Postpartum Care

In my blog Rio’s birth I have shared my pregnancy and childbirth experience. I hope it was useful for a few mothers.

Postpartum is up next. If you’re an Indian reading this blog, there are a lot of things that might take you by surprise. My family and friends back home are curious to know how we took care of the newborn. This post is dedicated to them. So, are you ready for my story? Here we go.

Postpartum had been a roller coaster ride, a pleasant one though. We are enjoying it. My little one is 8 months old now. In hindsight, nothing sticks to me except joyful parenting. There were a lot of learnings, surprises, fun and more.

I am an Indian living in the Czech Republic. Postpartum care here is a lot different to how it is in India. I come from the state of Karnataka. In most of the Indian traditions it is common for the woman to go to her mom’s home for the birth. Then, after birth her mom takes care of the baby and the mother. Massage and bath are special and one of its kind in India. Babies enjoy massages and go red crying while getting bathed in super hot water. They are then wrapped snugly in a muslin cloth and put in a hammock made of saree where they sleep tight. Mother receives a good energetic massage and then turmeric bath in uber hot water. This goes on for every day over 3 months or more. The belief is that hot water will help in getting rid of all the pain. My guess is it erases all the memories of any sort of feeling. Just kidding. I missed all this but not the love and affection of my parents and my in-laws who are always supportive of us. It was our decision to give birth in the Czech Republic and take care of our child all by ourselves.

The first 6 weeks after birth, “Šestinedělí” as they call it in the Czech Republic, is a crucial period for recovering mother and the newborn. Whether it’s a natural birth or a c-section challenges are quite common though it may vary to a certain degree. This is especially true if you are a first time mother.

My postpartum started as an adventure, turning into learning, teaching me patience and shaping me to be a mother, getting better and better every day. Hope my story helps you during your postpartum.

Prep for postpartum

Honestly, I was pretty nervous about how the first few weeks after birth were going to be. What to expect? and how to prepare for it? Now that I have experience, I can list a few things that might help you prepare for your postpartum.

As you are close to the due date, few things you can prepare for the postpartum are,

  • Keep enough stock of food. If you can make some ready to cook items that would be a lot helpful later.
  • Prepare a room for postpartum.
    • Incontinence is a common problem post childbirth. So, a room close enough to the bathroom and toilet is better.
    • Arrange things that you need on a daily basis for yourself and the baby
    • Think of a changing area for the baby
    • Clothing for you and the child depends on the season. Plan accordingly
  • If you’re co-sleeping you might want to have a baby nest until you get used to having a baby around.
  • If you are planning a crib with it is good to have a breath monitor for a few weeks.
  • Waterproof the mattress(es).
  • Sling or baby carrier and warm clothes can be kept in a place which is easily accessible so that you don’t have to search for them later.
  • Prepare your bathroom with things you may need during postpartum.

These are a list of things off the top of my mind. There might be more depending on your needs or any medical conditions you may have.

At the hospital

We spent 3 days at the Vyškov hospital postpartum ward after birth. We got a family room where my husband could stay with us. It costs a bit extra on top of what’s covered by the insurance. Not much and it’s worth it all.

After the 12 hours of birth ordeal, we were all tired. I was feeling dizzy and couldn’t walk by myself to the postpartum ward. I was assisted by a wheelchair. Terezie, my birth doula, helped us with moving all our belongings and then she cared for me.

After birth you need to be able to pee. Otherwise a catheter will be used for draining the urine from the bladder. Though I wanted to pee I couldn’t. I had to wait for an hour or so. Terezie consoled me that it will all be normal gradually. I was in the shower and didn’t realize when I fell unconscious. Thank God, Terezie was watching me. The next thing I remember is she helped me step out of the shower, dried me and dressed me up. She and my husband helped me to the bed. She guarded me like an angel. She wished us well and left us alone. We were very thankful for her and wished her a good rest. We both slept for a while until my son’s melody reminded me to feed him.

The morning was peaceful and bright. It enhanced the joy of our son joining us. There were no bounds to our happiness. We welcomed our son into our lives. We kept looking at the little one, subtle movements he was making and looking through us with his shining eyes.

