Delivery and postpartum care are one of those things you don’t think about until you’re pregnant and then you really think about it.
Your Google search, podcast playlists and conversations with friend’s with babies are filled with the burning questions you have.
And there’s a lot of them.
I figured who better to help us answer these questions for you than Beth, a midwife based in Melbourne, Australia and creator of ‘Birth with Beth’ an Instagram page and childbirth education business.
Beth and I deep dived into all things delivery and postpartum care on the pod covering topics like misconceptions, c-section vs vaginal deliveries, the role of midwives, how to prepare for early postpartum care and more.
We’ve brought you all the best bits from the episode in this blog post.
Let’s dive in!
“I do think there’s a lot of myth and mystery around what actually happens when people give birth. And I think a lot of that has to do with the movies. I think we often see women giving birth on their back with their legs in the air, screaming their head off”.
Beth explains that while that scenario can occupy a really small space of the birth world, for the most part women give birth in all different positions.
“They’re very mobile. And when I do my education courses, it often shocks people when I’m like, you know, you can give birth on all fours. You can give birth in side-lying. In fact, your body will probably naturally want to be in that position”.
Another misconception is that it’s always a medical emergency. Beth says “…this couldn’t be further from the truth. We’re built to birth and again, there will always be a percentage of people who do need medical help at some point. And there’s absolutely nothing wrong with that, but the idea that birth is inherently dangerous for both mom and baby and it is only safe to do that in a big hospital where there’s lots and lots of doctors is probably the other biggest myth that I’d love to see sort of debunked and start believing in ourselves a little bit”.
“And I think we need to be careful as well, because that doesn’t mean that the skill of doctors and by extension midwives is redundant at all. I’m really passionate about working collaboratively [and] I love it when couples and women are like, you know what? This is my body. This is my baby. I’m gonna learn about this as much as I can. And then I’m gonna take what resonates. And I’m gonna work in collaboration with my care providers to have an experience that I wanna have and be a little bit more in control”.
Postpartum Care After a Vaginal Delivery
“After someone’s birthed vaginally, like immediately postpartum, I guess the things that we’re looking at are making sure that their blood loss is settling. So it’s normal to lose blood after both the vagina and caesarean birth, but we want to make sure that that placental site is eluting and that we don’t have any significant tears that are contributing to blood loss”.
“If you have had a tear or a cut (an episiotomy), then we need to look at repairing that. So some women will need sutures and for the most part that can be done in the room with the midwife or the doctor who’s been caring for you, and then a small percentage of mums will need a more thorough repair in the operating theatre. And that’s when the tear has extended into their back passage”.
“After we’ve made sure that any wounds have been taken care of and that your blood loss is settling and that your kind of stable, I suppose, the immediate postpartum care is centred, giving you time with your baby”.
Beth says they then help set up a good environment for mum, baby and birthing partner. “…Protecting that skin to skin, I always try to dim the lights, if they’ve needed to be turned on for any reason, get mum a warm blanket, get her something to eat and drink and really start that process of [welcoming baby]. Let’s see if mom wants to breastfeed, let’s try to protect and support the environment so that can happen as organically as possible”.
“Once baby’s had a little feed, most moms are really ready for a shower and they’re like, get me out of this bed or off the floor. I need to have a rinse. I wanna put some clean, soft pyjamas on and usually the partner or support person can do some skin to skin with bub while mom just has a moment to herself and has a nice hot shower”.
“It’s actually one of my favourite parts- helping mum into the shower. Cause usually she’s like, oh my gosh, I’m so wobbly, I feel so raw. They’re quite tender and then you get them into a warm shower and into some clean pyjamas and they’re just like, I’m a new woman. I’m an absolute goddess and it’s the best feeling ever”.
Postpartum Care After a C-section
“I guess that’s a very different experience just because immediately postpartum, you are in a postoperative state, so you would be taken to a post-op area”.
“I think something that we’ve gotten much, much better in maternity care is keeping mums and babies together regardless of how they birth. So typically baby would come with you to the postoperative area while the surgical nurses are checking you and making sure that the anaesthetic is wearing off, that your blood pressure and blood boss is okay, your wound is comfortable and key clinical care”.
“There’s a midwife there as well to help you do skin to skin, to support baby, to breastfeed if you want to and we all stay together”.
“And then once you’re stable, you usually go up to a postnatal ward where there’ll be a midwife taking care of you. And I think the key difference is, is that you’re not super mobile”.
“Obviously you’ve just had major abdominal surgery so you might need a little bit more physical support in terms of lifting your baby out of the cot, to have a feed, to have a cuddle. You might need help for the first 20..40..48 hours with things like changing bubs nappy and midwives are there to support you and hopefully a support person or your partner as well”.
How Long Do You Stay in the Hospital?
Beth explains it varies hospital to hospital and between public versus private. “Typically for a vaginal birth, people would leave within 24 to 48 hours provided that there’s no issues, or even sooner, a lot of the time”.
