These practices can be found in many Asian cultures, such as China, South Korea, Morocco, India and Malaysia, along with many other cultures around the world. While some principles may differ slightly, the main focus of confinement practices across the world is prioritizing recovery after birth with warmth, bed rest, easy to digest and nutrient-dense food, and limited to no visitors. 

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Nowadays, many new mothers are adapting the idea of postpartum confinement to fit within today’s modern world. From hiring a confinement nanny or postpartum doula with knowledge around traditional practices, it’s possible to identify the principles of confinement that resonate with you—and create your own version. 

Related: 5 important reasons to practice postpartum rest, according to a midwife

What is a traditional confinement?

In Traditional Chinese Medicine (TCM), it’s believed after a mother gives birth there is an empty space within her body where the baby once was. The mother’s body is open, her ligaments are loose, and if wind or cold comes into this open space, it will cause further ailments and prevent the body from properly healing. 

This means that during postpartum confinement, a new mother is encouraged to stay warm inside and avoid touching cold objects, drinking cold liquids or eating cold food. In a very strict traditional Chinese confinement, a new mother will not wash her hair, shower or brush her teeth as it is believed that contact with water opens the pores, causing wind and cold to enter the body, which is believed to accumulate over time and cause health complications later in life. 

A traditional confinement also encourages no physical activity, including housework and sometimes includes removing all distractions like television, books and mobile devices to ensure that the primary focus of the mother during confinement is rest.  

Related: 5 truths about postpartum recovery every woman should know

How long does a traditional confinement period last?

A traditional confinement lasts 40 days to allow the mother’s body to close up and rebalance after childbirth. Nourishment during this time is the cornerstone of confinement and is considered essential in helping mothers to recover and restore energy and vitality.  

Leila Armour, founder of Village for Mama, is a holistic postpartum doula located on the Sunshine Coast in Australia, who supports new mothers in recreating a traditional confinement by providing daily, in-home postpartum support and nourishment for the first four weeks following birth. 

Related: Eva Chen on the immigrant experience and the importance of self-love

The term for Chinese confinement month is called zuo yue zi which can be directly translated to ‘sitting (out) the month’ and Armour’s “Golden Month” package helps new moms do just that. To support the health and healing of new mothers, during those four weeks, Armour provides five days of breakfast, lunch, snacks and beverages for the new mother and dinner for the whole family, addresses any postpartum conditions, provides emotional support and holistic breastfeeding support, cleans and tidies the home, runs local errands and grocery shopping, babysits older children, and schedules in-home TCM acupuncture and massage treatments. 

“We place so much pressure on new mothers as a society and culturally we do a terrible job of supporting them through this transition,” Armour explains. “We set an unachievable standard of the perfect mother, who ‘bounces back’ to her old self, unchanged by the whole experience.” 

Related: Making a postpartum plan is just as important as a birth plan

Anti-bounce back culture

Postpartum confinement is the stark opposite of today’s bounce back culture. The concept of confinement places importance on caring for the mother and recognizes that a mother needs time to recover from birth. 

Most importantly, confinement establishes a system where a mother isn’t supposed to do it all by herself, which is in contrast to many Western cultures where the postpartum period isn’t typically valued. 

Related: One mama’s moving post about bounce-back culture: “We’re growing forward”

“The race is on, as soon as you give birth, to how quickly can you get back to your old self with a baby in tow,” Armour says. “There is so much pressure for mothers to meet this ideal, that they then begin to associate their success as a mother with how unchanged they are from the experience.” 

Realistically, many new mothers in today’s modern Western society cannot replicate strict traditional postpartum confinement practices, which may seem somewhat extreme in today’s world. However, even Western society defines postpartum as the first six weeks and understanding the detrimental effect that jumping back into everyday life immediately following birth has on your and your baby’s health is important. 

The central idea of a traditional postpartum confinement, ensuring that the first six weeks following birth, a new mother feels rested, nourished and supported is just as important today as it was 2000 years ago. 

8 steps to creating your own postpartum confinement

Many traditional postpartum confinement principles can seem out of sync with modern motherhood, so take the practices that fit you and your family to allow for a period of time after birth dedicated to your rest and recovery. Armour recommends the following steps: 

1. Set an intention

Think about how long you would like your confinement period to last. This doesn’t have to be the traditional 40 days, as this isn’t realistic for many mothers today. Instead, focus on a timeframe that works for you and your family. Something is better than nothing. 

2. Make a confinement plan

Write a day-by-day postpartum plan for your confinement that includes nutrition, support and your priorities each day. Create a meal plan for your postpartum confinement. The meals you enjoy during this time don’t have to be complicated. It’s also such a small window of time that eating the same thing for a few meals, knowing that it is nourishing and replenishing you. (You can download a detailed confinement plan and recipes in Leila’s course Creating a Traditional Confinement in Today’s Modern World.”)

3. Stock your freezer

Most confinement meals freeze really well. Slow cooked stews and meals are easy to make in bulk and freeze for later. 

Related: 10 delicious postpartum freezer meals that will make life *so* much easier

4. Gather your village

A traditional confinement suggests you don’t have any visitors, but in a modern confinement we need to call on our visitors to support us during this time. Identify where you need support—and delegate. 

5. Hire support

If you have the means to do so, hire support like a postpartum doula, cleaner or nanny to help with older children so you can focus on resting and bonding with your new baby. 

Related: These under-the-radar-issues are all too common during postpartum recovery

6. Connect with local practitioners that do home visits

When you’re creating your plan, see if you can find care practitioners that will come to your home so you don’t have to leave the house. These could be pelvic floor physiotherapists, chiropractors, lactation consultants, midwives, etc.  

7. Stock up on essentials you will need for confinement

Some items you may need for your confinement could include: socks and slippers to keep your feet warm, a slow cooker for hot drinks and nourishing meals, and thermal bottles for teas and soups. 

8. Go easy on yourself

Follow confinement principles that resonate with you. It’s important to do the best you can for as long as you can, but give yourself grace—becoming a new mother is hard enough. 

Learn more about creating a traditional confinement, find a four-week confinement plan with meals and support, plus recipes for postpartum confinement meals and teas in Leila’s course at Atlas of Motherhood, or her book, Village for Mama.

Read on to learn about my top tips for childbirth recovery, so that you feel confident entering the fourth trimester

1. Assemble a postpartum recovery care team

As the old adage goes, it takes a village to raise a child. As you plan for your postpartum recovery, make sure you know who you will call on in your ‘village’ as you embark on your journey into parenthood. If you have a care team in place ahead of time, you will have a better idea of how to manage life while healing from childbirth, and while acclimating to the new full-time job of being the parent to a newborn. 

While assembling your postpartum recovery care team, you may want to include family, friends, and/or professionals like postpartum doulas and lactation consultants. Make sure you know who will be taking care of the other important parts of your life, including things like food shopping, cooking, household chores, taking care of pets, etc. so that you can focus on your baby and your postpartum recovery.

Related: 5 expert tips for healing your pelvic floor from birth (without leaving home)

Even if you have supportive friends and family who live close by, a postpartum doula is a great person to help you to heal and adjust because their job is to listen and provide emotional and physical recovery support. A postpartum doula will also help you build your newborn parenting confidence by providing baby care and education on diapering, soothing, bathing, grooming, babywearing, and more. Postpartum doulas can also check in on lactation and/or help you bottle feed. They might also help with light baby-related housework, laundry, and even help you with the challenges of getting out of the house with your baby for the first time. Whatever your needs, postpartum doulas are there to support you in the transition to parenthood. 

2. Assemble a postpartum recovery kit

Whether your postpartum period includes recovering from a cesarean birth or vaginal birth, and whether you choose to breastfeed or bodyfeed, formula feed, pump, give donor milk, or do some blend, your body will experience great changes and need considerable healing and soothing. Consider creating a postpartum recovery kit stocked with the following items: 

• Adult diapers: Especially for vaginal delivery recovery (but even with cesarean recovery) you will likely experience some heavy period-like bleeding, called lochial flow or lochia. Have adult diapers, overnight maxi pads, or postpartum absorbent underwear on hand for extra-absorbency. 

• Padsicles: These are menstrual pads which you prepare by soaking in witch hazel and placing them in the freezer. Padsicles can be used to relieve and soothe genital soreness, itchiness, or discomfort of pregnancy and childbirth, including hemorrhoids. Place a frozen pad in your underwear after birth for relief.