Every day, we got our breakfast at around 8:00 am, lunch around 12:00 pm and dinner around 6:30 pm. I was served a special tea with raspberry and fennel which is good for breastmilk. They advised me to drink more of it and keep myself hydrated. The staff took good care of us. We were touched by their service.

There were visits from doctors every day. They were gentle and caring. One of the nurses asked if she could give our son a bath. We refused (more later). Finally we agreed only to wash his hair using just water. The nurse gave Rio a quick hair wash and a punk hairdo. She was sweet.

One of the doctors did a rough check of his eyes. It left a bruise on one of his eyelids and eyebrow center. We didn’t anticipate it. It was unavoidable and we moved on.

I was weak and tired but couldn’t fall asleep as I wanted to cuddle my son and ensure he is fed well. He was on the crib by my bedside which had a breath monitor attached. I was so eager to have him sleep right next to me. But it felt safe for him to sleep on his own until I recovered a little more. Feeding while sitting was tiring and uncomfortable. But he managed a good latch while sitting. So I did my best to feed him while sitting as much as I could.

During the first day our son wasn’t so keen on feeding as he was tired. He fell asleep often. Whenever he was up I tried feeding him. Getting a good latch was difficult. It was a new skill for me and my son. We contacted the breastfeeding consultants at the hospital. We got a little help but they kept telling me this is normal or I might have less milk, which wasn’t the case. On the second day, we got a warning that our son wasn’t gaining weight and we might have to feed him formula milk. This made me anxious. We got in touch with Ivana Bednářová, my postpartum doula and breastfeeding consultant. Per her recommendation we fed him at least every two hours. I felt sorry for my son that sometimes we had to wake him up for feeding. We weighed him before and after feeding to prove he was gaining weight. We managed to avoid feeding him formula. It was a big relief.

We were slightly concerned when he started turning a bit yellow the second day. It was jaundice which is common for newborns. Doctor confirmed he was fine and the only way to help him was to feed him often and expose him to the sun.

On the 3rd day, something unpleasant happened that I can’t forget. The pediatrician on duty confirmed everything was okay with our son and we could leave. My husband went to fetch my son’s birth certificate from the Registry office. In the meantime, the gynecologist came to let me know there would be an ultrasound and I would be called in about 20 mins or so. He was a nice man and I was happy things are going well. After a while two nurses came. One seemed like a senior and she asked me to go with the other nurse for the test. I told her I would have to wait till my husband is back and I can’t leave my son alone. She told me ‘you have to go now, I will look after the baby’. I was not okay with it and she wasn’t listening to me. Then she told me to turn off the breath monitor. I got concerned and asked her why. All that she told me was she would be there to look after the baby. Where did I lose my voice to say a louder and clearer NO. Perhaps, I did not see something like this can happen or did I trust the nurse enough to let my baby with her? I left for the ultrasound with an unsure mind and prayed my husband would return soon. It took about 10 mins and I felt like running back to my son but I wasn’t fit enough. When I came back my son was sleeping peacefully and the nurse who promised to look after my son was nowhere to be seen. I went near my son and apologized to him that I left him alone and I would never do that again.

We finished discharge formalities at the hospital. Terezie came to pick us up. She helped us pack things and dress up our son. I felt happy that I could walk all the way to the parking area where Terezie had her car. She carefully drove us back home. She helped us settle down and shared some of the tips on how to care for the child and myself. The best advice she had for me was to avoid sitting or standing for long. This will put pressure on the uterus and pelvic area which is still healing. She suggested that I should lie down or slouch to relax as much as possible. She also suggested not to try a sitz bath, vaginal steam or hot water shower at least during the first 2 weeks postpartum. It might fast track the stitches to fall off without actually healing the wound. She recommended cold showers and gentle massage from St. John’s wort’s oil slowly after the stitches fall off. This will soften the scar and helps the skin recover its normal texture.

Home sweet home

Ivana came to meet us once we were back home. She helped us with all the questions we had as first time parents on how to care for the baby and mainly about breastfeeding challenges. She helped me to learn the right skills for breastfeeding from the very beginning.

