The Universal Needs of the Postpartum Mother

And the Great Struggle to Meet Those Needs

How many times have you heard the phrase, “It takes a village to raise a child?” 

I’ve probably heard it thousands of times. Each time I feel a little more rage. Not because I don't think it takes a village, but because we are so far from the village and getting farther. Our nuclear families are getting more and more isolated. We used to meet at the bus stop. Today, we have a pick-up line where we don’t leave the car. Neighborhoods full of kids used to travel from house to house in packs. Today,  organized clubs and team sports fill their time.  I have significant economic privilege, an involved and supportive husband, and involved and supportive grandparents for my children, but the loneliest I ever felt in my life was while on maternity leave after the birth of my first daughter. 

I’m often left wondering, “Where the f*&% is the village?” I hold two things to be true at the same time: 

1. I have it way better than most.

2. The way a society prioritizes the well-being of its new mothers and new children is a strong reflection of whether it prioritizes thriving life. In this regard, our society is sorely lacking. 

In Kimberly Ann Johnson’s book, The Fourth Trimester, she explains that postpartum women across all traditional and intact cultures have five universal needs during early postpartum:

• An extended rest period

• Nourishing food

• Loving touch

• The presence of wise women

• Contact with nature

How many of these did you or the mothers that you know get? 

A quarter of American women return to work within two weeks of giving birth, so they definitely aren’t getting an extended rest period. Even for women with 12 weeks of maternity leave, rest is often compromised by the need to host visitors rather than receive help from them, the need to prepare food for oneself (nourishing or otherwise), and the pressure to return to “normal,”whether that’s related to chores, sexual activity, or their “pre-baby bod.” When I asked friends about their experience, one said, “There was so much pressure to leave my house or have guests constantly. All I wanted to do was be a complete hermit.” This pull of the body’s needs versus societal pressure is constant. Many women have no help around the house while on maternity leave after their partners return to work after a week or two (or less), so they are responsible for healing their body, being the sole source of nourishment for a newborn, keeping their other children safe, loved, and feeling “normal”, keeping the house clean, waking with baby at night, etc. Another friend shared, “Due to [my partner going back to work the next day after birth], all household and childcare tasks were on me. As a breastfeeding/pumping mom, the majority of infant care was also on me. No one told me that I should do all the things, but I felt that I should be able to and that I needed to…The expectation at work [when you return] is that you are back to your prior level of productivity, which was impossible while pumping.”  I’ve come to realize that in spite of intense societal, external, and internal pressure to return to normal, that particularly after the birth of your first child, there is no normal to return to. A third friend told me, “I felt the pressure of, ‘when can we grab dinner, when we go out again, when can you leave her with a sitter, when can you pump and bottle feed, when can...’ As a first time mother I had no idea, I was learning/growing with a brand new person, and trying to make the best decisions.” Similarly, our culture’s dysfunctional association between productivity and a person’s worth leads to habits that are destructive to maternal and infant health and infant attachment to their primary caregivers.

Traditionally, women had a month to six weeks of support from female family members who took care of everything except for feeding the baby, leaving the mother plenty of time to rest and connect with her baby. In fact, in the ayurvedic tradition, the conventional wisdom is 42 days for 42 years, meaning that tending to the health of a mother at this critical time would significantly impact her health for essentially the rest of her life. On the other hand, some doctors diminish the importance of this sacred rest and feel that the risk of blood clots postpartum is so high that women need to get up and walk around regularly as soon as they are able. Family dynamics being what they are, being cooped up in a house with your female family members may not sound relaxing to you, but I think anyone who has given birth can attest to feeling a deep physical need for more rest than they got. In our culture, we view that exhaustion of early parenthood as “totally normal.” Sleep interruptions are unavoidable, true, however feeling like you are the triage resident on call in the ICU every night is not. 

When my second daughter was born, I knew I wanted to have nourishing food prepared. I knew that made me feel physically better and emotionally supported. I cooked some meals ahead of time, and my mom cooked some meals as well. By that time, I had read The First Forty Days, and I had a longing for that nourishment that was based on physiology, hormones, and tradition. Even though this was something I longed for, I was not comfortable asking others for it (aside from my mom, but even with her I didn’t want to ask too much or seem “needy”). Though this is a universal need, I felt uncomfortable “needing” something that other people obviously didn’t—or had been convinced that they didn’t—and I couldn’t bring myself to ask other friends and family for this more intensive support. Nourishing food is vital to the ability to breastfeed and physically heal from birth. The influence that nutrition has on our mental health is under-recognized as well. Foods like beans, greens, fish, and nuts have been shown to increase serotonin, which is the chemical in the brain we are trying to increase by taking the group of anti-depression medications called SSRIs. These also happen to be the most common antidepressants prescribed for postpartum depression. 