• Peri-bottle or squirt bottle: Often provided in the hospital, these bottles are extremely helpful for cleaning after using the bathroom, when you are sore and tender to the touch. They also dilute your urine stream, which reduces stinging and discomfort. While some people like to use warm water in their bottle, others prefer cold. Try both out to see which feels best for you! Simply squeeze the bottle toward your genitals while peeing. 

• High-fiber foods or stool softeners: People are often embarrassed to discuss the reality that after having a baby, you may find it challenging to have your first few bowel movements. Since you may experience constipation, or just be hesitant to apply any pressure in that general area, eating soft, easy-to-digest foods like warm broths and high-fiber foods may help ease your first bowel movement. Some people take a stool softener, too—check in with your birth care provider to discuss your best options..

• Nursing needs: If you plan on breastfeeding/chestfeeding, nursing bras, nursing pads, nipple balm, a silicone milk collector, and a high quality pump are not essential, but may be very helpful in the first few months of your lactation journey. Of course, having a great resource to find a lactation consultant can also be instrumental in your feeding journey. Many of these nursing accessories may be covered under your insurance plan or HSA/FSA. Be sure to check with your insurance plan to see what’s available. 

3. Make a postpartum priorities plan

While your new baby will quickly become your #1 priority, it is also vital to prioritize “you-care” including nutrition, hydration, self-care, mental health, and your emotional well-being. These can easily be placed at the bottom of your to-do list, but making sure you are running at your best is important for everyone, especially your baby. Consider making a postpartum priority plan for yourself so that you:

• Have warm & nourishing foods at the ready: Stock your postpartum pantry with whole nuts and seeds and nut-butters. It helps to order in bulk and meal prep and freeze foods while you are still pregnant so that you do not have to worry once the baby arrives. If you can, seek out sources of high-quality fat (think: pasture-raised meat, butter, eggs, oily fish like salmon and anchovies, and raw plant oils such as avocado, coconut, and olive). Because of the blood loss and open state of your womb after childbirth, eating and drinking warm foods and beverages can help boost your circulation and optimize your postpartum recovery and healing. Most cultures around the world have traditions around eating warm foods during the postpartum recovery period, such as bone broths, soups, and stews, which stoke your digestive system, helping it to absorb as much nutrition as possible.

• Stay hydrated: There are many teas replete with minerals and vitamins helpful to postpartum like red raspberry leaf, nettle, and red clover teas. Drink teas, soups, and stay hydrated with fruits, lemon water, or coconut water. New parents need to replenish the fluids they lose in birth. Plus, if you are breastfeeding/chestfeeding, you will have another great liquid expenditure, so staying on top of your hydration is key.

• Know how you will get rest: While it can be difficult to “sleep while the baby sleeps,” it is incredibly important to prioritize your own rest. Taking care of a baby is an around-the-clock, 24-hour job and at some point, you have to hit pause. Discuss with your postpartum recovery care team how you want overnight care of you and your baby to look, so that everyone gets the rest they need and deserve.

• Set boundaries with visitors: While friends and family may be eager to meet your new addition, it is important your boundaries are made clear and respected during the postpartum recovery period. Discuss with your care team who is allowed at your birth location and/or your home and if and when you would like to have visitors. Make sure you are clear on your expectations for potential visitors, like considerations around handwashing, masking and holding the baby. It is also perfectly fine to limit visits to 45 or 90 minutes and to only invite visitors who you feel comfortable allowing to do some helpful housework or baby holding.

• Have time for bodywork: Your mind and spirit will start to heal, as your changed/changing body heals. In many cultures, the birth parent receives special massages to aid in postpartum recovery. Family and friends can provide foot rubs, scalp rubs, and other general body massage, or if you would like professional help to elicit mind/body healing, professional massage, acupuncture, osteopathic or chiropractic care, and pelvic floor physical therapy are all excellent options.

Related: Pregnant mom’s rules for meeting her newborn go viral on TikTok—because they’re PERFECT

Both you and your new baby will require special care during this unique time. Assembling both a postpartum recovery care team and a postpartum recovery care kit, as well as making a plan that prioritizes your well-being, are the best ways to organize postpartum life. Instead of feeling overwhelmed to be winging it with little to no direction, you can feel reassured and confident if you plan for your postpartum recovery. 

This is an absolute mindset shift that my clients initially are perplexed by when they come to me for motherhood therapy or coaching. Yet once we unpack it a bit more, the load they are carrying feels lighter and they begin to deconstruct what they’ve internalized as their sole responsibility as mothers. 

Big sigh of relief. 

We’ve come far (yet still have a long way to go) in acknowledging that new mothers need some serious TLC those first few months postpartum. Conversations in the motherhood realm still focus on the birth of the baby, and leave much to be desired when it comes to conversations on postpartum support, care and health for the new mother. 

We plan for the birth of our baby, but we rarely plan for the birth of the mother

Culturally, we’ve got some tried and true tricks up our sleeves that we offer the newly postpartum mama. We organize a meal train, drop her off groceries, offer to watch her baby while she showers. We check in on her a bit more frequently than we did when she was pre-baby, but then…suddenly, once she hits that finishline of those six to twelve weeks postpartum, we often “forget” about her, her new life in this role and the fact that she too, was just born as a mother. 

• The mealtrains stop; they take a lot of work to coordinate and she “should” have a flow by now. 
• Our busy schedules keep us on the go; she’s busy now too, juggling her career and motherhood. We don’t want to “bother” her. 
• Her baby is a bit older and she probably has her own routine now for when she showers. 

So we pull our support for the new mama. Not intentionally or drastically, but because life goes on for all of us and just like we all have to do…she should figure it out (on her own).

But should she really have to figure it out all on her own? Should you have had to? The answer is a whopping no. 

No mother should have to go through postpartum—or any part of motherhood alone, villageless. 

So how do we actually foster that same postpartum support years into motherhood? How do we create that village that everyone keeps referencing but no one shows up for?

It takes a ton of patience, organization and willingness to put yourself out there, but if you’re like 40% of moms who say more support would improve their positive feelings around motherhood, then it’s time to become a community organizer. 

Related: Newborns need care, but so do new mamas

Here’s how to foster postpartum support beyond the early days

1. Organize a local meal train with your neighborhood families, church families or friend group

Start cooking in larger batches and coordinate a weekly drop-off schedule. Or have bi-monthly potlucks, picnic style, in your backyard. BYO blankets etc., and rotate who brings the paper plates. 

2. Bartering used to be commonplace, way back in those village days

“I’ll give you ____ in exchange for ___.” We all have strengths to offer to others and we all have areas where we need some extra support. Start putting your list of “offerings” together and share this concept in your friends circle. Maybe you can be the go-to date night sitter or the grocery runner. Maybe you need someone to help you get a grasp on your laundry or meal plan with you for the week. Sometimes, asking for help can be daunting. So offering support in exchange might take that initial pressure off. 

3. Save on babysitters

A friend of mine was recently quoted $45 an hour for a date-night babysitter. She turned them down and they haven’t had a date night yet. Hearing this, I immediately offered to be her babysitter. Our children are friends; movie night anyone? I’ll take your kids this weekend, and next month, we can swap. The offer wasn’t just a kind gesture; we booked the date nights then and there. 

4. Build a shared friends-circle errand list

We all have a running to-do list that makes getting the kids into the car a circus. Why not consolidate? “I’m running out. Heading to the dry cleaners, hitting up the pet store and swinging through the grocery store. What can I get you?” Thank goodness for Venmo—we can pay it back right away. 

Related: Errands and showers are not self-care for moms

5. Get to know your neighbors again

I remember growing up, when my mom needed an egg to finish the cake, I ran and asked our neighbor for one. It wasn’t even a thing. We can bring that back too; that’s just friendly, neighborly stuff. Bake some cookies, drop them off and introduce yourself. It isn’t a prerequisite that they’re parents themselves; that’s just a bonus. 

6. Shop small and support local mom-owned businesses

Where you put your money counts. Hire the house cleaner who is a mom. Buy flowers from your local florist. Give businesses helmed by women your support whenever you can. 

7. Have mom friends at all stages of motherhood and use one another to learn from

Maybe the 13-year-old of a mom friend needs a summertime gig and you need the extra help around the house. Perfect! A mother’s helper. Maybe your neighbor whose kids just left her an empty-nester is feeling lonely. Invite her for dinner and have her share a favorite dessert recipe. 