I had informed the Pediatrician of our son’s birth. She visited us at home to check on our son and confirmed everything was okay. She advised us on the next steps with regular consultations and vaccinations. We visited an orthopedic for his hip test for him once a month until the 3rd month.

I had also informed my gynecologist about the birth. I had a check-up after the 6th week. I was recovering well as my gynecologist confirmed.

Besides reading the book from Ina May on breastfeeding, talking to a breastfeeding consultant like Ivana was very helpful to me. She is a mother of two and has first hand experience which is a plus. She had very simple suggestions to get around some of the breastfeeding challenges I was facing. Thanks to her, my son and I crossed every hurdle during this journey successfully.

Here are a few important things I learnt about breastfeeding

  • Strive for a good latch. This is good for both the mother and the baby.
  • Feed whenever the baby asks for it, don’t time it.
  • It’s not only for hunger but breastfeeding is a solution for many other needs of the baby. So let the baby be at it as long as he/she wishes.
  • It’s good to continue breastfeeding as long as the baby wants. It’s the baby to decide when he/she wants to wean.
  • Breastfeeding and skin-to-skin contact helps the baby a great deal in recovering from any illness or discomforts.
  • It’s common to have a breast sore at some point during breastfeeding. Simple solution is to wash the breasts in cold water and apply breast milk around the areola. You can use some wet cloth or shields to relieve the pain. Thanks to Ivana, she had lent me silver breast shields that I used after every feeding during nights. This relieved me of any accumulated pain from constant feeding.

I was eager to have a hot turmeric bath but I went by the recommendation of doulas. It was nice autumn weather in the Czech Republic. I had a cold shower every day for the first month. It was a good start for the day. It was soothing and refreshing on the body and mind. Public water supplied in Brno is clean enough to drink. In India, I would have used warm water to avoid any infections.

As I had read from a couple of books, it’s very important to rest during the postpartum and give the time the body needs for healing. So, I was mostly lying all day. My husband served me food by the bedside. Incontinence is one of the most common issues post birth. I wanted to use the bathroom frequently for which I used to crawl out of the bed literally. This caused some bruises on my elbows and it was painful. Later after about 6 weeks things started getting better.

My baby was coping well with his new environment. Let me share a few common things you might notice and tips for handling them.

  • Baby acne - my son had a few at birth. They are harmless and will fall off eventually in a few weeks.
  • Jaundice will last for a month or so. As the doulas and pediatrician advised me, continue feeding often and expose the baby to the sun, not directly but through the window. Exposure to direct sun isn’t good for the newborns.
  • Umbilical cord dries and falls off within the first week. I wasn’t comfortable dressing the belly button. Dagmar Lovecká came for help. White clay (Bily jil) was applied which helped the belly button dry and it took a beautiful shell shape.
  • Cradle cap or seborrhea might appear during the 2nd month and might stay until the 6th month or so. Apply oil (I recommend coconut oil) on the cradle cap to stop further secretion of sebum. The skin dries and peels off by itself or you can remove it gently.

If any of them still bother you or something looks bad, talk to the pediatrician.

During the 4th week, Tereza Nožičková came to visit us. She is a skilled midwife and a good friend of ours. While massaging the belly she remarked that stretch marks are a symbol of power and pride of having given birth. What a beautiful thought! She admired how skilful our son was at breastfeeding. She shared a contact who teaches swimming for babies who are 2-5 months old. How amazing! Rio got his first swimming lesson when he was about 3 months old. He continues to swim in the bathtub once a week or so. We plan to take him to the baby pool sometime soon.

Food

Something easily digestible, simple and nutritious food is all you need during this time. If you are breastfeeding, ensure you have lots of water, more than what you used to during pregnancy.

