June 17, 2024
What Is the Postnatal Period and Why Does It Matter?
The postnatal period may just be one of the biggest emotional rollercoasters you will ever go on! You may feel both pride and happiness at what you’ve achieved and perhaps also guilt and sadness when it is not all going super smoothly. It is important to acknowledge these feelings, whether positive or negative, and find a way in which to cope and move with them on your journey as a mother or parent.
Postpartum is often not awarded the respect it deserves. This is certainly true of Western society where the overwhelming pressure mothers face is to ‘bounce back’ and get on with it, ignoring the significant life-changing events that have led to this period in the first place. ‘Bouncing back’ undermines the need for protection during this time and focuses on speeding through this precious time of adjustment. This lack of protection does not allow for the recovery, bonding and growth that is so necessary after giving birth for the woman or birthing person, their partner and their newborn baby.
Why Is Postnatal Care So Inadequate in the UK?
In mainstream maternity care, the postpartum period has been described as the ‘Cinderella’ of maternity services. In the UK postnatal NHS community midwifery care services are considered inadequate, having dwindled to provide the bare minimum. It is routine for women and babies to be discharged from midwifery care between day 10 – 14 after giving birth, having only been seen by a midwife approximately three times, often with only one of those being a home visit. Often, regardless of how you have birthed, the current state of your mental health, or the challenges faced on your feeding journey, you are expected to leave the sanctuary of your own home for postnatal care with your newborn baby as early as five days following birth.
Being discharged from care after 14 days leaves a lot of women and new families feeling quite isolated and at a loss for whom to turn to when support is needed, particularly as GP services are overstretched and many people don’t have a pre-existing relationship with a named GP. The impersonal nature of primary care has minimised a holistic approach and time constraints mean that healthcare workers are unable to explore people’s needs properly. As a result, care becomes more of a tick box exercise to rule out worse case scenarios instead of bringing to focus all the ways in which we can optimise the health of new mothers, parents and their babies.
How Did Postnatal Care in the UK Become So Neglected?
This erosion of postnatal care didn’t happen overnight but over generations. In the UK we can pinpoint this change in recent history. In the middle of the 20th century, as maternity care shifted from the home to the hospital, women were removed from their families and their community to give birth in hospitals. This change brought women and their midwives into tertiary centres that fragmented care and focussed significantly on ‘managing’ labour and birth, conforming to the medicalisation of childbirth. As increasing pressures on the NHS grew the adoption of the ‘conveyor belt’ system was firmly embedded in maternity services. The end of the production line was birth and the main goal was a healthy baby, with little regard to a woman’s experience. As a result, postnatal wards have become neglected over the years and women and their babies receive substandard care that does not offer the support and nurturing new parents need. It’s no secret that postnatal care is substandard, and this has been highlighted again in the recent APPG Report on Birth Trauma where postnatal mental health services and pelvic physiotherapy services, to name a few, are underfunded and poorly staffed.
When Does the Postnatal Period End?
In the UK the postnatal period often refers to the first month following birth. NHS midwifery care puts the cut off at 28 days – which is arguably an arbitrary number. Some people may see the routinely recommended 6-week check up with the GP as the ‘end’ of this chapter. Some may consider the postnatal period to be between 4-6 weeks as this is the expected time it takes for postnatal bleeding to stop, although this does not take into account the other aspects of physical recovery that may continue past this point. This 4-6 week endpoint does however fit in with Western culture, which expects women and birthing people to be able to return to everyday life within this timeframe. We know from many women, birthing people and their families, that there is no real defined endpoint and more a merging of stages of life that will find you to-ing and fro-ing between this life as a mother or parent and your former self.
How Other Cultures Honour the Postnatal Period
Across the globe the postnatal period is defined in various ways by different countries and cultures. In China a period of “sitting the month” is referred to where the first 40 days is a respected period of time where women and their babies remain home and support is provided by family. A similar cultural tradition exists in Latin America, called la cuarentena – which literally translates to “quarantine.” It is seen as a time for mothers to bond with their babies. And many societies within the Middle East also observe a period of 40 days which focuses on rest, seclusion and ritual. What these cultures and traditions all appear to have in common is the idea of rest, support, recovery for the new mother and new parents in a safe and contained space that allows for a healthy transition in life. Looking after the mother ensures long term health for her and her family and creates a culture of respect and high regard for motherhood.
What Is the Fourth Trimester?
‘The fourth trimester’ is a term now being used across Western society. Coined in 2002 by Harvey Karp, an American Paediatrician, this term initially referred to the baby and their first three months of life following birth. However we see ‘the fourth trimester’ is being used far more widely to refer to both the mother and the baby together as parts of society try to reclaim this period of recovery and provide the care needed to ensure mothers and families thrive.
The Five Elements of a Nourishing Postnatal Period
Receiving help after you have given birth should not be seen as a treat but a “natural order of things”. This is what the author Heng Ou discusses in her carefully researched book, The First Forty Days and she gently directs questions back to mothers and parents.
She argues it is a mothers birth right to have these five elements make up the postnatal period;
- A quiet safe retreat
- Healing warmth and nourishing food
- Help and support
- Plenty of rest
- Moments of ritual
It is worth asking yourself what these five elements might mean to you during your postnatal period and how you might go about achieving them. If you are only just beginning to think about your postnatal journey, don’t worry, part two of this blog (exploring postnatal plans!) will be coming out soon. Keep your eyes peeled for tips and tricks on planning for your postnatal period!
How to Start Planning for Your Postnatal Recovery
We offer at least 2 -4 weeks of postnatal care, depending on your wants and needs. We also can offer one-off postnatal appointments and birth debriefs at your home. You can book our one-off appointments here. If you're planning ahead and interested in our care packages - read about them here or book an intro chat to find out how we can work together. Our postnatal care is unhurried, flexible and individualised – you deserve to be supported and nurtured during this time.