When you're pregnant, it feels like you spend months planning. Planning your baby registry. Planning where your birth will take place and who will assist you and how it will happen (in theory!). Maybe planning your maternity leave.
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.
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.
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.
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.
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."
Heng Ou is the founder ofLearn More
Linyan Li. Social Factors of Postpartum Depression Among Chinese Women. 2021- 4(4) OAJBS.ID.000311.