How To Thrive Postpartum
Maslow's Hierarchy of Needs for Postpartum and Beyond
The Fourth Trimester - the three months after you give birth - is hard. Dealing with sleepless nights, a hungry and crying baby, and recovering from birth is no easy task and, while all these things are normal and expected for this phase of life, for some people it seems impossible. For those whom it seems like a never-ending hamster wheel - there are usually reasons it feels so hard and there are absolutely things we can do about it!
In this blog post, I will give you easy and manageable steps to get out of survival mode, thrive, and enjoy your baby.
In nursing school, I learned about Maslow’s Hierarchy of Needs - the five basic tiers of what a human needs to thrive. Depicted as a pyramid, each lower tier must first be satisfied before individuals have the ability to be able to focus on the higher tier needs. To me, this theory easily explains how people stuck in survival mode become trapped in an endless cycle of trying to meet their basic needs. Here, we will apply this psychology theory to the postpartum period and discuss ways to break out of survival mode and get on your way to self-actualization - thriving, achieving goals, and acceptance.
Physiological Needs
Maslow describes the most basic human needs as the ability to breathe, have consistent access to food, water, and shelter, get sleep, excrete waste, and reproduce. These needs must be met before a person can move on to higher needs towards thriving.
Now, lets think about this from a birth and postpartum lens. People who are homeless or experiencing food insecurity give birth every day. Experiencing issues like urinary retention or chronic constipation after birth are extremely common. Those who had extremely long hospital inductions and are completely deprived of sleep, food, and water before birth are then met with a baby crying 8-12 times daily keeping them awake.
According to the Merriam-Webster Dictionary, physiological means: characteristic of or appropriate to an organism's healthy or normal functioning. Birth, breastfeeding, sleep, and excreting waste are normal, physiological functions of the human body, so when these are disturbed, how is a person supposed to move on to attending to higher orders of needs?
Ideas for moving on from physiological needs:
Strive for a birth free from medical intervention such as inductions, augmentations, and medicated births and, therefore, potential iatrogenic (hospital caused) complications, if it is safe for you to do so.
Learn about breastfeeding before birth. Most people think breastfeeding will come easily, but breastfeeding is actually hard work and there is technique to it. Seek breastfeeding assistance immediately if you suspect problems or are worried it may not be going well.
Seek medical care or services for urinary retention, pelvic floor problems, or chronic constipation. Home care and over-the-counter tools exist such as: spraying warm water on the perineum to assist with urination, hydration, fiber intake, magnesium intake, and stool softeners.
Resources for homelessness exist in nearly every city and town and families with young children are often given priority services. Click here to be directed to the HUD Exchange.
Resources for food exist in nearly every city and town. Click here to find your local food bank.
Prioritize nutrition and nourishing foods which fuel and heal your body
Delegate your regular tasks like chores, meal preparation, sibling care, pet care, and errands to others so you can focus on resting, recovering, and learning to breastfeed. It is okay if you need to let some things go for a little while.
Nap during the day with your baby. Ask for help at night if you need it. Find an appropriate sleeping arrangement for you and your baby that will allow both safety and rest.
Safety Needs
Maslow’s second tier of human needs includes personal security, security of resources, security of health, security of their own body, financial security, and the absence of abuse.
More and more people are living paycheck to paycheck, experiencing constant worry about bills and expenses, and postpartum families in the United States are commonly forced to take unpaid time off work to recover from birth (often c-sections which are major abdominal surgery) and care for their children getting them behind on their bills. After they do return to work, they often have to pay outrageous bills for daycare equivalent to their rent or mortgage. Those who experienced birth complications, birth trauma, breastfeeding problems, or are dealing with PTSD or perinatal mood disorders may not feel secure in their body’s ability to support them. Those in toxic, unhealthy, co-dependent, or abusive relationships are in constant fear of their partner removing their safety.
Ideas for moving on from safety needs:
Consider family members, neighbors, or friends whom you trust for affordable or free childcare after returning to work.
Seek immediate expert and professional assistance with any breastfeeding questions or problems you have - reach out to an IBCLC Lactation Consultant.
If you feel you had a traumatic birth or are experiencing symptoms of postpartum depression, anxiety, OCD, or psychosis, seek immediate medical attention from your primary care provider, mental health counselor, and/or emergency room. Specially trained professionals can be found a psidirectory.com or you can call or text the PSI Helpline 24/7 at 1-800-944-4773.
Remove yourself and your family from abusive relationships. Help exists to provide for your safety and help you find housing and financial independence after escaping an abusive relationship. Call the National Domestic Violence Hotline 24/7 at 1-800-799-7233.
The Long Game: We need paid maternity and paternity leave which is no simple or easy feat and seems to be largely out of our control. In the meantime, preparing during preconception and pregnancy for after birth by consolidating and paying down debt and avoiding predatory loaning practices with high interest rates like credit cards and payday loans and avoiding living beyond our means are good options.
Love & Belonging Needs
Maslow’s middle tier of human needs includes family, friendships, intimacy, and a sense of connection to the people and the world around us.
As families and the world in general become more and more divided and separate, these needs become harder and harder to meet. Over the last several years, people have become more isolated and their support systems and connections have broken down and dissolved. Maintaining close and meaningful relationships has become more difficult with the widespread use of social media where we see each other more, but know each other less. Families no longer live close to one another and often live clear across the country. This creates a disconnect during the postpartum period when your support system is supposed to be the people you lean on and reach out to for help, but where are they?
Ideas for moving on from love and belonging needs:
Build your support system. Include health care providers, your partner, supportive family, friends, neighbors, community members, friends, church members, allied health care providers like lactation consultants and mental health counselors, hire a postpartum doula, and find a infant feeding or parenting support group locally or online.
