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Postnatal Doula Jojo Hogan: First 40 Days with Baby

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I learned a lot from my first pregnancy. Top of my list during my second pregnancy was self-care, minimising stress and rallying a team around me to bring incredible gifts and knowledge to the pregnancy, birth and postnatal table.

In my search for finding a spa for pregnancy massage, my osteopath recommended Bella Mama Pregnancy Spa and Wellness Centre. And so, I took my bump to Auckland’s North Shore and had one of the most divine massages I’ve ever had. Blissed out, I vowed to make this my little sanctuary during the remainder of my pregnancy.

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Upon finding out owner Jojo Hogan is also a postnatal doula, I promptly made an appointment to chat about postnatal care, and how I might incorporate her services into my 40 days of rest after bub arrives. I left our appointment feeling uplifted, confident and excited—I knew then I had a team of incredible women with me on this transformative journey called pregnancy, birth and mamahood.

As a first time mama, I had no idea about so many things, especially postnatal rest and care. So, I’m excited to be able to share this interview with Jojo, so you might learn some things I had absolutely no clue about the first time around. 

How did you become so passionate about mums and babies?

It was after completing my Infant Massage Teacher Training in London in 1998. I had been working as a massage therapist for a few years and I always felt in my heart that massaging babies would be something very special to do. That amazing training (with the International Association of Infant Massage) really opened my eyes as to the importance of the mother/baby bond and the  profound difference that compassionate, loving touch can make to the development and wellbeing of babies and therefore of course to the future of the human race!

I was so transformed by this training and information that I went on to have my own son about nine months later!  I then went on to research and discover that these benefits start in-utero and how we treat women during pregnancy can significantly impact on their health, birth experience and postpartum recovery.

When a mother is healthy and well in body and mind she is more likely to have a positive and transformational pregnancy and birth experience with fewer complications. This in turn eases her transition into motherhood. I went on to complete specialist post graduate training in pregnancy and postnatal massage in Devon, UK where I was based at the time.

Why Bella Mama?

After returning to New Zealand from the UK in 2002 I decided I would start a business that focussed on my passion. I realised there was a gap in the market for a business that specialised in this unique area, working with pregnant and new mamas (and their partners) throughout the ‘childbirth year’.

Pregnancy massage is very safe when practised correctly, however the standard of training in New Zealand are minimal meaning many therapists refused to work with pregnant women who had complications or were high risk—the very group that needs it most!

I imagine mums-to-be would book a treatment, but walk away with so much more than just a massage. How do you help them on their pregnancy journey?

You are absolutely right! Massage has so many more benefits than just the physical and the importance of deep relaxation during pregnancy cannot be overstated! In many different cultures they have rules and regulations around keeping pregnant women relaxed and cared for and research now backs up the fact that stress can have negative impacts, not only on the mother but in the growth and development of her baby too.

The thing is, we often can’t avoid stress in our busy lives. It just happens. However what we can do is understand that we must also prioritise relaxation and massage is a wonderful way of doing this. It can help reduce stress hormones, ease muscular aches and discomfort, increase oxytocin and other beneficial hormones and give the mum the time and space to really connect with her baby.

The thing is, we often can’t avoid stress in our busy lives. It just happens. However what we can do is understand that we must also prioritise relaxation and massage is a wonderful way of doing this.

The effects of massage during pregnancy go far deeper than just a pampering treat, it’s a way of improving the health and wellbeing of mother and baby, physically, emotionally and spiritually. At Bella Mama we also advise on other ways that mum can care for herself and her baby during this time i.e. yoga, optimal nutrition, osteopathy etc and I teach various workshops and classes including a gorgeous workshop for birth partners teaching them the benefits and techniques of using massage in the labour room.

Why do we put so much emphasis on pregnancy, but fail to think about the “fourth trimester”?

Great question!! I heard a quote once: “I knew I was pregnant but why didn’t anyone tell me I was going to have a baby!?” I totally felt this way following the birth of my son. I had focussed so much on the pregnancy and how I wanted the birth to go that I was completely blindsided that I was now caring for a newborn baby.

