“Mothering the mother”.
Promoting postnatal care in the light of Ayurvedic medicine.
Being a mother, as well as an Ayurvedic practitioner, I often have the opportunity to meet and talk to women.
From my personal experience as well as from listening to my friends and patients’ stories I have come to realise that the majority of us did not have proper postnatal care.
Modern medicine recognises that it takes six weeks for the mother’s body tissues to recover from childbirth echoing the age old tradition that advised to women to stay at home for 40 days -“the Quarantine”- to rest and recover.
In our contemporary society where time is money and people are so busy, this art of taking care of mothers after delivery seems to have been lost.
If there are no complications women stay in an NHS hospital between 24 and 48 hours, some are even discharged the same day. They then return to the hospital or GP for their six-week check-up.
After the baby is born, it is generally advised to have a healthy diet and rest. The local health visitor comes for few visits but no other support is provided to the mother unless she suffers from a medical condition.
There is not much information provided about this postnatal time and no emphasis is given to its importance in preventing health problems. The advice offered is quite general and doesn’t seem to take account of the great psychophysical stress and dramatic changes that a woman’s body undergoes during labour and after delivery.
It is evident there is a big gap in the maternity services that need to be filled: supporting women and babies at this vital time can have such a positive impact on their future health and well-being. I am concerned that the measures taken by the government are not going to improve the quality of maternity care provided by the NHS.
A survey conducted only last year by the National Childbirth Trust, the UK's largest parenting charity, highlighted that over the past 10 years there have been only limited improvements in postnatal care with an overall decline in quality standards.
The survey found that out of 1,260 first-time mothers 57% said they did not get the emotional support they needed in the 24 hours after a hospital birth and 43% said their emotional needs were not met from 24 hours to a month after the birth. Women who had operative births (forceps, vent use or caesarean) had the greatest gaps in care: only 3 in 10 women who had a caesarean reported to have found kind and understanding midwives and just over half (52%) felt they did not get consistent advice about feeding. The majority of women said there were only sometimes or never enough midwives to help them in hospital and that they felt let down by the care they received after having a baby.
It is quite normal for a new mother to feel down after delivery. What it is called the baby blues is due to the dramatic changing in the mother’s body after her baby is born. It is also common for women to feel physically and mentally exhausted after the stress of the labour and then by the lack of sleep and the excitement and worries of providing for a new life.
It is in this extremely delicate time, which lasts about 40-days that mothers need more help and support.
In many cultures mothers are traditionally looked after by the female family members, but
in our society, and especially in big cities, no many women are lucky to have an extended family around.
The role of a postnatal doula is in general to provide the same loving support and care to mothers enabling them to recover more quickly and my work in particular has been influenced by an extraordinary medical science known as Ayurveda.
This is an ancient natural system of healing that promotes an holistic care by means of natural drugs and body treatments as well as psychological and spiritual counselling. According to Ayurvedic medicine, the choices made the first 42 days after birth influence a woman’s health and ability to be a mother and a partner for the next 42 years.
It is very important that mothers are properly looked after delivery as they need to regain their strength and immunity and be ready and fit to care for their newborn.
Only with a proper postnatal care they can get restore their health as well as prevent the onset of future problems.
Ayurveda recognises that after the enormous psychophysical stress of labour and delivery the mother’s body tissues become depleted.
The amount of pain and fatigue endured has driven her body elements (doshas) out of balance. She has also been left with the enlarged uterus empty and creating a ‘vacuum’ that immediately fills with vata dosha.
Vata is the air principle that governs all movements within the body and it is responsible for the functioning of nervous system as well as of the respiration and elimination of urine, stools, gas, sperm and menstrual blood. It is very active during pregnancy and especially during labour as it is the force that pushes the baby out.
Vata is made of the elements of air and space. From these elements it gets its qualities which are cold, dry and mobile. It is mainly located in the abdominal/pelvic areas which play a key role in childbearing.
When it is balanced we feel active, light, creative, flexible, enthusiastic and strong.
When unbalanced, we experience various symptoms either on a physical or mental level. Pain, cold, dryness, constipation, shakiness, gas, cramps, sleep disturbance and fatigue, feelings of being overwhelmed, fearful, distracted, anxiety, insomnia and depression are some of these.
High Vata due to physical and mental exertion is one of the main culprit of postnatal depression.
It is essential that after delivery this vata gets removed slowly, but completely as we want the uterus to shrink back to its normal size and all organs return to their original positions.
As Ayurvedic treatments follow the simple rule of counteraction, the best ways to balance the mobility, coldness and dryness of vata are to use moisture and oiliness, warmth, heaviness, routine, peace & quiet, and a smooth, flowing lifestyle.
It becomes important that the mother rests as much as possible and has regular massages.
She also needs to eats warm, liquid, unctuous, food which is nutritious but light to digest.
Ideally she should never be left alone and great care must be taken to ensure her needs are met and that she is happy because her happiness makes the baby happy and also improves the quality of her breast milk.
She should rest and spend time only to breast feed and bond with her baby.
I recommend regular Abhyanga (warm oil massage) for several weeks after birth with special attention to the back and abdominal region.
After delivery the mother digestive system becomes very weak and it is very important to follow a specific postnatal diet to regain her digestive power and ensure the quality and quantity of the breast milk.
For at least the first 10 days after delivery I recommend the consumption of warm vegetable and mung beans soups seasoned with spices, avoiding meat, cheese, yogurt, pastry, oily food as they are heavy on the system and beans, potatoes, cabbage, cauliflower, green peas, broccoli as they aggravate vata dosha and can make the baby gassy.
I also advise taking plenty of ghee (clarified butter) to balance vata and to nourish and rejuvenate the body. Also the new mum should avoid cold drinks, ice, juices and frozen foods as vata is cold and dry. Health foods at this time are boiled milk, hot/warm water and vegetables such as tender green beans, carrots, squash, and different types of greens, zucchini and beets along with vata –pacifying spices, like ajwain, ginger, cumin, black pepper, sea salt, turmeric, fenugreek, fennel, saffron, cinnamon, nutmeg and cardamom.
In general food should be organic and prepared in small quantities sufficient for one or two meals, because stale, leftover and frozen food is not nourishing and can cause indigestion.
The main meal should be at lunch-time when the sun is high in the sky and our digestive power is at his peak. It is always advisable to eat with a calm mind as emotion can alter the digestive function and make food toxic.
Many women in our culture feel a pressure to get back to "normal" life as quickly as possible to prove their strength and efficiency.
With this article I wish to awaken their sense of responsibility and promote a return to a proper postnatal care as a health investment for mothers as well as a way to show respect and love to life.
Margherita Tessarin, Ayurvedic doula