8. Join a virtual village of like-minded women and mothers like yourself

There’s many great options available these days, some that even include in-person meet-ups. I started a “modern day” village myself, because the need I was seeing in my practice demanded some bigger system work. 

Related: This is Motherhood: Author Helena Andrews-Dyer on navigating the world of mom groups

There is no quick-fix to bringing back our village in the way we once used to have it; gone are those days. It’s now about making what we have work for us and therefore, change the way we do motherhood in our modern culture.

I was up holding him every hour, on the hour, night after night. It felt as if we were the only ones awake in the world and I felt so alone, even though I had this beautiful baby in my arms. This left me with many sleepless nights listening to my infant’s every breath and feeding him frequently through the night to keep his weight on track. I walked around like a zombie every morning, feeling unable to enjoy the day due to my severe exhaustion. The process of teaching my new baby how to sleep felt daunting and I wasn’t sure where to turn for help. 

Related: Your Guide to Baby Sleep

After countless sleepless nights (and the darkest circles under my eyes!), I went on a quest to learn how to help my son sleep better. Now, I do the same for other families as a trained Good Night Educator and sleep consultant with Good Night Sleep Site. 

Should you nurse your baby to sleep?

It depends on the age of the infant. In the early months, when your infant’s sleep hasn’t consolidated yet, it’s fine to feed or nurse your baby to help them fall asleep. 

Once your baby turns 4 months old, their sleep should start to become more regulated, and feeding or nursing your baby to sleep could become something they depend on to fall asleep or get back to sleep, which is what we call a sleep association.

Sleep in the fourth trimester

For the first four months after birth, babies tend to sleep 16 to 18 hours a day and feed on demand. We call this the fourth trimester—a beautiful and sometimes challenging time for a parent to adjust to life with a new baby. 

Awake time ranges from 45 to 60 minutes and mostly consists of feedings, diaper changes and resting in the arms of their caretaker. 

Parents often become exhausted due to the demanding and unpredictable schedule, and sleep is crucial, both for the parents and baby. 

In the early days, it may seem like babies sleep all day and are awake all night. At about 2 months, their night sleep will begin to lengthen, and day and night confusion will start to dissipate. To help your baby’s day/night cycle synchronize, expose them to bright light during the day and dimmer light at night. 

By about 8 to 12 weeks, your baby’s circadian rhythms will begin to develop and the nighttime hormone melatonin, which makes us sleepy, will start to be produced by the pineal gland. The true function of melatonin and its regular production does not fully calibrate until your baby is about 4 months old. 

Therefore, there is no need to create a formal sleep schedule before the 4-month mark as babies are not biologically ready. 

Do whatever it takes to help your baby sleep in this period, even if that means feeding them to sleep. You won’t create any hard-to-break habits during this time, I promise.

Sleep after 4 months

At 4 months, an age-appropriate sleep schedule is recommended, and an early bedtime is key at this stage. As your baby’s sleep consolidates, they will naturally begin to take more predictable naps during the day and have longer sleep stretches at night. 

Night feeding may still be happening during this period, but I highly recommend not feeding your baby to sleep. 

Why this change? We all have sleep associations, the things and routines that help us and soothe us for the most optimal sleep. If your baby falls asleep sucking on their bottle or nursing, they will expect to be fed to sleep again when they have a night waking. This creates a negative sleep association and will become a merry-go-round you can’t get off as your baby’s sleep has now become dependent on you to provide a feeding to get back to sleep. 

Instead, I suggest continuing to feed your baby as many times as needed for their weight and size, but be sure to put them in their crib drowsy but awake. 

If your baby falls asleep in your arms during a feeding, gently rub the palm of their hand or slightly raise their arm and then place them in their crib. It’s OK if their eyelids flutter or are even closed. 

Putting your baby down drowsy but awake may be hard at first, and may even seem near impossible, but I strongly encourage you to stick with it as you are helping your baby become an independent sleeper who can soothe themselves to sleep. 

It’s not too early to establish a bedtime routine

Creating a calming bedtime routine and optimal sleep environment for your baby can be very helpful during those first four months and beyond. 

Start by giving your baby a soothing, warm bath followed by a gentle massage. Dress them in soft pajamas, dim the lights, and read a book or sing a lullaby. Feed your baby during this time or after the last step of your bedtime routine. The room should be cool, dark (blackout shades recommended), and quiet with some white noise. Give them time to play in their crib and get used to their sleeping environment. Plan for the bedtime routine to last about 30 minutes.

With time and consistency, you and your family will be getting the much-needed rest you’ve been searching for.

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Sleep training doesn’t have to be miserable—gentle sleep training was just what our family needed

As someone who had struggled with PPD previously, I found it very difficult to find the help that I needed then—even though I’m a physician. Our healthcare system is broken and does not adequately support the health and wellness of new mothers. I didn’t speak up to my colleagues about my own struggles until years later because, as a neonatologist who cares for moms and babies every day, I was afraid that I would be judged and thought of as weak or incapable of doing my job. 

But as it turns out, lots of moms feel like they have to lie to their providers about their mental health in postpartum and put on a happy face. That helps no one.

Recognizing the fourth trimester

A pregnant person usually sees their doctor 14 or more times during pregnancy, but after childbirth, they are scheduled to see their doctor only once—6 weeks after delivery. 

Sadly, up to 40% of women in the U.S. aren’t seen at all because of gaps in care.

The medical community thinks that pregnancy should include a ‘fourth trimester‘ because women need continued medical attention after childbirth. In fact, as many as 1 in 5 women are at risk of postpartum depression up to a year after delivery, but 75% are left untreated. The healthcare system is actually losing $32,000 per mother-infant pair with a total cost of $14.2 billion yearly.

Related: Dear mama, you shouldn’t be an afterthought after giving birth

Spotting the signs can be difficult

I was one of those women who went undiagnosed and untreated for over a year. After the birth of my first child, I remember seeing my doctor at 6 weeks but don’t remember filling out a questionnaire or being asked about my mental health. 

By that time, I felt like so much had already happened—breastfeeding struggles, insomnia, panic attacks. 

I wish I could have had my doctor’s appointment sooner or had someone check in on me regularly because I didn’t realize those early symptoms were signs of anxiety and depression. 

You would think that as a doctor who works with moms and babies, I would have recognized my own symptoms. I think it’s even harder for female doctors sometimes because we’re used to being the one helping others and often overlook our own health. 

Related: 5 postpartum depression symptoms you may not have heard of

My appointment with my OB was so rushed, and she clearly had a checklist that she needed to get through, so I didn’t feel comfortable speaking up about how I was feeling. I also felt embarrassed and ashamed. If she had asked me specifically if I was having panic attacks, difficulty sleeping or overwhelming sadness, I probably would have said yes. 

So for over a year, I struggled in silence. I was a trainee in a clinical Neonatology Fellowship program at one of the top ranked children’s hospitals in the country and only had 6 weeks of maternity leave before returning to work. I was struggling to keep up with being on-call every fourth night, pumping every 3 hours at work, while also finding time to spend with my new baby. 

I considered telling my colleagues, but I’d seen people judge other female doctors for leaving meetings to pump, and I didn’t want them to think I wasn’t committed or worthy of being there. 

Seeking help for maternal mental health

When I finally reached a point where I knew I had to do something—a year later—the only place I knew to turn was employee health, but I wanted to remain anonymous and didn’t want anyone at work finding out. Having just moved to the area, I didn’t have girlfriends to lean on, and when I tried googling new mom groups, I didn’t find any that were easily accessible. 

I looked for a therapist who had experience in maternal mental health, but I quickly realized that the specialty really didn’t exist. These types of providers are few and far between and only a few of them were covered under my insurance. How can women afford to pay more than $100 for every therapy session out-of-pocket? I felt helpless, alone, with nowhere to turn.

After I found the courage to tell a colleague at work, she referred me to a female physician who was a mom herself and had gone through what I was going through. She validated how hard it was to be a working mom and said my baby would be just fine if I wanted to stop pumping. She also told me that it was OK if I wanted to take a break from work to spend more time with my baby. 

She gave me permission to lighten my load. 

When I heard this, I felt a wave of relief come over me, like a weight was taken off my shoulders. She became my peer coach, and she saved me.

