3 Areas Commonly Overlooked in Postpartum Care from a Maternal Health OT that specializes in Lactation

Welcome back to another post where I share my authentic, multi-passionate collection of thoughts to bring more awareness to the scope of occupational therapists specializing in maternal health.

Maternal health occupational can span from fertility to postpartum care. My interest and expertise are within the postpartum period. If you’ve heard my story before, you know it was a traumatic birth experience in 2017 that brought me to the wonderful specialty of maternal health. Through the process of specializing in lactation, I’ve seen many areas (outside of feeding) that are commonly neglected by families that could have been brought up prenatally. 

So be reassured that if you’re interested in maternal health you can make a huge impact at any stage, from fertility to postpartum, you don’t have to wait until the baby arrives.

The past few weeks I’ve been doing A LOT more education in the “associated topics” (the name I use for all the other areas of lactation that directly impact the trajectory of lactation, but families often overlook). Essentially, these areas can boil down to mental health, nutrition, and rest/sleep. I’ll try to separate these out as much as possible, but you’ll see they’re interconnected.

SO many misconceptions about these areas.  

So if you’re an occupational therapist following along, this is a great way reminder to connect back to the OTPF 4 and brush up on the areas of occupation. If you’re a parent, then follow along to find some helpful resources. Either way, make sure to share with a friend, I’d appreciate it.

Mental Health

Contrary to popular belief, mental health postpartum is very much linked to mental health preconception, during pregnancy, and impacted by related events of birth.

The physical recovery from birth can be a lot. Around 50 to 60% of women experience pelvic floor disorder postpartum whether it’s urinary incontinence or pelvic pain. Persistent pain during the first 3 months postpartum doubles the odds of a positive screen for postpartum depression and if it's severe acute pain in that first 8 weeks, that triples the odds of postpartum depression.

Even if the body isn’t in physical pain, other shifts and changes are happening that place other demands on the body. 

Starting with the birth of the placenta, there is a drastic flux of hormones. Progesterone and estrogen decrease, oxytocin increases to stimulate the contractions and the involution of the uterus, and prolactin increases to transition milk from colostrum to mature milk.

It’s this drastic drop that many researchers believe to be linked with the baby blues.

This shift in hormones along with general blood loss is also the cause of many common postpartum symptoms such as “afterpains” or cramping, constipation, breast engorgement, fatigue, and brain fog.

While recovering (and possibly in a great amount of pain or discomfort), there are shifts in how you see yourself and your relationships. Bringing Home Baby is a great program if you have an interest in prepping your relationship before the baby’s arrival.

Nutrition 

It’s truly mind-boggling to me how many people ignore eating postpartum. Laundry, dishes, returning emails, opening baby gifts, shopping for new stuff, and a list of other things get prioritized. 

I just mentioned how the body needs to heal physically and nutrition (the nutrients needed for tissues to heal) is key!

Not to mention nutrition is very much linked to mental health through the gut-brain connection. 

Since the GI system will still be moving slowly immediately postpartum, it’s going to be important to modify the postpartum to account for this change in digestion to better absorb nutrients. Many things can cause disruptions within the gut microbiome (such as antibiotics) and gut-brain communication is linked with postpartum depression.

Rest and Sleep

Sleep when the baby sleeps may not always be possible, but resting while the baby sleeps is completely feasible.

According to the occupational therapy practice framework (OTPF-4), rest is “identifying the need to relax and engaging in quiet and effortless actions that interrupt physical and mental activity; reducing involvement in taxing physical, mental, or social activities resulting in a relaxed state; engaging in relaxation or other endeavors that restore energy and calm and renew interest in engagement”. 

Sleep doesn’t need a definition, but I think it’s important to point out that the OTPF-4 splits sleep into sleep preparation and sleep participation. How many times have you heard that it “takes forever” to fall asleep? Frequent night wakings are also common during the newborn stage and beyond.

Postpartum sleep deprivation paired with unmet dietary needs can actually disrupt gut-brain communication. Generally, the current body of peer-reviewed literature suggests that sleep disturbances are associated with fatigue and depression.

See how easy it can be to fall into the web of lack of sleep, decreased nutrition, and mental health challenges?

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I’d love to hear from you! If you have questions or feel called to share something you’ve thought of while reading this, drop me a message. 

If you're looking to learn more about maternal health as an occupational therapy practitioner, check out the Maternal Health course by The Lactation OT Continuing Education platform.