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Topic: Postpartum

RC: Hello everyone, this is Liz Harvey coming to you from our studio in New York City where we are dedicated to bringing you cutting edge interviews from many of the leading industry professionals across the United States.

In today’s episode, we are speaking with Stephanie Heintzeler. Stephanie is a German educated midwife, a U.S. educated doula, an acupuncturist and she is a certified lactation counselor (CLC). She is known as The New York Doula.

Stephanie has delivered over 1200 babies and has experience with twins, triplets, breech babies and water births. She also works with newborn parents in their postpartum stage and holds classes and seminars for moms and dads to be.

With a wealth of experience and knowledge in her field, Stephanie Heintzeler is widely considered to be one of the top doulas in the country. She is also a contributing member of our national network of industry professionals.

Today we are going to talk about a very important topic: Postpartum

RC: Hello Stephanie, how are you today?

Stephanie Heintzeler: I’m very well, how are you?

RC: I’m doing great.

Question 1: The Postpartum period refers to the period of time beginning immediately after the birth of a child. How long does this period last and how do you define when it ends?

RC: Let’s jump in, the postpartum period refers to the period of time beginning immediately after the birth of a child. How long does this period last and how do you define when it ends?

Stephanie Heintzeler: Officially the postpartum period is 6 weeks long if you had a vaginal birth. And if the mother had C-section, it’s 8 weeks. It in fact starts right after the baby is born and there’s no really definition of when it ends because in the end, bleeding – postpartum bleeding- for example, it ends after 4 weeks, so that’s before the postpartum time actually ends. The uterus is back to its original weight after 9 months, so that’s much, much longer. We know that 6 to 8 weeks is when the main things have gone back to original, meaning that bleeding has stopped and mom usually feels more stable, more balanced, has more of an everyday life, goes back to work, feels stronger, has more energy and therefore it’s 6 to 8 weeks.

Question 2: What are some of the challenges that new mothers face during Postpartum?

RC: Okay. What are some of the challenges that new mothers face during postpartum?

Stephanie Heintzeler: It’s considered to be pretty much the biggest change in a person’s life, to have a baby at home especially bringing baby home. The biggest challenges are the body changes, together with sleep deprivation and taking care of someone else. The body changes are of course the bleeding, the breasts might hurt when the mother is breast feeding, she might have all these new questions, she needs to learn a lot about her baby and herself and the changes. She might have baby blues. There’s a lot of hormonal changes that are happening the first 6 weeks, mainly the first 10 days – which we call the baby blues – where the mother cries a lot, she’s feeling overwhelmed. She’s very happy, it’s not necessarily negative, it’s just really intense.

The mother has contractions after birth where the uterus just contracts to go back to original size. The mother has, of course, this really, really intense experience of childbirth that she needs to find her story and see how was that for me and how do I heal from this emotionally and physically? At the same time, there’s another human being that completely relies on the parents and for many mothers, that is a very, very big issue to just let go of their own needs and completely succumb to what the baby wants. The other thing is, of course, the responsibility with a partner, the partner, the relationship in general, what can the partner take on to help with the baby?

Many moms are not comfortable when the dad says, or when the partner says, „You know, let me do this, let me do this or that.“ The mother just thinks she can do it best and only she knows. The relationship, there’s a lot of tension and a lot of discussion that needs to get done to really see what kind of parents do we want to be?

Question 3: If new parents feel overwhelmed and unsure of themselves after bringing their new baby home, what types of services may be available to help them?

RC: If new parents feel overwhelmed and unsure of themselves after bringing their new baby home, what types of services may be available to help them?

Stephanie Heintzeler: Thank goodness there’s a lot of services and they are really necessary. Parents have no idea how demanding it is to come home with a baby when the mother needs to recover and there’s a baby needing 24/7 attention, especially at night. There are postpartum doulas, which I have a lot of postpartum doulas in my team, and they get booked quite a bit because it often is the case that parents just feel that they need someone who can just tell them what to do and tell them it’s all good and really be by their side and teach them a few things. It’s not really that a postpartum doula would take over, it’s more that the postpartum doula makes sure that the parents feel more confident of taking care of their child.

Postpartum doulas can come during the day, they usually show up 4 hours every day, they can come overnight, they do 12 hour services. If parents think they need help all the time, there’s baby nurses. Baby nurses come in and live with the parents 24/7 for 1 or 2 weeks or even several months. Many parents use that as well because they just want to have someone. A baby nurse is more someone who takes over, she takes your child, she’s not someone who teaches so much but she really takes the child. The doula is someone who teaches the parents how to take care of their child and helps a little bit more in the background. She might run errands, she cooks for you, she makes sure the house looks neat and nice and she does some baby laundry. They take care of you so you can take care of your baby. It’s a different approach and there’s no right or wrong, it really depends on what the parents need.

What I really, really preach to my clients is that they should be able to take care of their child and find a lot of help for everything else. Also the partner can get some rest because the partner had a birth too, and oftentimes the partners are running around and taking care of everything else and they don’t get enough time to take care of the child and get to know the baby. In fact, then they go back to work after 2 weeks, maybe longer if they’re lucky and they feel like, „I’m exhausted now.“ Use their time, maybe, „It was my vacation and I’m exhausted, and I didn’t get enough time because I was doing household chores.“ That really shouldn’t be the case.

