The ABCs of Postpartum Self-Care

by Aga Grabowski, LCSW, Co-founder of Wildflower Center for Emotional Health                    

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All life transitions, even the joyful ones which mark the beginning of a new, wished-for chapter, are tough. The transition to motherhood is even more challenging than a move to a foreign country, getting married, or setting on a different career path. Why is that? The arrival of a baby forces changes that are abrupt, intense and all-encompassing. A woman’s body, mind, routines, relationships, beliefs, priorities, and the very essence of who she is, are tested. She must rapidly mobilize all her internal and external resources to meet the challenges of new motherhood – all while she is sleep-deprived, recovering physically, and dealing with hormonal changes!

There is no way to enter motherhood – for the first or subsequent time – without some struggle and difficulty. However, there are ways to ease this process, resulting in a more robust sense of wellbeing and resilience. Here are the ABCs of postpartum self-care: 

Assistance  
Every mother of an infant needs assistance with a variety of tasks. It may take many forms: having someone hold your baby while you take a shower, asking a family member to get groceries on their next visit, handing the baby over to a friend while you drink a cup of tea, mobilizing support so you can nap peacefully without worrying that your little one will wake in five minutes and require attention. The key is to recognize the need for help and explicitly ask for it without feeling like a burden or a failure as a parent. We also have to realize that for many people in our lives (even those who are parents themselves!) our needs may not be obvious.

Boundaries
Do not say yes to hosting the Thanksgiving dinner just because you have always done it. If you are exhausted and desperately need to sleep, do not pick up the call from your talkative aunt who wants to ask how you are doing. If your friends are over at night and you are wondering when they will leave, gently let them know you wish you could stay up but need to get some sleep. These seem like simple examples of boundary-setting; still, new moms struggle with this quite a bit. In order to care for your baby in the early months, you must seriously prioritize your own self-care, and setting boundaries allows for your relationships to support this. You may feel ambivalent about being direct about your needs. Try to have frank conversations with your support network about where you are coming from. We need to help our loved ones figure out how to care for us. After all, this is a transition for them too. 

Comfort
Seek to make yourself as comfortable as possible. Your comfort needs to be a priority. Often new moms feel ambivalent about this – despite tiredness and lack of energy, they try to keep the house tidy, make dinner nightly and fold laundry. This is sometimes driven by an understandable need to feel “normal” and in control. Yet no matter how much you might try to restore a sense of normalcy, the reality is that in the early months it cannot be had at the expense of your comfort. Try to let go of the idea of bringing order to chaos in your home; instead, throw the little bit of energy you do have into caring for yourself. Linger in the shower. Read an article. Watch a TV show. You will be surprised by how much better you’ll feel. 

Doctor
Your obstetrician/midwife and your pediatrician are critical sources of information that will help dispel your worries and anxiety. Use them as much as you need to! If you are worried about your postpartum recovery or about your baby’s health, reach out. Similarly, if you fear you are struggling with depressive or anxiety symptoms, call your obstetrician/midwife. They will help you figure out what to do next.  

Expectations
Having realistic expectations towards yourself when you are a new mom is one of the most important ways of supporting your emotional wellbeing. Here are some helpful expectations to hold on to: no one is an expert at parenting, it takes time and practice to develop confidence; bonding with your baby is process; it is impossible to be always happy and fulfilled as a new mother; it takes more than six weeks to regain a sense of normalcy. Reflect on some of your other expectations and ask yourself whether they are realistic. If not, do your best to let go of them.  

Forgiveness
You will make many mistakes as a mother, and not just in the early months – always. Most parents want what is best for their children and dread the possibility of someday learning from their offspring that they caused them pain. Yet all relationships are flawed, and making mistakes is a huge vehicle for growth for all involved. When we make and own our mistakes, our children learn that it is okay to be imperfect. They also learn to deal with the world which is not always going to bend to their needs and wants. Practice forgiving yourself for making mistakes. Let go of negative judgments as they will not fuel your growth as a person or a parent. It is possible to learn from your errors and improve without beating yourself up. The added benefit is that you will be teaching your children to do the same!

Grief
It is okay to feel sad at times about the ways in which having a baby has changed your life. It is normal to miss your old routines and freedoms, to yearn for uninterrupted sleep and nights out, or miss your pre-pregnancy body. If you have other children, you might be sad about how your relationship with them is affected by having a newborn at home. Talk to trusted people in your life about your feelings. Being sad does not mean you are depressed as long as the feelings of sadness are transient and not a source of significant, unrelenting distress or causing inability to function. Grief is very much part and parcel of new motherhood. Making space for its expression without guilt or judgment will help you cope with it and ultimately lead to greater acceptance of your new situation. 

Humor
Leaking breasts, your living space invaded by diapers and diaper rash creams, and tiredness so severe that you actually place your meal on a shelf and wait for it to re-heat because you mistook it for the microwave. Simply put, there are times when it may feel like you have two options: either to laugh or to cry. It can be helpful to do both. As much as you can, look for humor in your situation. Not taking yourself too seriously during this time will help you cope with the myriad challenges you are facing (who would have thought that getting to a grocery store would be so difficult?). 