“And then a caesarean. is more like three nights as a minimum usually. In the private system, you might have a little bit longer regardless of how your baby arrives.
Beth says “if you do go home early, then typically midwives are coming to visit you at home just to weigh your baby, check your stitches, all of that kind of stuff”.
What to Expect From the Midwives
Part of a midwives role is to take care of your baby and teach you how to take care of your baby when you are physically well enough.
“So often a midwife will come and change your baby’s nappy and they’ll do a demonstration and they’ll run through things like what equipment to use and the technique and everything like that”.
“And then if you, for example, had a C-section, but your partner was there and you’d already had a demonstration from the midwife, there would then be an expectation that your partner or a family member would help you with that”.
“In saying that you are always, always welcome to call for a midwife to help you. Particularly overnight if your partner has to go home and you’ve just had a caesarean birth, you are always encouraged to lean on the midwives for support with your baby care”.
“But overall our role much more than taking care of your baby for you is to put things into place so that you feel confident to do that. The closer you get to going home so that, you know, we’re not looking after your baby for three nights, and then we’re like, okay, time to go home. You get home. You’re like, I don’t know what to do”.
Does the Role of the Midwives Differ Public Vs Private?
“It should more or less be the same. The key thing that’s different in terms of postpartum care in a private hospital is that most of them have something called a baby nursery, where you have the option to check your baby into a room overnight, that’s staffed by a nurse or a midwife. You can send your baby there overnight so that you can get some rest”.
“They will be looked after or they can bring them back for feeds or you can send them with bottles. Completely up to you, which I think has strengths and limitations. Like I’ve worked in those nurseries as well. And I think for some people it’s brilliant to have that opportunity for rest, particularly first time mums who maybe have had a really, really long labour, and they’re running on empty. Really wonderful to have that option, to have your baby taken care of for a few hours so that you can catch your breath so that we can take care of you”.
“I think where it falls down is that sometimes if you, for example, did stay for four nights and your baby was in the baby nursery for four nights in a row, and you weren’t doing the cares it’s a little bit of a rude shock when you go home and find out that this baby’s actually very nocturnal, that they need lots of care overnight.”
Tips for Postpartum
Beth explains that postpartum prep is all about thinking about what your needs will be as mum, baby and family, in that fourth trimester.
“Those first 12 weeks are such a pivotal time for parent baby bonding for establishing feeding for mum and physically healing.”
‘So it looks like things, like food prep, filling your freezer with really nutritious food. Organising family and friends that you trust to be available to support you, whatever that looks like”.
Something to note is that “… a lot of people want to come and help with the baby but in reality, new parents don’t need other people to come and look after their baby. Most of the time they need people to come and look after everything else. They want a clean house, a food drop, someone to come and hang out the washing, take out the bin,take their dog for a walk so that all they do all day is rest and feed and cuddle their newborn and really ease into that parent life without having to juggle a million things”.
“There’s an app called ‘Meal Train‘ where you can enlist like family and friends and they can go on and do an online roster of who’s going to do what so that you’re not having four lasagna’s arrive on your doorstep on a Monday and then nothing for two weeks”.
“You might have three meals dropped off throughout the week by different people. You might have someone that’s like, I’m going to come over and while baby’s asleep, I’ll just pop on a load of washing for you and you can have a rest as well or something along those lines”.
How to Set Boundaries
Beth explains that everyone is different and your boundaries will look different to others too. Start to think about what this may look like for you. It’s all about protecting your emotional space and energy.
“The other aspect of postpartum prep that I think is really important is having conversations ahead of time before you’re exhausted, before your hormonal with family and friends about expectations and boundaries. So for example, if you have a really big involved family and there are aunties and uncles coming at you from every direction, and you’ve got a, you know, a ‘WhatsApp’ text thread that’s buzzing every five minutes. That can be really emotionally taxing”.
But “…you’re bleeding, you’ve probably got a wound, whether that’s in your perineum or your tummy where you’ve had a C-section. You’re tired. Your boobs are huge and sore, and you are semi naked a lot of the time. Your space needs to be protected and your emotional energy needs to be protected”.
“So I think a big part of preparing for that season is saying to family and friends like, Hey, you’re so excited to share this baby with you, we’re so honoured that you’re part of our family, but, maybe for the first week, we’d like no visitors or if you do choose to come over, please keep your visit short”.
Thank you, Beth!
To learn more about pregnancy, delivery and postpartum make sure you check out Beth’s Instagram page.
You may also be interested in her online course called ‘Power Birth’- a self-paced birth course perfect for expecting mums. There’s lots of different modules with videos and graphics and audio from Beth, taking you through labour and birth, how to prepare, what to expect and all the frequently asked questions that she’s answered in her career as a midwife.
If you want to listen to the full episode check it out at ‘The Postbump Podcast’.
See ya there!