Everything you need to know about postpartum care for the mother

The day after giving birth, your body is battered, tired, and exhausted. After going through the grueling period of pregnancy, it has undergone a real trauma with childbirth, whether it was vaginal or by cesarean section. In addition to being a time when you meet your baby and come to terms with the fatigue that comes with constant attention, you need to reclaim your bruised body. Postpartum care is essential in this regard. As a concept store dedicated to women's intimacy, Gapianne is committed to helping you through the difficult postpartum period. In this article, discover everything you need to know and understand about postpartum care, and when to worry, and when not.

Body Changes and Postpartum Care

Pregnancy and childbirth have taken a toll on your new mother's body. Your body changes, suffers, and requires different types of care. Depending on your pregnancy, childbirth, and your vulnerabilities, you won't experience the same issues: find below all the problems you may experience and all our solutions 🫶.

Uterine pain and cramps

The first symptom following childbirth is intrauterine cramps and pain, similar to menstrual pain. These are known as "severe cramps."

It's normal

These pains accompany your uterus as it returns to its original shape and size after childbirth.

Generally, they can:

• last from a few days to a week after birth;

• be stronger if you choose to breastfeed;

• be more intense if this is not your first baby.

What care should be provided?

You can respond to these pains in the same way you usually respond to menstrual cramps:

1. Take pain medication. Be sure to check that any medications you have are compatible with breastfeeding, if applicable, or ask your doctor for a prescription;

2. Apply heat to your stomach. Thanks to its vasodilatory action, heat can help reduce pain. A compress, a hot water bottle, or even a warm bath can soothe your pain;

3. Use electrodes. Electrical impulses can help reduce pain. If you have a device like this to help reduce menstrual pain, give it a try!

When should I be worried?

Consult your doctor if you experience:

• different, or worsening, pain in your abdomen;

• pain that does not go away with pain medication;

• hemorrhage: if the pain is accompanied by very heavy blood loss and blood clots larger than a plum, contact your doctor urgently.

Postpartum bleeding and vaginal discharge

Second postpartum symptom that can ruin your life: vaginal bleeding and discharge, also called “lochia.”

It's normal

Vaginal bleeding after childbirth is used to expel all the tissues and cells that have developed in your uterus to support the development of the embryo and then the fetus. Generally, lochia can last up to 6 weeks, most often until the return of menstruation (also called “the return of menstruation”). It occurs after both a cesarean birth and a vaginal birth.

Generally :

• The first few days, the discharge is heavy and bright red. You may notice small, darker blood clots;

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• After a few days, the discharge gradually decreases and its color changes to pink or brown. This is due to the fact that it is less abundant, more diluted (as at the end of menstruation);

• After 10 days, the lochia decreases further and changes color again. It turns pink, then white or yellow.

What care should be provided?

You can manage postpartum vaginal discharge the same way you manage your period, except it's recommended that you don't insert any sanitary protection inside your vagina for 4 weeks after giving birth to let it rest and heal; so forget cups and tampons!

• In the first few days, especially during your stay in the maternity ward, we highly recommend using disposable maternity briefs. Tear-off and disposable, they'll be especially handy the day after your delivery when moving around might be a bit tricky. 🌈 Jhô's disposable, loose-fitting, comfortable, and, above all, highly absorbent postpartum diapers are our favorite. We love that they're made from organic cotton 🌱 and dermatologically tested to ensure they protect your fragile vaginal flora. Check out our tips for choosing your postpartum briefs.

• After a few days, you can switch to pads (disposable or reusable, depending on your preference) or menstrual panties. If your menstrual panties have colored bottoms, take the time to pay attention to the color of your discharge when you shower and use the toilet to check that everything is okay.

Finally, when it comes to hygiene, the best thing to do is to clean your vagina with clean water once or twice a day, depending on your preference. Do not clean inside your vagina (douching), as this could further disrupt your vaginal flora, which has already been disrupted by childbirth.

I have to worry

The main risk associated with lochia is postpartum hemorrhage and, to a lesser extent, anemia (iron deficiency) related to significant blood loss. Consult your doctor urgently if you have:

• particularly heavy bleeding (or if you notice a sudden, significant change in your discharge);

• clots larger than a plum;

• bad-smelling discharge – this may be linked to an infection;

• continuous stomach aches;

• fever.

