Your Baby Home: A Few Tips for a Calmer Hospital Departure
by Sylvia Brown and Mary Dowd Struck
The day before
you are to check out, send home as much as possible especially
flowers, plants, gifts, and any large items.
will still be wearing maternity clothes -- or at least ample,
roomy clothes -- for another two weeks. For the next two to six
months, be prepared to wear clothes that are at least two sizes
larger than your pre-pregnancy clothes.
the hospital, you will probably be escorted to the door in a wheelchair.
Some hospitals allow you to walk to the door unescorted. Once
you are released by the nurse or aide, carry only the baby and
your handbag, and a burp cloth in case the baby spits up. Ask
the person accompanying you home to carry everything else.
A new mother
walks more slowly than usual, especially after a cesarean. Take
your time. Checking out of the hospital always takes more time
than you think it will. If you are still taking painkillers, keep
them handy, so as to be at ease on the way home.
Ask the person
accompanying you to bring the car close to the hospital door.
If you have
never put a baby in a car seat, do not underestimate how complicated
this can be at first. You should have at least read the instructions
beforehand and preferably practiced at home. Some mothers prefer
to settle the baby into the car seat while still in the hospital,
and then install the seat in the car with the baby already in
place. Do not forget that you should never place the car seat
in front of an airbag. Pediatricians also advise against leaving
the baby in a car seat for several hours. Once on the road, resist
the temptation to take the baby in your arms to comfort or feed
him. If you must take him out of the seat, ask the driver to pull
over to the side of the road.
ask your family to turn up the heat in your home to 72F, the night
before you come home, so that the temperature will be comparable
to that of your hospital room. Once you are at home, you can reduce
the temperature one degree every day until you reach your household's
normal temperature. To save your partner needless trips to the
pharmacy, buy all your sanitary napkins ahead of time for the
four to six weeks during which you will be bleeding (special postpartum,
extra-long and extra-absorbent for the early days or "overnight"
pads, then normal ones for day and night, and finally smaller
pads for light flows).
the hospital, ask for the direct number of the maternity ward
and the name of a nurse or two (and their shift hours) that you
call from home if you have an important question. Many hospitals
provide a call service or "warm line" for new mothers
© 2003 Sylvia Brown with Mary Dowd Struck
articles from The
Post-Pregnancy Handbook by Sylvia Brown and Mary Dowd
Nursing Mother's Diet
Partner to Father - The Importance of Expectations Management
click on one of the links below:
a number of books exist which deal with various aspects of the
postnatal experience - breastfeeding, exercise, motherhood, post-partum
depression - this is the first complete source of information
on what a woman experiences both physically and emotionally in
the days, weeks and months after childbirth. It is also the only
book in its field which balances medical advice with practical
tips and numerous references to alternative remedies. From Sylvia
Brown, a mother, and Mary Dowd Struck, RN, MS, CNM, a nurse/midwife,
Post-Pregnancy Handbook, a wonderfully comprehensive,
honest self-help guide which every new (and repeat) mother should
keep by her bedside. Read
more about the book here.
Brown wrote The Post-Pregnancy Handbook in response to her own
frustration at the lack of comprehensive information for the mother
in the weeks and months after childbirth. Sylvia graciously answered questions from StorkNet Members.
Hello, Sylvia, and welcome to StorkNet! We love The Post-Pregnancy
Handbook and are very grateful that you are here to chat about
it and take questions from our site readers. Thank you for taking
the time out of your schedule. You explained that you wrote this
book in response to your own frustration at the lack of information
for new mothers after childbirth. So with that in mind, do you
have a favorite chapter? A specific topic that struck close to
home more than others? What's next for you?
Hello Nancy. I'm delighted to share some of the advice and information
that I gathered in researching The Post Pregnancy Handbook. All
of it comes from medical sources. My job was to make it clear
and easy to understand. Before writing the book, I sent questionnaires
to 300 new moms on the topics that they wanted covered. But as
a mother of two myself, I consider my three most important chapters
to be the ones on the pelvic floor, postnatal depression and loosing
weight after childbirth. These happen to be three of the most
misunderstood topics relating to the post-pregnancy period. So
I very happy that your readers have sent me questions on all of
The Post Pregnancy Handbook exists in America and France. I am
currently working on a British edition and hope to produce a Spanish
edition soon. Each version requires an almost complete re-write
because childbirth is approached so differently from one country
to the next!