So after the birth of my second child, I’d pretty much given up on getting help through my doctors or the healthcare system—which is why I lied on my postpartum depression questionnaire. 

What’s the point if I know that the healthcare system can’t help me? 

Many moms have told me that they are afraid their babies will be taken away by social services if they speak up. One mother shared with me that when she opened up to her doctor about feeling sad and anxious, that doctor made her feel like she was crazy and misdiagnosed her with bipolar disorder.

Related: More than half of new moms aren’t getting the mental health support they need

We shouldn’t have to lie

I certainly do not recommend women lie to their doctors like I did, but I do understand why so many women do it.

New moms deserve to feel nurtured and supported after childbirth, not judged and neglected.

In the aftermath of the Covid pandemic, there is an even greater shortage of mental health providers. We need to fill the gaps in our system to support new mothers now, and we can’t wait for the healthcare system to catch up. 

That’s why, after recovering from my own battle with PPD, I started Mommi, to give birthing people access to all of the resources they need to stay healthy and happy in the postpartum period. Our mission at Mommi is to break down the stigma surrounding maternal mental health and provide equitable access to postpartum services that will improve the health and wellness of mothers and babies around the world.

I truly believe that one way we can start filling that gap is by giving women access to peer coaches, other moms who have gone through similar experiences. My coach saved me, and I know that other women can benefit, too. 

Sources

Byatt N, Levin LL, Ziedonis D, Simas TA, Allison J. Enhancing participation in depression care in outpatient perinatal care settings: a systematic review. Obstetrics & Gynecology. 2015 Nov;126(5):1048. doi:10.1097/aog.0000000000001067

Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstetrics & Gynecology. 2005 Nov 1;106(5 Part 1):1071-83. doi:10.1097/01.aog.0000183597.31630.db

Luca DL, Margiotta C, Staatz C, Garlow E, Christensen A, Zivin K. Financial toll of untreated perinatal mood and anxiety disorders among 2017 births in the United States. American Journal of Public Health. 2020 Jun;110(6):888-96. doi:10.2105/AJPH.2020.305619

McKinney J, Keyser L, Clinton S, Pagliano C. ACOG Committee Opinion No. 736: optimizing postpartum care. Obstetrics & Gynecology. 2018 Sep 1;132(3):784-5. doi:10.1097/01.aog.0000183597.31630.db

But for some mothers, those negative emotions don’t go away. Instead, they linger, fester and evolve into serious mood disorders that transform new motherhood from a challenge into a nightmare. 

Two of these disorders are postpartum depression (PPD) and its lesser-known cousin, postpartum anxiety (PPA). PPD may feel like baby blues at first, but persists long past a week or two. A mama with PPD may feel isolated, overwhelmed and hopeless; she might withdraw from family and friends, or have difficulty making decisions or doing things she once enjoyed. 

Conversely, a mother struggling with PPA may seem like she’s always on red-alert. Her thoughts will race constantly, fixated on panic and disaster, and she’ll live in a constant state of dread. Both PPA and PPD can include physical symptoms, like nausea, fatigue and panic attacks, and both disorders interfere with a mama’s ability to take care of herself or her baby. 

If a friend or family member is struggling with PPD or PPA, it can be difficult to know how to help. If you feel moved to say something to them, be sure to come from a place of love, understanding and support, rather than from fear, confusion or control. Here are some phrases to try—and some to avoid. 

What to say to a mama struggling with PPD or PPA

“I know you’re going through a lot. How can I help?”

What not to say: “Just hang in there!”

If you’ve never experienced a postpartum mood disorder like PPD or PPA, you may not know how to reach out to someone who’s going through it. It’s tempting to throw out a familiar platitude, something well-meaning and positive but ultimately hollow. “Not only can hollow and empty platitudes prevent a struggling mother from feeling heard and seen, but they can actually trigger deeper feelings of guilt and shame,” says Sarah Pool, MA, LPC, NBCC, a counselor who works with parents and women in the postpartum period.

It’s far more meaningful to ask an open-ended question and listen actively to the response. Try not to project what kind of help you would want in this situation, or what you wish the person would say in return. Just listen, then make a plan to help. Most importantly, follow through. 

“Would you be open to talking to a doctor?”

What not to say: “My friend had PPD/PPA and she said yoga/meditation/gratitude lists fixed everything!”

PPD and PPA are both diagnosable health conditions that can be medically treated. It’s important that mamas know this, because it means that they can get professional help.

Rather than throw out anecdotal evidence for miracle cures, encourage your loved one to see a doctor. If they’re open to it, you can even go a step further and offer to help make them an appointment, drive them there, or treat them to lunch afterward. PPD and PPA make it difficult to seek help, so if you’re able to, do what you can to ease the burden.

“Even with the increase in awareness of mental health struggles, a stigma still very much exists around struggles with depression and/or anxiety, and even greater stigma if you are struggling with PPD/PPA,” says Pool.

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“This isn’t your fault.”

What not to say: “If you had made better choices during your pregnancy, you wouldn’t be dealing with this.”

Any new mama can experience PPD or PPA. It can develop after the birth of any child, not just the first. There are certain factors that can raise the risk of these disorders, such as a history of mental illness, recent stressful experiences, or relationship difficulties.

“There is a growing body of evidence to support that isolation and loneliness are major risk factors for women suffering from anxiety and depression, but specifically those struggling with PPD and PPA,” adds Pool.

If someone has PPD or PPA, they in no way caused it or brought it upon themselves. If your loved one is feeling guilty, telling them it isn’t their fault reminds them that they did nothing wrong.

“I’m here for you. You’re important to me.”

What not to say: “I promise that everything will be OK.”

Unfortunately, it’s impossible to guarantee that your mama friend’s struggles will end when we say so. “We often think the best way to help a struggling friend is to try and fix their problems or band-aid their wounds, but in reality just listening and holding the space for their pain can be more helpful and powerful than anything you could ever say,” says Pool.

Promising that everything will turn out for the best may make them feel invalidated or frustrated. Instead, the best thing you can do is remind them of their inherent worth and of your presence in their life. Taking care of a new baby can feel lonely; PPD and PPA make that isolation even worse. Make sure your friend knows you’re in her corner. 

“I’ll check in with you again tomorrow morning.”

What not to say: “Fine. I’ll leave you alone.”

Everyone has bad days. Someone suffering from PPD or PPA may be having quite a few of them. If you reach out to your loved one and they lash out, give you the cold shoulder, or otherwise react negatively, it can be tempting to stop trying. However, just because they hurt your feelings doesn’t mean they don’t still deserve help, love and support. Let them know you’ll reach out again later, and at a specific time. It gives both of you time to cool off and lets them know that you’re not giving up on them. 

A note from Motherly

In the early weeks and months, new mothers need lots of support both physically and emotionally, notes Pool. “It’s critical that we try not to fall into problem-solving or cheerleading mode. Often in our attempts to make things better or brighter, we might invalidate their feelings, which can actually trigger more feelings of guilt and shame. New moms who are struggling need an advocate—and people who can show up to help without having to ask.” 

Lastly, regardless of the severity, it is always best to encourage a suffering mother to seek support and assistance from a medical professional, Pool suggests.

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The baby blues, a euphemism for mild feelings of sadness, fall on one end of the spectrum, while postpartum depression (PPD) and postpartum anxiety (PPA) land on the opposite side. But what if the way you feel lands somewhere in the middle of the two? It could be postpartum stress syndrome.

Postpartum stress syndrome encompasses a whole group of new mamas who may be forgotten by the other diagnoses but still struggle beyond what’s typically expected.

So what exactly is postpartum stress syndrome and how is it different from other postpartum mood changes? We examine the details here.

What is postpartum stress syndrome?

Postpartum stress syndrome is a type of adjustment disorder where an external, stressful event (hello, pregnancy and childbirth) triggers feelings of unrelenting stress that are much more intense than expected. With postpartum stress syndrome you have a profound need to be the perfect mother but feel you are failing at the job.

Mothers with postpartum stress syndrome are crippled with anxiety, disappointment and major self-doubt that translates to intolerable stress.

The postpartum experience is a whirlwind of love and exhaustion. Most new mamas can attest that it doesn’t matter how many parenting books you read, there’s no way to truly grasp how profoundly life changes after having a baby. You may have a vision of what life will look like as a new mother, but the leaking breasts, barely showered, what did I do all day reality doesn’t always match up.