Vulvar pain and tears

Third symptom often experienced by women who have given birth vaginally: vulvar pain, or even tears.

It's normal

Due to the significant enlargement your vulva had to undergo to accommodate your newborn, it is very common to experience pain in the vulva. A majority of women who have given birth experience bruising, tears (uncontrolled or episiotomy), tension, tingling, etc.

Generally :

• You may experience bruising, swelling around the vulva, and pain related to the trauma. All of this will slowly and gradually diminish.

• If you have had stitches, either from an uncontrolled tear or an episiotomy, you may feel some tension and tingling in this area, especially when urinating. Healing can take time. Stitches dissolve within 2 to 4 weeks after delivery (you may find traces of them on your underwear or sanitary towels).

• Your vulva may look different than before and more open. This change may or may not be permanent, as with many changes in your body after childbirth.

What care should be provided?

You can respond to vulvar pain following childbirth as you would to regular vulvar pain.

• The first day:

• Cold can help. Apply a cold compress or ice (wrapped in a towel or bag to avoid burning yourself) to your vulva for 15 to 20 minutes every hour for the first 24 hours.

• To wash, use a squeeze bottle to rinse your perineum with water when you go to the bathroom.

• In the following days:

• Wipe from front to back after using the toilet; this prevents bad bacteria from being brought back to your weakened vagina;

• Soak your vulva in a few inches of warm water every day. You can do this by cupping your hand in the shower and collecting some of the shower water. Use plain water instead of soap to rinse;

• Change your sanitary protection at least every 4 hours to prevent the growth of bacteria;

• Sit on a pillow or donut-shaped cushion if sitting is painful;

• This may seem obvious to you, but we'd like to repeat it here: only resume penetrative sexual activity when you feel ready. Don't force yourself;

• Take pain medication. Check that it is compatible with breastfeeding, if applicable, and ask your doctor for advice.

I have to worry

The main risk is infection, vaginal and vulvar, or at the level of the stitches, and the reopening of wounds.

Consult your doctor if you have:

• a sudden change in your blood loss, becoming heavier;

• a yellow or greenish discharge from your stitches or vagina, this could be an infection;

• bad-smelling discharge, often also symptomatic of an infection;

• flu-like symptoms (dizziness, fever, fatigue, body aches), symptoms that your body is fighting the infection;

• pain that does not go away with pain medication.

Distended perineum

A new common symptom following childbirth: a distended perineum. The perineum is a group of muscles and tissues that stretches, like a hammock, between the vulva, anus, and hips, and serves to support the entire digestive and reproductive organs. A distended perineum is most often characterized by difficulty holding back urination or even defecation.

It's normal

Between the weight of the baby pressing on the perineum throughout the pregnancy and the necessary stretching of the perineum during childbirth, the perineum may become distended during pregnancy.

💡 Your perineum may be stretched even if you had a cesarean section. This is due to the hormones that worked throughout your pregnancy to stretch your perineum in preparation for delivery.

What care should be provided?

Postpartum, French social security automatically reimburses you for 10 physiotherapy sessions for perineal rehabilitation.

In addition to these sessions, it will be important to do the recommended exercises or even invest in a perineal rehabilitation probe to accelerate remission.

Your doctor or gynecologist may prescribe additional perineal rehabilitation sessions if the initial sessions are not sufficient.

During rehabilitation, if you suffer from urinary leaks after childbirth and it bothers you, you can opt for disposable postpartum panties. Highly absorbent and disposable, they will allow you to go about your business without stress while you wait to feel more comfortable.

I have to worry

The main risk of perineal distension is its rupture and organ prolapse. This is rare. More generally, you may continue to experience urinary leakage, either daily or occasionally, during physical exertion, laughter, or sneezing.

You should be concerned if:

• you continue to have occasional urinary leaks after rehabilitation, within three months of giving birth;

• you are unable to hold back urination or defecation, or you may not even feel yourself when you have these needs;

• You have increasing pain in your lower abdomen and you do not notice any improvement.

Difficulty urinating

Another symptom that can make your life miserable after giving birth: difficulty urinating.