Imperfection
You want to do a great job at parenting. You will strive to do your best and still feel at times, many times, that it is not perfect. That has to become okay. Actively embrace imperfection; try not to just become resigned to it. You are not a robot and so you cannot always give 100% (and even when you do, the results might not be fully to your liking since not everything is in your control!). To help yourself with this, remember that your child/children do not need you to be perfect. Good enough will do it. This means there is plenty of space for mistakes. 

Joy
While our culture’s media-fueled depiction of new motherhood as a supremely joyful experience is inaccurate and oversimplified, it is important to look for moments of joy during this time. Joy brings meaning and positivity to days that might otherwise blend together and drag on. Sometimes joy may be spontaneous and exuberant, washing over you like a tsunami wave as your baby sleeps in your arms and you hear her breathing. At other times it may be quieter, found in conversation with a loved one, or accessed intentionally through reflection on this new chapter of your life. To maximize your ability to get in touch with joy, think about what tends to bring this emotion into your life and make space for it as much as you can.    

Knowing your limits
Respect your limits. Your physical and emotional energy is a finite resource. Use it wisely and refuel when you are running low. This can take different forms: sleep, an hour away from home, coffee with a friend, gentle yoga, meditation, a decision not to wash the dishes. Whatever you do, respect the voice inside you that is demanding space for self-care. This will help you be present to the most meaningful aspects of having a baby at home. 

Love
We thrive when we feel cared for and when we feel a strong sense of belonging. As a new mom, you likely feel more vulnerable and raw, and nothing reestablishes a sense of safety better than being embedded in relationships with people who love you. Be open to receiving gestures of caring from others even if they are offered in an imperfect way. If you have a partner, brainstorm with him or her how you can make sure that your bond continues to feel loving despite lack of time and fatigue. You will also fill your heart with love by getting to know your baby. It is okay if you feel that you do not love her yet – after all, you “met” your little one only recently; what matters more is the desire to come to know her and to feel increasingly connected.

Mindfulness
Mindfulness is about being present to the here and now without holding on to all the judgments about ourselves and the world around us that our minds so readily generate. Being mindful does not mean being “blissed out” or even relaxed. It means opening up to the reality at hand in an accepting manner. This takes practice (no one “masters” mindfulness, though it can become more familiar and hence more easily accessible). For a few minutes at a time, make a decision to be here and now, as though the past or the future did not exist. If you get distracted, just gently bring your attention back again and again. It may help to take the moment in through your senses: sight, smell, touch, taste. Begin your practice with moments during which you are already more present, gradually working up to experiences you typically struggle with. 

Nutrition
Eat. Do whatever you need to to ensure that you are nourished. It is incredibly easy to relegate the task of feeding yourself to the very bottom of your to-do list. Your body and mind will pay dearly for it if you do. You will find yourself feeling more exhausted and overwhelmed. Make sure to stock your fridge with easy to access snacks. Prepare meals that are simple and quick. If there are close friends or family who could help, ask them to.

Outdoors
After a few weeks (or days) at home with your baby, you may begin to feel isolated and restless. If that is the case, get outside as soon as you feel up to the task. Take walks. Go to a nearby coffeeshop or playground. The destination is less important than being out of your home and surrounded by other people. 

Patience
Strive to be patient with yourself and with others (and forgive yourself if you are struggling with this; it is very hard to do when tired and overstretched). No one can navigate this transition flawlessly and adjusting to the new reality takes a long time. Be especially patient with your post-pregnancy body; it cannot just erase the fact that for nine months it supported a developing new life. Instead of judging it, shouldn’t we marvel at what it has been able to accomplish?    

Quality time with partner
Amidst the never-ending demands on you as a mother, it is very easy to forget the relationship with your partner. Yet studies show that the closeness and quality of this relationship plays a crucial role in mitigating effects of postpartum stress. Conversely, conflict and distance contribute to depressive and anxiety symptoms. It really is difficult to focus on your partner when you have little energy left at the end of the day. Still, doing so will leave you feeling replenished and happier. Try to go on dates at least once a month, and make sure to spend time just checking in with each other to stay connected. As best as you can, be understanding and patient with your partner – and ask for the same. Bickering about chores and division of tasks will not solve whatever struggles you may be experiencing in adjusting to unfamiliar expectations. Rest assured that every couple has difficulty navigating the new landscape. Try to approach your disagreements as challenges meant to be faced together, rather than problems in the other person that require fixing.   

Rest
You gave birth. You are responsible for literally keeping another human being alive. You likely do not feel like yourself and maybe even wonder what this even means. One of the ways women deal with this enormous identity shift is by quickly trying to resume routines and tasks they used to have prior to having a baby (chores, errands, social engagements). This is understandable. However, if there isn’t sufficient balance between activity and rest, you will quickly deplete yourself and suffer physical and emotional consequences. Prioritize rest. Once your baby lets you have several hours of uninterrupted sleep, you will be able to do more and more. Try to be patient with yourself. Motherhood is a lifelong journey that requires pacing, not a sprint.