Sylvia, what a great endeavor that will be. I imagine the research
is quite interesting if you are rewriting the book to assist different
cultures. We would be interested to know some of the differences
you have discovered. Our membership is comprised by women from
all over the world, so we'll announce your upcoming editions.
to read your replies, so let's get to the questions...
Does your book discuss how to deal with the onslaught of visitors
who insist on "just stopping by" the first couple weeks,
well-meaning mother-in-laws, and other intrusions? Do you have
any suggestions? This time around I just want help, but no visitors
who stay. Is that logical?
Hi Maria. Isn't it amazing how people just seem to pop out of
the woodwork when you're just home from the hospital with a newborn!
You are absolutely right to demand peace and quiet, especially
if this is your second baby (you'll probably be more tired because
you'll also be caring for the needs of your older child). This
is a time when your partner can play a vital role in "guarding
your door." Here are some of my suggestions:
a message on your answering machine giving all the vital statistics
that people want to know about the new baby. Then don't pick
up the phone. Send out an e-mail mailing (with a photo if you
have a digital camera!)
- Plan one
or two "open houses" in two or three weeks (or whenever
you feel ready) after the birth when friends and family can
come by to see the baby.
- For really
close friends and family, suggest that they come by at a specific
time either bringing a meal, or the ingredients to a meal which
they can cook and WASH UP at your house.
to friends and family that they give you hours of housekeeping
time or a subscription to a diaper service or a food delivery
services (a close friend can organize this) rather than yet
another outfit for the baby.
- Make certain
that visitors don't smoke inside your home. Ask them to speak
- If you
feel uncomfortable breast-feeding in front of visitors, ask
them to leave or to entertain themselves with television or
magazines while you nurse in another room. Don't feel rushed.
Your baby is your first priority.
- Make sure
that visitors don't ignore your older children.
you mention mothers-in-law. This is a tricky topic. If you
are already having a difficult relationship with your in-laws,
this is not the time to bring tensions into your home. Later on,
however, the baby may provide a bridge between the two families.
If you plan to have your mother or mother-in-law around to help
with housekeeping, she may have her own habits and ideas. Are
you ready to let her do it her way, at least for a while? If you
plan to have both your mother and mother-in-law around, be aware
of potential conflicts between the two grandmothers. This is one
of the vital topics to discuss with your partner well before the
birth. Remember, you will be more sensitive than normal - you
don't need additional sources of stress.
Do you suggest using a wrap or snugli? Are they really safe? I'm
worried about carrying my baby at first. I have slight back problems.
Cathy, opinions differ on whether a wrap and/or a Snugli®
may exacerbate back pain. Part of the problem is that many women
don't know how to adjust a Snugli®.
You can't imagine the number I see on the street
who have theirs strapped much too low! You have to be able to
kiss the top of the baby's head just by bending your neck down.
I find wraps are good for newborns and the Snugli®
for older babies. You might want to try putting your baby in a
facing out while you are sitting down. In many other cultures,
babies are carried on their mothers' backs.
A few more
posture tips (at a time when your back is particularly sensitive
- 50% of new mothers suffer from back pain): Don't carry a baby
over six months old on your hip - this will pull your spine to
the side; Don't bend over to lift your older children (or to tie
a shoelace). To lift a child, kneel on one knee, tighten your
pelvic floor and abdominal muscles, breathe out, and then stand
up with the child in your arms.
I had my son just over 7 months ago, and am still really struggling
with weight loss. I still have about 25 pounds to lose (combined
from two pregnancies -- we lost our first son late term, and then
I got pregnant again quickly, so the two pregnancies were only
a few months apart). My son is eating two servings of solids a
day, and other than that I'm exclusively breastfeeding. It seems
like most of the women I know shed the pounds fairly effortlessly,
and are back to their regular clothes, or one size up, by this
point. I'm still wearing clothes that are two sizes larger, and
I had to fight to get into those. Any ideas? Suggestions? I've
been trying to follow the Weight Watchers lactation program, but
I'm hungry all of the time, and am having a hard time sticking
to it. Thanks!
