Let’s have a little doula chat, shall we? You’re pregnant, and as a result, you’ve acquired a whole new vocabulary: baby-wearing, layette, milk-duct, meconium, hybrid-diapers, effacement, linea alba – the list goes on. One word that will become ever-present on your prenatal planet will be this one: “doula”. You’ll hear it from friends, on social media, in your childbirth class, maybe even from your local grocery store check-out staffer. So, because you have an inquiring mind of the prenatal kind (where you HAVE to know everything, but then forget it five minutes later), you are going to investigate the heck out of this doula thing. And we applaud you for that. If you want a solid intro as to why you should hire a labor support doula, please watch Anne’s video.
Busting Two Common Hospital Birth Myths
“Thankfully you were in the hospital!”
Unless you are well prepared, have an advocate, and are going to a provider and setting that supports natural physiologic birth, the following are unfortunately the common scenarios. A healthy pregnant mama gets admitted to the hospital in labor, put on the continuous fetal monitor, given an IV, told she can’t eat or drink, put in bed, labor stalled, she was then given Pitocin to augment her contractions which caused fetal distress, resulting in an emergency cesarean. And they tell you, thankfully you were in the hospital. We need to send love to all who still face this prevalent “we saved your baby” after the cascade interventions that proceeded it, that often caused it all.
Another common scenario is a mama is told her baby has macrosomia - is too big (well above 9 pounds for example) and they schedule an induction, which has all the above interventions and their risks, including not creating the necessary ingredients for her to succeed in progressing to have a natural, let alone vaginal birth, and she is told she needs a cesarean for a failed induction; or they just jump to cesarean without a “trial of labor” and baby weighs up to several pounds less than the estimated weight, indicating the induction or cesarean was not even necessary in the first place.
I’ve posted often about each one of these interventions and how they are not evidence based. No animal could labor well with any one of them, so how could a human being? Each one in their own right increases risk and may lead to this cascade of interventions, stress and rescue when nothing wasn’t broken to begin with. Whether you’re planning a birth at home or birth center to avoid this scenario in the first place, or hospital, especially if it’s your first time giving birth vaginally, your excellent preparation is key. Set yourself up for success with my online Guides to Pregnancy, Birth & Postpartum. And in adjunct my Natural Birth Secrets book 2nd edition.
“We just want a healthy mom and baby.”
Heathy to medical providers and hospitals means a mom and baby who are alive without any serious unstable conditions that need immediate or ongoing attention. They are not often concerned with long term effects of their treatment - even medical ones like the disruption of the microbiome from antibiotics - especially concerning when overused and unnecessary, or the short and long term harmful impact of early cord clamping. They are not concerned with the traumatic impact of their type of treatment on mother or baby. Over 45% of mamas in US experience birth trauma - PTSD from their birth experience and how they were treated. I discuss this in depth for mom and babies in my Natural Birth Secrets book 2nd edition.
If this is your only goal YOU are selling yourself short. A live mother and baby without obvious concerning physical complications is baseline, but what about the bigger and long term picture of real health of your mind, body, heart & spirit, the health of your family? What about your experience - is it deeply positive, respectful, empowering, beautiful, sacred, personal, one you will love and treasure forever even if challenging? Do you feel heard, respected, supported? Do you feel safe, comfortable, free to labor as you want? Do you get full informed consent and your decisions and choices honored? Was your partner involved in a meaningful way? This is the most important day of your life - let it be fully and truly healthy and absolutely glorious. Make this happen with my Guide to Pregnancy, Birth and Postpartum. And compliment it with my Natural Birth Secrets Birth second edition - where I go into both of these topics in more depth, along with the research, and the safety and better outcomes from homebirth with midwives in the healthy population.
I’ve taken everything I’ve learned, trained, and supported women locally for over 28 years in my private practice and I’ve poured all of my love, passion, knowledge, and experience into creating something truly special for you… my new and updated Pregnancy, Birth & Postpartum Guides. Same Beloved Content Plus Over 40 Added Bonus Videos! Buy Here Now!
They can be used via the mobile App or on your desktop! It’s the most up to date combination of Love Your Birth and Walk With Anne for Mamas online courses at a cheaper price! And they have an option for direct access to me for your questions and concerns!!
Whether you’re an experienced or new parent, there are hours of videos, workbooks, and PDFs to answer all of your questions. Everything is searchable, so you can just type or talk and it’ll bring you right to the exact moment in the video where I answer your question. It’ll blow your mind! If English is not your strongest language, you can even change the captions or even the audio to the language you prefer. The Prenatal, Birth & Postpartum Guides can be sold separately or in a bundle to buy only the section you need or get ALL of the guides for a limited-time offer of 50% off -> RIGHT HERE!
The key to a positive birth is feeling confident, strong, relaxed, and empowered during the entire process, regardless of the twists and turns it may take. I give my full heart and all I know in everything I do to support Mommas.
VBAC After One, Two or More Cesareans
What is a VBAC?
A VBAC is a vaginal birth after cesarean.
If a woman has had a cesarean and wants to plan a vaginal birth for her next, it would be considered a VBAC, and the number after it depends on how many prior cesareans there were.
What are the chances of having a successful VBAC and who is a good candidate for a VBAC?
The stats range that 60-80% of women, who have had previous cesareans, are candidates for a successful VBAC. In actuality, most healthy pregnant women carrying healthy babies are candidates.
The chances of a successful VBAC are higher if a woman is using a midwife, even higher in free standing birthing centers and home settings.
Going to a hospital and working with an OB/GYN with high cesarean rates, will increase the likelihood that a woman will have another cesarean.