So what foods are most nourishing during postpartum?

• Anything that’s warm and easily-digestible

• Nutrient-dense, tonifying foods, especially those that are rich in iron and high in protein

• Cooked vegetables

• Water, ideally via hydrating foods and teas

• Low- sodium foods and drinks

Loving touch was a type of support I never even considered until I read The Fourth Trimester. Byrd, my very sweet doula, felt that because my labor was so short she hadn’t “earned” her fee, so she gave me some bodywork when she came to visit for my postpartum check-in. It was a revelation because again, it wasn’t just physically relaxing, but also felt emotionally supportive too. This is something that it never would have occurred to me to ask for. Having experienced it just once, though, I fully believe that it would be a wise prescription for all women in the weeks and months after giving birth as a potential way to reduce the risk for postpartum depression.

Mothers and children suffer most when we are not part of multi-generational communities. We rely on elders for guidance, wisdom, support, and attention. Postmenopausal women in our culture often feel invisible; like they are overlooked in social situations, the workplace, and the media. Traditionally, the opposite was true. The elder women were really the culture keepers and tending to new life is, of course, one of the most profound ways to impact and preserve a culture. Sometimes there is a difference between people who are simply older than us and those with the hard-earned wisdom of elders and many women in our grandmothers’, mothers’ and our own generations are disconnected from birth practices that are best for our and our children’s well-being. However, even if your elders are not familiar with the latest trends in gentle parenting or the latest AAP recommendations on safe sleeping, having that circle around you prevents that loneliness, provides support, and helps you separate the big stuff from the small stuff when your hormones have you convinced that you, for instance, broke your baby’s nose. 

Original artwork from my 4-year-old daughter. This art represents to me a new (old) way of organizing community. I learned of this from Ian MacKenzie, of the Mythic Masculine podcast, who learned this from indigenous elders (apologies that I do not know the tribe or individual). Children are in the center, surrounded by elders, surrounded by parents, surrounded by warriors. I find I have a lot more to say about this, but perhaps that’s another essay for another time.

My first daughter was born in January. My second was born in April. My mood and stress levels in the two postpartum periods were so incredibly different. There were many factors to explain this, including having five months of maternity leave instead of three, but I think the ability to be outside nearly everyday definitely played a role. Research proves that time in nature decreases cortisol, a key stress hormone. Cortisol levels affect the likelihood of developing postpartum depression, impacts milk letdown in breastfeeding, and may increase cortisol levels in the breast milk that’s passed on to the child, too. From personal experience, I feel like time in nature helps big problems feel smaller,or at least helps me find it easier to separate the things I can’t control from the things that I can. 

I’m not sharing these universal needs to shame individual mothers or families who are not able to craft a perfect postpartum nest from whole cloth with no support. Instead, I hope to call attention to the fact that these are not “nice to have” things that only those with the means should be able to access, and only those with high self-worth will ask for. These are things that we need to build our society around. We can create small pockets of community, but ultimately for our mothers and our children to be healthy—which leads to physically- and emotionally-healthy communities—we have to put these needs at this critical time of life at the top of our to-do list. When we shift from what indigenous elder Pat McCabe calls the “power over paradigm” to the “thriving life paradigm,” we recognize that supporting mothers and babies when they are vulnerable fills them with vitality for years to come. 

I’d love to hear from you:

• What was your postpartum experience like? In what aspects of your life did you feel pressure to return to “normal”?

• Which of these needs was the easiest and most difficult to meet for you or your family? What did you long for the most?

• What are the barriers you see to meeting these needs for moms?

• What are the “trickle down” impacts of meeting or not meeting these needs for moms?

• What emotions does this discussion bring up for you about your birth and postpartum experience or your partner’s or your mother’s? 

Stay tuned next week when we’ll explore the universal needs of the young child. And please do share your experiences as parents or children in the comments.