Preparing for Postpartum: 9 Areas of Support to Think About Before Baby Arrives

Using Jane Honikman’s 9 Steps to Wellness to think beyond the baby registry and consider what support you might need, too.

When we prepare for a baby, a lot of the focus naturally goes toward the baby. We learn about feeding and sleep, make registries, think about car seats, bottles, diapers, pediatricians, childcare, and sometimes spend a lot of time preparing for labor and delivery.

I think we should put just as much thought into preparing for what the postpartum period will ask of us as parents. Across cultures and throughout history, the time after a baby arrives has often been recognized as a distinct period of recovery, transition, and care. Our culture doesn't always make much room for that.

There is a tremendous amount happening during this transition. You may be learning the needs of a brand-new person while functioning on interrupted sleep, navigating changes in your relationships and identity, keeping up with the needs of the rest of your family and life, and, for the person who gave birth, recovering physically at the same time.

When I talk about preparing for postpartum, I'm interested in how we prepare for that part too. What will support you as you learn your new role? What might need to look different for a while? Who and what will be around you as your family adjusts?

Jane Honikman, one of the founders of Postpartum Support International, developed a framework called the 9 Steps to Wellness that I often come back to when thinking about these questions. The nine areas are education, sleep, nutrition, exercise and time for yourself, nonjudgmental sharing, emotional support, practical support, referrals and resources, and a plan of action.

I like this framework because it reminds us that mental health during the postpartum period does not exist separately from sleep, food, relationships, physical recovery, community, and practical support. At the same time, I would be careful about handing all nine steps to someone who is already overwhelmed. I can imagine reading a list like this while exhausted with a newborn and immediately turning it into nine more areas where I felt like I wasn’t doing enough.

I tend to think of this framework more as a way to prepare for postpartum and build support ahead of time. It can also be helpful for partners, family members, therapists, and other providers who want to think more broadly about how to support someone during this transition.

1. Education: Having language for what you're experiencing

Dr. Dan Siegel uses the phrase “name it to tame it,” and I think that idea can be really helpful during the reproductive years.

Education can give us language for experiences that otherwise feel confusing or scary. Learning about intrusive thoughts can help someone recognize an anxiety response that they were afraid to talk about. Learning about birth trauma can help someone understand why an experience is still affecting them years later.

I’ve had clients become emotional simply from being able to name that something really did have an impact on them. Sometimes understanding what happened gives us access to more compassion for ourselves.

Education is also helpful for the people around us. When you are deep in functioning mode, it can be hard to step back and recognize how much you are struggling. A partner or support person who understands perinatal mental health may be able to notice changes and ask more useful questions than “How are you doing?”

They might ask, “I’ve noticed it seems hard for you to relax even when the baby is sleeping. What happens when you try to rest?” or “You seem like you’ve been carrying a lot of worry about feeding. What has that been like for you?”

2. Sleep: Making room for rest

Sleep with a new baby is complicated. Babies wake up. Feeding can require overnight feeds or pumping. Some babies sleep better than others. Telling a new parent to “get more sleep” can feel pretty useless when the reality is that there may not be much sleep available. Still, I don’t want to dismiss exhaustion just because disrupted sleep is expected.

If someone tells me, “I’m exhausted, but that’s just having a baby,” I want to get curious about the exhausted part too. How much sleep are you actually getting? Can you sleep when you have the opportunity? Is anxiety keeping you awake? Are you staying up because that is the only quiet time you get to yourself?

Sometimes sleep also competes with the standards we bring into parenthood. If you are used to being productive, organized, or on top of things, it can be hard to leave the kitchen messy, ignore the laundry, or decide that something can wait until tomorrow. If protecting sleep requires lowering a standard and that feels really uncomfortable, that is worth paying attention to.

3. Nutrition: Feeding yourself counts too

Feeding a family takes a lot of mental energy, and in many families mothers carry a large portion of that work. There is deciding what everyone will eat, keeping track of groceries, preparing food, cleaning up, and then doing it again a few hours later. Once you add feeding a newborn into that, it makes sense that feeding yourself can become an afterthought.

There are also so many cultural messages wrapped up in food and motherhood. Parents can feel pressure to feed their children perfectly, while also navigating messages about postpartum weight, body image, health, convenience foods, and what a “good mom” is supposed to provide. This is an area where perfectionism can find itself.

Sometimes chicken nuggets for dinner several nights in one week really is a caring choice. Your kids will eat them. You know how to make them. Dinner does not require much thought or cleanup. Maybe you have more capacity tomorrow.

I think we can offer ourselves the same flexibility. The goal is not to eat perfectly. The first goal is to eat.

If you notice that you are putting a lot of thought into how everyone else is fed while your own food has become an afterthought, it may be useful to ask what it would feel like to put some of that same care toward yourself.

What does your body need to help carry you through the next few hours?

4. Movement and time for yourself: Inhabiting your body again

I like thinking about movement during the reproductive years less as exercise and more as a way of reconnecting with the body.

Our bodies can feel very public during this time. They may be examined, weighed, monitored, touched, scrutinized, changed, or medicalized. Birth trauma, survival mode, feeding a baby, body image concerns, and feeling touched out can all make it harder to feel connected to your body.

Movement can be one way of coming back into it.

That might mean walking and noticing your feet against the ground, stretching and paying attention to what feels good, moving to music, or simply noticing how it feels to move in the body you have today.

There can be something meaningful about learning what it feels like to live in this body now, rather than immediately focusing on how to change it.

5. Nonjudgmental sharing: Letting yourself say the thing

People often tell me they are about to say something difficult before they actually say it.

“This sounds so bad.”

“I feel really bad saying this.”

Sometimes I can see someone thinking hard about how to find the “right” words.