In some hospitals, there are a lot of restrictive procedures, like continuous electronic fetal monitoring, confining a laboring woman to lay in bed, not allowing her to eat or drink, routine IVs and time limits, which increase the risk of a cesarean.
There are many benefits to a VBAC, that are physical, emotional, mental, and spiritual.
These are only a few important benefits on the long list:
No risks from major abdominal surgery. This is huge. Unfortunately, a cesarean can lead to trauma to the internal organs or reproductive tract, risk of hemorrhage, complications with scar tissue, long term post operative pain, wound infection, blood clots, stroke, and possible respiratory problems for the baby. High rates of cesarean section contribute to high rates of morbidity and mortality – and this is occurring in modern countries such as the US, which ranks among the bottom of them in terms of outcome stats.
Easier postpartum healing and recovery.
Baby receives needed bacteria for optimal health, from mother when passing through the vaginal birth canal.
Breastfeeding may be more successful
No potential harm to future fertility.
Feeling more positive about the birth experience
Increased sense of empowerment.
More involvement of family and support people.
Less risk of postpartum depression and emotional birth trauma.
What is the main risk of a VBAC?
The risk of separation of the one prior uterine scar is approximately 2 in 1000 VBACs, but often it is a mild superficial dehiscence (slight separation of some layers of the surgical wound) that has no clinical significance and does not impact the health of mom or baby. The risk of severe life-threatening emergency from a partial or complete uterine rupture of all the scar layers is significantly lower – a highly unlikely occurrence, significantly less than 1 %., 1.36% after 2 cesareans, slightly higher after three cesareans, with a higher comparative maternal and newborn morbidity with each repeat cesarean - but still in perspective, low, and depends on a variety of factors related to your individual situation. The main risk is of a VBAC is this rare catastrophic rupture of the previous uterine incision. This rare total disruption of the uterine scar risks both the mother and her baby, and can lead to catastrophic outcomes. It cannot be ignored and must be monitored for appropriately; but it cannot be exaggerated or make the risk of repeat cesarean less alarming. Frank uterine rupture is often mistaken for more common mild separation of the previous uterine scar without consequence, happens in less than 1% of all pregnancies. Even ACOG released guidelines that it’s reasonable to consider women with two previous low transverse uterine incisions to be candidates for trial of labor and to counsel on the combination of other factors that affect their probability of achieving successful VBAC.
But, it is getting harder to find a provider to attend to your desired vaginal birth after one cesarean let alone after two or more. It is still possible, and you have the right to decline another cesarean, but it is ideal for you to find a provider and setting most supportive to birth YOUR way safely.
Although every decision has risks, a VBAC is a reasonable, appropriate and safe option. If a woman panning a VBAC decides to give birth at home, I highly recommend working with a well trained and experienced midwife and consider the distance to a hospital (30 minutes or less driving time is ideal).
There are risks and benefits to every kind of birth and in every setting. I provide women with evidence based information, encourage each family to dig deep and look at the pros and cons to having a VBAC in a hospital setting, free standing birthing center or home, vs a routine cesarean and have informed consent for her birth.
Are there benefits to a cesarean?
A planned cesarean is in a controlled environment, and some women find great comfort in that knowing. Perhaps a woman has had a previous traumatic, long labor the first time and they just don’t want to go through that experience again. Some women are very anxious about that and they just feel safer knowing they will have another cesarean.
I take that seriously, because she won’t labor well if she doesn’t feel safe.
Like I mentioned before, the serious risks for a VBAC can be often prevented, treated or transferred to surgical care in time, with a skilled midwife or obstetrician who is attending to the laboring women, aware and mindful of the symptoms that lead up to that.
Thankfully some hospitals are now at least allowing more time for baby to get the cord blood from the placenta, skin to skin bonding, and her partner or main support person in the operating room. Some hospitals and providers are performing “gentle cesareans” – cesareans that are family and woman centered, and try to provide the environment of a natural birth as much as possible. This is a wonderful attempt to restore humanity to birthing in the operating room
In most cases, a VBAC is a safe option.
I share the opinion of many concerned with improving maternity care and reducing our rising rates of maternal and newborn death and serious health consequences from the interventions in childbirth, that a woman should not be forced to have a major surgery against her will, rather provided research and empowered to make her own decision, considering she is having a healthy AAOG removed the previous unreasonable restriction requiring immediate availability of a surgical staff for an emergency cesarean, as most hospitals around the country, let alone free standing birth centers and home settings, do not meet this criteria. Most hospitals are not able to have a surgical staff at all times and cannot perform an emergency cesarean in under 30 minutes.
Despite this, research is showing that far too many obstetricians and the midwives they back do not offer VBACs after one cesarean, let alone more. They routinely recommend repeat cesareans because they may fear law suits, succumb to scheduling pressures, have restrictive hospital or malpractice insurance policies, and/or feel pressured to uphold certain standards among their colleagues who are not supportive of VBAC. The hands of a midwife whose collaborative obstetrician and hospital do not support VBAC can often be unnecessarily tied as well for these reasons. Most repeat cesareans are not actually medically necessary, and are commonly recommended due to various non-medical reasons. This is very concerning.
What also concerns me is that the risks of a VBAC are magnified in conversation with women, while the risks of a repeat cesarean are downplayed, so women may feel forced, afraid and powerless.
I want women to feel like they have a voice, as they do have a legal and medically ethical right to autonomy over their bodies, their births and their baby’s.
Some women who want to VBAC have limited options and local doctors in the area are only offering cesareans. Some feel they have no option other than having an unattended homebirth, or labor alone at home until the last minute without any monitoring, or not be truthful with their providers about their previous cesarean birth – all of which can increase the risks for her and her baby.
