Changing Postpartum Care Is Important to Mothers Everywhere

One of the most frustrating things I’ve encountered as both a mama and a maternal/child health care provider is the lack of care for mothers in the United States during the most vulnerable weeks and months immediately after delivering their babies.

Currently, in the United States, mothers are encouraged to visit with their OB/GYN or pregnancy care provider 6-8 weeks post-delivery. Sadly, this is a stark contrast to postpartum practices around the world, in which the new mother is supported and cared for in the days immediately after birth and for several weeks and months afterward. Compared to the intense focus on women’s health prenatally, the postpartum care available to women in America is severely lacking, creating detrimental risks for the postpartum mother-baby dyad.

Inadequate Postpartum Care

Lack of postnatal care has created a void where many severe issues that impact both mothers and their families go undetected and under the radar, including maternal mental health issues, like postpartum depression and anxiety, eating disorders, and other physical, emotional and mental conditions. Inadequate postpartum support can also contribute to breastfeeding difficulties and an overall increased risk of morbidity and mortality.

The lack of maternal health care, particularly in the postpartum period, is alarming given that more than one half of pregnancy-related deaths occur after the birth of the infant. Recently, the American College of Obstetricians and Gynecologists (ACOG) released a committee opinion on how to fundamentally address many of the challenges that mothers are facing in our broken maternal health care system, particularly during pregnancy and postpartum. “Optimizing Postpartum Care” outlines a paradigm shift in postpartum care practices that would significantly change the mainstream manner in which women transition to mothers.

Some of the main highlights include:

• Reinforcement of the need for support during the “fourth trimester,” as a woman is adapting to multiple changes and considerable challenges
• Transition of postpartum care as an ongoing process that is tailored to meet a woman’s unique health needs, rather than just a single appointment
• Development of a postpartum care plan that begins during pregnancy
• Suggested components of the postpartum care plan include a care team, postpartum visits, an infant feeding plan, reproductive life plan, mental health and more.
• Contact with a maternal health care provider within the first three weeks, followed by ongoing postpartum care on an as-needed basis (rather than an arbitrary “6-week check”)
• A comprehensive postpartum assessment of physical, psychological and social well-being, no later than 12 weeks after birth
• Recognition of the need for policy change to effectively shift the current standard of postpartum care from a single, isolated visit to an ongoing process
• Endorsement of paid parental leave as “essential, including maintenance of full benefits and 100% of pay for at least 6 weeks”
• Adequate or timely follow-up care for women who have experienced a miscarriage, stillbirth, or neonatal death

These recommendations and guidelines are a welcomed and much-needed change for women everywhere in the United States, especially those who are without access to health care. These guidelines shed light on the greater issues at stake due to a gridlock on a policy level when it comes to maternal/child health. According to one study:

“The lack of policies substantially benefitting early life in the United States constitutes a grave social injustice: those who are already most disadvantaged in our society bear the greatest burden.”

Fundamentally changing our approach to maternal health care on all levels is necessary for bettering poor health outcomes, including maternal and infant morbidities and mortalities. The foundation of human health is programmed in early life, and with improved care during this critical period, benefits may include:

• Higher rates of breastfeeding
• Fewer infant deaths
• Fewer low birthweight babies
• Improved mental health
• Longer parental lifespan
• Increased long-term achievement for children

As noted by the ACOG, “By providing comprehensive, woman-centered care after childbirth, obstetrician-gynecologists and other obstetric care providers can enable every woman to optimize her long-term health and well-being.”

Positive Changes for the Future

Personally, I found myself more isolated, alone and vulnerable during the fourth trimester after birthing my babies than at any other point of my motherhood journey, and I know my story is only one of many; countless women are suffering during a time when they need the most help and care.

Ensuring adequate, timely and efficient care for mothers postpartum is important to our society as a whole. When we are lifting up, honoring, and supporting mothers in the critical postpartum period, we are ensuring that we are giving new families everywhere the best start possible.

As a survivor of postpartum depression and a maternal/child health care provider, I am thrilled to see these recommendations by the ACOG and even more hopeful for the future of maternal health care. Let’s continue to advocate for these much-needed changes on behalf of mothers everywhere. The costs of not improving our current system are too high to ignore or remain stagnant.

What can you do now?

While these guidelines are being recommended, there will likely be some time before changes are implemented in our current system.

If you are pregnant or newly postpartum, there are some important things to keep in mind as you navigate our current healthcare system:

• Trust your intuition: If you ever feel like something is not right with you or your baby during pregnancy or postpartum, please reach out to a health care provider and seek professional advice. Just because your physician might recommend a 6-week check-up after delivery does not mean you have to wait until then to be seen. Many issues often arise before this routine appointment, but many mothers are often hesitant to ask for help before then. Trust your gut instinct and reach out for help immediately as needed!
• Be your best advocate: It’s important for women to find their voices when it comes to their healthcare and bodies. If something doesn’t feel comfortable at your appointments, be sure to speak up for yourself and your baby. Just because our current healthcare system has recommended guidelines for certain procedures doesn’t mean that this is what is necessarily right for you.
• Ask for help when you need it: Our current maternal health care system has significantly burdened mothers with more responsibility we can reasonably bear. Utilize the resources available for help and support, whether for yourself, your baby, or your family. Many professionals and organizations offer low-cost or free resources for breastfeeding support, postpartum mental health, and more. You don’t have to do this alone – find your village!
• Create your own postpartum care plan: Creating a plan for postpartum is essential, and this is something that you can ideally start thinking about during pregnancy. Line up your professionals and have numbers and resources on hand and ready so you know who to reach out to should you find yourself struggling. Put your postpartum team together, including your family and friends, primary maternal care provider, infant care provider, lactation support, etc. to make the transition easier for you.

What changes are you looking forward to seeing in the maternal health care system?