When I was a young mother and childbirth educator, my community taught me that it was normal to bleed for six weeks after birth and sadness was considered normal.  Then, I began witnessing what postpartum healing looked like for women in communities that had respect for postpartum rest.  Women who truly rest and are nourished by those around her generally bleed less and have less trouble with breastfeeding and depression.  Whether we have adequate help or not, there are a few rules we can follow to increase our well-being postpartum.

Traditional wisdom suggests that we follow the rules of three:

• 3 days in the bed, only up to the bathroom and a lot of laying down in between
• 3 days on the bed, beginning to sit up, but still only walking to the bathroom
• 3 days near the bed, beginning to sit for longer periods and walk more, but not venturing too far from the restful bedroom
• 3 hours to see if baby can latch before beginning pumping
• 3 days to stimulate milk supply nursing or pumping every three hours to ensure the milk sacs develop and are triggered properly and the milk volume expands
• 3 weeks to fix baby’s latch with position changes, bodywork, and oral revisions

Yes, there is wiggle room in these rules, but you can see how much rest is encouraged, and historically this would have been closer to 40 days of remaining near the bed.

Regardless of your restfulness, blood loss on the first day will look like the heaviest day of your period and get lighter every day.  You shouldn’t have bleeding that trickles or gushes and you shouldn’t have clots as large as a chicken egg.  Remember that 3 pads in 3 hours is time to be at the hospital. So, if you are filling pads in less than an hour, rest and nourish before it gets to that point.  If your bleeding is heavier than it was the day before, you’re doing too much (even if all you did was sit upright for a bit or make a sandwich).

Too much exercise or activity increases bleeding and damages the long-term health of the abdomen and pelvic floor.  Tissue must have a resting phase to heal properly.  Our muscles get bigger from the damage that is caused when they are overused.  Cells break down and new cells are rebuilt and scar tissue develops which attempts to accommodate the increased activity.  We’ve already overused our muscles in birth and we don’t need our muscles to get bigger or develop scar tissue. Our muscles need flexibility as much as strength, and after birth we’ve already witnessed how strong they already are.  There are a few things to do while resting.

It is important to stretch in bed and walk to the bathroom.  Circulation prevents blood clots which are more likely postpartum as our blood adapts to aid breast changes, reduce the uterus, and heal the pelvic floor.  The best exercise for strengthening the cord and pelvic floor is diaphragmatic breathing.  This can be done in bed and may begin on the first day after birth:

1. Lie on your back with your knees bent and a pillow under your knees.
2. Place one hand flat on your upper chest and the other one your abdomen.
3. Breathe in slowly through your nose, feeling your abdomen rise first and your pelvic floor expand. Keep breathing until you feel your chest rise next.
4. Breathe out slowly as your chest falls first. Continue breathing as you tighten your abdomen and pelvic floor to push up and out every last breath.
5. After three weeks, you can start walking longer to build tone and by 6 weeks you can begin other exercise activities

If you’ve had tears, it is important to use a healing herbal rinse each time you use the bathroom.  This reduces stinging, helps prevent infection, and hastens tissue repair.  If scar tissue or tight tissue remains after 6 weeks, rub evening primrose oil over the scar tissue daily to soften it and increase comfort.  If you don’t have stitches for tears, rest is even more important and walking stairs, sitting cross-legged, or sitting up on the tears should be avoided.  Once bright red bleeding has stopped, you can start herbal pelvic steaming, if desired.

Finally, tell your birth story, especially if it was challenging or traumatic.  The best way to integrate these life-changing events to prepare us for our next birth is by storytelling.  Remember, no matter what your experience was, find the joy in your birth, too, so you remember it positively.