A trained and experienced midwife who is continuously with the woman in active labor, can detect concerning signs and symptoms before they can become a crisis, and she be transferred and treated in time to save her and her baby’s life and heath. A midwife wears many hats, one of which is protecting the space so the natural process of birth can proceed with ease and grace, and another is a lifeguard – to know when and how to intervene to prevent problems or manage emergencies. There are many wonderful obstetricians supportive of VBAC who have this training and style of practice as well; they are just harder to find.You have the right to decline the repeat cesarean, and find a more supportive skilled provider at home. There are midwives and OBs who do it and post about it around the globe. It is worth every penny to even travel quite a distance to a practice who honors your choices. You REALLY have to want it, and you must prepare as best you can to set yourself up to succeed, like it’s your Mount Everest to climb, to have your healing, redemptive beautiful healthy birth.
Last tips:
If a woman knows she wants to have another baby, I would start with research and education. Ask yourself: “What do I want and why?”
A woman should get the support she needs. Most women who have had one or more prior cesarean births have issues they need to discuss and heal from. One of my dedications and areas of expertise is creating space so a mom can debrief, process and recover from her previous upsetting or traumatic birth experience, as well as plan for a better one next time around. Schedule a coaching call with me for more personal guidance if you need.
I tell mamas to do what they can to educate, prepare and empower themselves in a whole different way than last time as I want them to succeed, build their circle of support, and include in their birth team advocates to speak for them when they are in the heat of labor. I tell them to prepare for a natural vaginal birth. The mind, body, heart and spirit can prepare for a natural vaginal birth - and a deeply positive, beautiful and empowering one. Yes, it takes work and practice, but it is worth every penny, every effort and amount of time you put in, if this is the birth experience you want and dream about. This is one of my passions and main focus of my online childbirth prep course Anne’s Guide to Pregnancy, Birth and Postpartum - sold separately or bundled together in adjunct to my Natural Birth Secrets books 2nd edition and Trauma Release Formula 2nd edition if you need help previous healing birth trauma - both extensive but very different resources that compliment each other to heal and prepare for your different next birth.
I also recommend hiring an awesome doula, as those who have a doula are less likely to have a cesarean.
A doula is amazing because they offer the mothering comfort and support that our ancestors had. When women would give birth in their tribe or village, and they were surrounded by mothers, aunts, sisters, grandmothers, and the other women of their community, they received that mothering support by women who were comfortable with birth and relaxed around it. Fear has no place in birth, and a doula provides needed calm and loving support.
Remember, In the end it’s not in our control, and we let go and surrender,
If you do all of these things and end up having a cesarean, it’s not a failure. There is no failure in birth. It is a birth, a belly birth, and it’s the birth of your baby and you as a mother. It is the birth of your family and your partner as a parent. Stay present, stay involved and keep a positive mindset. Focus on the blessing, that you did all that you could, and thankful for modern medicine, which saved you and your baby’s life and preserved health. Also, you can ask for a gentle cesarean, which restores humanity to the operating room by doing such things as allowing your support people in with you, enabling baby to emerge from the incision simulating as much as possible a vaginal birth to help baby clear his/her own lungs, enabling you to participate by lowering the drapes so you can see your birth, giving you sterile gloves to receive your baby, optimal umbilical cord clamping so baby can benefit from the cord blood, encouraging immediate skin to skin bonding and early breastfeeding.
Healing can occur afterwards, and may take time and lots of support. But there is no place for shame and negative self judgement here.
Questions to Ask When Interviewing Your Provider, Red Flags and Choosing Your Best Provider
Here are some key questions to ask your midwife or obstetrician if you want a natural birth. Listen to them and within you. You will get your answers about best provider for the birth you want. And do pay attention to red flags.
Do you have training and experience supporting natural physiologic undisturbed birth when all is well?
What’s your rate of primary cesarean?
If I need a cesarean, are you or your collaborative obstetricians experienced and do with gentle/family centered version?
Do you encourage VBAC? What’s your rate?
Are you skilled and supportive of physiologic breech and twin birth? What’s your rates?
Do you support my birth preferences and my right to decline interventions?
Do you advocate for doulas and other support persons I want?
Do you support and have training/skills for vaginal breech and twin birth?
What’s your rate and policy for induction of labor - like going past due date, suspected big baby, water breaking before labor etc.
Is your setting when you practice in alignment with you? What restrictions might be placed on me becasue their protocol?
Most importantly, do support my legal and ethical right to autonomy over my body, birth and baby?
Will my rights to make informed decisions about my and my baby’s care be respected?
If they don't support natural undisturbed health birth or evidence based care, their rate of primary cesarean section is above 10-15%, they don't support your birth preferences & right to decline interventions, they don't advocate for doulas & any other support person you want, they don't encourage VBAC and have rates lower than 70-80%, they have high induction rates for things like going past due date, suspected big baby, water breaking before labor, they don't support and have lots of experience with vaginal breech and twin birth, and/or the setting where they practice is not in alignment with them & they place a lot of restrictions on you because of protocols and policies you have your answer. You can switch providers anytime and hire one that is most in alignment with what you want, who will work collaboratively with you.
Here are some red flags, but here are so many others, especially when all is well with mama and baby such as:
They don’t support natural physiological birth.
They don’t care to read your birth plan or respect your birth preferences.
They don’t do VBAC.
They don’t do vaginal breech or twin birth.
They advise frequent ultrasound, routine multiple tests and procedures without discussion.
They perform weekly internal exams at 36 weeks.
They induce everyone at 41 weeks or sooner.
They do not believe in or practice natural physiological birth.
They don’t like or support doulas.