The feedback from the mothers that I work with has is often they have felt underprepared for the challenges of the postpartum weeks and have often struggled with sleep deprivation and mood disorders and breastfeeding issues. This, along with my own experience made me want to find out more about this important time and I started training as a postpartum doula.

What cultures can we learn from to recover properly from pregnancy and childbirth?

Nearly every traditional culture worldwide emphasises a period of rest, recuperation and care for the new mother following the birth of her baby. It is common throughout Asia, Africa and India. I fact, even today I was massaging a mum from Saudi Arabia who confirmed they too observe a postpartum resting period in their culture.

The postpartum seclusion is often around 30 to 40 days and although there are differences, for example in the foods the new mother is given, the basic practises are very similar.

Complete rest and abdication from household tasks such as housework, cooking and childcare, keeping warm, having nutritious food cooked and fed to her and massage and belly binding (sometimes daily!).  It is understood that this period of rest is essential for the new mother to recover from her pregnancy and birth and also to develop a strong bond with her new baby.

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Why is it important for new mums to get specifically 40 days of rest once baby is born?

I feel that in the West we totally underestimate the profound changes a woman experiences during and after pregnancy and birth. Many women are working until late in their pregnancies and/or caring for other children at a time when it’s much more physically taxing to move easily with little chance to rest or prepare for birth.

The birth experience itself has a huge impact on the physical body with fluid and blood loss, enormous energy expenditure and (in the case of a c-section birth) recovery from major abdominal surgery. The hormonal aspects are also profound.

‘Baby Brain’ is a real thing and although it is derided and dismissed in our culture, recent neuroscience shows the changes to a woman’s brain in the last few weeks of pregnancy and the first few weeks postpartum are actually incredibly important and designed to prepare her for effectively bonding with, protecting and breastfeeding her baby. It’s a time of her life (along with puberty and menopause) when the hormonal impact creates the opportunity for brain plasticity – allowing her to learn new skills, to be more emotionally empathetic and aware and to bond, not only with her baby but with others around her at the time. Amazing!!

The birth experience itself has a huge impact on the physical body. The hormonal aspects are also profound.

For all this to happen however, we have to keep her stress levels very low and her oxytocin levels high.  Caring for a newborn baby is a 24/7 job so giving her extra work to do over this time will only serve to exhaust her. Something that is played out in our culture time and time again as 80 percent of new mothers report being exhausted and overwhelmed in the weeks following birth which is tragic.

The relevance of ‘The First Forty Days’ is that around the six week mark, the new mother has usually stopped bleeding, breastfeeding is established and, as long as she is well rested, nourished and has had a reasonably complication free birth, she is starting to regain her energy.

Why do you think Western society celebrates women who “get back to it” and “bounce back” after just weeks? How can this impact the mum later in life?

There is a saying in Ayurvedic (traditional Indian) medicine – ‘Forty Days for Forty Years’, which means what happens to the new mother in the first forty days postpartum will impact on her life for the next forty years.

In Traditional Chinese Medicine (TCM) there is a similar understanding that if a woman is depleted, exhausted and stressed in the weeks after birth then she will never completely regain her vital energy and this will have implications for her later in life including sometimes a difficult menopause.

In the West, we don’t honour and respect the enormous expenditure of energy that it takes to to grow, birth and feed a baby. Instead we expect and even praise women who ‘bounce back’ and recover quickly with no acknowledgement of how this might be impacting their physical and emotional wellbeing in the long term.

There is a saying in Ayurvedic (traditional Indian) medicine – ‘Forty Days for Forty Years’, which means what happens to the new mother in the first forty days postpartum will impact on her life for the next forty years.

You may have heard the term ‘postpartum depletion.  This is when a mother never regains her original vitality after pregnancy and birth and goes on to have further children, again without adequate care, rest and support from others.  The effects and repercussions can felt years, if not decades after the birth of her first baby.”   Currently in the West we are experiencing increasingly rising levels of postpartum mood disorders, decreasing breast feeding rates and tragically, suicide is now the leading cause of death for pregnant and new mums in Australasia.  Something is wrong with the way our society is treating pregnant and new mothers.

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Can you explain your work as a postnatal doula?