When that happens, I’m often interested in the part of them that is worried about what the thought might mean. Will someone think I’m a bad mother? Does this mean I don’t love my baby? Am I ungrateful?

Nonjudgmental sharing is partly about having people around us who can hear the harder parts without immediately fixing, correcting, or judging them.

It is also about noticing the judgment that comes from inside us.

I work from a parts-based approach, so I’m interested in the different responses that can exist at the same time. A part may feel angry while another feels guilty for being angry. A part may love the baby deeply while another misses life before parenthood. A judging part may be trying to protect us from shame or rejection. Giving each of those parts some room can help things feel less tangled.

Support groups can be really valuable here too. There is something powerful about hearing another person say the thing you thought only you were thinking.

6. Emotional support: Who is holding you?

So much of parenting involves holding.

At first, some of that is literal. You hold a baby because they cannot support themselves yet. You also help them move through hunger, fear, discomfort, exhaustion, and overstimulation before they have the capacity to regulate those experiences on their own.

At the same time, becoming a parent can surface vulnerable places in us too. Fear, grief, self-doubt, memories of our own childhood, experiences from pregnancy or birth, relationship changes, and the vulnerability that comes with loving another person this much can all show up.

The person doing all of that holding needs somewhere to be held too.

When I talk about emotional holding, I mean having someone who can be fully present with what you are feeling and let the emotion unfold without immediately trying to fix, control, or analyze it. Therapy can be really supportive here.

This is why I pay close attention when someone tells me they feel lonely. You can be surrounded by people and still feel very alone. Sometimes loneliness is communicating that we don’t feel fully seen or witnessed.

Do the people around you know what this experience is actually like for you? Is there anywhere you can bring the whole version of how you are doing?

7. Practical support: Receiving help can be hard too

Some of the most meaningful support in this phase of life tends to look very practical: meals, laundry, washing bottles, taking the older kids somewhere for a while, holding the baby while you shower, grocery delivery, childcare, or someone else taking responsibility for one of the many tasks that keeps a household running.

When someone is struggling, those needs can extend well beyond a few unfinished chores. There may be days when feeding everyone feels difficult, important tasks are getting missed, the home is becoming harder to function in, or there simply isn't enough capacity to keep up with what daily life requires.

Practical support also doesn't always arrive on its own. Sometimes we have to ask for it, and asking for help can be its own vulnerable process. You first have to recognize that you need something, figure out what might actually help, decide who feels safe or reliable enough to ask, and then make the request. For someone who is used to being capable, independent, or the person other people rely on, even getting to the point of saying, “I need help,” can bring up a lot.

And then there is receiving the help once it comes.

Maybe someone else does the task differently than you would. Maybe accepting help makes you feel indebted. Maybe having needs feels uncomfortable. Maybe you've learned that needing other people is burdensome. Sometimes you've asked before and people haven't shown up in the way you needed, which can make asking again feel even harder.

I appreciate KC Davis’s work in How to Keep House While Drowning because she separates our ability to complete care tasks from our worth as people. If you are struggling to keep up with the tasks of daily life, I don't think adding shame to the pile helps us understand what you actually need.

Birdie Gunyon Meyer has talked about life having seasons of giving and seasons of receiving, and I really like that framing for new parenthood.

For mothers especially, both asking and receiving can bump up against cultural messages about what motherhood is supposed to look like. Mothers are often expected to anticipate needs, keep things moving, and take care of everyone else. It can feel very different to be the person saying, “I can't carry all of this right now. I need someone else to take some of it.”

I think there is value in getting curious about what makes asking difficult, what makes receiving difficult, and what kind of practical support would actually feel supportive to you.

8. Referrals and resources: Building a team

The reproductive years can involve a lot of different providers. OB/GYNs and midwives, fertility specialists, pediatricians, lactation professionals, pelvic-floor physical therapists, doulas, therapists, psychiatrists, dietitians, primary-care providers, and support groups may all be part of someone’s care. Specialization is valuable and I don’t think one person should try to be the expert in everything. What I do value is having providers who can still see the whole person.

A feeding struggle may be affecting sleep. Lack of sleep may be affecting anxiety. Anxiety may be affecting a relationship. Physical pain may be making all of it harder. The person experiencing those things does not divide themselves into specialties.

In my own work, I try to learn enough about adjacent areas of reproductive health to recognize when someone may benefit from another kind of support, and I value building a referral network of providers who think similarly.

How do we support the whole person while they are learning to support a new person?

9. A plan of action: Start with what would help most

After looking through eight different areas of wellness, it would be easy to walk away with a long list of things to work on. That is not the goal.

If you are preparing for postpartum, you might notice one or two areas where it would be helpful to put more support in place ahead of time. Maybe you and your partner need to talk about protecting sleep. Maybe you want to learn more about perinatal mental health together. Maybe you want to know what support groups or providers are available before you need them.

If you are already postpartum, the question may simply be: What feels hardest right now, and what kind of support would make that part a little easier?

It is also important to recognize that people can know exactly what they need and still not be able to access it. There may be no paid leave, family may live far away, therapy or specialized healthcare may be difficult to access, childcare may not be available, or someone may be parenting alone. There are real structural barriers that cannot be solved by asking someone to advocate for themselves more effectively.

Preparing to receive care

What I appreciate about Honikman’s framework is that it gives us more ways to think about what support can look like.

If you are preparing for postpartum, you do not have to anticipate every need you might have. You cannot know exactly how recovery, feeding, sleep, your emotions, your relationships, or your baby will unfold. You can, however, spend some time thinking about who and what will be around you.

Where might you need more support?

Who can pay attention with you?

What might be hard for you to receive?

Which standards may need to lighten up for a while?