They do routine episiotomies on all first time vaginal birthers.
They do immediate cord clamping, or rush clamping without waiting until it is limp, white and pulseless.
Their cesarean rate greater than 10-15%.
scheduling a cesarean because they tell you your baby is too big
Unless you are planning to birth in an out of hospital freestanding birth center or at home with authentic midwives, most maternity care practitioners and the settings they work have not seen natural undisturbed birth - and they are trained and quite used to disturbing it. They think it’s necessary to fix what isn’t broken when all is well. It’s like everyone trying to interfere with your heart beating or your lungs breathing when it’s doing just fine on it’s own. It is a sad state of affairs with what’s going on in most modern hospitals especially in the US. I’ve had obstetricians, nurses and even medwives (midwives who practice more medically like many OBs) tell me they have never seen a natural undisturbed birth. Some actually want to shadow me to see one! I love when I do hospital shifts and the med students follow me - it may be their only chance to see natural undisturbed normal physiological birth. That’s the vast majority of what I see and I don’t get how it can be otherwise. Why is this happening as if it were some cool freak show, when the research supports it, when it’s evidence based care, when this is how birth occurred for thousands of years since the beginning of time, and still is the way it happens for the majority worldwide.
Here is a wonderful testimony sent to me from a mama who took my online Guide to Pregnancy, Birth and Postpartum, prepared, informed and empowered herself to tell her obstetrician (the only provider in her rural area) who never saw natural birth, to do nothing but be a fly on the wall, just in case of emergency. He said he never did that, does mostly inductions, medicates births and cesareans. But she respectfully spoke up and he finally agreed. And who was touched to tears, crying the most at her beautiful natural birth? Think of the ripple effect that has on his care for other mamas? If you want a natural birth without disturbance-ask your provider if they’ve seen one. You’ll get your answer whether you should run or not, to a provider and setting where it’s the norm.
If you choose to stay with such a provider with so many red flags, you have to prepare even more, fight even more for what you want, make sure to have an advocate, and know your legal rights to autonomy and informed refusal so you don't allow anyone to dictate you to do anything against your will or manipulate you with playing the fear of dead baby card when there is nothing wrong. Dig deep - is this what you want to be doing during your pregnancy and such a sensitive time as labor?
For more information on how to best prepare for having your baby, feel well educated and informed , confident and empowered, bust through fears and trust the process, and have the most beautiful birth of your dreams take my online signature comprehensive prep course - Anne’s Guide to Pregnancy, Birth and Postpartum and read my Natural Birth Secrets 2nd book edition. I created them for you to do just that, based on over two decades of holistic nurse midwifery experience and attending over 1000 births.
I’ve taken everything I’ve learned, trained, and supported women locally for over 28 years in my private practice and I’ve poured all of my love, passion, knowledge, and experience into creating something truly special for you… my new and updated Pregnancy, Birth & Postpartum Guides. Same Beloved Content Plus Over 40 Added Bonus Videos! Buy Here Now!
They can be used via the mobile App or on your desktop! It’s the most up to date combination of Love Your Birth and Walk With Anne for Mamas online courses at a cheaper price! And they have an option for direct access to me for your questions and concerns!!
Whether you’re an experienced or new parent, there are hours of videos, workbooks, and PDFs to answer all of your questions. Everything is searchable, so you can just type or talk and it’ll bring you right to the exact moment in the video where I answer your question. It’ll blow your mind! If English is not your strongest language, you can even change the captions or even the audio to the language you prefer. The Prenatal, Birth & Postpartum Guides can be sold separately or in a bundle to buy only the section you need or get ALL of the guides for a limited-time offer of 50% off -> RIGHT HERE!
The key to a positive birth is feeling confident, strong, relaxed, and empowered during the entire process, regardless of the twists and turns it may take. I give my full heart and all I know in everything I do to support Mommas.
INITIAL POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE: PART ONE
POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE TO THE FIRST FEW WEEKS - PART ONE
Welcome to the postpartum period, the fourth trimester, a period of healing and adjustment, of getting to know and comfort your baby, and mastering breastfeeding. All your baby needs now is love and breast milk. If you are unable or choose not to breastfeed, consider feeding baby pumped breast milk, or donor breast milk from registered milk banks. Breast milk is the ideal food for your baby, although organic goat milk formula is most similar to human milk and you can discuss best alternative options with your pediatrician. And do see the Postpartum Guide to Breastfeeding Postpartum, for initial issues specific to that.
The rest will follow naturally, as you learn on the job, take guidance from wise experienced others, and let Baby be your teacher. As in pregnancy and birth, trust your instincts and your heart. But, do not hesitate to ask for help and support as needed. Hopefully you prepared in your pregnancy so that you are well supported during this sensitive time, as it has always taken a village to raise a baby as well as new parents. A postpartum doula is a must if you do not have family and friends to help you.
After the first week or so, but before your memory of details fades, it is a wonderful experience to reflect on your pregnancy and birth with heartfelt honesty, and write your pregnancy memories and childbirth story down in a bump to birthday journal. This is something special to share with your child one day, and it is also a wonderful gift to yourself. It can be especially helpful for healing if things were difficult, or your labor and birth did not go as planned or as you hoped. Journaling will help you express, later process, understand, come to terms and make peace with any painful feelings that come up more deeply.
Below are some helpful hints to make the next few weeks easier and more comfortable, so you are more able to heal, enjoy and reflect upon your extraordinary new miracle. The most important advice is to slow down, stay in the moment, try to resist the temptation to do, do, do...and just be, be, be. Trust that you will heal, as you are perfectly designed to do, given the proper care and support.
