When you're expecting a little one, many parents put a lot of time, thought and effort into creating the perfect baby shower, gender reveals, birth announcement or birth plan. When talking to parents as a Midwife, it's very clear that about half of that same time [if any time at all] is put into creating a postpartum plan. The reality is that a postpartum plan is often overlooked but is so important to have. And this is why.
WHAT IS A POSTPARTUM PLAN?
A postpartum plan is much like a birth plan, except for the six weeks after birth. It's a guide for yourself and for those around you, focusing on what postpartum will look like for you. It's also a way of educating yourself on all of the options and possibilities by having those conversations before bub arrives, choosing what's right for your family and communicating it to those around you.
WHAT SHOULD I INCLUDE IN A POSTPARTUM PLAN?
Stance on when visitors will come
Do you want people visiting you in the hospital, and if so, who? Do you want people visiting you at home in the first few days, and if so, who? If not, when are you comfortable for people to come to see you and meet your little one? Some people like to use the early days for bonding and getting to know their little one, while others prefer to have loved ones around to meet their newest addition and for further support.
Regardless of what you choose, being united on this means there are no misunderstandings or unexpected visitors, as whatever you decide can be communicated to loved ones prior to baby arriving.
What will you do, and what will your partner do to look after yourself after having a new bub? This goes more than basic needs like eating breakfast or showering each day. It could be something like having 30 minutes each day to do whatever you need while your partner cares for baby solo. Maybe it's going to the beach twice a week or getting your hair done sometime in the first few weeks after bub is born. Perhaps you'll do in-home yoga each morning or meet up with friends once a week. Before baby arrives, work out what you need to do to feel like yourself, and plan ways to implement that once bub is born.
Who will do the nighttime bath? Who will read books at bedtime? Who will feed baby? Will one person always do a specific role? Will you switch it up? Or will you just play it by ear?
BOUNDARIES FOR BUB
These might apply to bub, visitors or loved ones. What are you not comfortable with? Think of things like:
No one is to kiss our baby except for us/ grandparents can kiss baby on the top of the head only if they are well/ no one is to kiss bub at all.
We're happy for people to upload pictures of bub onto social media/ we're not comfortable for pictures of baby to be on social media until we have done so/ we don't want any pictures of baby at all to be on social media.
Bub won't be using a dummy/ baby will be offered a dummy after little one has established breastfeeding/ bub can have a dummy from birth if they want it.
Bub will be staying at home until they've had their 6 week vaccines/ baby will be going out before their 6 week vaccines.
Siblings can meet baby in hospital/ siblings can meet bub once they arrive home.
These are just examples of some things that can be discussed. The more things you've spoken about before baby arrives, the better. So, if another idea or situation comes up, absolutely discuss it!
COOKING AND CLEANING
Who will cook each night? If one cooks, will the other clean? What if baby is having a rough night? Is take away an option? Do you have pre-cooked meals from before bub was born? Do you feel comfortable employing a cleaner? Whose responsibility is it to do the groceries, mowing, laundry, or feed the dog? Both partners assuming the other person will do the task can lead to resentment and anger. Having that conversation and creating that expectation before baby arrives can help avoid all of that.
VACCINATION STATUS OF VISITORS
If you're having a bub, chances are that at some point during pregnancy, a Doctor or Midwife has spoken to you about the Whooping Cough vaccination for yourself and for loved ones who will be around baby in the first 6-8 weeks of life. That's because Whooping Cough is a highly contagious bacterial infection that may initially present like a common cold but develops into a serious and life-threatening condition. To prevent babies from contracting this, the recommendations are:
- Every pregnant mama is encouraged to receive the whooping cough vaccine during every pregnancy, regardless of how long between pregnancies
- Anyone who will be around young bubs under 6 months old is encouraged to receive a booster whooping cough vaccine every 10 years, even if they've had whooping cough personally in the past
- Anyone who is unwell, even if it seems like a mild cold, should stay away from newborns until they have recovered from their symptoms [keeping in mind whooping cough is contagious for up to 3 weeks after symptoms appear if not treated]
- We know that everyone has their own opinions and preferences, so chat with your parents, work out what is best for your family then let your family know your stance.
Incase no one has told you yet, babies wake in the night, sometimes multiple times overnight, and it's NORMAL! The SIDS recommendations are for bubs to sleep in their own sleep space in your room for the first 6-12 months, meaning when baby wakes up, it can result in interrupted sleep for everyone. Because of this, some parents choose to sleep in separate rooms overnight to prevent both of them from having interrupted sleep, particularly if one of them is working during the day. Sometimes this arrangement is solely during the week, or singular nights when one parent is particularly exhausted. Other parents feel they would rather deal with any interruptions in order to sleep together in the same room. Again, it's about what's best for you and your family, but it's good to have your sleeping arrangements set out before baby arrives.
MENTAL HEALTH RED FLAGS
If you've experienced depression, anxiety or feeling mentally unwell in the past, you may be aware of thoughts, feelings or behaviours that you do that indicate that you're struggling mentally. You might also be aware of certain triggers that make you feel this way or feel other emotions, like being overwhelmed. If you know these red flags or triggers, it's good to communicate these to your partner before baby arrives so they can help prevent these situations from occurring or identify when you need some extra support. Some examples include:
- "When the kitchen is messy when I get up in the morning, I feel overwhelmed." From this, your partner knows it's a good idea for you both to clean the kitchen before going to bed at night.
