Sitz Herbs in the Doula’s Birth Bag; One Midwife’s Perspective



by Deborah Simone, Midwife

All of us have been taught that after the birth of a baby we should put an ice pack on the Mama’s bottom. But truth be told, this is a fairly new Western medical practice, that once closely examined, turns out to be lacking in value & is actually somewhat harmful.

In Chinese medicine, the teaching is to heat the mothers after the birth. Many indigenous cultures also have some form of Mother Roasting- keeping the mother & baby very warm, feeding them hot soups or gruels and keeping the Mother/Baby dyad secluded for some weeks after the birth. When we look at these practices from an anthropological perscpective, we recognize that they must impart some benefit to the individuals, as well as the community, or they would not have become codified into the culture.

While many of us birth workers are aware of these practices and may even incorporate them into our postpartum protocols, most of us still continue to put ice packs on Mamas’ bottoms, without applying our critical analysis to this one small piece of the process.

While applying ice to cool a hot nerve, or for use as a numbing agent has some value, it has no business on woman’s yoni after birth. Instead, following the Chinese way of applying a hot tea of soothing herbs is much more beneficial & effective. Heat increases circulation, which allows the fluids sitting in the tissues to be carried away, while fresh oxygenated blood brings nutrients and speeds healing. If we accept that blood placed in a freezer will solidify, what do we think happens to tissues full of fluids when we keep icing them? Far from being beneficial or even benign, this procedure keeps Mama bottoms from healing as well or quickly as they might otherwise.

At a homebirth, we delay assessing the perineum in the two hours post birth. (This assumes no excessive bleeding that needs to be dealt with). During that time we are placing fresh hot compresses on the Mama’s bottom every 10 to 15 minutes. What we have discovered since implementing this procedure is, that by two hours, much of the swelling is gone and often a tear that looked like it would require stitches will lie together so nicely, it is hard to see, even when the Mama’s legs are splayed open during the exam.

Obviously incorporating the use of these herbs is well within the Doula scope of practice, but will require a bit of adaptation, especially for hospital births. It would be very easy to put together a postpartum packet for a small fee for the clients: 1.5 cups of the herbs, 1 muslin tea bag and 1 dozen wash-clothes (to be cut up).

I can see a couple of possibilities for the preparation of the herbs. Doulas who meet their laboring clients at hospital could prep the herbs at their own home, cut up the wash-clothes and bring the herb tea already hot, in a thermos to the hospital. A second batch would be made for the client once she returned home and kept hot in a crock pot.

If the Doula is with her client at home prior to birth, herbs could be prepped there, as well as setting up everything for the client’s return home.

It is understood that at hospital, the assessment of tissues after birth is not going to be delayed for two hours, and in fact, probably not at all. We can barely get them to wait 3 minutes to cut the cord! But this does not mean the tea would be any less effective. Once the doctor or Midwife has finished suturing, the Doula would simply remind the nurse that, in her birth plan, the Mother declined to use ice pacs in favor of hot compresses and begin applying them, while the Mama is helping her baby find the breast. This is also a great way for the Doula to be close to Mother/Baby, able to unobtrusively observe, offer suggestions and assist with promoting latch.

Supplies & Instructions

The herbs: Uva Ursi, Yarrow, Plantain leaf, Sage leaf, Witch hazel leaf, Comfrey leaf & root

Sea salt

1 dozen wash-clothes: 4 cut in 1/2, the remainder cut into quarters.

1 muslin tea bag with draw string

16-20 oz Thermos

Client’s home set up:

Crock pot

1 clean long-neck bottle w/a funnel (like a Martinelli’s bottle)

Peri Bottle (Mama brings home from hospital)

Container with lid for discarding used rags

Place 1/2 herbs into muslin tea bag, tie w/a bow (you will need to undo it to make the 2nd batch)

Bring 1qt water to boil, turn heat to lowest possible setting, add tea bag. Cover and allow to steep for several hours. Fill thermos, and bring it with the eight 1/2 wash-clothes to hospital. After repairs are done, fold the clothes in thirds length-wise and pour tea long-ways down the center. Make it wet, but not dripping. Test on Mama’s thigh as tolerance is individual. Lay over her yoni, discard and change every 10-15 mins. This will take you thru the first two hours postpartum, after which the Mother/Baby will be ready to go to sleep.

Before going to hospital, empty the tea bag, rinse and hang somewhere to dry. When meeting the Mother/Baby at home for your 1st postpartum visit, refill the tea bag with the rest of the herbs, place it in her crock pot, cover with boiling water. Set the crock on Keep Warm. Instruct client to leave tea bag in pot and simply add water as level drops. The crock and the rest of the cut wash-clothes go in the bathroom.

Fill the Martinelli’s bottle with the tea. Explain to the Mama that she should use this to fill her peri bottle 1/3, then add hot water, to make a warm wash for cleansing after pee or poo. After she goes to toilet, she should take a rag, fold it into thirds length-wise, dip into the crock, using the lid to press out excess tea. She places this on her bottom for 2+/- minutes, discards & repeats the process one or two more times. The rags can be washed as often as necessary, but must not be re-dipped. The Mama will do this for between 3 and 10 days, depending on her tear & individual constitution with regards to healing time.

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