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Helen Dandurand (Host): Welcome back to the Well Within Reach podcast, brought to you by Riverside Healthcare. I'm your host, Helen Dandurand. And joining me today is registered nurse Bridgette Macander, who is here to talk about postpartum care. Welcome.

Bridgette Macander: Thanks for having me.

Host: Of course. So, can you start by telling us a little bit about your background?

Bridgette Macander: Yeah. So as Helen mentioned, my name is Bridgette and I'm a registered nurse here at Riverside in the Family Birthing Center. A little bit about me, I graduated with a master's degree of nursing, and a clinical nurse leader certification in '24. And I actually started my first job here at Riverside in the ortho-neuro unit on the fifth floor, and I just transitioned to the postpartum unit about a year ago. And when I'm not taking care of people, I'm off traveling the country.

Host: Awesome. Where's the last place you traveled to?

Bridgette Macander: I was out in California at Yosemite National Park.

Host: Amazing, amazing. Love California travels. Awesome. So, we're going to talk, like I said, about postpartum care, which is perfect. That's the unit you work on, and you work with people all the time. So when people hear the term postpartum care, what does that really mean, and why is it such an important part of having a baby?

Bridgette Macander: Yeah. So, the birthing process doesn't end right when you have a baby. You have kind of this thing called the fourth trimester. And so, that's your postpartum era, and that's usually about six weeks, like, medically. But physically and mentally, it can actually last up to a year, even, like, 18 months after the baby's born. So, postpartum care is important. Because as a parent, you're just worried about the baby and you're not really worrying about yourself.

But there is a recovery aspect after you have the baby. It doesn't just stop, like you have the baby and you're good to go. So for the first day or two after giving birth, when you're in the hospital at the postpartum unit, you will have a nurse specifically to take care of your needs. So, somebody's there 24/7 to help you navigate the postpartum journey. And I would say definitely utilize us when it comes to questions and understanding what the next few weeks are going to look like for you, because it's definitely a big change for women, whether you've had a baby before or this is your first time.

Host: Awesome. A lot of parents kind of spend a lot of time preparing for labor and delivery or even just like their things at home, their nursery, that kind of thing, but not always for this recovery part. So, what are some things you wish that every parent knew about this postpartum period?

Bridgette Macander: So, like I said before, postpartum care can take even weeks, months, to feel like yourself again. It's a new change whether you're a new parent or a seasoned parent. Not every postpartum care is going to be the same. You might have different experiences with each baby. And it's okay to not be okay. It's also okay to have boundaries. Do not hesitate to set boundaries benefiting you and your baby. Your main focus should be recovering and bonding with your baby. So, take care of yourself first. The baby can't thrive if you're not thriving. So, drink your water, eat your nutritious foods, get some sleep. And now that it's summertime, definitely get outside, strap the baby in a stroller, and go for a walk.

Host: Perfect. What are some of the physical changes and symptoms that are completely normal after having a baby? And then, when should someone reach out to their provider that something might be, you know, not right?

Bridgette Macander: So, it is completely normal to bleed up to six weeks, maybe even longer after giving birth. I feel like sometimes people don't understand that. Even after a C-section, it is also very normal to bleed. When it's not normal and when it's considered abnormal bleeding is when you're soaking through a pad within an hour, or having clots larger than the size of an egg or multiple clots in a short period of time.

This is when you should seek medical care, whether that's calling the office L&D department or just coming to the ER. It's also normal to feel overwhelmed and go through, like, this emotional rollercoaster. You can end up with postpartum depression, which I'll talk about later. But being exhausted all the time is completely normal. Not only did you just labor for hours to days. But now, you're taking care of an entire human being who is completely reliant on you. So, it's normal. Some big things to look out for that I would recommend to seek help if anything happens, is the excessive bleeding, as I mentioned. Headaches that don't go away with intervention.

So if you've had a headache and you're taking Tylenol and you're doing all the things that you normally do and it's still not going away, definitely come in, or wanting to harm yourself or the baby. If anything is going on and you're concerned, don't hesitate to reach out to the office L&D department or just talk to your provider at your two-week and six-week follow-up.

Host: Okay. We know that, like, sleep can be hard to come by with a newborn. How does that lack of sleep affect recovery? And what advice do you have for new parents trying to take care of themselves during that stage?