Nutrition for Postpartum Care
Maintain at least the same healthy nutrition as you did in pregnancy, especially now for recovery after birth, and during breastfeeding. This will help you to make good quality milk, and nourish your baby as well as yourself. Make sure to eat at least three whole food varied healthy meals and snacks, and even a little bit more than you would normally consume. And keep well hydrated with at least 64 ounces of water daily.
Traditional foods for the early postpartum weeks across cultures typically include soups and stews with a lot of vegetables, including the starchy ones like sweet potatoes and winter squash, stew meat or chicken, and whole grains like barley and oats. Also, do eat plenty of eggs, seasonal fruits and vegetables. Much nourishment can be added to fruit/veggie smoothies, soufflés, whole grain hot cereals, and breads/muffins like zucchini-apple, banana-date or carrot-raisin, enhanced with almond flour or chopped nuts and seeds, nut milk, and eggs.
Herbs and Supplements
Make sure to supplement your diet as in pregnancy, with herbs, vitamins, minerals, omega threes and probiotics to complete nourishment not supplied by diet alone. This will aid in your recovery and help supply all of your and your baby’s nutritional needs. Do increase iron foods and take an herbal iron, especially if you were anemic in pregnancy, have low iron stores, lost a lot of blood at birth, gave birth by cesarean, and/or are still anemic.
Do continue your nourishing pregnancy herbal infusion to your diet but add alfalfa and red clover. You can have a support person make this by:
Blending a handful of dried Nettle leaf, a handful of dried Red Raspberry leaf, a pinch of Alfalfa, large pinch of Red Clover, and several Rose Hips.
Add a pinch of Comfrey to help with healing. (optional)
Brew in a mason quart glass canning jar of boiling water 1-4 hours. The longer the brew, the stronger the taste and effect.
Strain, and drink plain or lightly sweetened with Rose Hip infused honey and/or a splash of fresh squeezed lemon or lime juice.
Enjoy hot or cold, up to 4 cups per day.
You can make it in larger quantities and store in the fridge.
Other herbal tonics for new moms to promote general physical and emotional postpartum recovery and healing include Ashwagandha and Gotu Kola (½ -1 tsp each twice daily), and Milky Oats (1/1-1 tsp 1-3 times daily), in addition to herbs mentioned below as appropriate for each specific issue.
To promote healing after birth, take 3-4 pellets of homeopathic Arnica 30 c under your tongue every few hours for the first 3 days, then three times daily for a week. You can also dissolve the pellets in a clean unused bottle of water, shake vigorously a few times, then gargle a mouthful before swallowing, which increases the strength of the remedy.
Treatment for Afterpains
Periodic cramping, known as afterpains, commonly occur as your uterus muscle fibers contract around the blood vessels that supplied the placenta. This is your body’s natural defense in order to minimize excessive bleeding and return to its non-pregnant size. They can be quite painful, and can occur with increasing intensity after each subsequent baby.
Breastfeeding can temporarily increase the severity of these pains, which is actually helping your body heal and prevent excess blood loss. Afterpains should gradually subside over the next week and lessen significantly over the first 3 days after birth.
Below are some suggestions to lessen the discomfort.
Frequently empty your bladder, even though you don’t feel like you need to pee, as is common from the swelling after childbirth.
Especially during the first 24 hours, check the top of your uterus several times per hour to make sure it is nice and firm like a hard nectarine or knuckle. Massage the top of your uterus gently when it begins to soften or feels boggy.
Lie on your stomach with a pillow under your lower abdomen.
Apply warm moist towel compresses, hot water bottles, hot herbal packs or rice packs heated with a few drops of essential oil of Lavender, or a heating pad to your lower abdomen.
Practice your breathwork, deep breathing and conscious relaxation exercises during the afterpains, dropping your focus right down into them, relaxing with surrendering to the intense sensations as you did in labor.
Try soaking in a well-cleaned, warm bath with drops of Lavender or Chamomile.
For an effective herbal infusion:
Mix a large pinch of Chamomile blossoms and/or Catnip in 1 cup boiling water.
Brew covered for 10-20 minutes.
Strain in a glass canning jar.
Add honey to taste (optional).
Drink very warm, 1-4 cups daily.
Take a dropperful of Motherwort herbal tincture up to 4 times daily. If without relief, try Cramp Bark herbal tincture, 1 dropperful every 30 minutes to 2 hours, then 2-3 times daily. You can add a dropperful of Black Haw tincture 3 times per day. You can make your own cramp bark infusion by steeping a handful of Cramp Bark and Black Haw with a pinch of Hops and generous pinch of Blue Cohosh root in a quart mason jar overnight.
Take Wish Garden AfterEase herbal tincture as directed
Take 3-4 pellets homeopathic Chamomilla, Arnica, or Caulophyllum 200 c. Try one remedy under your tongue. If no relief try the other. If the remedy works, repeat daily as needed.
Try Moxibustion treatments by an acupuncturist.
Try additional suggestions and remedies mentioned here for aches and pains in pregnancy. They work!
If the pain is too much for you and interfering with your ability to breastfeed, rest and sleep, you can take ibuprofen (up to 800 mg every six hours) OR acetaminophen (up to 650 mg every four hours) ½ hour before nursing for the first several days only, as needed. But before reaching for these medications, try 1-2 grams of Curcumin (Turmeric), a natural herb studied to be as effective for pain relief than most over the counter synthetic analgesics without their associated potential risk of toxicity.
Consult your practitioner for severe cramping or cramping that lasts longer than 1-2 weeks, or if accompanied by uterine tenderness, fever or foul smelling discharge.