When Karen Kleiman, founder of The Postpartum Stress Center wrote the book This Isn’t What I Expected in 1994, she and her co-author Dr. Valerie Davis discovered just how many women were struggling. “In our clinical practices, mothers were describing experiences of loss, grief, intense anxiety, pervasive worry, along with strong feelings of doubt, lack of confidence and guilt,” Kleiman shares with Motherly.

While it’s true that a new baby can lead anyone to second-guess themselves, for mothers with postpartum stress syndrome, that feeling never goes away. (We have a lot more about what to expect and prepare for in our book, The Motherly Guide to Becoming Mama.)

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How does postpartum stress syndrome differ from PPD and PPA?

Differentiating between PPD, PPA, and postpartum stress syndrome can feel confusing because they share some common characteristics, but there are also key differences.

• PPD is a major depressive episode that can occur up to one year after having your baby. Red flags include excessive crying, feeling disconnected or detached from your baby and a lack of interest in things that used to bring you joy. It’s different from baby blues in that it’s debilitating and doesn’t go away after the first few weeks.
• PPA isn’t as well known as PPD, but thankfully awareness is growing. It often crops up alongside PPD. Signs include non-stop worrying and feelings of dread, racing thoughts, sleep issues and even physical manifestations like nausea or heart palpitations.

Postpartum stress syndrome shares some of the symptoms from both, like trouble sleeping and constant worry. But while PPA and PPD interfere with everyday life, women with postpartum stress syndrome can function and go through the motions. But on the inside, they are deeply suffering.

Kleiman estimates that the number of women with postpartum stress syndrome is higher than we know, mainly because many mothers struggle in silence, unsure if what they are experiencing is just a normal part of becoming a mother.

How to tell if you have postpartum stress syndrome, PPD or PPA

If you are concerned about how you feel, the number one recommendation is to reach out for extra support and get proper care.

According to Kleiman, “Well-trained providers can help determine whether the distress is a symptom of an anxiety or depressive disorder, or whether [it] falls within the parameters of an adjustment disorder, such as postpartum stress syndrome.”

Even with all the joy in becoming a parent, it’s not easy. It’s totally normal to have hard days with tears. But Kleiman suggests taking a look at the frequency, intensity and duration of your challenging days. “In other words, how much distress is it causing you? How much is it impairing your ability to function the way you usually function?” she asks. If it feels unrelenting, it’s time to ask for help.

Tips for managing postpartum stress syndrome

Here’s the good news: If you struggle with postpartum stress syndrome, professional support can make a huge difference and give you the tools to feel better.

Additionally, there are things you can do on your own that may help:

• Hold boundaries. Don’t be afraid to say no to others and protect your space. It’s OK to tell someone you aren’t up for a visit. Setting boundaries is a form of self-care.

• Accept help. At the same time, allow people to help you. Find those friends or family members that you trust and let them take care of you, whether it’s cooking, cleaning or just holding your baby while you shower. 

• Put your needs first. “Let your own needs take precedence,” Kleiman suggests. It’s the same old story about the oxygen mask on the plane; if you don’t put yours on first, you can’t help others. 

Maybe most important—for postpartum stress and all the phases of parenthood—accept where you are with the knowledge that everything passes. It’s OK to feel all the feels. “Remind yourself that this is a stressful time when you will be vulnerable and susceptible to emotional upheaval,” Kleiman advises new mamas. “That’s perfectly OK.”

Sources:

O’Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol. 2013;9:379-407. doi:10.1146/annurev-clinpsy-050212-185612

Pawluski JL, Lonstein JS, Fleming AS. The neurobiology of postpartum anxiety and depression. Trends Neurosci. 2017;40(2):106-120. doi:10.1016/j.tins.2016.11.009

Seyfried LS, Marcus SM. Postpartum mood disorders. Int Rev Psychiatry. 2003;15(3):231-242. doi:10.1080/0954026031000136857

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But annoying as night sweats may be, your body is doing exactly what it needs to do to keep you healthy postpartum. Your body takes on 50% more blood and body fluids during pregnancy to support your baby’s growth. This fluid is no longer needed after you give birth. According to the Mayo Clinic, postpartum sweating is your body’s way of flushing out all the excess fluids that helped keep you and your baby healthy during your pregnancy.

Related: Fatigue, hot flashes, insomnia—could it be perimenopause, or is it your thyroid?

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What causes night sweats?

While pregnant, your body produces large amounts of two key hormones—progesterone and estrogen. After you have your baby, hormone levels change dramatically as your body adjusts to not being pregnant anymore. These changes can increase your body temperature at night, and like menopausal hot flashes, make you sweat. “During pregnancy, levels of estrogen and progesterone rise. After birth, these levels fall. Low estrogen levels mimic what happens in menopause, and some patients experience mood swings, vaginal dryness, along with night sweats.” explains Dr. Dara Matseone-Peterssen, MD, MPH, chief of general obstetrics and gynecology at New York-Presbyterian Allen Hospital, in Yahoo.

This happens even more if you are breastfeeding, because rising levels of prolactin—a hormone necessary for breastfeeding—also act to keep estrogen levels low. “The reason breastfeeding moms get night sweats is because exclusive breastfeeding affects your hormones, suppressing ovulation and your period. It’s kind of like menopause, which is why women have similar symptoms,” Dr. Heather Beall, MD., an obstetrician and gynecologist at Northwestern Medicine McHenry Hospital, says to Yahoo.

Related: Here’s how to tell if you’re in perimenopause

How long do postpartum night sweats last? 

It usually takes about two weeks after you have your baby for your hormone levels to reset to their pre-pregnancy levels. Night sweats should gradually decline after this time, and typically last no longer than 6 weeks, although some symptoms may continue longer. In a year-long longitudinal study conducted in Japan, 29% of postpartum women complained of excessive sweating at night, and the proportion of women with hot flashes peaked at 2 weeks postpartum. 

Managing postpartum night sweats

When you are adjusting to taking care of life outside your womb, and your body is recovering from birth and rebalancing its hormones, instinctively you might find yourself drawn to natural methods to find your personal remedy for relief, especially if you are breastfeeding. Good thing Mother Nature has many options you can rely on to help.

1. Stay cool

• Open your windows to boost airflow
• Place a fan beside your bed
• Turn on the air conditioning in your bedroom
• Use lightweight sheets and layered bed covers
• Sleep on a towel that can be easily swapped out
• Cool yourself by putting a cold damp washcloth on your neck, armpits and groin

2. Drink some water

As fluids or “water weight” leaves your body as sweat or urine, you still will need to drink lots of water to stay hydrated. Drinking water before you’re thirsty will prevent dehydration and help your body recover after pregnancy, returning to normal body functions. “Stick with water, especially if you’re nursing, to replace the fluids you sweat off,” says Dr. Matseoane-Peterssen. 

Related: The 5 doctor appointments to make for yourself each year

3. Eat some soy

Since postpartum hormonal shifts can mimic menopause, options for relief of menopausal hot flashes can often be effective for postpartum night sweats. In a small pilot study in India, 50 peri- and postmenopausal women were prescribed 100 mg soy isoflavones for 12 weeks. The researchers found that taking isoflavone soy supplements could significantly relieve frequency and duration of hot flash symptoms. These plant-based estrogens work like estrogen in your body, but less strongly. Be sure to talk to your doctor first before starting any new supplement regimens.

But postpartum mamas don’t necessarily have to rely on supplements. You can easily incorporate soy isoflavones into your diet by eating more soy-based foods. The highest levels of isoflavones are found in unprocessed sources of soy, like edamame, tempeh, miso, soymilk, and tofu.

4. Switch to natural fibers

For so many reasons, the longer you are pregnant, the harder it can be to sleep. And after your baby arrives, night sweats and other causes of discomfort during the night can make it even more difficult for you to get enough sleep. Sleeping in natural fibers—like cotton, linen or silk—can help your body’s heat escape, whereas synthetic fabrics—like polyester or Lycra—can make you sweat more by preventing your body from losing heat. Sleeping in tight jammies can also trap heat. Cotton or linen sheets can also help keep you cool.