Self-compassion
Mothers in general struggle with being self-compassionate. Our judgmental, comparisons-prone culture that seems to suggest that there is one right way to parent well – does not help in this domain. Parenting is hard – there is no clear roadmap or manual and no one can predict with certainty how each decision and action will affect our children. Self-compassion is about acknowledging the times when hardship and pain are present. It also means being gentle with yourself and being moved by the experience of struggle, desiring to make it better. Lastly, self-compassion is about feeling less isolated in our pain which is achieved by recognizing that vulnerability, struggle, and imperfection are part of the shared human experience. 

Tears
All new mothers cry. It is okay to cry. During the first two weeks postpartum, crying is likely a manifestation of postpartum blues, a normal and mild experience of feeling weepy and moody that is triggered by hormonal changes. Whether in the first two weeks or beyond, tears may stem from frustration, exhaustion, helplessness, grief. The list goes on! New mothers have plenty of good reasons to cry. Crying in the postpartum does not automatically mean you are depressed. It can be difficult to differentiate when crying becomes a symptom of depression and/or anxiety during this time. Pay attention to your general mood, intensity of your emotions, how long they linger, and what effect they have on your day to day life. Are you feeling overwhelmed most of the time? Sad most of the time? On edge, anxious or irritable? Do these emotions make it hard to get through the day? Or do you find that it is just moments of mostly mild struggle surrounded by many other moments of relative peace? If it is the former, consult with your doctor as you may be experiencing symptoms; generally, the sooner they get addressed, the quicker will be your path to feeling better, so do not delay!  

Unplugging
Mothers are certainly not the only people who would benefit from unplugging from their phones, social media and news. If you are finding that your friends’ or family’s updates on Facebook make you feel not good enough or cause any other form of negative self-talk, consider limiting what you see on social media, how often and for how long at a time. If news cause stress or anxiety, take a vacation from them.  

Village
The old saying that it takes a village to raise a child still holds true – it is just that for most women no village awaits them as they return from the hospital with a newborn in their arms. Instead, women have to find their village and also sensitively teach people in their existing support network how they can be part of their village (just because your mother raised you does not mean she knows how to be there for you!). Once you feel well enough physically after giving birth, join a new mothers’ group. Many women have met lifelong friends this way. Be sure to spend time with people who make you feel better – not worse – about yourself. If you feel isolated and lost, considering talking to a therapist who can also help you create a sense of community. 

Wonder
In our culture, we have little tolerance for uncertainty and ambiguity. We want to know things and we want to know them now. This makes life with children uniquely taxing – often we are bombarded with expert advice, only to find ourselves more confused and anxious to have the “right” answer. Rather than approaching the experience of not knowing with anxiety and trepidation, we can engage a sense of wonder – a mixture of awe, curiosity, mystery – at the role we have found ourselves in and at the small human being whom we call our child. We might not be able to understand everything, but perhaps that is not necessary. 

eXercise
Exercise is a natural medicine with profound mental and physical effects. As soon as you have permission from your doctor to begin to exercise, see if there is a way to bring it into your life – even 10 minutes a day counts. Activities such as brisk walking with a stroller will likely yield greater clarity of mind and make you feel more connected with yourself and the world around you (those early months can feel so disconnected!). Think of exercise during the first postpartum year as something to do to feel better. Try not to be competitive about it or surround the idea of exercise with “shoulds”.   

Yearning
There is so much about parenting that may draw us into a state of yearning – for rest, for peace of mind, for a real vacation, for quiet, for a night out, for our old selves. This yearning is normal, albeit not sufficiently talked about. Mothers in particular are gripped by societal expectations of self-sacrifice and fulfillment through their parenting role, and often experience guilt for wanting things to be different or easier while also feeling unable to give themselves permission to do things their way. There are a thousand ways to create a loving, happy family. Remembering that will hopefully help you make space for some of your dreams and wishes without concluding that you are a bad mother.

Zzzs
If you are at a stage when your baby is waking up more than once per night, you need to take every chance you have to catch up on sleep. Many mothers roll their eyes at this suggestion – there may have other children, work schedules to juggle, dinners to make. There may also be the desire to get that one hour once everyone is in bed to yourself even if that means that you turn in for the night way after 10pm, only to be woken up for a feeding at midnight or earlier. This is not sustainable. If you accumulate a major sleep deficit that is not being rectified by naps or at least by early bedtime, you will likely find yourself struggling both physically and emotionally. It truly is hard to make sleep a priority in the chaos of early postpartum months. The biggest part of the challenge is buying into the idea that this is what you need to do. Do whatever you need to in order to catch up on sleep (if you have a partner, take turns attending to the baby whenever possible; ask other family members to step in; consider hiring a postpartum doula or night nurse if you can afford it).