Home Remedies for Bleeding
During the first two to five days, bleeding is no more than a heavy period with an occasional clot the size of a 50 cent piece or egg, dark red in color with a fleshy smell. It tends to be less after cesarean birth. Clots are simply congealed blood mostly that pools in the vagina when you are reclining, and can occasionally be as long as the vaginal canal. Sometimes bleeding increases with nursing, strenuous activity, heavy lifting and pushing motions, full bladder, and as you rise from a lying down position.
During the next week or so, the bleeding becomes paler pink or brownish, and it lessens in amount so that you only need to change sanitary pads several times per day. Over the following two to four weeks, discharge becomes creamy white or yellow and even less in amount, but usually returns to red bleeding or spotting for a day or two around the second postpartum week.
Some women occasionally spot on and off for longer periods of time or throughout breastfeeding. Suggestions for keeping clean and comfortable are:
Take a daily bath in a well-cleaned tub (add Calendula tincture and Lavender oil to water if desired) or shower.
Change disposable organic sanitary pads or herbal infused natural pads every four to six hours, and after going to the bathroom. Do not use tampons, menstrual sponges, or menstrual cups. The first day or two, especially at night, consider wearing adult diaper type pads simply because it is just easier, as bleeding can be heavier than common postpartum maxi pads can accommodate, and can leak onto your clothes and sheets. Use them with a smile.
Wash hands before and after changing pads.
Remove pad from front to back, squeeze a peri-bottle of warm water over perineum. If you had tearing with or without repair, you can also add 1 tsp Calendula tincture and Lavender oil to the water. Pat dry.
Do not douche.
Check the top of your uterus for firmness several times per hour when awake for the first 24 hours, then several times per day for three days. It should feel as firm as a hard nectarine. If it feels soft, massage it firmly so it re-contracts.
To prevent excessive bleeding, take homeopathic Arnica 30 c as described in the supplement section.
Take herbal Shepherd’s Purse, 1 dropperful of the tincture three times daily for the first 3-5 days.
Wear an abdominal binder or Bellefit’s postpartum support girdle. You get a $20 off with code: ANNE20 at checkout.
Continue your herbal iron dose until your bleeding stops in 4-6 weeks, which may need to be increased per your practitioner if there was hemorrhage. Eat foods high in iron, like red meat, dark turkey meat, eggs, dark leafy green veggies, and dried fruits.
If bleeding becomes heavy (you are saturating more than a large maxi pad every half hour):
Try herbal Shepherd’s Purse tincture (1 dropperful under your tongue), repeat every few minutes as needed)
Add 3 dropperfuls tincture of Cotton root, 2 dropperfuls each of Lady’s Mantle, Witch Hazel and Blue Cohosh, and 1 dropperful Yarrow. Take them every 10 minutes under your tongue until the heavy bleeding resolves, but only up to an hour.
If heavy bleeding persists, take 2 dropperfuls of HerbPharm Erigeron/Cinnamon tincture of Erigeron and Cinnamon under your tongue every 20 minutes for no more than 2 hours, and add 1 dropperful of Angelica if without relief.
Report to your practitioner if you’re saturating more than one pad an hour for more than a few hours not relieved by the other suggestions above, especially if you are starting to feel lightheaded, weak, disoriented, cold and clammy with rapid shallow breathing and heart pounding. Contact them also if you’re experiencing large clots, foul-smelling vaginal discharge, severe lower abdominal pain, temperature over 100.4 after the first few days, and deviation from the described pattern of bleeding.
Perineal and Vaginal Discomfort
After delivery, your perineum and vaginal area may feel sore, swollen and uncomfortable. Any pain or tenderness should gradually lessen over the next several weeks, or longer if you had a large tear.
Suggestions are:
Practice good perineal hygiene as previously described in the section on bleeding.
Don’t forget to take the homeopathic remedy Arnica 30c as directed above, in the first few weeks to support healing after giving birth, which definitely helps your perineal and vaginal areas.
For a small tear that did not need stitches, using a peri-bottle, squeeze warm water with several drops of Calendula tincture and Lavender oil over the area as you urinate to reduce stinging. Squirt Vitamin E oil a few times daily on the tear to promote healing. Motherlove and Earth Mama make wonderfully soothing and healing herbal combination perineal sprays.
Apply a perineal ice pack or frozen maxi pads saturated with Witch Hazel for the first 24 hours (with 30 minute respite each hour) or as long as you feel it is soothing.
Periodically sit in a cool sitz bath during the first 24 hours or as long as you feel it is comforting.
After the first 24 hours, take a warm sitz bath, or warm shallow bath 2-3 times per day. You can also add tea tree oil, tincture of calendula, garlic, ginger and/or lavender, or try herbal sitz bath combinations with Uva Ursi, Comfrey and Sage or Calendula and Oatmeal (both combos have Witch Hazel, Yarrow and Plantain). You can also try herbs with Epsom and Dead Sea salt or herbal salt soaks and see which feels best for you. You can use any leftover unused liquid for compresses or your peri bottle rinse.
Use a pillow or cushion when you need to sit.
Contract your pelvic muscles (Kegels) or even better, engage your mula bandha (all of your pelvic floor muscles) when changing positions.
Take the homeopathic Arnica 30 c as directed above for general recovery.
Report pain that worsens or does not improve over time, an increased area of redness, swelling or pus-like discharge.
If You Have Difficulty Urinating
During the first four hours after birth, many women have trouble urinating such that they feel no urge, feel the urge but cannot urinate, or feel burning after the urine comes out. It is essential that you urinate within eight hours after birth as difficult as it may be, to prevent infection and excess uterine bleeding.
Suggestions to help you urinate are:
Listen to running sink water.