My work at a postnatal Doula is to ‘mother the mother’ giving her focussed care, love, attention and support as she does the important work of mothering her new baby.

Historically, this was often the task of other women in her life but increasingly we are living in a disconnected society where new mothers are isolated away from their support networks, families and friends.  The saying ‘it takes a village to raise a child’ is truer than we believe.

Studies of traditional tribal cultures show a newborn baby is held and cared for by multiple people throughout the day with the mother only holding the baby 40 percent of the time. This gives her time to rest, eat and do other things. This is necessary as newborns are very vulnerable and needy in the first few weeks and benefit from constant body contact, stimulation and feeding on demand. However this is too many jobs for one person (or even two people!) and in our culture we expect women to mother in isolation and then wonder why they feel exhausted, depressed and overwhelmed.

When I work with a new mum as her doula I support her to find her own path to mother her baby in a variety of ways. I treat her to specialist postpartum massages to help her relax and recover from birth, I bind her belly to support her organs and back, I cook nutritious and delicious food for her to enjoy and to build up her strength and resiliance and I listen to her if she needs to talk about her challenges.  I also encourage her to trust her instincts, difficult for many women in the days of ‘Dr Google’ where mums are bombarded with advice (most of it conflicting) and may not have even held a newborn baby before they bring home their own.

I treat her to specialist postpartum massages to help her relax and recover from birth, I bind her belly to support her organs and back, I cook nutritious and delicious food for her to enjoy and to build up her strength and resiliance and I listen to her if she needs to talk about her challenges.

Most new mums need not to be told what to do but rather encouraged to trust themselves and their babies, to be able to make mistakes and learn from them, to ask for help and to gather around support.  This is my role and I feel so very privileged to be a part of their journey.

What’s your vision for the future of childbirth in the Western world?

My concern is that, even though we are living in a more technologically advanced world, women are increasingly losing confidence in their body’s ability to effectively and safely grow and birth their babies.

Of course technology and intervention have their place and are absolutely vital and lifesaving for mothers and babies in some instances however our c-section rates are rapidly rising (over 90 percent in some countries!) which means that many women and babies are missing out on the hormonal cocktail of hormones (hormones of love and bonding) that help them to prepare for mothering and breastfeeding.

We are actually very lucky in New Zealand compared to other Western countries because our midwifery lead model of care is world class but even then in my experience, many women view childbirth with fear and trepidation rather than viewing it as a time of transformation and power.

My concern is that, even though we are living in a more technologically advanced world, women are increasingly losing confidence in their body’s ability to effectively and safely grow and birth their babies.

In the bad old days women had very little information or choices around birth. More recently we are bombarded with both information and choice however mothers are not being taught the skills needed or the understanding of how their bodies work necessary to actively participate in their births.

My life’s work is to improve women’s experience of pregnancy, birth and postpartum so that they trust their bodies to birth their babies with love, joy and confidence (whether vaginally or surgically!) taking this confidence and positivity into their mothering journey.

What are your top tips for mamas-to-be, particularly those who have never had a baby before?

I would love for mamas to view their pregnancies, births and postpartum weeks as a time of immense transformation, power and possibility. A time to learn about and celebrate the incredible workings of their bodies and their brains and to honour this accordingly by getting enough rest, eating well and, just as importantly, doing things that make them happy and joyful on a regular basis as we know that babies benefit from their mothers physical and emotional wellbeing too.

I would encourage them to be an active participant in their birth. Learning about birth physiology and how they and their support people can facilitate the right environment for birth to progress smoothly and easily reducing their need for intervention and complications.

I would love for mamas to view their pregnancies, births and postpartum weeks as a time of immense transformation, power and possibility.

Most importantly I would remind them that ‘it takes a village’ and to put in place support networks of friends, family and care providers that will honour the mother/baby/dad, allowing them time and space to get to know each other, bond and fall in love without any extra stress or strain around them.

Anything else you’d like to add?

I truly believe that mothers and babies that are born into a space of peace, love and respect will in turn bring that energy into the world, changing it for the better.

Find Bella Mama Pregnancy Spa and Wellness Centre at www.bellamama.co.nz

    @shannondunnwriter