to help you navigate contractions and overwhelm
– the benefit of staying active in labour and how it can assist cervical dilation
– how optimal maternal positioning in late pregnancy can encourage your baby into an ideal birth position
– how to prepare for a successful vaginal birth after caesarean (VBAC)
– your pain-relief options, both non-pharmacological and pharmacological
– the risks and benefits of birth interventions and how they can help or hinder labour
– typical complications that lead to an emergency caesarean and what’s involved in the process
– what to expect in the hours after birth, including breastfeeding and blood loss
– breastfeeding advice to guide you through the fourth trimester with confidence.
– and so much more.

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