Preparing food was nothing less than an adventure. But my husband nailed it. During the first 4 weeks, first thing in the morning I had porridge out of cress seeds and roasted dry fruits mixed with dates and gond (edible gum) served with melted ghee on top as we do in India. Both are good for boosting bone strength and immunity. I continued having dry fruit mix until the 3rd month. For lunch and dinner, I had something simple and nutritious like soup, rice or cooked buckwheat with lentils, buckwheat porridge, toasts made from rye or wheat bread, greens like spinach, kale etc (cooked) and lots of vegetables. I started having small portions of legumes after the 3rd month.

Self care

Ivana recommended sleeping on the belly at least 30 minutes every day during early postpartum is a good exercise. This will help in getting rid of any blood from birth and healing of the wounds. She helped me sleep on my belly. I started doing it slowly after the 1st week and did it whenever I found a chance. After the 2nd week, she gave me belly massages once a week until the 6th week. It felt relaxing and rejuvenating. Belly massages are not recommended during the first 2 weeks of postpartum.

I started doing yoga around the 6th week. I fit it according to my son’s feeding schedule. It is quite a challenge but I managed it somehow. If not the whole routine every day, I do whatever I can. To see the benefits of yoga it’s good to be consistent. For anyone interested, find more details under the references section. Please talk to a professional before practicing any exercises.

I had a physiotherapy session around the 8th week. The physiotherapist was kind enough to come home. She is a mother too and shared some tips for breastfeeding and relaxing. She did a short and effective closing bone therapy for me. She introduced me to bengkung belly wrapping. This technique helps in relaxing the pelvic muscles and closing of the bones. In India usually a saree is wrapped around the belly tightly during the postpartum. It is good to wrap it for an hour or as long as you are comfortable but not so long that it interrupts the muscles from getting any exercise to get back in shape.

Feed-Pee-Poo

“Breath in feed the baby, Breath out change the nappy” - taken from the book “Mindful parenting”

For the first couple of months, It’s literally that. First 3 months were a learning curve for me and my baby. It is a crucial time for getting your latching skills firmed up. If done right, feeding becomes second nature. Fatigue, breast sore and sleepless nights are common symptoms of a learning parent during this stage. Don’t worry, it will pass. Patience is everything. Keep going.

It was the 2nd week. There was a change in Rio’s feeding. He wasn’t leaving my side. He clinged on my breast and cried when I took a break. I was going mad. What was going on? I called up Ivana. She told me this is a way babies set the amount of milk they need so that my body in response gets ready to produce it. Wow! She explained things might change week on week or every 2 weeks as the baby grows. I was happy to learn that and learned to be patient.

You might call it common sense but let me say it anyway. Most commonly babies cry when they are hungry, their nappy is wet or they are colic. Well, the other important reason is when they want to pee or poo. You have a window of a few seconds to respond. It feels so good when you catch it. Like a win-win for you and the baby. It was an interesting game for both me and my husband to read his cues and respond. Having come so far, I think we aced it. Our son almost never peed or pooped in his nappies.

Be lazy when it comes to bathing the babies. For the first few months they hardly move to get any dirty. Babies’ skin is protected with vernix when they are in the womb. It’s recommended not to bathe the newborn immediately and good to let the vernix get absorbed. We did not give a bath for our baby until the 3rd week. He got his first bath from Ivana. A rule that she shared which sticks to my mind is “oil for wet skin, cream for dry skin”. I followed this diligently. Unlike in India, we give him an oil massage after a shower which opens the pores on the skin and it is receptive to the oil. Until 3rd month, we gave him a bath twice a week and later switched to once in two days and after 6th month or so almost every day. Recommended temperature of the water was around 40° C and bathing time 2-5 mins until 3 months and may be a little longer later.

I also learned techniques for baby wearing and making cloth diapers from Ivana. Our baby has been wearing cloth diapers since the 2nd week. Sometimes we let him nappy free for a while. We use disposable diapers when necessary like when we are going out, during nights or when we aren’t feeling well etc. Cloth diapers are good for the environment and soothing on the baby too. That’s why, our baby never had nappy rashes.