Squeeze warm water over your perineum with your peri-bottle, infused with a few drops of oil of Peppermint.
Dabble your fingers in water.
Apply light pressure to the area above your pubic bone.
Put oil of Peppermint in the toilet.
Sit in a sitz bath with several drops of the oil of peppermint..
Take a bath or shower.
Blow your thumb.
Concentrate on relaxing and opening your pelvic floor muscles while imagining the urine flowing out.
Drink eight glasses of water per day.
Try homeopathic Arsenicum or Causticum both at the 30 c dose.
Report inability to urinate more than eight hours after the birth, burning pain before or as the urine is coming out, feeling the urge to urinate frequently but little urine comes out, fever, or back flank pain.
Cesarean Birth
If you birthed your baby by c-section, it will take more time to heal physically, and psychologically - especially if unexpected and unplanned, or traumatic. Trust that you will get back to your new mama self. The scar will be there but will eventually fade. Allow for at least 3 months recovery for your body from major abdominal surgery, possibly longer to heal the mind and heart. Homeopathic remedies help tremendously and definitely speed and enhance your recovery safely and naturally. If your cesarean is planned, start Arnica 200 c three times daily the day before and continue through 3-4 days postpartum.
Other remedies helpful to have on hand are Aconite 30 c for intense fear and panic before surgery, Bellis Perennis 200 c post cesarean to boost healing after you finish the Arnica, Staphysagria 200 c for incisional pain and healing, and Hypericum 200 c for shooting nerve type pain from the spinal anesthesia (only if needed). Use one remedy at a time and take it three times daily until you feel improvement. Consult your classical homeopath for more personal guidance.
The first week is the hardest in terms of postoperative pain, so take ibuprofen or acetaminophen if absolutely needed, then switch to more natural pain relief remedies like ginger or turmeric that are safe for you and your breastfeeding baby, but still effective.
Use the skills from breathwork and mindfulness to center and ground yourself, stay present one breath at a time, surrender, lean into and embrace the temporary painful sensations you feel, without the story, with love and compassion towards yourself. Whenever you feel overwhelmed or stressed, take a few minutes to simply breathe, keeping your focus softly on a distant nonmoving object (drishti) or close your eyes and internally gaze between your eyebrows, relaxing deeper with each exhale. Send your love and breath (divine life force) and imagined light to areas of pain. Use visualization to support you as you desire. This is powerfully healing.
While in the hospital, it is important to take deep abdominal breaths also to keep your lungs fully expanding (use the incentive spirometer many hospitals give you), and to get up and walk within 12-24 hours after birth for 10 minutes each waking hour, especially to prevent serious blood clots and painful abdominal gas buildup. The more you walk, the sooner you pass gas and get your bowels moving, and you keep your blood flowing rather than stagnating from immobility.
Ask to be progressed from a clear to regular diet within this time, and choose healthy foods and bottled spring water from the hospital menu (if that even exists!) or have your family and friends bring you more wholesome real food meals and snacks. For gas and bloating, limit:
Gluten containing foods found in wheat, spelt, rye, barley and some oats
Some fresh fruits and veggies
Cow dairy if lactose intolerant
Carbonated liquids
Chewing gum.
Eat slowly, chewing thoroughly and mindfully. Natural remedies for gas and bloating include chewing Fennel seeds, drinking Fennel tea, or taking 2-4 ml of the tincture three times per day, taking Slippery Elm lozenges 3-4 three times daily, and a high quality multi species probiotic twice daily on an empty stomach. Eat and drink more fermented foods like kefir. For bad gas and abdominal pain, take 1 dropperful each of Chamomile and Passionflower, ½ dropperful each of Hops and Lemon Balm, and ¼ dropperful of Lavender tinctures every four hours.
The dressing over your incision should be removed within 12-24 hours, so your incision is kept clean and dry to prevent infection. You can apply a clean maxi pad over the incision if your belly is folding over it, so it does not stay warm and moist, inviting bacterial growth. You have been sewn back together in many layers, and the skin is brought together by a glue like substance, absorbable stitches or staples, or removable metal staples. While it takes time to heal, when all is proceeding normally, it is unlikely to open as commonly feared.
Sometimes they use steri-strips over the incision which will come off eventually or you can remove them in a few days. You can definitely shower, but do not use soap initially on the incision. Dry the area gently. A little oozing of blood is common to see on the dressing, as is a tiny amount of clear, white, or yellowish fluid, as long as it is not pus- like discharge. Look at your incision so you can monitor its healing as well as work on acceptance and appreciation for the journey you and your baby needed, made especially for you both. Once you go home, you can apply herbs for perineal and vaginal tears mentioned above to soothe and enhance healing. Earth Mama makes a lovely herbal balm specific to healing a cesarean scar and there are other organic balms that also help the scar fade.
Make sure to keep Baby skin to skin in dim quiet as much as you can, bonding and soothing baby with your love, telling Baby all is well, Baby is safe and acknowledge that was a tough journey for both of you. Get help with breastfeeding as soon as possible. Baby may be sleepy from the medications, and it takes longer for the full breast milk to come in, but you will get the breastfeeding going with excellent support and patient perseverance.
I encourage you to love, be proud and grateful for your cesarean scar. This may take time to cultivate, but is a worthwhile goal. Do not be shy to ask for extra needed help, and get support processing and healing emotionally. For online and local group support and advocacy, there are many wonderful resources like ICAN, but you may want to consider breathwork to release the strong stuck emotions and trauma energy in your body if it is interfering with your well-being. If you are suffering from birth trauma or you suspect your baby has it as well - as is common after cesarean birth - there are resources for healing for you and for your baby.