5. Maintain a whole-foods diet and avoid triggers

Eating well is always a good prescription for health, but is especially helpful in mitigating these steamy postpartum symptoms. Bonus—you can improve your body’s ability to recover after pregnancy, improving both physical and mental health by increasing your intake of vegetables, fruit, whole grains, lean protein and healthy fats along with moderate exercise. 

Some mamas’ symptoms can be triggered or worsened by certain foods or drinks. Spicy foods, caffeine, alcohol, hot foods or liquids, can cause your body temperature to spike, which can cause sweating, so are best avoided. 

6. Try natural remedies

In general, pharmacological interventions are seldom used in postpartum women, especially when breastfeeding. According to a 2014 review study, relaxation training (where you focus on relaxing the muscles of each body part in turn, from your toes to your head), paced breathing and hypnosis was shown to help with hot flashes, though the authors state more research is needed to confirm the relationship. 

Additionally, the North American Menopause Society’s evidence-based position on non-hormonal management of hot flashes states that cognitive-behavioral therapy has been shown to be effective in reducing hotflashes. 

Other non-pharmacological options include introducing into your diet:

• Beets/beet juice
• Dong quai (a Chinese herb used to balance hormone excesses and deficits)
• Acupuncture
• Vitamin E

Be sure to avoid the medicinal herbs valerian root and black cohosh if you are breastfeeding, even though these also have been associated with relief of night sweats.

When to see a doctor

If low estrogen after delivery is causing your postpartum night sweats to last longer than a few weeks, making you extra irritable and sleepy (and generally affecting your quality of life), or if your night sweats come with chills and a fever, contact your healthcare provider to rule out an infection or other conditions, like hyperthyroidism and diabetes. 

Occasionally, medication you take can also cause night sweats, so your doctor might want to check your blood sugar levels and your thyroid hormone levels and make adjustments. Lastly, always talk to your doctor before making dietary changes or introducing supplements, especially while breastfeeding.

Sources:

Ahsan M, Mallick AK. The Effect of Soy Isoflavones on the Menopause Rating Scale Scoring in Perimenopausal and Postmenopausal Women: A Pilot Study. J Clin Diagn Res. 2017;11(9):FC13-FC16. doi:10.7860/JCDR/2017/26034.10654

Hytten F. Blood volume changes in normal pregnancy. Clin Haematol. 1985 Oct;14(3):601-12. PMID: 4075604.

McKinney, Jessica, et al. ACOG Committee Opinion No. 736: optimizing postpartum care. Obstetrics & Gynecology 132.3 (2018): 784-785.

Nowakowski S, Meers J, Heimbach E. Sleep and Women’s Health. Sleep Med Res. 2013;4(1):1-22. doi:10.17241/smr.2013.4.1.1

Pal, Rashmi S., Yogendra Pal, and Pranay Wal. A review on post pregnancy healer herbs. Current Women’s Health Reviews 15.2 (2019): 102-108.

Sideras K, Loprinzi CL. Nonhormonal management of hot flashes for women on risk reduction therapy. J Natl Compr Canc Netw. 2010;8(10):1171-1179. doi:10.6004/jnccn.2010.0086

Smith I, Saed K, St-Onge MP. Sleep and food intake. Sleep and Health. Academic Press, 2019. 243-255. doi.org/10.1016/B978-0-12-815373-4.00019-8.

Thurston RC, Luther JF, Wisniewski SR, Eng H, Wisner KL. Prospective evaluation of nighttime hot flashes during pregnancy and postpartum. Fertil Steril. 2013;100(6):1667-1672. doi:10.1016/j.fertnstert.2013.08.020

A version of this story was originally published on Dec. 17, 2021. It has been updated.

When you’re in the thick of new mom life, it can feel hectic, unmanageable and overwhelming. It’s hard to see the path you’re on, let alone trust that you’re actually moving forward.

But you are: Each day you’re getting closer to feeling confident in your mom skills. Each day you and your baby are growing together. It’s not linear growth. Sometimes it’s two steps forward and one step back, but hey, that’s still progress.

Learning to let go a bit and trust yourself is key. Trust that you are enough for your baby. Trust that you will feel like yourself again. Trust that you will make it through. Trust that you are a good mother. Trust that boosting your mental health will have trickle-down effects in every aspect of your life. It’s time to make your mental health a priority, mama.

10 mental health tips for new moms

1. Ditch social media for real life

Those early days (and nights) of endless feedings, rocking and pacing the halls trying to soothe your newborn set the perfect stage for losing yourself in social media. Before you know it, baby is asleep in your arms and you’re still scrolling. While social media absolutely fills an important need for new moms—providing community and support no matter the time or location—it can also have a negative impact.

Over-reliance on social media can make it seem as if there isn’t a need for in-person support as well. And while the convenience of online communities can make it easier to reach out for help at times, there is tremendous value in face-to-face social interaction.

Related: Quitting social media made me a better parent

Particularly for new moms, having another adult you can spend time with in person can go a long way toward decreasing the sense of isolation that often comes along with this period in life. Whether it’s having a friend over for a playdate, or your mom tagging along while you run errands, few things are as good for the mental health of new moms as face-to-face time in the presence of supportive others.

In addition to the risk of decreasing real-life social interaction, social media overloading can also expose moms to harsh, judgmental behavior that can be quite damaging. The anonymity of social media can cause people to say things they would never say to another mom in real life. Responses to a post about ideas for how to help your newborn sleep are often filled with criticisms of the way the poster is raising their child. This is never helpful, but it is particularly damaging for new moms who have not yet developed much confidence in their mothering.

Related: Social media is redefining the new motherhood—but is that a good thing?

2. Change up your to-do list

To-do lists can be a mom’s best friend. With so many things to get done and so much swirling around in your head, combined with a nice dose of sleep-deprivation, it would be easy to forget tasks otherwise. But a traditional to-do list is not always the best fit.

Generally, these lists have tasks assigned to particular days. Tuesday is the grocery store, post office and laundry. Wednesday is an oil change and vacuuming.

The problem is that life for a new mom is not predictable enough to determine ahead of time how much can reasonably get accomplished in a day. A rough night or particularly clingy baby can quickly turn a to-do list into a reminder of how much didn’t get done that day. This can cause unnecessary stress, feelings of inadequacy and frustration.

Related: How to be a good mom: How to ditch perfectionism & embrace being ‘good enough’

So what to do instead? Change your conceptualization of the to-do list. Instead of it being one list that contains all of your must-do tasks, break it into two lists:

• One list contains your daily required tasks. Things that absolutely must get done on a specific day—picking someone up from the airport, taking the dog to a vet appointment—go there.
• The other list is a running, prioritized list of other things that need to get done, but have some flexibility on when exactly they happen.

On any given day, you will now know what must happen, and then you can make a decision about what to pluck from the second list based on how your day is going.

Some days you may not be able to take anything off that second list, and that’s totally fine. Other days you may get more done than you could possibly have imagined you’d have time for, and that’s totally fine too.

The main point is your to-do list is now flexible and lines up with the reality of your day, rather than being rigid and causing distress when thing don’t happen as planned. New motherhood is all about learning to roll with it.

Related: 7 things you can do right now if you’re feeling overwhelmed

3. Trust your intuition

Studies have confirmed that intuition is not all in our head; it is a real thing. Intuition is essentially all of the things we know without knowing how we know them. And for moms, it can be a powerful force in our decision-making process.

When we try to fight it or discount it, telling ourselves to ignore those feelings and concerns, not only do we cause undue stress trying to suppress something that is coming up automatically, but we potentially miss out on valuable information.

Now I’m not saying to trust your intuition over advice or information from medical professionals, but I am saying to start valuing your knowledge of your baby and trust your own mommy expertise.

Related: The one piece of parenting advice 51 moms want you to know

4. Forget the snap-back

There are so many pressures new moms face, and bouncing back from pregnancy in a matter of weeks is one of the big ones. Rather than spending the postpartum period focusing on rest, recovery and bonding with our new baby, we are told to start the countdown until we fit back in our pre-pregnancy jeans. And when we find that it doesn’t happen quickly, we are frustrated and disappointed in ourselves. We view it as a lack of discipline or a sign that we’re forever doomed to a “mom bod.”

Here’s the thing: Pregnancy permanently changes you.

So yes, exercise and eat a balanced diet to keep your body healthy and your energy levels up to meet the physical demands of motherhood. But stop wasting time and energy focused on this unrealistic idea that your new self is inferior to your old one. It’s new and different, and that is totally okay.