Seek intimacy from your partner and your closest friends and family members. Intimacy is not always sexual; intimacy can be achieved by physical closeness like sitting in the same room, hugging, holding hands, and cuddling, or sharing your feelings, thoughts, and experiences with a trusted person who will actively listen to understand. It is the small things like eye contact and non-verbal communication and being willing to drop what you’re doing to be there for another person.
Find a peer support group, child play groups, or another activity where you can meet and spend time with other parents experiencing the same things you are. Examples are Le Leche League, BabyCafe, or Kindermusic. Find out if their is a kid’s gym near you or search on Facebook Events to find out what other moms are doing with their kids - if you take your kids to activities, you’ll be sure to meet other moms.
Bond with your baby. Make eye contact while feeding your baby. Stroke your baby’s skin with your fingers. Hold your baby skin-to-skin as often as possible. Try baby wearing. Smell your baby’s head. Respond to your baby when they cry. Get in the floor and do tummy time and floor time with your baby. Sit your baby in front of you and talk to your baby, smile at your baby, and make funny faces at your baby. Read to your baby. Sing to your baby. Narrate your day to your baby. Slow down and use mindfulness. Parents are frequently encouraged to separate themselves from their baby which is counterintuitive to our own and our babies’ psychological needs.
Esteem Needs
Once your physiological needs, safety needs, and love and belonging needs are being met, we can move on to esteem needs. According to Maslow’s Hierarchy of Needs, these include having confidence, respect (self-respect and the respect of others), recognition for your hard work, autonomy, and being accepted and valued by others.
Low self-esteem is extremely common during the postpartum period. I see it every day in my lactation private practice. Parents are always asking me “what am I doing wrong?” or “am I doing something to cause this problem?” New parents often feel they need to gain self-esteem by buying products that promise to solve all their problems and make them a “good mom.” I believe this stems from not knowing everything (which is impossible), a sense of loss of control of their ever changing body, their lack of a schedule, and their sense of identity changing, being raised to be a people pleaser or a “good girl,” and being susceptible to marketing tactics that take advantage of this vulnerable time.
Ideas for moving on from esteem needs:
Trust your instincts. Those feelings of being unsure, worrying about not knowing every single fact about babies or breastfeeding, and conflicted feelings about what you should do or what is best - all go away when you realize that the answers are already inside of you. Every human and animal have built in instincts that lead them down the right path. Humans are the only beings who actively shut out our own instincts and instead listen to “experts” or need to be told what to do despite feeling conflicted about what we are being told is best, recommended, or what we hear are the “shoulds.” Instead, when you feel that conflict in your brain, turn off your brain and listen to your body instead.
Trust your baby. Your baby is born with all the instincts and reflexive behaviors they need to survive. You baby is wired to cry when they are away from you or need something - trust that this is fact and respond each time. When your baby is placed on your belly skin-to-skin, observe their movements and let them happen - healthy and full term babies not affected by labor medications can latch on and nurse without you needing to learn complicated latching positions and rules.
Go with the flow. An old proverb is ‘We plan, God laughs.’ which definitely applies to birth and the postpartum period. It seems that the more attached we are to our plans and how thing “should” be or play out, the more things seem to go sideways. Labor, birth, and the fourth trimester are not a time for rigid plans, schedules, or routines. Instead, it is a time for surrendering to our bodies, or instincts, and our purpose. In my private lactation practice, I often find that when parents let go of rigid schedules, expectations, and prescriptive regimens like whatever they learned from the parenting book they read or sleep training course they took, things start going much more smoothly and they are able to move back to their normal routines more quickly that those who never find a flow state.
Try going a week, two weeks, or a month without buying a baby product. Babies don’t need expensive products and you don’t need expensive products to be a “good mom.” If you feel you need a breastfeeding products, reach out to an IBCLC instead to find out if that product is truly necessary.
Check in with your boundaries often. The postpartum period is often a time when people pleasing really backfires. Endless people want to meet and hold the baby, which often cuts into your available time to rest and nurse the baby. If allowing this feels stressful to you, simply don’t allow it! Communicate your need to rest and recover. Communicate when it is time to get your baby back and nurse. Communicate when you or your baby are feeling overstimulated and the visit needs to be over. Another idea is to create conditions, like, “Yes, you can come hold the baby for a full two hours while I nap.” or “Yes, you can come see the baby if you’re okay with me nursing in front of you.” or “Yes, you can come hold the baby, but bring food - here’s my Chipotle order.” or “Yes, you can come hold the baby, and afterward I have a to do list I really need help marking some things off of.” Recovering from people pleasing is hard!
Know that confidence comes with time and experience - you will get there if you just keep on keeping on and ask for support and help when you need it.
Self-actualization
Finally, self-actualization can occur when all other needs on the pyramid are met. Self-actualization is not really the end of the line, because humans are always becoming and never remain the same. Instead, self-actualization is an area of personal growth toward becoming something that you desire to be - such as being the ideal parent. You can never become the ideal parent, because you are always “becoming” and working toward an ever moving target. Aside from that, the ideal parent for one child is not the ideal parent for another child. The ideal parent for your newborn is going to be different that the ideal parent that your eventual toddler, teenager, or young adult needs. Instead, of happily ever after, self-actualization is really about personal growth and discovery, acceptance of self and circumstances, thriving instead of suffering, and achieving your personal goals.
Ideas for self-actualization:
Understand that perfect doesn’t exist. However, optimal does exist and takes into account your abilities, strengths, and weaknesses and your individual circumstances that cannot be changed. Optimal is just as good as perfect!
Self-actualized people are not as susceptible to predatory marketing and manipulation.
Finding a balance between going with the flow and maintaining boundaries is really key for maintaining self-actualization.
Once you get here, help your friends and family meet their own physiological, safety, love and belonging, and esteem needs.