Bridgette Macander: So, sleep when baby sleeps. Definitely take naps with the baby. I know a lot of people put the baby down to sleep and they'll race to go do chores or watch a new Netflix show because this is the only time that they have without the baby. But in those first few weeks, getting sleep is the most important thing to do for yourself. The dishes can wait and so can Off Campus. So, sleep is important for healing, and I highly recommend a sleep schedule between you and your partner, especially at nighttime. Taking shifts taking care of the baby, especially at night, will allow you to take turns on the exhaustion train. And also, the more sleep you can achieve in one period of time, the better you're going to feel.

Host: Great. We're going to take a quick break to talk about primary care at Riverside.

At Riverside, our primary care providers are right here in your community offering personalized care for you and your family, close to home and connected to the specialists and services you may need. Having a primary care provider means having someone who knows you, listens to you, and helps you stay well through every stage of life, from annual checkups and preventative screenings to managing everyday concerns when they pop up. Because remarkable care should never be out of reach. Remarkable care right where you live.

To find a primary care provider who's right for you and your family, visit myrhc.net/acceptingnew.

Okay. And we are back. We hear a lot about the baby blues, and you kind of touched on that before, postpartum depression. How can someone tell the difference between what's expected emotionally after birth and when it might be time to seek help?

Bridgette Macander: Yeah. So, it's completely normal to feel off or not like yourself after giving birth. There's a lot of hormones at play, which makes us all feel different. So, there's a thing called the baby blues, and this happens in about 70% to 80% of women postpartum, and it actually is normal. This occurs because that accelerated drop in hormones that occurs after giving birth.

It can be categorized as, like, mood swings, unexpected crying spells, feeling anxious, overwhelmed, having insomnia or fatigue. This usually occurs within the first few days, but it can last up to about two weeks. Postpartum depression can occur in the first few weeks of the postpartum period, and it can actually last up to one year. So, the difference between the baby blues and postpartum depression is baby blues is normal. A lot of people get it. Postpartum depression is when you should start seeking help.

This is when the baby blues and those symptoms become more severe. And it's important to discuss with your OB-GYN provider what you're feeling. And also, don't be ashamed to speak up with your friends and family about how you're feeling. If you are worried about harming yourself or the baby, please seek help immediately. Postpartum depression is nothing to be ashamed about, but it actually is a serious condition that a lot of women suffer with.

I also would like to add that postpartum depression and baby blues are not just exclusive to the birthing parent. The non-birthing caregiver can also experience sadness, hopelessness, and mood swings. So, it's also important to recognize these symptoms in either parent and both get help.

Host: That's really helpful, I think. And I don't think everyone else thinks of that other partner in the process always. But I think that's super important and good to know. So many new parents feel like they should be able to do it all on their own. Why is having a support system so important during that time, and how would you recommend someone can ask for help when they need it?

Bridgette Macander: So, an old saying that I've always heard from my parents is, "It takes a village to raise a child." And that most certainly is a fact. It's not impossible to do it on your own, but it definitely is hard. And it's way better for you and baby to have a support system. I know for some people, asking for help is extremely hard. I am also one of those people. But it's a new world you're navigating, even if it is your first child, your second, or even your sixth child.

It's always different every single time. And asking for help and accepting the help that people are trying to give to you is important. When you're here at the hospital, I do highly recommend sending baby to nursery overnight, even if it is for a few hours just to get some sleep or a break. You don't always have that kind of help at home. But when you're at the hospital, our entire goal is to make that transition as seamless as possible. And our nursery is the most qualified babysitters you can get around here, so I would probably utilize them.

I also wanted to mention that there's a lot of support groups online and even in our community to give you a sense of you are not alone. In our community, we actually have a lot of mom groups. So, I just wouldn't hesitate reaching out to another mom to get coffee or ask for just some advice if you need it.

Host: Definitely. I think that's great. I find myself, like, on TikTok seeing all the different things. And I feel like there's a line. Sometimes people get really wild out there, but it is helpful to have that community and kind of hear from someone who's done it before in that capacity if you don't always have people in your immediate life that you're able to talk to.

Bridgette Macander: Right. And I feel like there's a lot of, like, different opinions out there. So definitely, ask multiple people.

Host: Right.

Bridgette Macander: And kind of make your own decision and what's best for you and your baby.