5. Stop comparing yourself to other moms

Theodore Roosevelt once said, “Comparison is the thief of joy.” Oh goodness, he could not have been more correct when it comes to moms. Any time I am feeling pretty good about my mom skills, a quick scroll through Instagram can bring me right back down.

Her house is way cleaner, she’s doing a better job than me. Her kids get along so well, she’s doing a better job than me. Her hair and makeup are done, she’s doing a better job than me.

While we may logically know that most people carefully choose and filter what they share on social media, we still find ourselves engaged in negative comparisons that can result in anxiety, depression, and lots of self-criticism.

Although this happens most frequently on social media, we can easily fall into the comparison trap in real life as well. Other moms at the park that seem to be managing their children better or women who look more put together at Target can all start that comparison cycle going in our heads.

When you notice this happening, I suggest taking a deep breath and telling yourself that you don’t know the full story based solely on outward appearances. Things are always more nuanced than they seem. And remember: YOU are the mom your children need. Perceived flaws and all.

Related: Ditching social media comparison saved my motherhood

6. Stop comparing your baby to other babies

Just like every mom is different and excels in different parts of motherhood, every baby is totally unique. Yes, your friend’s baby may be sleeping through the night already, but yours is doing way better with solids.

Or yes, your cousin’s 8-month-old is walking but has yet to take an independent nap. Keeping this all in perspective is key. Kids develop at their own rate and in the time that is right for them. But that’s hard to remember when you feel like your baby isn’t doing what she is “supposed” to be doing.

One of the biggest sources of this anxiety is developmental milestones. Remember that these milestones are broad and no two children will follow the same timeline. They will get there in their own way, and all you can do is support them as they develop.

So rather than comparing your baby to another baby, compare him to himself. Is he learning new things as time goes on? Then he’s doing great, and so are you!

Related: Why your parenting can’t be measured by when your baby hits their milestones

7. Appreciate your body (and all it’s been through)

Let’s take a moment to think about all that your body has just been through. Depending on the specifics of your situation, things that your body may have endured include: Fertility medications and treatment, morning sickness, growing a new organ (yes, the placenta is an actual organ that your body is able to manufacture on demand), growing a human being, managing excruciating pain without medication, spinal injections, major abdominal surgery and providing all sustenance for a rapidly growing baby.

That’s a lot. And it’s reasonable to expect it to look a little—or a lot—different than before.

While it’s easy to spot the flaws you see in your current body, focusing on them will serve only to increase your dissatisfaction with your body. Instead, try focusing on gratitude. We know that a gratitude practice has tremendous mental health benefits, and making sure to include some body-centric gratitude can go a long way towards making peace with the body you’re in.

This doesn’t mean you can’t have weight loss or fitness goals, it just means that they are well-balanced with an appreciation for what you currently have going. Like strong arms to carry your body. A voice that allows you to express yourself. Eyes that let you take in the beauty of your child. Focus on these things with regularity, and you will notice a shift in your body-related stress and anxiety over time.

Related: 6 easy ways to practice gratitude, mama

8. Leave time in your schedule for “nothing”

Adjusting to life with a new baby is hard in so many respects. One particularly difficult aspect is learning to temper your expectations of yourself and redefine what productivity looks like on a daily basis.

Once you’ve healed from delivery, it can feel like you’re ready to get up and out and going again. You crave interaction with adults and a return to some sense of normalcy and routine. This is a totally normal and understandable desire, but unfortunately, the reality of caring for a newborn is that normalcy and routine are somewhat out the window for a while. If you were used to being on the go and running at full speed at all times, this can be quite the shock.

Related: Mama, your to-do list can wait

Over-scheduling and expecting that you’ll get too many things done in a day is a setup for disappointment, frustration and distress. Instead, it’s a good idea to start exploring what productivity looks like for you now in this phase of life.

Perhaps it’s making progress on getting baby down for an independent nap. Or getting a load of laundry washed, dried and put away in the same day. Or figuring out how to get everything together and loaded into the car on your own. Or making a homemade meal once a week. These things may have seemed trivial a year ago, but right now they’re big accomplishments that should be honored as such.

Unrealistic expectations will not motivate you to accomplish more. In fact, the resulting unhappiness may actually decrease your motivation and lead to even less being accomplished. Not to mention the emotional toll it takes when we fail to live up to our goals. Right now you cannot change the intensity with which your baby needs you and your time. But you can certainly adapt your expectations to fit your reality.

Related: Happiness can be contagious—the scientific benefits of happy mothers on their families

9. Try talk therapy

With the convenience of e-therapy apps (try BetterHelp or TalkSpace), new moms don’t have to try and figure out childcare just to talk to a mental health expert. Text-based or video chats with a licensed therapist can serve as a helpful outlet for you to talk about what you’re going through right now—and can be squeezed into a nap time.

While having a set therapy appointment might feel like just another thing on your to-do list, making time to focus on your mental health in this manner can help you gain perspective and get needed support as you navigate your new role as mama.

Related: How to find the best therapist for you (and what to expect)

10. Remember, this season doesn’t last forever

I spent a long time trying not to get caught up in the “Can we really have it all?” debate. I felt torn and unsure of the answer. But then I heard the answer that made the most sense to me: Yes you can have it all, but not all at the same time.

Different times of life require that certain aspects of ourselves come to the front and others have to step back a bit. So right now, mothering has moved to the top of the list, which means other things are going to get bumped. You may have to scale back the amount of time you have for socializing or pursuing hobbies or work hours. Now, of course, this will look different for everyone depending on your needs, preferences and resources.

The important part here is to remember that this is just one season in your life. Things will change. You will have more time for yourself again soon. Your baby will get on a schedule, and you’ll be able to plan around naps and bedtime. You and your partner will have date nights again.

While you’re in this new phase, try to appreciate it. There will come times you’ll long for days spent at home with your baby and miss the unscheduled time. Those other parts of you will have their moments again soon. For now, enjoy being mom first.

A version of this post was originally published on August 6, 2018. It has been updated.

But once your baby arrives, there’s often no comprehensive plan in place. Can your in-laws come to stay? Will your partner handle any night feedings? Is there someone who can bring over a hot meal? You’re forever changed after crossing the threshold from woman to mother, you just went through an incredibly challenging physical event equivalent to running a marathon—and now you have a tiny, mewling infant to care for, too. Everything is different.

Why, when we create birth plans, don’t we also create postpartum plans?

Doctors and midwives routinely ask for a birth plan to review in advance of your labor and delivery. And though births rarely go to plan, it’s still helpful to have your birth preferences laid out and communicated to your providers so they can honor your wishes as closely as possible.

Making a birth plan can also help new parents start to process and grasp the scope of the shift that’s about to happen. The act of making decisions for an entirely new human—and of talking through those decisions as a new family, together—can help things feel more real.

It’s the same for a postpartum plan.

“A postpartum plan is also a beautiful way for couples or families to grow closer through open communication about the fears, questions and joys related to the new logistics of having a newborn,” says Esther Lavi, OTR/L, infant sleep coach and CEO/Founder of Dream Big Baby, doula, and parent wellness specialist at Wevillage. “This mitigates surprises around your partner’s and family’s preferences and values when the baby is born, and will help soften or even bypass the stress of conflicting needs and opinions.”

The fourth trimester is a sacred time

The postpartum period, also known as the fourth trimester, is marked by significant shifts: of the body, of the mind, of the self and of the family. After birth, you’re experiencing major hormonal changes, healing from delivery and immediately responsible for the care and feeding of an entirely new human. Add in chronic sleep deprivation and increased nutrient needs, and you have a recipe for imbalance.

Postpartum women are more susceptible to anemia, anxiety, fatigue, osteopenia and depression.

To prevent not only the physical depletion common in this phase, but the emotional and mental depletion too, many cultures treat the first 40 days after birth as a sacred time designated exclusively for rest and healing. Confinement, mother roasting, sitting the month and lying in are commonplace and celebrated across the world. Just not in the U.S.

Heng Ou, founder of Mother Bees and author of the book “The First 40 Days: The Essential Art of Nourishing the New Mother,” shared on the Motherly podcast that the mentality behind the Chinese practice of zuo yuezi (translated as sitting the moon cycle) “is really about reserving [or] preserving all that has opened. The womb has opened, the cells, the hair, all the pores have opened, especially after such a dramatic experience. So it’s perceived as a very, very pivotal time of a woman’s life. They say, if [the mother’s body] is not sort of contained at that time, it could be the catalyst for many other health issues down the line.”