He had gained the required weight by the 4th month and the doctor had suggested we could give him solids slowly. After discussing with doulas and midwives, we decided to delay solids till he is 6 months old to give enough time for his digestive system to develop. We would like to follow baby led weaning. But now that he can’t sit up by himself, we feed him puree from fruits, veggies and muesli etc and sometimes offer finger food. He gets his regular dose of vitamin D from two drops of vigantol every morning. It’s recommended not to feed salt, sugar or honey for babies under 1 year of age.

Sleep

As I have heard from many mothers, sleep deprivation is one of the major problems they face after birth. As a matter of fact, before birth too as it’s not very comfortable to sleep with a heavy belly.

I managed to sleep well two times a day during pregnancy. Thanks to Yoga and the guidance from midwives who showed me some poses which are good for sleeping. During the last month I noticed a change in my sleep routine. I slept light during the night. Thanks to yoga nidra, I had learnt to relax without falling into a deep sleep. It felt like preparation for postpartum. Body knows it all. Be in tune with it.

After birth, I was ready to care for my son. Many people recommend the mother to sleep when the baby sleeps. It’s a good suggestion though not practically possible every time. I slept whenever I could and tried yoga nidra whenever I needed to relax.

During the first 3 months, I ensured he had milk every 2 or 3 hours during the night. This meant waking up to check on him. If he is fast asleep and it’s not more than 2 hours, I would wait. Otherwise, I slowly take him to my side and feed him. We were using cloth diapers during nights as well initially which woke him up whenever he wet his nappy or wanted to pee. We then started using disposables during the night which helped him sleep without interruptions and nights got better for us too. Since we co-sleep, I could feed my son whenever he wanted. From the 3rd month or so, we managed to sleep through the night without any issues.

Other formalities

Fathers are busy with legal and administrative formalities soon after birth.

Brno expat center provides detailed information about all such formalities and how-to in their article having a baby.

Knowing is half the battle. Here are a few tips that we gathered when we were at it.

  • Hospital where you give birth will help with required documents for Birth registration at Matrika (registry office in the Czech Republic).
  • Within 60 days of birth, you have to apply for the passport, residence card at MOI and health insurance.
    • Health insurance companies will need the residence card or equivalent ID of the baby for processing.
  • Generally the Indian embassy requires the baby to be present to apply for the passport. Traveling and sitting for hours on the train was unimaginable for me and I believe it would be the same for any mother right after birth. I discussed it with my gynecologist and she gave me a letter explaining that I can’t travel. My husband shared it with the counselor at the embassy over email and spoke to the official on the phone. We got confirmation that he can go alone to submit the application and for collecting the passport.
  • MOI will need the passport of the baby for processing the residence card. It is important to apply for it within the first 60 days of birth, clarifying the status of the passport. We got help from Czech Relocate with all the formalities.

Hang on. My husband interrupts “Sushma, he is refusing to wear the diaper”. And, the fun continues!

Before I go, I would like to thank doulas and midwives for all their help and support. I still reach out to them on any questions I run into. They gladly help me out.

By the way, have you heard of “Closing bone ritual”? Stay tuned for my next blog.

References:

Useful Links

Yoga practice

I have listed the yoga routine I practiced during postpartum below. Suitable changes may be required for individuals depending on their health condition and fitness. Please check with a professional before practicing. If you need help, you can reach out to my yoga teacher Prabhakar Upadhyaya (email yogaprabhakar.u<at>gmail.com)

Postpartum (for first few months until you feel ready for a regular routine)

Asanas

  • Vajrasana - a small prayer
  • Pavanamuktasana 1
  • Pavanamuktasana 2
    • Pada chakrasana
    • Supta pavanamuktasana
    • Supta udarakarshana
  • Vajrasana
  • Marjari
  • Shashanka
  • Ustra
  • Tadasana
  • tiryaka tadasana
  • Kati parivartana
  • Ardha kati chakrasana
  • Paschimottanasana
  • Makarasana
  • Poorva bhujangasana
  • Makarasana
  • Matsya kridasana

Pranayama

  • Ujjayi
  • Nadishodana
  • Bhastrika
  • Brahmari

Mudra

  • Vajroli
  • Ashvini mudra

Bandha

  • Moola Bandha

Shavasana, Yoga nidra

Written on May 10, 2023