I do recommend to hire help rather than get family members in their house because family members who live there, it’s distracting. They have their own opinions, they have done it 30 years ago, things have changed. There’s always tension. It’s great if they come in after 2 weeks, that’s amazing, as long as it’s clear that they’re coming to help, they come to help with everything else but the baby and of course, take care of the baby a little bit. The parents want to do that most of the time. Otherwise, the first 2 weeks, it’s important that the parents learn and have a professional with them who teaches them a few things so they can figure out what my baby is like, and then they get family help. Then they know, „Okay, this is what we want, this is what works.“ It works so much better, there’s much less tension if the parents are well set up when family arrives.

Question 4: What are some of the symptoms that women experience if they are suffering from postpartum depression? And what causes it?

RC: That’s really great advice. What are some of the symptoms that women experience if they’re suffering from postpartum depression? What causes that?

Stephanie Heintzeler: Yeah, that’s a really, really important question. Unfortunately we have a rate of 1 over 7 mothers get postpartum depression in the United States. It’s caused by a hormonal shift after birth. The birth basically causes it but it’s really the hormonal shift after birth. A few other things. C-sections actually bump the risk much higher, every second mom, so every other mom who had a C-section gets postpartum depression. Traumatic births, of course, can case postpartum depression, medication during pregnancy or labor and birth, if the mother would not breastfeed the risk is higher, if the mother is older, like 37 or older, we know, unfortunately, that the tendency is a little more. If a mother is pregnant with twins or more, trips, if the baby is in the NICU, so if mom and baby were separated for a day or longer, that brings up the risk.

It all leads to being tired, overwhelmed, worried, moms cry much more, lack of sleep. All of these – medication and C-section and all these risks, the band, this results in being more tired and overwhelmed, and therefore the hormones don’t lead to the shift they’re supposed to do. The good thing is that postpartum depression is extremely treatable. I hear the therapists where I do my continued education work, and like her, she always says, „It’s extremely treatable.“ The thing is, people don’t get help and you need to get help, it doesn’t go away just like that. It’s really important.

I had a mom 2 month’s ago and her birth was so-so, it was okay, but for her it was traumatic. That’s what we need to look at. Was it traumatic from our experience? Like, „Oh, this was a great birth, there was no medications.“ Or, for the mother? She wasn’t prepared for the power of birth, or maybe she’s just someone, she’s just a sensitive person. We need to look at the mother. What does she say about her birth? How was it for her? Then, get help and bring someone who goes to her house and she doesn’t have to go anywhere. Then, it’s really treatable, and it’s not necessarily medication, it’s most of the time, it’s just talking with a therapist who can look at a few things.

Also, what’s in the past? Is there depression in the family? Did she have depression maybe during her teenage years? Did she ever take medication? Does she have help, support? What’s her partner like? Things like that can really help. Then, the rest is really sleeping enough, bonding with the baby, and taking time, be patient. I really think many mothers are not aware of the fact that having a baby changes their life. They want to continue with their life when that life is gone, it’s just gone. You know, having twins, right? It’s just like, „Here, welcome to my new life, here are my babies.“

Sometimes it’s that. Even for me, I notice, I spoke with some mothers, just sat down with them for 20 minutes and here they are, suddenly they give in to the fact that, „This is my baby, and this is my new life.“ Yes, it’s a little bumpy the first weeks but this is how it is, it’s normal. It’s normal to question things. It’s normal to not fall in love with my baby at this second and accepting that. That alone, it helps tremendously because everyone thinks the mom will be in love, and blow drying her hair, she’s got makeup and she’s sipping a coffee on the street. No. She’ll have spit in her hair and she won’t have slept for 2 days. That’s what’s normal. I see it every day. If they have support and go to a new moms group or have a therapist come in, that is really, that can help tremendously.

Question 5: During pregnancy, what are some ways new parents can prepare for the Postpartum time period?

RC: All right. Now, you touched on this a tiny bit, but during pregnancy, what are some ways new parents can prepare for the postpartum time period?

Stephanie Heintzeler: Yes, preparation. It’s really preparation in terms of taking a class. Many parents, they look at the birth, „Here’s the birth. That’s the big thing we need to prep for, is the birth.“ They forget that postpartum is 8 weeks. How do I breastfeed? How do I feed my baby? What can a partner do to help? How can I set up my apartment so that I feel everything is in place? Who can help? Who can clean my apartment? Who can I hire that can clean my apartment?

Hiring a doula, talking with a doula even, talking to friends who have kids, really, really reading up on a few things for postpartum. That is mainly important. I highly recommend a breastfeeding a newborn care class. We have those classes on our page. Taking a CPR class, just so you know what to expect once you have a baby, and hiring a postpartum doula. I really think it’s a great investment and it really helps tremendously. It lowers the rate by 65% in postpartum depression, so that’s amazing. Successful breastfeeding, 90%. It’s really … Versus 40% when you don’t have a doula. It’s really, it can help. You could put that on your list, like if you have a baby shower, put that on your list, you want a postpartum doula. Get that help because it’s not only going to help the mother, but also the partner. The whole family will really get some support.

RC: Okay. Thank you so much, Stephanie. We know you’re really busy, so I just want to thank you for all of your time and help today.

Stephanie Heintzeler: You’re very welcome, thanks for having me.

RC: For our listeners across the country, if you’re interested in speaking with Stephanie Heintzeler, you can either go online to www.thenewyorkdoula.com or call 917-399-2031 to schedule an appointment.

On behalf of our entire team, we want to thank you for listening. We look forward to bringing you more top quality content from our country’s leading industry professionals.