An estimated 385 000 babies are born worldwide every day. Perhaps because the process is so common, we forget how harrowing it can be, or the impact it can have on a new mother’s physical, emotional and mental health. We spoke with Jo-hanné Linde, a paediatric community service physician at Potchefstroom Hospital, about the common challenges mothers face, and what care is available to them after giving birth.

Q: What are some of the physical and emotional repercussions of childbirth that mothers don’t know enough about?
A: What many women often forget is that giving birth, whether natural or via caesarean section (C-section), results in a major internal wound, approximately the size of a dinner plate. This happens because the placenta has detached from the uterus, where this organ was growing for nine months along with the baby. It’s normal to experience a great deal of pain. And if you had a C-section, you were probably given a spinal, which means you can’t move for four to six hours afterward. This can be very frustrating for mothers. A C-section, while common, is a major surgery that requires significant recovery time. Pregnancy itself is usually very demanding on the body: a woman’s organs are constantly shifting, and her breasts are preparing for milk production and feeding. Then there’s the physical exhaustion. A woman who has given birth naturally loses around 500ml of blood, while a C-section can cause loss of up to a litre of blood. Some women experience dizziness, nausea or headaches afterwards. A woman usually bleeds for a significant period of time after giving birth. Urinating or bowel movements afterwards could also be painful. With vaginal birth, there is the risk of tearing, which requires its own recovery time. When it comes to the emotional aspect, pregnancy and birth can be very unpredictable. Most women don’t sleep well in their final trimester. Some women prepare for natural birth, and when they need to have an emergency C-section, they may feel the need to mourn their inability to have a natural birth. Furthermore, breastfeeding doesn’t just come naturally to everyone.

Q: Why is sufficient rest so important after having given birth?
A: When we rest, the body can heal. A woman who is not getting rest will have heightened cortisol levels, which doesn’t allow her body to heal from the effects of childbirth, and also negatively affects her emotions and her ability to breastfeed. Suffcient rest is also important for the prevention of post-partum depression, in addition to the promotion of healthy bonding with her baby. A woman who is not well-rested may also be at higher risk of making errors in judgment when it comes to taking care of her baby

Q: What medical specialties are available to mothers after the birth?
A: A woman’s first responder is usually her gynae, although some women opt for a midwife. Nursing stay and lactation consultants can also be very helpful, and a paediatrician is always available. Dieticians provide a good nutritional foundation for nursing mothers, while wound care physicians can help to keep wounds clean and treat scars, especially in the case of infection. Finally, a new mother who is concerned about her mental health should definitely see a therapist.

Q: Which myths need to be dispelled about birth control post-partum?
A: Breastfeeding is not a reliable form of contraception. Speak to your doctor about options that are available to you. After giving birth and once your doctor clears you for resuming intimacy, barrier methods such as male or female condoms are good options, as there is a heightened risk of blood clots through the use of other birth control options, which can also influence breastfeeding.

Q: Why is limiting visitors an important part of post-partum care?
A: A mother who is home with her newborn is not being idle. This is the mother’s time to establish a bond with her baby, her baby’s bond with its family, and a routine for her newborn. Too many visitors can disrupt this bonding process and put unnecessary pressure on her to entertain. Furthermore, too many visitors puts the baby and the mom at risk of picking up unnecessary germs and bacteria. Don’t feel bad about setting boundaries and restricting visitors, at least for the first six weeks.

Q: What’s post-partum depression and what signs should I look out for?
A: There’s PPD and there are the post-partum blues. The latter can aect up to 85% of mothers and usually occur within the first 10 days, peaking at around Day 5. The symptoms include mood swings, little to no excitement about the new baby, irritability, tearfulness, excessive fatigue and confusion. Usually they go away on their own and don’t require treatment, but they should be monitored. PPD, on the other hand, affects around 15% of mothers. A major depressive disorder with onset at about a month after giving birth, it’s one of the most underdiagnosed and undertreated conditions relating to childbirth. If any of the following symptoms persist for two weeks or more, the mother should be evaluated:

  • Loss of interest/pleasure in activities
  • Sleep disturbances
  • Poor appetite
  • Loss of energy
  • Feeling of worthlessness/guilt
  • Poor concentration
  • Thoughts of suicide

Q: How do I keep myself physically healthy after delivery?
A: Follow your gynae’s recommendations when it comes to resuming intimacy – this will depend on what happened during the birth. Speak to your nutritionist about post-natal supplements. Enjoy healthy meals, and avoid alcohol and caffeine. Try to avoid gas-producing fruits and veggies when breastfeeding, and avoid rigorous exercise for at least six weeks.

You and your immediate family have access to the ICAS EWP which provides an omnichannel point of access.

Written by LifeAssist