by Martha Oakes, Postpartum Ayudoula
First published as, “Postpartum Care, the Black Hole in Health Care” in the Boulder County Parent, March 1995

It is natural for a woman to mother well and to enjoy it.  When a culture allows its women to lose their health, vitality, or joy through the very process of re-creation, it has lost touch with the greatest source of its vitality! Experts in perinatal care declare postpartum is “the black hole in health care.”  In western culture, a rapid accumulation of stress and aging is the norm for postpartum women.  A University of Minnesota study of 436 first time mothers showed a high percentage of women with health and sexual problems for several months to a year after delivery, and reported this as “normal”.

According to this study, common problems at one month include:  fatigue, hemorrhoids, constipation, poor appetite, hot flashes, and breast problems.  At 3 months, 40% of postpartum women have sexual problems, including painful intercourse, decreased desire, or difficulty reaching orgasm.  Twenty-five percent complained of respiratory infections, increasing to 42% at three months!

A professional report at a Denver International Childbirth Educators conference reported sadly that 40% of divorcing men felt the beginning of the break-up of their marriage was during the first weeks after their baby was born.

According to an article in Mothering magazine (Spring 1994), “5 – 15% of women in the western world experience mental illness following childbirth . . . Postpartum depression affects about 10% of childbearing women, typically one day to six weeks postpartum, and includes symptoms of extreme anxiety, inability to sleep, inability to eat, unrealistic and inconsolable concerns about the baby’s health, and occasionally, suicidal thoughts.”  More recent reports routinely cite depression figures of 10 – 20%.

If you are experiencing these or more severe symptoms, postpartum crisis expert from Boston and founder of the Depression After Delivery (DAD) organization Jeanne Driscoll, RN and lactation consultant advises mothers clearly.  “Be sure you seek help, and get it from those who know your problems are physiological, not mental or emotional based. . . Most medical and psychological experts today still think your problems are in your head.”

Although little noticed there is really good news also.  Cultures in which mothers and families statistically do not have these problems all do similar things after childbirth.  Most commonly, they recognize a 42–day reclusive healing time as key for recovery.  Ayurvedic and Midwives and childbirth educators, who give strong recommendations to their clients to take it easy during the first few weeks, and to arrange for help, know what they are talking about.Chinese, Indian (Ayurvedic), Vietnamese, Sikh, Colombian, and Native American cultures, to name a few, have traditions which (when followed – the last two generations show great loss here, too) take very seriously the care of their women after childbirth.

5,000-year-old Ayurvedic medical texts explain that because a woman’s psycho-physiology is in complete transition for six weeks during the postnatal period, a rare opportunity exists to reset all systems for ideal health.  Chinese health professionals agree that the quickest way to help a postpartum mother become a better mother is by taking care of her physiology, and letting her do what comes naturally emotionally, which is to take good care of her baby.

Changing all systems over to normal functioning, recovering from the work of childbirth, being up at all hours, and lactating – which is nutritionally alone like running 10 miles a day – all put heavy demands on a mother’s body and emotions which are already fragile at this time with the tremendous invisible work of recovery from birthing.

Postpartum “Doula” care, which can include cooking, lactation support, house cleaning, shopping, childcare, and massage for baby is offered by many doulas around the country.  Ayudoula care is an advanced doula profession trained in the wisdom of the long proven tradition of Ayurvedic medicine.  United States Ayudoulas are available in Colorado, California, Iowa, New Mexico, Vermont, North Carolina, Florida, and occasionally include traveling live-in service.

Ayudoula care includes education about and cooking for the rare digestive needs of newly delivered mothers which make a tremendous difference for avoiding both infant colic and maternal depression.  These factors are largely unknown by both allopathic and complementary medical models.  Ayudoulas offer private consultations by phone or in person as well as special postpartum massage for mom, easy to learn infant massage instruction for mom and dad, postpartum herbal nutrition and other options.

According to Ayurvedic medicine, the influences of this time last for about 42 years.  42 days for 42 years is a sound investment, and a concept which catches Dad’s interest!  It starts with education and understanding about this new twist on “God helps those who help themselves”.  Baby showers, best friends, and childbirth education classes are all key resources to engage.  Avoiding the potentially high emotional and physical costs of childbearing is very important for us all.

A best friend can organize others to provide support – to bring a loving meal … better yet, one a week for 6 weeks, with a backup friend on call when their own family or health needs attention.  Friends who want to come by can fold some laundry or take out the garbage, and enjoy holding the newborn while mom takes a soak in a hot bath, gets a massage or in the many little ways which support this mother’s special window for some of the deepest work of her life.

Husbands can make sure a note goes on the door, she has her slippers, the room is cozy warm, herbal teas are made and in a thermos by her side, and that the older children get his first attention when he comes home. Little things like this make a big difference at a time when a mother’s psycho-physiology is as delicate as her baby’s.

A father’s affirmative support for his wife’s tremendous invisible work often makes a big difference for her to relax and accept this responsibility which is quietly (or loudly!) whispering already in her ear.  It may also make the difference in her willingness to ask for this help – which is not about pampering at all, rather powerfully supportive of her desire to care for her family. Let us all take better care of each other, and save all of us much emotional, financial, and spiritual grief.  The benefits to our children are enormous!