Consult your practitioner with:
For fever over 100.6 with general muscle aches and chills
Persistent or worsening pain
Area of tenderness/foul smell/pus/redness/swelling by your incision
Area of leg swelling, redness, warmth and pain worse when you flex your foot
Unusually frequent, urgent or painful urination
Heavy or foul smelling vaginal bleeding
Vision changes, nausea, vomiting, chest pain and/or headache, especially if you had high blood pressure
Anything unusual you are concerned about.
Obviously, if you have problems breathing, feel weak, disoriented and faint, call 911.
Constipation and Your First Bowel Movement
It is normal to go a few days after delivery without having a bowel movement. Many have loose stools before labor and pooped during pushing, and those who birthed in hospitals who don’t allow eating in active labor probably did not eat much, if at all, in labor, unless they (hopefully!) respectfully challenged that outdated policy, or simply sneaked it. So you have a few days leeway. Some mothers are afraid that a bowel movement will be painful or open their tear more or stitches if they had them. Other women are too busy and preoccupied with all that is involved postpartum to even think about taking the time. Do rest assured that although the first few bowel movements may be uncomfortable, they will not open your tear or effect the stitches. Even if you had a large tear, it’s extremely rare for them to be torn by a BM.
Suggestions to limit your discomfort and prevent constipation are similar to remedies in pregnancy with some additions:
Replace refined highly processed foods with whole grains, lots of fresh fruits with the skin, and vegetables (especially green leafy salads).
Drink at least 64 ounces of fluid each day, preferably filtered, spring or well water, or herbal tea. Consume between meals, at least 20-30 minutes before or 2 hours after eating.
Do Kegels and abdominal muscle toning exercises.
Drink warm prune juice or a cup of tea or coffee on an empty stomach.
Drink Smooth Move Tea, which tastes yummy and works like a charm.
Mix 2-3 Tbsp oat or wheat bran, or ground flax seed, in your hot cereal or apple sauce. Or, mix with stewed prunes or dried figs.
Try raisin bran muffins with black strap molasses (ask someone to make you a batch, with whole grains, or Paleo - gluten, sugar and dairy free).
You can take these remedies in these doses for preventing and treating constipation which include Magnesium or the powdered liquid equivalent in Natural Calm, herbal Floradix liquid Magnesium, Triphala, Psyllium seed husks, or homemade Dandelion and Yellow Dock root infusion.
Use Colace (stool softener) as directed if your bowel movements are getting hard despite these above suggestions, and you are on opioid pain medication after a cesarean birth.
If you are taking iron, use alternative sources of iron other than ferrous sulfate, such as ferrous fumarate, ferrous gluconate, or herbal iron.
Do not ignore the urge to have a bowel movement, which usually occurs ½ hour after breakfast.
Take an interesting book or magazine into the bathroom with you to enjoy some relaxing time on the toilet.
While on the toilet, rest your feet on a low stool and avoid straining. Support your perineum by applying counter pressure with a folded tissue if needed.
If it hurts while having the first few bowel movements, do some relaxation and deep breathing exercises, relax into the discomfort instead of fighting it and tensing up, or try splinting the perineum with your hands to provide extra give to the area.
Avoid relying on enemas and laxatives on a regular basis.
Ask your classical homeopath, or refer to books like Homeopathy For Pregnancy, Birth and Your Baby’s First Year by Miranda Castro, for a homeopathic remedy specific to your unique symptoms.
Consult your practitioner if there is no bowel movement by the end of the fourth postpartum day, or you experience unusual pain or bleeding.
Treating Hemorrhoids
Hemorrhoids are varicose veins of the rectum, and are a common postpartum occurrence. They resemble a pile of red grapes or marbles just outside the anal area, but they can be internal as well. They can itch, bleed and be quite painful during the first 2-3 days, before gradually becoming smaller. Refer to the suggestions for natural remedies for hemorrhoids in pregnancy as many still apply now.
Suggestions for relief are:
Herbal sitz baths as mentioned above for your perineum, with Epsom salts, Witch Hazel, and/or Comfrey.
Sleep on your side.
Lie down several times each day with your hips and legs elevated with pillows.
Try gently placing the hemorrhoids back inside your rectum with a lubricated finger, and then tightening your rectal muscles around them for 2 minutes.
Natural remedies with dosing are here for internal and topical use, and include applications of already made Witch Hazel compresses (known as Tucks in the pharmacy) or make your own by pouring Witch Hazel onto round cotton pads, plantain, pure Aloe Vera gel, clove of garlic insert, and homeopathic Hamamelis and herbal combinations in a salve or ointment.
Shine a red heat lamp on the affected area.
Avoid constipation and straining. See above.
Report if pain, swelling or bleeding worsens or becomes severe.
Postpartum Dizziness or Faintness
It is very common to feel dizzy, light-headed or faint the first few times that you get up from a lying or sitting position, especially after a long, hard exhausting labor with a large amount of blood loss.
Suggestions are:
Make sure you are eating well and drinking enough water as described in nutrition and constipation sections.
Have someone assist you the first couple of times that you have to rise.
Rise from lying down gradually. First sit, then stand slowly.
If feeling lightheaded or woozy while standing, lie down with your feet elevated or sit down with your head between your knees. Ask for someone to bring you a few large glasses of juice, as well as a high quality whole carbohydrate, fat and protein meal. For example, a nut butter and jelly sandwich on sprouted multigrain bread, or yogurt with fruit and granola.
If you feel faint or do faint, sniff ammonia or smelling salts. This is an important first aid item to have, especially if birthing at home.
Open windows to get fresh air.
Splash water on your face.
Contact your practitioner with dizziness that lasts longer than the first few days or any actual fainting.
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