- "When I'm starting to get anxious, I get worried about every little thing". If your partner is aware of this, they may be more easily able to identify the anxiety and support you through it.
- "When I'm starting to feel down, I usually won't bother getting dressed or showering each day". Again, if your partner notices, they can support you to get the help you may need.
GETTING THROUGH THE NIGHT
When bub's wake overnight, it's usually for a breast or bottle-feed, for a cuddle or a nappy change. If a mama is breastfeeding, it's most likely going to be the mama who will do the night feeds, unless they express a bottle for one of the overnight feeds to share the load [remembering this may impact supply]. But if baby is bottle-fed expressed milk or formula, you'll need to decide; who will do the night feeds? Will it be your turn at 9pm and their turn at 1am? Will it be the parent who isn't back at work yet? Will it be the parent who feels the least tired that day? Will it be a tag team situation? Will it always be you, or always be them? And if it's just one parent doing the feeds, will the other do the settling and nappy changes? Or will you take a night each?
WHAT IF MAMA OR BABY GETS READMITTED TO THE HOSPITAL?
Sometimes, things can go wrong after birth, such as bub experiencing too much weight loss or dehydration, feeding difficulties, secondary postpartum haemorrhages, or wound infections. In more serious cases, you or baby may be readmitted back into the hospital for treatment. If you're admitted, will you keep bub on the ward with you as a border? If baby is admitted and one parent can stay, who will it be? If both parents are allowed to stay, what will you do with older siblings?
Hint: border babies are babies that are staying with their mama, but aren't under the care of the hospital, meaning the feeding, changing, settling and overcall care of the bub comes down to the parent. Midwives and Nurses can help when required, but baby isn't classed as a patient.
WHERE CAN YOU GET HELP IF YOU NEED IT?
Having a new bub is hard, and everyone needs help sometimes. Asking for help doesn't make you weak; it makes you strong. So before baby arrives, plan or create a list of names and phone numbers of people, health professionals or organisations you can contact if you need help, guidance or support.
Some good examples of numbers to have on hand are:
Friends or family who live close by and can come over for support when you need a break, a cry or some love
Local maternity ward hospital or the number of your continuity Midwife if you've got any concerns or questions out yourself or bub that aren't an emergency
Australian Breastfeeding Association: 1800 686 268. Volunteer counsellors who are trained to answer your breastfeeding questions or provide support and information relating to breastfeeding 24/7. Note: they can't provide medical advice and will refer you to your medical practitioner.
Rednose: 1300 998 698 To answer all of your questions relating to safe sleeping.
Beyond Blue: 1300 224 636 A confidential service that takes calls 24/7 for people experiencing depression, anxiety or suicidal thoughts.
Lifeline: 13 11 14 Available 24/7 for a confidential discussion to get emotional, crisis and suicidal support.
Pharmacist on call [M-F 9am-5pm]: 1300 633 424 An on-call pharmacist who can answer your medication questions. It could be things like how to take a medication, is it safe during pregnancy, how to store it etc.
Pregnancy, birth and baby helpline: 1800 882 436 Speak to a Registered Nurse or Midwife 7 days per week between 7 am and midnight [AET] for emotional and parenting support, and education relating to growth, behaviour, feeding, settling and normal development.
Healthdirect Australia: 1800 022 222 This number is available to call 24/7 and speak to a Registered Nurse to get some health advice when you're unsure of what to do if you or bub is unwell. Note: it's not to be used for emergencies, instead of a medical consult or to diagnose sicknesses. Instead, they provide advice about who, where and when you should get help in your local area, and what your next steps should be if it's suitable for you to manage at home.
Poisons information centre: 13 11 26 If you or bub has been poisoned, bitten or stung, this number will be your first phone call. They'll ask what happened, what & how much they've been exposed to, signs and symptoms and provide a recommended treatment plan.
Emergency services: 000 or 112 from mobiles For life-threatening emergencies or time-critical situations.
How long does a postpartum plan need to apply for?
This post will focus on a postpartum plan for the first six weeks after birth, but you can create yours to apply for as long or as short as you like.
What if I change my mind or things change?
That's the beauty of a plan; it's flexible. I'm not at all saying that once you've chosen what you'd like to occur, that's it, and things must be this way. Instead, I'm highlighting topics that should be discussed prior to make postpartum a smoother experience for you, your little one and those around you, and making sure the decisions you do make are based on research rather than heightened postpartum emotions.
Do I need to physically write out the plan?
No, you don't. The idea around creating a postpartum plan is to get yourself and your partner talking, educated and on the same page before bub arrives. In saying that, if writing it down and having it on paper makes you feel better, then go for it.
Like I've said many times during this blog, a plan is just that; a plan. If things change, you can always change your mind. But if you do change your mind, you're educated, informed and empowered to do so. Do what works for your family best, and don't apologise to anyone for doing so.
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