In contrast, here in the U.S., you’re sent home from the hospital with your newborn, and left to your own devices without medical support until a full six weeks later.

“While the 6-week visit is necessary and a potentially positive experience, on its own it barely scratches the surface in terms of satisfying the physical, spiritual, emotional, and mental needs of a mother after she has given birth,” says Lavi. “A mother in the postpartum period is experiencing her own personal rebirth. We should support her as much as we support her baby.”

A postpartum plan, therefore, should outline the nutrition, support and self-care needs of the mother during the first 40 days of postpartum—at least. Coming up with a plan for this time is an investment in slowing down, resting and healing after birth. It’s about recognizing that the new mother can’t do everything by herself, and shouldn’t have to. Studies have shown that getting additional social support during this time—asking for and receiving help—can prevent postpartum depression.

Start making a postpartum plan in your third trimester

Just like a birth plan, you’ll want to create your postpartum plan before your baby is born, ideally sometime in your third trimester. That’s for a couple different reasons: for one, you have the time now, before your world becomes a whirlwind of feeding sessions, naps and diaper changes.

Two, you can communicate your preferences ahead of time with your medical providers (talking to your midwife about their postpartum services, or asking your OB for recommendations on a postpartum doula, for example), or have conversations with family members about your preferred visiting protocols (ensuring everyone has current vaccinations against Tdap, flu and Covid, let’s say).

Taking these steps now can better set you up for a smoother adjustment to the fourth trimester down the road. Otherwise, decisions like these have a way of getting made for you—or resulting in potentially uncomfortable conversations you’d rather avoid.

“A postpartum plan ensures a sense of preparedness,” Lavi notes. “Even if [and when] things don’t go exactly as planned, the act of creating actionable postpartum steps becomes soothing and empowering for families expecting a newborn.”

Of course, it’s impossible to know how you’ll actually feel about your plan once your little one is earthside, but talking about the postpartum period with other parents now can be helpful in terms of grasping what’s to come. Plenty of new mamas will be eager to share what worked—and what didn’t—during this time of transition.

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How to make a postpartum plan

Just like with a birth plan, all you need is a general outline—there’s no need for a formal proposal or anything long-winded. Consider the following ideas just a starting point. Your postpartum plan should be customized to your home and family situation, and can be a living document you update when necessary.

1. Planning for parental leave

If you’re partnered, will you and your partner take time off together or alternate care responsibilities? Because parental leave may vary from company to company, there’s no universal standard here, and some workplaces may be more flexible than others. Talk through your options with your partner and outline a tentative schedule for taking time off work.

2. Planning for rest and healing

In Traditional Chinese Medicine, birth signifies an energetic shift from yang (full, warm) during pregnancy to yin (empty, cool) in postpartum.

After your digestive organs have been compressed and compacted for so many months, your digestion and metabolism are slow and weak.

To support this shift, we can prioritize new mother care through plenty of warming food and rest. Stock up warming bone broths, congee and plenty of soups, as well as grounding, high-fiber foods like oatmeal and lentils to help prevent constipation, and make a note to yourself about drinking room-temperature water or hot herbal teas—avoid iced drinks. Talk to your care provider in advance about adding in supplemental iron and vitamin C after birth to promote tissue healing.

Related: Secrets to better postpartum care from mothers across the globe

3. Planning for visitors

Gathering your village now can ensure you’ll have plenty of helping hands when the time comes. Identify one or two people who can come and stay with you in the early weeks to assist with the baby and housework while you heal.

For everyone else, create a visiting policy for any other guests who may want to stop by and meet your new babe. “Here is where a postpartum plan makes a great entrance. If birthing couples get clear within the partnership and with their friends and family regarding what the expectations and preferences are, they get to bypass visitation pressure of any kind,” Lavi shares.

Get specific too about the details. Will you require certain vaccinations? Masks? Handwashing? Outdoor visits only? No visits until after baby’s 2-month appointment, when they’ll get their first inoculations? Think through these options now.

4. Planning for breastfeeding or bottle-feeding support

It can be helpful to start considering whether you’ll breastfeed your infant, do a combination of breast milk and formula, exclusively pump or exclusively formula feed. If you’re planning to breastfeed, stock up on your prenatal vitamins, lactation teas and nutrient-dense snacks (breastfeeding requires more calories per day than in the third trimester!). Order a breast pump and a Haakaa.

If you’re planning to use formula, start researching brands now and asking other parents for their input. Now’s also a good time to chat with your partner about divvying up feeding and diaper duty—outlining responsibilities now can avoid frustration down the road.

Related: How to choose an organic baby formula

5. Planning for home support

From meal preparation to laundry to house cleaning to pet care, don’t expect to be able to handle all your home-based duties by yourself. Sure, you are probably in the midst of a serious nesting phase right about now, but once baby is here, something as simple as walking the dog suddenly takes three times as long. Think about whether you might need cleaning, cooking or dog walking help for at least the first 40 days and try to arrange that support ahead of time.

Most importantly, give yourself permission to accept help—even imperfect help. Your mother loaded the dishwasher wrong? Resist the urge to reorganize it. Your father-in-law forgot to put sunscreen on your toddler at their play date? Try not to criticize.

6. Planning for new rituals

Though every former ritual takes on new meaning with a newborn (hello, showering), you’ll likely need to start a few fresh ones as well—for baby and for you.

Skin-to-skin contact and babywearing carry big benefits for baby but do require some prior organization, like learning how to use a soft wrap or structured carrier, and making sure you have a private, warm space where you can spend a good amount of time topless to cement in that precious skin-to-skin time.

For mama, you may need new rituals around rest. “This sounds a bit silly, but the most proactive way to plan for rest is to become fully aware of its importance,” says Lavi. I find that as a practitioner when I aggressively educate around how invaluable rest is for postpartum health, parents tend to honor good rest and sleep hygiene practices. The most important thing to remember is that wakeful ‘rest’ (sitting, lying down, practicing intentional breathing, or meditation) is just as valuable as actually sleeping during the first postpartum weeks. This goes far beyond the old ‘sleep when your baby sleeps’ adage.”

7. Planning for mental health support

Consider whether hiring a postpartum doula or booking a home visit with a midwife might make your postpartum transition easier.

“It’s really about you not being the victim, saying, “Hey, you know what, this is what I deserve. This is what I want to feel. I don’t know what it’s going to be like, but whatever it’s going to be, I want to feel supported,” Ou shares.

If you have an existing relationship with a therapist, booking a session for a week or two after birth to talk through your experience can be a welcome respite—a safe space and set time to discuss what’s going on.

Related: 4 online therapy options that are ideal for busy moms

8. Planning for returning to work

It’s impossible to know how you’ll feel about work after new motherhood, but starting to think about a potential return to work—or not—might make your path easier later. This might mean ramping up slowly, starting back just part-time, or shifting your hours around so you can be there for bedtime. Know also that prioritizing your health before a return to work is vital.

“Many parents cannot afford to stay at home with their babies,” notes Lavi. “What they can do however is take every action humanly possible to optimize their health and wellbeing… Parents of newborns will be sleep deprived. Nourishing the body with healthy foods, and using good sleep hygiene techniques such as avoiding staring at blue light (anything with a screen) will ensure that parents will be as healthy, rested and balanced as possible if going back to work is an unavoidable necessity.”

Making a postpartum plan is about self-advocacy

Carving out time now to make a postpartum plan is ultimately an important investment in your own future health—especially as everyone else’s attention naturally shifts to the infant. Recognizing your role in this transitional phase between pregnancy and parenthood is powerful, and means you’ll be an advocate for your own feelings and needs here as you ramp up into your new role as mother.

You’re rejecting the societal expectation that you’ll keep up with everything you were doing before, only now with an infant in your arms. “I think that’s a problem of our society. Why are we going so fast?” Ou says. “There’s a lot of power, you know, in slowing down… slowing everything down and paying more attention.”

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Heng Ou

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Sources:

Linyan Li. Social Factors of Postpartum Depression Among Chinese Women. 2021- 4(4) OAJBS.ID.000311.

A version of this article was published February 25, 2022. It has been updated.