Bed Rest is best in the first 1-2 weeks post partum.

January 5th, 2010

A few months back I had a booth at a baby fair. During a lull in the participant traffic a woman strolled by and had the teeniest little bundle strapped to her chest. I asked her how old her baby was and she replied, “5 Days old.”

Her response took me aback. Okay, perhaps this is going to seem judgemental, but what could this woman have possibly needed at this baby fair, a consignment show I might add, that necessitated her bringing her 5 day old infant out amongst a throng of people? This show was at a local convention center and while it was mostly clean, it is not a place that I would have brought my newborn and most especially with the hundreds of people passing through.

But this mama’s presence brought up other questions for me. Why wasn’t she home resting after recently giving birth? How was breast feeding going? How was she feeling? Given that she was at the show, I can only surmise that she was feeling pretty well, but as a former clinician, I had to wonder what impact her early post partum sojourn was having on her recovery.

Pregnancy, labor and delivery (along with death) are very likely the most natural events in all creation. All animals experience these stages as they bear offspring and even though these are very natural events, I do believe and will state here that we need to treat the processes with respect. Obstetrics has become a very scientific, interventional discipline within medicine and we have gotten away from allowing a woman and her body to go through many of the natural processes surrounding pregnancy, labor and delivery. Sure, we are able to detect and intervene when abnormalities and/or problems arise, but we have also begun intervening when no intervention is necessary. Women are losing some of their inherent physical wisdom and as such we are seeing more and more reasons to ” intervene”.

In my opinion, this woman should not have been at this baby show. I would have rather she remained at home, resting and tending to her baby. Now I am sure that there are many out there who will vehemently oppose this view and I welcome your responses so that we can discuss the issue. But I believe for the first week, and possibly the first two weeks, new mamas should remain in bed, resting, nursing and recovering from their deliveries. Here are my reasons:

Pregnancy, labor and delivery are stressors on a woman’s body. On the scheme of things they are good stressors, but they are stressors none the less. The very process of developing an entire human being, bringing that being forth to this physical plane and then preparing to feed and nurture that being requires a lot of physical energy. For example, pregnant women are at greater risk for contracting colds and other viruses than their non-pregnant counterparts because much of the energy their bodies would normally use to fight infection is being used to help grow the baby. Their circulatory systems (heart and blood system) are temporarily stressed;   their hearts are working harder circulating the increased blood fluid load which is being used to help feed and nurture the growing baby.  The joints and connective tissues are stressed as they adapt to support the additional weight pregnant women must carry. All of these “stressors” miraculously take place and the body adapts to fulfill the task at hand, but once the stress is removed, it’s time to recover.

A woman’s Body needs to recover after pregnancy and delivery. I stated above that pregnancy, labor and delivery are natural processes that stress the body. So just like ordinary stress, once the stressor(s) are removed, the body needs a period of recovery during which it resets itself back to baseline. Robert Sapolsky, Ph.D, describes the effects of stress humorously and eloquently in his book “Why Zebras Don’t Get Ulcers.” Sapolsky describes how zebras in the deserts of Africa are initially in a calm (resting) state. When a predator comes along, like a cheetah, the zebras’ bodies react with the fight or flight reaction in order to prepare to defend themselves or to escape. Once the Cheetah is gone and the zebras are relaxing in safety,  their bodies revert back to their normal calm states. In his book, Sapolsky uses this analogy to explain why we humans are at risk for heart attacks and ulcers-when we stay stressed, remaining in the fight or flight state even once the stressors are gone, we use up all of our resources and over time don’t have reserves from which to draw to protect ourselves when confronted with future stressors.

The same analogy can be used for new mamas who get up too soon after delivery. A woman’s body has stretched and organs have moved in order to accommodate pregnancy. Now that the baby is delivered, a time of rest is needed for a woman’s body return to baseline; for the muscles of the abdominal wall to recoil and for her uterus to migrate back down within the pelvis behind the pubic bone. This process is aided significantly by breastfeeding in the early post partum. Many women (myself included) recount that as their newborn suckled, they could feel their uterui contracting. These contractions aid in the uterine migration back into the pelvis. If a woman is up and about, the contractions will occur during nursing (if she nurses) but the abdominal muscles  won’t contract and “flatten out” as much because they are also being used to hold her upright. Likewise, the uterus may or may not fully migrate back into the pelvis leaving her with a “pooch”. Activity in the early post partum has also been associated with increased lochia (post partum vaginal discharge) dizziness and lightheadedness. Time to recover can alleviate these adverse reactions.

JDavisHarteRest aids in breastfeeding. Finally, as if a woman’s body has not done enough, those mothers who are planning to nurse will find it easier to “get nursing going” if they aren’t moving about trying to keep order in the home and resume full activity levels. Again, breast milk production takes a lot of physical energy (about 800 extra calories daily!). If a woman is trying to run her household, care for older children, heal from pregnancy labor and delivery and breastfeed her body may not have the physical energy to meet all of its demands. At least in the first 1-2 weeks, if a woman can focus on letting her body recover; eating well, sleeping as much as she can and establishing nursing with her infant, she is more likely to be have ample milk supply for her infant and to be able to nurse for as long as she and her infant decide.

I know that many will disagree with me regarding early post partum bed rest. Post partum bed rest is not as confining nor need be as stringent as bed rest prescribed in the high risk ante partum woman. However, in those first 1-2 weeks after delivery, if a woman can give her body that time to recover and to establish nursing, both she and her infant will greatly benefit.

3 responses to “Bed Rest is best in the first 1-2 weeks post partum.”

  1. […] This post was mentioned on Twitter by Darline Turner-Lee, Sandra Hicks. Sandra Hicks said: RT @mamasonbedrest: Bed Rest is best the first 1-2 weeks post partum. http://bit.ly/6Q1bSp What do other ppl recommend to their new Mamas? […]

  2. Hicksgirl93 says:

    When I was younger and had my first child (27) I would have disagreed with you. I couldnt wait to get outside with my new baby. But 10 yrs later? I wholeheartedly agree. Take the time to allow the body to recover, do not rush it. You body will be so much happier and balancedd if you do. There will be plenty of time to “run around” in the months and years to come as your child grows up.

  3. […] getting up except for bathroom breaks and showering. This resting period is not only a benefit to heal physically (such as avoiding uterine prolapse and lessen bleeding faster) but also has shown to be impactful […]

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