Mum’s the word – part two: ‘D-Day’ and the perinatal period

Part one of this series focused on early pregnancy leading up to maternity leave. This article explores the period leading up to labour and the paradigm shift that follows the arrival of a small, fleshy being who will change your life forever.

The third trimester is no walk in the park. In fact, walking in the park can present challenges as the bump expands and compresses internal organs – namely, the need for frequent trips to the loo, shortness of breath and potential complications of cholestasis, constipation, heartburn, symphysis pubis dysfunction (SPD), oedema and back pain.

Working during this time can present real challenges. My lower legs were tree trunks by the end of the day, and I had to consult and operate sitting down, as well as factor in several additional trips to the loo. Frequent small snacks, compression socks, sitting whenever possible and a Gaviscon nightcap help to control the symptoms.

When maternity leave begins for us, as vets, our tendency is often to be task-oriented and productive. But while you can, take the time to rest, nest and catch up with friends and family. Cook lots of tasty, healthy meals that you can eat with one hand and portion them in the freezer for quick dinners. Investing in yourself – mentally and physically – will be investment in your new baby. I’ve always been a runner and continued to jog up to six months, but I overdid it and paid the penalty of SPD. I did keep swimming and weight training, which was vital for my mental and physical health – and good preparation for carrying a baby around. Do your pelvic floor exercises, too.

Preparation

Take time to prepare yourself mentally and emotionally for the birth and afterwards. Hypnobirthing is worth exploring, with evidence-based roots firmly founded in controlling your catecholemines and, therefore, allowing labour to progress smoothly.

We all know the importance of evidence-based decisions, so take the time to inform yourself of the options and possibilities during labour, so you have understanding and more control. If you create a birthing plan, it’s best to view it more as preferences; be prepared to go off-piste. The one thing you can be sure of with labour and parenthood is things very rarely go to plan. Maybe your experience is premature labour and the emotional challenges around a pregnancy curtailed, and lack of opportunity to nest and prepare practically and mentally. Then there’s the subsequent worry and strain of caring for a premature baby – often within a hospital neonatal intensive care unit. Or there’s the opposite worry of being overdue, talk of when and how to induce you, concerns over complications and a baby ever growing in size.

Labour itself can be wonderful and joyous, or traumatic and difficult to process. Many hospitals offer the opportunity to discuss your birth experience with a maternity professional, and post-traumatic stress disorder (PTSD) counselling if necessary. Use this help – don’t be the perfectionist vet and think you have to get on with it.

Some top perinatal tips are:

• Let go of work. Maternity leave is comparatively short, and your practice and clients will get on fine without you. I answered a work telephone call while in labour – turn your phone off.
• Before the birth, find out about local support services – such as mother and baby groups, health visitors, local breastfeeding (BF) support and postnatal depression support – and write the numbers and details to stick on your fridge.
• Create a birthing playlist, or use a hypnobirthing one, if you find this relaxing.
• In the hospital, take lots of high-calorie snacks and ensure everything (including the emergency buzzer) is reachable.
• Trust your instincts. We’ve had years of training to deal with animals that cannot tell us what’s wrong – just as with our neonate – but, for some reason, logic often evades us when dealing with our own baby.

Labour

Labour, though powerful, is the shortest part of the motherhood journey. The overwhelming sentiment from the Vet Mums Facebook group was the unexpected challenge of the postnatal period.

So much focus is put on pregnancy and birth advice, afterwards it can feel as though you’re left as a new mum with little clue about what to do.

The immediate physical changes can be alarming – it can be odd to see your deflated belly, struggle to sit down (the doughnut cushion will be your friend) and injure yourself because ligaments remain slack for months. Your mammary glands find their purpose, and become engorged and painful. You need to do a damage report and then allow yourself time and space to heal, medicating where necessary while you manage stitches, piles and postnatal contractions while your uterus involutes (especially during BF), chapped nipples and hair loss. It’s important to remember it will all heal, and to not let these changes affect your mood.

Some top postnatal tips include:

• Ask for help – it’s normal to feel low and out of your depth, and you’ll find a sisterhood of mums to reassure you this is completely normal.
• If baby is in a neonatal intensive care unit (NICU), line up friends and family to help look after siblings/pets and so on. Some NICUs are BF friendly; others are not.
• Ask friends and family when they visit to cook, clean and hold baby while you sleep. Tell them to leave if you need them to – don’t be polite, protect yourself and your baby.
• You will get through 12 to 15 nappies per day, and sometimes as many changes of clothes.
• Feeding – it’s worth giving BF a good go, but as long as baby is fed, you’re doing just fine.
• BF on day two when colostrum dries up and before milk comes in is hard. If you can get through the first few days, BF should become easier, convenient and enjoyable.
• If BF proves difficult, check for tongue tie. Then check again.
• On day three, when milk comes in and hormones go wild, you may experience “baby blues”. For me, this manifested as Godzilla screaming at my husband for unwashed dishes.
• If your baby is crying all the time, refluxing or is colicky, seek help – sometimes adjusting sleep position and/or gastroprotectants can help baby (and your sanity).
• Be prepared to achieve very little for several weeks – getting to the end of the day fed is achievement enough (dressed is a bonus).
• Co-sleeping, while not advised, is the only way to maintain sanity for many (myself included). Try open-sided cots that attach to your bed, or snuggle down so your head is level with baby.
• If you want to sleep train your baby, be prepared baby may not comply. This may be desperately disappointing, but no rhyme or reason exists to some babies just refusing to sleep through.
• You’ll lose all concept of time, so apps to help you keep track of feeding and so on can be useful for some.
• Wear your baby (in a sling) – this is great for walks, getting stuff done and normality.
• About six weeks in, when you’ve just about had it, baby will smile. Suddenly, it’s all so worth it.

The paradigm shift of suddenly being wholly responsible for an entire new life is the greatest and most rewarding challenge we are likely to face – even more so than graduating and being trusted with other people’s pets.

However, the same principles apply – prepare as well as you are able to and talk to others for help and support. You are not underachieving if you are struggling – it will get easier and you are never alone.

Something for you dads

Dads – you share the incomparable burdens of parenting, even more so as modern men. Partners can feel like a spare part or sidelined by the midwives in what can be a traumatic time – especially in an emergency situation. Dads can suffer PTSD, experience baby blues, and partake in the sleep deprivation and emotional exhaustion of the postnatal period, too. If you are finding it difficult, talk, and seek help and advice. You don’t have to be the strong man and suffer in silence.

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In part three, Liz discusses and advises around keeping in touch on maternity leave and returning to work.