The importance of self care for mothers

We have had Dr Shazia Malik contribute to our website and community before. She wrote about contraception which you can read about it here. I believe as Mothers this topic is something we will come by at some point or another. Today she discusses the importance of self care for Mothers.

When you have delivered your baby, all your attention becomes focused on this new little person. But for him/her to be happy and healthy, you need to feel good both physically and mentally. So self-care for a new Mother is really very important for the wellbeing of the whole family. I therefore spend quite a bit of time with my clients, especially first time parents, after their delivery on discussing this issue.

In the first few days, the most pressing things are recovering from the birth itself and establishing feeding (whether breast, bottle or both). If you are in pain, it can be difficult to get comfortable, sleep or go to the toilet, so regular and effective pain relief is crucial – make sure to take it before the discomfort becomes intense as then it can get quite hard to overcome the pain. It is not harmful to your baby if you are breastfeeding and actually helps you to do all that is required for your baby. After a difficult vaginal birth or a caesarean it is quite normal to need painkillers for several weeks, so make sure that you have enough at home when you are discharged.

If you have gad a vaginal tear or episiotomy, and are feeling sore and swollen, sitting on a ring cushion can be very helpful as well as using ice-packs – for example you may have heard of vaginal popsicles, which are in fact condoms that have been filled with water, tied and frozen at home. You can take one out, let it become a little slushy and then put it against your perineum (not in the vagina) after wrapping it in a cloth or paper towel, or even inserting inside a pad or large panty liner between the backing and the pad. . Once used, throw away. You should use pads not tampons for the first 6 weeks after birth, until your body has healed and got back to normal. Sitting in a warm bath twice a day with a cup of sea salt and a few drops of tea tree oil is also very helpful to aid in healing and reducing swelling. Do not use shower gel or soap until you have completely healed. Also Arnica tablets are thought to help with bruising and swelling whatever kind of delivery you have had – and are safe to take whilst breast- feeding. I also recommend trying to get air to the perineum – best done by lying or sitting on a disposable nappy changing mat after having washed your perineum. Try and sit like this for an hour at a time if the bleeding allows, and change pads at least every 4 hours or so.

If you have had a caesarean birth, similar advice applies – try and get as much air to the wound as possible, don’t use shower gel or soap, and pat dry after washing with water. You should wait until your postnatal check to start applying Vitamin E cream or Bio- oil to it – this helps to break down scar tissue and the typical hardness directly under the healing scar – you can massage for 10 minutes a day, but very gently and not if it is at all painful. I would not recommend wearing a caesarean ‘corset’ for more than 8 hours a day and not at all for the first couple of weeks.

Try to avoid constipation – if plenty of fluids and fibre don’t help, then do get medication from your doctor – or you can buy Movicol sachets which work very well, and are gentle on the tummy. Don’t be afraid to open your bowels – the stitches will hold! Also the time to do pelvic floor or Kegel exercises is whenever

you feed your baby. You are usually sitting then for long enough to do the exercises and help your vaginal tissues to regain their tone and strength. Good maternity units will have a physiotherapist to visit you and discuss postnatal exercises and self-care for muscle support.

Do drink plenty of water and mobilise as much as is comfortable – this helps your milk supply, passing urine and reduces the risk of developing a thrombosis. Now is not the time to diet – have a varied and healthy diet, and multivitamins (especially Vitamin D) if you are breastfeeding. If you need iron do take it – and treat constipation if that is an issue rather than stopping the iron tablets. Do get support with breast-feeding – even having a breastfed a child previously, you can still find yourself with sore nipples or latching difficulties the next time – there are often local workshops and some health authorities have breastfeeding support teams who will visit you at home until you feel confident.

Emotional and mental well-being is so very important for your health and ability to care for your self and your baby. It is perfectly normal to feel overwhelmed and ‘blue’ in the first few weeks – but if you feel negative and low all the time or have thoughts of harming yourself or your baby, then please speak to a professional – your midwife or GP are best. Do discuss how you are feeling with your partner, relatives and friends – and make sure that you get out regularly even for a little while. Try and make some ‘me time’ at least once a week when someone you trust can take care of your baby between feeds and you can do something you enjoy. Sleep whenever you are able especially after the morning feed – and always have enough food and snacks at home to keep you nourished. Try and get in to a routine as soon as you are able including getting changed and freshened up– get some postnatal clothes whilst pregnant so that you can feel more like your old self, and do try and catch up with old friends and colleagues when you feel able. I do encourage my clients to join local antenatal and postnatal parents’ groups, as this gives a local support network which can be invaluable in those first few months after having a baby.

If you can, do get some help with your baby to allow you time to spend with your partner and any other children that you have. It can be hard to do, but allows you to give attention to the rest of your family, and also to yourself – all part of caring for yourself and your loved ones.

Most of all trust your instincts as a woman and a mother – and love your body whatever pregnancy and birth do to it as you have achieved a miracle!

When to seek urgent medical attention:

• You have a fever ( temperature over 38° C/100.4 °F)
• You notice swelling, redness, warmth or pus around your incision
• You have sudden worsening pain around your incision or in your abdomen • You feel pain when you pass urine
• You have foul-smelling vaginal discharge
• You have leg pains or swelling

• You experience difficulty breathing or chest pain
• You get severe headaches, vomiting, blurred vision or upper abdominal pain

(signs of pre-eclamsia)