First of all, Whitney, congratulations on the birth of your little
boy, especially after your painful loss. Because of your two pregnancies,
you are in a special category and should not compare yourself
to your friends. Let me tell you a little about the mechanism
of weight loss after childbirth:
on your size before you became pregnant. About one third of new
mothers, who were "skinny" before pregnancy and gained
only 25-30 pounds, will be back to their normal weight about three
months after childbirth. Older moms, 3rd or 4th time mothers,
or borderline overweight women will loose most of their excess
weight between the 3rd and 6th months after childbirth. Overweight
women (10-15% of the population) will loose most of their excess
weight six to nine months after childbirth. They also benefit
the most from breastfeeding for a long time (more than five months).
You are probably
in the second to third group. This means that your weight loss
will begin about now. Please, please keep breastfeeding! For the
first six months, your body had high levels of the hormone prolactin,
which stimulates milk production. Prolactin also tends to stimulate
appetite and make nursing moms retain fluid. Now finally, your
prolactin levels have dropped, but because you are still breastfeeding,
your metabolism remains high. Your body will start using up its
fat reserves now, especially on the thighs (yippee!). Make sure
that you are getting about 2500 calories a day (you burn 750 breastfeeding)
which include 12-15 grams of protein (6-11 will go back out in
your milk), distributed as 50-60% complex carbohydrates, 25-30%
fat, 20% protein. Your excess weight will come off. It just takes
a little longer.
Are there alternatives to Kegels for strengthening the pelvic
floor muscles after birth? I found it difficult to remember to
do Kegels, they were awkward feeling, and I was never sure if
I did them correctly. A year after my first child's birth I have
serious problems with incontinence and sexual dysfunction. I hope
to lessen/avoid this problem after my second child is born in
a few months. Thank you for your advice!
Hello Corrie. You have hit upon my favorite topic. I'm always
shocked at how little attention the pelvic floor gets in America.
Whenever I meet with new mothers' groups, I always ask who had
their pelvic floor muscles tested at their six-week check-up and
almost nobody raises their hand. I also keep meeting women who
start an exercise program far too early after childbirth, and
before toning their pelvic floor. No wonder so many women have
incontinence and sexual dysfunction problems (they get much worse
after menopause, so the time to do something is NOW). Unfortunately,
most women are too embarrassed to talk about it, even to their
doctor (they wait on average 7 years before seeking help - who
wants to have bad sex for seven years!) So thanks for speaking
the weight of the uterus increases by twenty to thirty times.
As it grows, the uterus pushes the bladder downward. Furthermore,
the muscles and ligaments that normally hold up the reproductive
and digestive organs are how weaker under the effects of relaxin.
Childbirth will then stretch and distend these muscles, no matter
how well a woman prepares for delivery - after a vaginal delivery,
the pelvic floor looses about 50% of its tone. Episiotomies, tears
and abnormal straining during the expulsion phase all add to the
damage. If the pelvic floor muscles are not restored to their
proper tone, the sphincters can no longer clamp down properly
on the bladder (and in some cases on the anal) opening, causing
It is therefore
essential to begin gentle pelvic floor toning exercises (described
in my book) in the days after childbirth and to practice these
for nine minutes a day for the first six weeks. Pelvic floor exercises
are also very helpful in speeding the healing process after an
episiotomy or tearing. DO NOT BEGIN AN EXERCISE PROGRAM UNTIL
YOUR PELVIC FLOOR HAS RECOVERED ITS TONE. Your health practitioner
should check your pelvic floor tone at your postpartum check up.
If they don't ASK FOR IT!
In your particular
case, Corrie, please get your doctor to recommend a urologist
NOW, while you are still pregnant. A specialized physiotherapist
can watch you do your kegels, help you get them right, and suggest
other exercises for your specific needs. You probably should plan
to have several sessions of urinary physiotherapy after childbirth
too. In France, the government pays for every new mother to have
ten such sessions! It means fewer hysterectomies and long term
problems, which will end up costing them much more. Good luck.
Don't take no for an answer.
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