It's normal

Between vulvar pain and the complications you may be experiencing in your perineum, it's not unreasonable that urination can be difficult. Furthermore, your bladder has been compressed within your body throughout your pregnancy, which may have affected its proper functioning.

It is therefore common to experience:

• difficulty when trying to urinate;

• discomfort, stinging, burning and problems when urinating;

• leaks that can last for several weeks;

• and urinate more than normal.

These problems will be all the more significant if you are naturally prone to urinary tract infections (especially if you do not drink enough).

What care should be provided?

If you have difficulty urinating after giving birth, the care you need is generally similar to that for a urinary tract infection:

• Drink plenty of water (around 2L per day, or even a little more if you are breastfeeding);

• Use a squeeze bottle to rinse your vulva with warm water when you go to the bathroom;

• Wipe from front to back to avoid contamination with new bacteria;

• Urinate in one go and do not hold your urine while urinating;

• Try urinating in the shower to encourage your body to urinate and help you regain sensation;

• If your perineum is stretched, do perineum rehabilitation sessions to strengthen it and have better sensations;

• Wear postpartum diapers to avoid feeling uncomfortable if there is a leak when you go out;

• Take pain medication if it is too severe. If you are breastfeeding, consider asking your doctor for advice.

I have to worry

The most significant risk associated with postpartum urinary difficulties is urinary tract infections or even kidney infections (pyelonephritis).

Make an appointment with your doctor if you experience:

• continuous pain while urinating;

• pain in your bladder (lower abdomen) or kidneys (lower back);

• difficulty urinating or you can only urinate in small amounts;

• an urgent need to urinate or a need to urinate frequently, with a burning sensation—this is the most representative symptom of a urinary tract infection;

• fever.

Milk production and breast pain

Breast pain is another phenomenon you may experience the day after giving birth.

It's normal

The arrival of the baby rhymes, for the body, with the rise of milk 🥛. Your breasts fill with milk and begin to feel sore.

You may feel your breasts:

• swollen

• hot

• sensitive

• painful

These sensations and pains often last between 2 and 5 days after delivery.

Some people feel no discomfort.

What care should be provided?

The care you need will essentially depend on your choice: to breastfeed or not.

In the first few days after delivery:

• Wear a supportive bra to reduce the feeling of heaviness. Choose a seamless, non-wired bra for your comfort;

• If you notice any milk leakage, wear nursing pads inside your bra. If you have chosen not to breastfeed and therefore not to invest in specific pads, cotton will suffice;

• Apply cold compresses to your nipples and breasts for 10 to 15 minutes every two hours;

• Take pain medication as prescribed by your healthcare provider.

If you have chosen to breastfeed:

• Do this often (8 times every 24 hours). The more milk your baby draws, the more your breasts will produce. Putting your baby to the breast often will help stimulate lactation from the start;

• express a small amount of milk by hand or with a breast pump before breastfeeding if your breasts are engorged, this will provide relief and prevent the baby from taking too much milk in the first few sips;

• Take a warm shower or apply a warm, damp towel to your breasts to help with milk flow before breastfeeding

• wear nursing pads in your bras to limit leakage and protect your nipples

• Apply a suitable cream to your nipples to protect them

• Seek advice from a breastfeeding specialist if you feel that you are not receiving enough advice on this part from the hospital staff.

If you have not chosen to breastfeed:

• Do not express your milk, even to relieve yourself: this will increase the production of milk in your breasts;

• Do not apply hot compresses: you risk increasing lactation;

• The milk flow will subside, as will the unpleasant sensations, after a few days. Hang in there 💪.

I have to worry

The main risk associated with milk production is breast engorgement and the infection that can result.

Contact a doctor if you have:

• swollen, red, hot, and painful breasts for more than 48 hours

• a sore, hard, red, painful area on your breast

• fever:

Sore or cracked nipples are signs that your baby may not be latching on properly. They're not serious, but they are painful and may cause you to stop breastfeeding sooner than expected. Don't hesitate to seek advice from your doctor or a lactation specialist.

Constipation and changing stools

Constipation and changing stools, regardless of your diet, are a common occurrence after pregnancy and childbirth.

It's normal

Between the surge of hormones in your body, your possibly stretched perineum, and vulvar pain, it's not unreasonable that having a bowel movement can be a nightmare in the first few days after giving birth.

