What is the 5-5-5 Rule?

Is the 5-5-5 Rule really a rule?

A hard and fast rule, or any one size fits all structure, can often be misapplied, so I want to take some time to talk about the validity of the 5-5-5 Rule.

If you haven’t heard of this rule before, it refers to the period immediately after birth when the birthing person should spend 5 days in the bed, 5 days on the bed, and 5 days near the bed. I love this structure as a guidepost, but not so much as a hard and fast rule. Each person’s body is different, each birth is different, and every circumstance is unique. However, it is evident that birthing people need to rest after birth, no matter the mode of delivery. We typically hear six weeks for vaginal delivery and eight weeks for cesarean section births, but it takes significantly longer to fully heal. According to an article published in the Journal of Prenatal Medicine, “[the] postpartum period is distinct in three phases... The third phase...can last up to 6 months” (Romano). This third stage includes changes such as “restoration of muscle tone and connective tissue to the prepregnant state” (Romano). Not taking amble time to rest and recover could lead to a longer healing process and possibly lead to other complications. Many times, women may notice increased bleeding after doing too much physical activity after birth. If you notice your postpartum bleeding slowing down, then to only have it pick up after a lot of activity, that may be your sign that you need to take a rest. However, the 5-5-5 rule may be too much time or not enough time for your individual recovery needs.

For my first birth, the 5-5-5 was almost a perfect layout for speeding up my recovery. I may have been closer to 4-4-4 (four days in the bed, four days on the bed, and four days near the bed). In the early days, my husband was able to bring things to my bed and we set up a cart in our bedroom for easy diaper changes in bed. All families look different and you may need to find the best support system for you. This could look like having a hired or pro bono postpartum doula, having a friend, in-law, or parent helping you in the early days. Some states have in-home nurses that can visit you in the comfort of your home during these early days.

However, for my second birth, the 5-5-5 Rule was entirely too much time. I actually started to feel worse with so much bed rest. I felt like my muscles were atrophying. I decided to do a short family hike two weeks postpartum just to get my muscles moving again. I don’t recommend this for most people, but I could tell that was what my body needed­­– movement.

It can be great to strive for the 5-5-5 Rule to help manage your own expectations of “getting back to normal”, and also help to manage the expectations of visitors and family members. If you have a visitor coming in the first 10 days post birth, they can expect you to be in your bed with the baby. This can manage the expectation of you “hosting” guest, and instead any welcomed visitor understanding that they should help assist you in recovery.

As most things related to birth and mothering, you have to listen to your body and to your intuition about what you need. That being said, let’s talk a little about important warning signs to know about in postpartum:

1. If you have extremely heavy bleeding (soaking through a pad every hour) or golf ball sized clots – CALL YOUR HEALTH CARE PROVIDER IMMEDIATELY. If you have more than that, PLEASE GO TO THE EMERGENCY ROOM

It’s important to rule out issues such as a retained placenta, where there can be pieces of the placenta left behind. This can turn into a dangerous situation and can also impact the ability to produce enough milk.

Depending on the type of birth you have had, you can give yourself a uterine massage to help get your uterus back down to its pre-pregnancy size. Nursing also helps in the process of the uterus returning to pre-pregnancy size, as the oxytocin released during nursing stimulates contractions in the uterus. Be sure to follow the protocols of your healthcare provider for the type of birth you have had.

All in all, we can just refer to this “rule” as a framework. A framework being something you can work within, but there is room for flexibility.

If you want to receive more prenatal and postnatal education, feel free to sign up for one of my classes at www.mymommavillage.com

This article is for educational purposes only.

References:

Romano M, Cacciatore A, Giordano R, La Rosa B. Postpartum period: three distinct but continuous phases. J Prenat Med. 2010 Apr;4(2):22-5. PMID: 22439056; PMCID: PMC3279173.