History of birth & postpartum
Historically birth & postpartum were home-based. Up until the 19th century women gave birth in their home with the help of an elder experienced woman from there village at first and a midwife in more recent years.
The strenuous nature of birth along with the fact that breastfeeding was the only way to keep a baby alive mandated the great care new mothers received from the people close to them and from their village. Most people used to live in small communities and after birth the mother was supposed to stay in bed and learn to breastfeed her baby. The older women were there with valuable guidance and advice and the community was there to provide food and help with older kids and housework.
The modern era
Medical advances combined with the urbanization of societies meant that Postpartum care declined greatly in quality in the 20th century! Now we know that mum is safe, there are doctors that take care of her for 3 days at the hospital, midwives that teach her the basics and then off she goes…alone to the house with no one to help!
And then we are sad about low-breastfeeding rates and high rates of Postpartum depression in most developed countries! What we need to understand is that this should not surprise us. Breastfeeding is a learned skill and requires a lot of support from other women that have the knowledge to share in order to be successful! Dana Rafael, US Anthropologist and Breastfeeding advocate that studied birth & postpartum of around 200 traditional societies, said that:
“breastfeeding was a physiological process that needed to have something in place in the culture or else the lactation function would not work. Breastfeeding needs support”
Also, birth and breastfeeding are energy draining activities and the new mother needs nutritious meals and help with all the tasks she previously undertook with ease. And foremost she needs psychological support, confirmation that she is doing ok, that things are going to get better, that she is a good mum! A new mum needs to be mothered also and in modern societies we have forgotten that…
In Luxembourg a recent survey conducted by Happy New Mama showed that 65% say they were not prepared for life after birth & especially for the postpartum period, although 74% amongst them had received a Prenatal education course. When asked to describe this period the majority (66%) is on the negative side, with 27% responding “Very Hard” or “Not Good” and another 39% said “Average” which is amazing if we think that this is the period were we finally meet the person that was growing inside us for 9 months! When it comes to negative feelings, “Tired”, “Exhausted” and “Overwhelmed” were naturally on top but some other not so obvious were highlighted. 1/3 of respondents reported feeling “Isolated” or “Lonely” and 27% “Scared”. Finally, around 25% felt “Depressed” and experienced the “Baby Blues” with 11% reporting “Postpartum Anxiety” and 6% “Postpartum Depression”. The majority of the population that took part on the survey relied on help from their partners mainly, 46% had an independent midwife visiting and 40% had one of their parents helping.
However, these numbers are only an indication) as Luxembourg does not publish data on Postpartum Mental Health!
Factors associated with a negative experience seem to be C-sections, especially emergency ones. And consequences involved lower rates of long -term breastfeeding (39% breastfed their baby over 6 months vs 80% for women with a ‘very good’ postpartum period).
Moving finally on what would help during that period, top answer were more sleep, a warm cooked meal or help with housework but “company, someone to talk to” was also chosen by 42%, which is in line with the loneliness of that period!
In Luxembourg the state provides some visits after birth from an independent midwife (sage-femme liberale). They visit at home, check baby’s weight, check the breastfeeding and if there are any medical or other issues with the new mom (e.g. excess bleeding, any infection, pain etc) and this is a valuable service for new mums. They visit in the first 15-21 days postpartum and reimbursed by CNS. However, the visit lasts 45 min and often there are not enough midwives in Luxembourg to cover the demand. Many midwives also offer other services in private and are an invaluable resource.
For sure the postpartum experience of women giving birth in Luxembourg is a topic that needs to be explored further and official authorities should start paying more attention to it as this period affects women’s well-being and is probably the most fragile period of their lives, mentally and physically.
Role of doulas
This is the point where, in many modern societies, a Postpartum Professional (or Doula) comes. The role of a postpartum doula is NON-medical and it’s focus is Mothering the mother, it is to give space to the new mum to recover from birth and to get to know her new baby. They offer practical help and emotional support to the new mum until she is confident and strong enough to take care of her new family. A Postpartum Doula will prepare nutritious meals, will give a massage to increase oxytocin, will take care of older kids, support and encourage mums with breastfeeding and give them time to have a nice bath or show some exercises to help recover from birth. But most of all she will be there to listen! Listen to her birth story, her worries and anxieties of being a new mama and to celebrate the most intense transition they will go through, the transition to Motherhood. A postpartum doula is the village we have lost!
Because postpartum care should be given again the position and value it once had and because..
It is not enough to keep new mamas alive, we need new mamas to thrive!
More about the contributor
Christina Anyfanti is a Certified Postpartum Professional & part of the Newborn Mothers Collective as well as a Birthlight™ Motherhood & Baby Yoga Teacher.
She also has a Diploma in Counseling Psychology among others. happynewmama.lu