Typically, you may experience painful and difficult bowel movements. This can occur up to:

• 2 to 3 days after vaginal delivery;

• 3 to 5 days after delivery by cesarean section.

What care should be provided?

The care is very similar to that for difficulty urinating:

• Drink plenty of water (about 2L per day, or even a little more if you are breastfeeding), this reduces constipation. Herbal teas to aid digestion can reduce gas and constipation;

• Favor foods containing fiber for good transit;

• Use a squeeze bottle to rinse your anus with warm water when you go to the bathroom;

• Wipe from front to back to avoid contamination with new bacteria;

• Avoid pushing even if you are constipated, as this can cause hemorrhoids (more on this below). Place your feet up to make it easier to pass stool and massage your stomach in circular motions;

• If your perineum is stretched, do perineum rehabilitation sessions to strengthen it and have better sensations;

• Take pain medication if it is too severe. If you are breastfeeding, consider asking your doctor for advice.

I have to worry

If you experience constipation for more than the "normal" number of days, even if you have a balanced diet, you may want to consult your doctor. The norm is at least one bowel movement every two days; anything less than this means you are constipated.

Your doctor may prescribe stool softeners or laxatives to soften your stools and make them easier to pass until things return to normal.

Postpartum hemorrhoids

Hemorrhoids are a phenomenon that affects a large proportion of pregnant women and persists for 6 weeks after pregnancy.

It's normal

Hormonal fluctuations and constipation, coupled with the crushing of internal organs by the baby at the end of pregnancy, increase the risk of hemorrhoids during and after pregnancy. Hemorrhoids are the name given to veins in the anus that swell and thicken to the point of being painful.

Within 6 weeks of delivery, symptoms include:

• itching

• bleeding

• blood clots (thrombosis)

• pain

What care should be provided?

To limit hemorrhoids, the most effective way is to limit constipation (see above)—difficulty evacuating stools being one of the factors causing hemorrhoids.

Additionally, you can:

• Sit on a cushion to limit daily pain;

• Ensure good hygiene in this area by taking sitz baths and cleaning thoroughly with clean water;

• Apply corticosteroid creams to reduce the appearance of hemorrhoids;

• Prescribe laxatives to limit constipation;

• And finally, when you can again: resume regular physical activity. A sedentary lifestyle is a source of hemorrhoids: walking and exercising can help make them disappear.

I have to worry

Consult a doctor if you still have pain and discomfort 6 weeks after giving birth.

The main risk of hemorrhoids is the development of small blood clots within the hemorrhoids. A surgical incision may then be necessary to remove them.

Different periods

This postpartum symptom is little known, and yet many menstruating people experience a change in their periods following pregnancy.

It's normal

After pregnancy and childbirth, the hormonal madness calms down a little but the menstrual cycle resumes after about 6 weeks, this is the return of menstruation.

💡 Menstruation may return later when breastfeeding due to the surge of hormones it causes. This is why it is sometimes said that breastfeeding plays a contraceptive role. Be careful though: this varies enormously and we can only recommend that you choose a method of contraception in addition to breastfeeding if you wish to avoid a second pregnancy in a short time.

Menstruation may change:

• More abundant losses or not;

• Different pains;

• Long, irregular cycle.

I have to worry

Occasionally, some women experience postpartum endometriosis. This is called "secondary endometriosis" but can be just as painful and debilitating as primary endometriosis, which occurs in some people as soon as their periods begin.

Generally speaking, if you experience pain or symptoms that are disrupting your life and mental health, it is essential to consult a doctor and seek medical advice. Pain medication and tests may be prescribed.

The special case of cesarean section

People who have had a cesarean delivery need to take extra care of their bodies as this can be a tough experience.

It's normal

After a cesarean section, it is common to wait up to 6 weeks for your body to heal. You may experience:

• fatigue;

• tightness at the scar;

• pain at the incision and in your lower abdomen;

• difficulty and pain when moving;

• bleeding from your vagina.

Stitches are designed to dissolve on their own. Staples, on the other hand, must be removed by a healthcare professional: your doctor will schedule an appointment with you and ensure proper healing before removing them.

What care should be provided?

Taking care of your body the day after a C-section can be challenging because you're simultaneously welcoming and caring for your newborn. The following tips should be adapted based on your fatigue, pain, and situation: do the best you can 🫶.