Host: Absolutely. So, you touched on this a couple of times. You said if you're bleeding more than a certain amount or if you're wanting to harm yourself or your baby, but what are some other maybe postpartum warning signs that new moms and their loved ones should know and not ignore?

Bridgette Macander: Yeah. So, postpartum depression, postpartum hemorrhage, and preeclampsia are probably the three biggest things that people are experiencing, and the most serious ones. So yeah, I already touched on a postpartum, like you're bleeding. So, some people may not know that postpartum hemorrhages can actually happen days, even weeks after giving birth, and it's considered a late postpartum hemorrhage. So, just make sure that if you're worried about your bleeding, seek help.

And then, I already talked about postpartum depression, but preeclampsia is another thing that can happen up to 12 weeks postpartum. So, preeclampsia usually happens with high blood pressures, but a lot of people don't have blood pressure cuffs at home, so you're not going to know if your blood pressure's high or not.

Usually, the signs that you're going to look out for is those severe headaches that I mentioned earlier. So if you have a headache and it's not going away, you should probably come in. Any upper abdominal pain, it's like a severe sharp abdominal pain, any vision changes or sudden swelling to your hands or face that might have not been there prior to pregnancy or in your postpartum period. So, those are the three biggest things that I would probably look out for, is the depression, you're bleeding, and then if you have preeclampsia.

Host: Is there anything with those three things that you can do to prevent, or is it just things that could happen and there's not much you can do to help it?

Bridgette Macander: Yeah. So unfortunately, it's just things that happen.

Host: Yeah.

Bridgette Macander: So, postpartum depression, I talked about the hormones. So, it's kind of just how our body is reacting to those hormones. With a hemorrhage, there's different things that can happen in your postpartum period, or it could just end up happening without even knowing. And then, when it comes to preeclampsia, there's no real set evidence as to why preeclampsia happens, but it does affect a lot of women while they're pregnant, so antepartum and postpartum.

Host: Gotcha. Gotcha. So, what would you say are some things about postpartum recovery that often surprises new parents the most?

Bridgette Macander: I think what surprises people the most is just how hard it is. I don't think they realize, like, you're in this pure bliss of being pregnant, and then you have a baby. So, you're so in love with this baby, and then reality of day to day kicks in. And you would think that going through labor would be the most difficult part, but it's really not. It's this postpartum, it's the changing your day-to-day routine, now taking care of a baby while now you're trying to take care of yourself.

Another thing that I think people are most surprised about is newborns are very noisy sleepers. So, they grunt, snort, squeak, breathe super loudly. It is normal. So when you have those babies bedside, it's going to be a little harder to get some sleep, because they are very noisy.

Host: Yeah. No, that makes sense. Is there anything that you would say that someone could prepare beforehand in order to make that transition easier? Like, are there things that you're like, "I've seen parents who do one, two, three, or this thing, and they've said that the postpartum transition was a lot easier because of it"?

Bridgette Macander: I think it all just depends on how you want your postpartum period to be. I know being prepared. So, everybody is prepared for the labor aspect, but I would say get prepared for the postpartum aspect. And that's unfortunately maybe buying those adult diapers if need be. Getting those mesh panties, the pads. Making sure that your freezer is stocked with food, easy food that you can get. Asking for help. So if you have a mother, a mother-in-law, or a friend, or somebody that wants to come and help out, definitely have them come and help out. And maybe even prior to your postpartum period, even, like, getting the house clean, like, asking people to come clean the house because you're not going to want to clean the house for those first, like, two weeks, if not six weeks.

Host: Definitely. That makes sense. This might be a kind of a redundant question, but I'll ask as our last question. If a new parent is listening to this while feeding at 2:00 AM or trying to navigate those first few weeks, what is one piece of advice that you'd want them to hear?

Bridgette Macander: Stop scrolling through TikTok and panicking over what you should or should not be doing or how you should or should not be acting during your postpartum period. Whatever works for you is going to work for you. You're doing great. Keep it up. You'll get through this. Just take it day to day and enjoy all the baby snuggles.

Host: Amazing. Well, thank you so much for being here today. It was great.

Bridgette Macander: Thanks for having me.

Host: Yeah, of course. And thank you listeners for tuning into the Well Within Reach podcast. Be sure to like and subscribe to Well Within Reach on Apple, Spotify, or wherever you get your podcasts. To learn more about the services that Riverside Healthcare has to offer, go to riversidehealthcare.org.