• Rest when you can, especially in the early stages: healing requires rest. Sleep when the baby sleeps, and don't feel guilty, even if you didn't have time to do everything you had planned.

• Take pain medication: this will be prescribed by your doctor. If you plan to breastfeed, please specify this so that the treatment can be adapted;

• Don't lift anything heavier than your baby for the first 6 weeks. This is roughly the time it takes for healing. For other things (lifting, bending, housework), be willing to ask for help from your partner, family, and loved ones;

• Wash yourself in showers or cat baths, depending on what you are allowed to do with your scar. Wait until your incision is completely healed before bathing;

• Cover your incision with a pillow when coughing or sneezing, this will limit pain;

• Use a pillow to protect your belly while breastfeeding. A pregnancy bolster is an excellent nursing pillow;

• Massage your scar to prevent adhesions when you get the OK from your doctor (usually after 2-3 weeks). A physiotherapist can give you techniques for doing this;

• Move around often, even just a little: this helps prevent adhesions and prevent further pain. Gradually increase your physical activity as you feel comfortable doing so;

• Until you have medical approval, avoid high-impact exercise and anything that strains your stomach muscles: they were traumatized by the cesarean, you need to protect them;

I have to worry

The main risks following a cesarean section are infection and reopening the section. Watch for symptoms of infection:

• swollen and puffy scar, red, particularly painful;

• effusions of pus (yellowish or greenish fluid) from the wound;

Since a cesarean section can also cause thrombosis, watch for pain or reddened swelling in your calf, behind your knee, or in your thigh or groin.

Taking care of yourself physically after childbirth

In addition to taking practical care of the ailments left by pregnancy and childbirth on your body, it's essential to take care of yourself physically. These actions will help heal your body and help you feel less tired, and you'll likely notice that they're similar to the wellness tips you regularly give.

Drink plenty of water

After giving birth, and even more so if you're breastfeeding, it's essential to drink plenty of water. Aim for 1.5 to 2 liters. Hydration can be achieved through water, of course, but also through herbal teas and other sugar-free and caffeine-free beverages. Tea and coffee are not recommended due to their caffeine content and diuretic properties, but you can consume 2-3 cups per day.

Eat well

Food is the body's first medicine. You've probably heard this phrase before, but it's still very true. Eating a balanced and varied diet is the key to gradually getting your body back in shape as quickly as possible. That said, we suspect that cooking a balanced and varied diet every day after the birth of a baby is far from easy. Ask your loved ones to prepare meals for you if possible, and don't feel guilty if you order in to get by!

Sleep well

Sleeping “well” may be overkill the day after a birth. So let's just suggest you sleep as much as possible, when your baby is napping, and without feeling guilty. Tips for sleeping better during this time include alternating nights with your partner if you're not breastfeeding (or consider mixed feeding, bottle/breast, as an alternative).

Have or resume physical activity

Physical activity is essential to help you gradually regain your smile and health after giving birth. This is thanks to the calming hormones it generates, the people it allows you to meet, and the physical aspect it helps you regain. Some activities are gentler for resuming (walking, swimming), while others will require the advice of your doctor before you resume them. Discuss this with your healthcare professional.

Avoid substances

Whether you're breastfeeding or not, we strongly recommend that you avoid smoking (tobacco and cannabis) and drinking after giving birth. These practices are known to be bad for your health and will tend to slow down your body's recovery.

Taking care of your sexual health after childbirth

Beyond the health of your postpartum body, we believe it's essential to address the issue of sexual health: when to resume sexual activity, contraceptives to consider, and when to get pregnant again. We'll tell you everything!

Getting your sex life back

As always when we talk about sexuality, let's reiterate that there is no standard in sexuality. After giving birth, you can resume your sexuality, very quickly or not.

When to resume sex: give your body time

Vaginal (and anal) penetration should be limited for 2-3 weeks after delivery because the area is extremely sensitive and you run the risk of reopening the stitches. Don't hesitate to ask your doctor for advice if you have had stitches or any specific internal tears.

That being said, sexuality isn't just about vaginal penetration. If you want to rediscover intimacy with your partner in a different way, go for it!

Be ready

Because that's what matters: desire. Your desire. Your libido, your desire to resume sexuality or not, your desire to rediscover intimacy. Don't force yourself and don't let yourself be crushed by guilt: there is no normality when it comes to resuming sexuality postpartum.

A word of advice: don't panic if you don't quickly regain your libido after giving birth. Hormones, fatigue, and labor-related pain can all impact your libido in the long run. You can consult a sexologist if you want tips on how to regain your libido, or simply let tenderness and time with your partner do the work.

Beware of the return of menstruation: think about contraception

If you're returning to sex soon, don't be fooled by the resumption of your cycle. Beware of misconceptions: just because you're breastfeeding doesn't mean you can't get pregnant, and just because you're still having lochia doesn't mean you can't get pregnant.

Your cycle usually resumes within 6 weeks of giving birth. While breastfeeding can help delay it due to hormones, this isn't always the case. Also, as soon as you resume your sex life, consider using contraception. Some forms of contraception can be dangerous for your newborn if you're breastfeeding, so don't immediately go back to the contraception you were taking before you started planning a baby: ask your healthcare professional for advice.

❓ How does breastfeeding help with contraception? Breastfeeding has a contraceptive role because the baby's suckling triggers the mother's production of a hormone: prolactin. This hormone blocks ovulation under certain conditions. When breastfeeding slows down, the contraceptive function diminishes and ovulation may resume. This is why we do not recommend using breastfeeding as your sole contraceptive.

❓ Is the pill dangerous if you are breastfeeding? Combined pills are not recommended for breastfeeding women. Ask your healthcare professional for advice.

Have a new baby project

Are you planning to have children close together and want to get pregnant again? While you can biologically get pregnant as early as about 6 weeks after giving birth if you're not breastfeeding, a 2018 US study (1) suggests that the optimal time between pregnancies is 12 to 24 months.

In this study, a cohort of 123,122 women was recruited between 2004 and 2014, corresponding to 148,544 pregnancies. Of these pregnancies, 83.4% involved women aged 20 to 34, 11.8% were over 35, and 4.8% were under 20. The survey showed that the risks, for mothers and babies, were more than doubled in the case of pregnancies that were too close together.

Taking care of your mental health after childbirth

Mental health is particularly fragile during pregnancy, childbirth, and especially the postpartum period. Due to the drop in hormones, followed by the exhaustion and feelings of abandonment that can result from the arrival of the baby, there are numerous mental repercussions postpartum.

The risk of baby blues / Postpartum depression

Baby blues, another name for postpartum depression, affects up to 70% of new mothers. It is not indicative of a postnatal mental health problem or psychological disorders in the new mother, as it may simply be linked to the hormonal drop that occurs following childbirth.

Baby blues are normal

Baby blues often begin on the third day and last for up to three weeks. It is common, with 50 to 70% of women affected postpartum.

There are many causes of baby blues:

• the impact of stress caused by pregnancy and going through childbirth, often anticipated by young mothers;

• significant hormonal variations during this period, as the body gradually returns to its pre-pregnancy state;

• the reality of motherhood and being confronted with it after having fantasized about it for several years, for some women;

• fatigue, from childbirth, from the first days.

Symptoms of the baby blues

Due to the baby blues, it is then normal to experience:

• fatigue, which will fade as the body recovers;

• sleep disorders and more, lack of sleep linked to several aspects: the infant's awakenings (and worry), episiotomy, epidural, the rise of milk and desire to breastfeed;

• intermittent crying and crying fits, sadness is latent;

• the doubts, ambivalences and fears that arise: of not being up to it, of not succeeding, of losing the baby and so on;

• hypersensitivity to criticism and to trivial remarks – unfortunately quite recurrent at this time of life;

• frustration and unusual irritability;

• body changes may feel strange;

• the disconcerting feeling of strangeness towards one's baby;

• short-term memory problems that can make you feel like you are losing your mind;

• perceptual distortions, especially upon waking. These symptoms are generally confined to hallucinations and gradually diminish.

When baby blues become postpartum depression

Baby blues is characterized by mild symptoms and their short duration (from about day 3 to week 3). If the symptoms are more intense and last longer than this period, it is generally referred to as postpartum depression.

When to ask for help?

Discuss your difficulties with your primary care physician or midwife. They can refer you to a psychologist who can support you. If you're unable to travel easily, you can consult via video.

Postpartum anxiety

Approximately one in five women suffers from an anxiety disorder after the birth of their child. While these disorders can be somewhat confused with the baby blues, they are nonetheless debilitating.

Symptoms of Postpartum Anxiety

Postpartum anxiety is a feeling of worry that is not only pervasive but also intense, even debilitating fear. Beyond being difficult to control, it can be debilitating and embarrassing during the postpartum period.

Postpartum anxiety:

• is often linked to your baby and his well-being: are you able to take care of him, is he well, is he breathing...?

• may occur concurrently with baby blues/postpartum depression, or be experienced alone;

• generates sleep and falling asleep disorders which can lead to significant fatigue (a source of stress which adds to a fragile emotional state);

• may include periods of very high anxiety or panic. Panic attacks, characterized by difficulty breathing or even generalized paralysis, are thus one of the most acute and uncomfortable symptoms of postpartum anxiety;

• may include thoughts or images that are difficult to get out of your mind (called intrusive thoughts);

• causes fatigue, increased irritability, difficulty concentrating and excessive and uncontrollable worry.

When to ask for help?

Just because postpartum anxiety is common doesn't mean it doesn't need to be addressed. If your anxiety is making your life miserable and making it difficult to begin your pregnancy, don't hesitate to talk to your doctor. They may be able to offer you sedatives or recommend a mental health professional to help manage your issues.

Perinatal obsessive-compulsive disorder (OCD)

New parents may find that their existing obsessive-compulsive disorder (OCD) may be amplified by pregnancy and childbirth. Fatigue, hormonal fluctuations, and stress can contribute to an increase in OCD. This is called perinatal OCD.

Symptoms of Perinatal OCD

OCD involves disturbing thoughts or images that you may struggle to get out of your mind. These thoughts sometimes lead to repetitive behaviors, most often in a desire for control, which can begin to interfere with your daily life. These OCDs most often co-occur with postpartum anxiety disorders.

Concretely, you can:

• feel anxious or tense;

• have trouble sleeping or concentrating;

• have persistent and intrusive thoughts or images;

• regularly check, count or wash objects.

When to ask for help?

Just as it's important to seek help for postpartum anxiety, consider seeing your doctor if you feel your OCD is starting to interfere with your daily life. They may prescribe medication or suggest seeing a psychologist who can help.

Post-traumatic stress disorder (PTSD)

Post-traumatic stress refers to a set of stress signals that occur after experiencing a particularly painful/striking/traumatic event. Childbirth can be a trigger for PTSD.

Symptoms of Postpartum PTSD

Signs that you may be suffering from postpartum PTSD include:

• overwhelming symptoms related to childbirth;

• persistent avoidance of stimuli related to childbirth;

• negative alterations in cognition and mood (irritability, stress);

• alterations in arousal and responsiveness.

When to ask for help?

As with all the mental health issues discussed in this section, it's essential to seek help as soon as your life and comfort are impacted. If you feel fragile and no longer able to cope, we recommend seeing your doctor so they can prescribe medication or refer you to a mental health professional. A video psych consultation is also available to help.

Postpartum psychosis

Postpartum psychosis is a very serious mental illness, but also very rare, affecting 1 to 2 women in 1,000 new mothers. It has the characteristic of worsening quickly and putting you and others at risk.

When to worry?

Postpartum psychosis usually occurs within the first two weeks after delivery.

Symptoms include:

• seeing and hearing things that are not really there (hallucinations);

• having beliefs that are not true about you, your baby, or other people;

• have severe mood swings;

• have poor concentration, insomnia, and confusion;

• behave hyperactively, feel agitated, and ramble (talk quickly and not make sense).

If you suspect postpartum psychosis, you should not be alone, or alone with your baby. Go to the hospital emergency department immediately.

Taking care of family health after childbirth

Last but not least, we wanted to address family health in this article. After giving birth, this is also one of the things you (and your partner) need to take care of.

Baby's health

Caring for your baby and taking care of their health is a chapter in its own right. Since this article is primarily about your own health, we will soon be offering an article specifically dedicated to infant health and the basic care you need to provide.

Partner's health

Following the birth, your partner's health may also decline, particularly mentally. Postpartum depression also occurs in men, and while it isn't triggered by exactly the same factors, it can still be devastating if left untreated. If you realize your partner is failing, don't hesitate to talk to them or your primary healthcare provider: they can help you find the right words and support your partner.

🫶 Don't feel guilty if your partner isn't feeling well or if you don't feel able to help them. You too are going through a period of change and adjustment that may require some serious soul-searching. Talk about it together if possible, or with a healthcare professional.

The art of being a parent

Becoming a parent is a significant, momentous, and colossal change. A first birth involves learning about parenting and responsibilities. It's also a constant process of discovery and adaptation, something quite different from any book you might have read about raising a newborn.

Better anticipate parenthood

To prepare before the birth, read books on parenting and involve your partner in the discovery process. This will help you better understand the challenges you'll face. It will also allow you to discuss the parenting you want to provide and the key points together.

Communication is the key

It's a bit of a stretch, but let's remember it all the same: the best way to overcome the difficulties you'll face at the beginning of parenting together is communication. Talking will allow you to clear away negative thoughts, stop potential arguments, and nip resentment in the bud. Listen to your partner's needs as themselves and as a co-parent, and communicate your own as you understand them. Accept that your needs and desires will change: nothing can fully prepare you for what you're going through.

Accepting that you are not perfect

In the first months of parenthood, you'll learn to get to know your baby and discover him or her. Be willing to adhere to certain principles, maintain others, and challenge yourself. If parents' social media accounts make you uncomfortable, turn them off and get to know your child and do the best they can.

Agree to ask for help

To conclude this section dedicated to discovering motherhood, simply agree to ask for help. You are surrounded by your partner, your family, your loved ones, the healthcare staff, and the PMI (childcare provider). Agree to ask them for help when you feel you can't take it anymore.

Domestic violence

Last but not least in this "family" section: the risk of developing domestic violence. Pregnancy and then the birth of a newborn are pivotal periods in the development of domestic and intrafamily violence, most often against women. Several reasons can "explain" this change (fatigue, anxiety, depression, etc.), but this is not why you should 1) accept them and 2) feel guilty. You are in no way guilty of the abuse you suffer. One in 10 women report having experienced violent episodes during their pregnancy or the day after giving birth.

🫶 You deserve a healthy relationship, and your child deserves to grow up in a safe and secure environment. If you (or your baby) are the victim of any form of violence (mental, physical, sexual), ask for help. If filing a complaint seems complicated at first, talk to your loved ones and the healthcare professionals who are supporting you. They can provide support and refer you to a social worker who will give you solutions and tools to overcome this situation.

Helpful Support and Resources

Last paragraph of this looong article on the support and useful resources that can help you during your pregnancy and childbirth.

Prioritize contact with your healthcare professionals

The first point to remember—we've stopped repeating this—is to contact the healthcare professionals monitoring your pregnancy if you have any doubts, questions, fears, or concerns. They will be able to answer your questions and, if necessary, conduct additional tests if they deem it necessary.

The healthcare professionals you should contact are those who will be monitoring your pregnancy. Typically, these professionals will be your primary care physician and a gynecologist or midwife. In France, here is the scope of action and care provided by each of these practitioners:

• Your attending physician: the attending physician has the advantage of knowing you and having an overall view of your health;

• Your midwife: A midwife is a professional dedicated to the woman's body. She may work within the healthcare facility that supported you during your pregnancy or in private practice. In private practice, she may be required to consult you directly at home. Some midwives also have specializations, such as lactation expertise if you wish to breastfeed or pelvic floor rehabilitation;

• Your gynecologist: A gynecologist is a specialist in the female genital system. They have been with you throughout your pregnancy and may be employed by the facility where you gave birth or work independently. They will be able to prescribe and conduct more in-depth tests than a midwife, providing valuable support to the midwife.

Find in our directory various professionals who can support the postpartum period.

PMI, your preferred contact

In France, Maternal and Child Protection (PMI) services are government agencies. Their mission is to welcome, inform, and provide preventive medical care to children aged 0 to 6, and some also to pregnant women. Health professionals and social workers offer appointments to support you.

Sources:

(1) https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2708196 (article in English 🇬🇧, 2018)