Why is Postpartum Care for Mothers so Important but SO Neglected?

Within the past 6 weeks, your entire life has changed. You have brought a new life into this world and never realized the implications of what that might bring. The joy of being a new mother engulfs your thoughts as you’ve patiently waited over 40 weeks to bring that new life into this world. You’ve planned, you’ve prayed and you’ve tried to prepare for this new season of life: Motherhood. Your identity is now not only a Mother, but protector, source of life and nourishment, warmth and care, nurturer and caregiver, educator and source of comfort. Your life is no longer just yours: but you have been entrusted with another life-one that is completely reliant on you.

Every now and then, your thoughts are interrupted with the questions of:

“Who am I now?”

“Am I enough?”

“Do I have what it takes to keep myself and this baby alive?”

As these questions fill your head walking out of your 6 week postnatal check in with your OBGYN or midwife, your mind spins. Sure your OB did a pelvic exam on you and checked your uterus and reproductive organs as well as checked on the healing on your incision if you had an episiotomy. You talked about modes of contraception as well as struggles with breastfeeding. She asked questions of your mental state and assessed you for signs of postpartum depression. Overall, you feel as if it went well but it was honestly a blur. So much information in such a short period of time.

Your body is still healing one day at a time and your mind is still racing with all the questions you have. Your physician just ended your appointment by clearing you for exercise.. and let alone for sex. The thought of engaging in either one of those at just 6 to 8 weeks postpartum might scare you as for some it could be a glorious day. And yet, thousands of women are getting cleared at either their 6 to 8 week appointment to go back to “normal activity.” You might think to yourself, How can I go from being told I needed an emergency C- section during labor to being cleared for exercise after just 8 weeks? And where the heck do I start with exercise? Was does “normal activity’ even mean?

At 6-8 weeks postpartum, you are left baffled, confused, frustrated and maybe a little lonely. What you really longed for was someone to ask you, yes you as a mother, as an individual and as a wife how you were doing emotionally? You wanted someone to address the importance of self care, your nutrition, how to engage back into exercise, what to do about your recurring fatigue or maybe what to do to help your baby latch better. Or maybe you just want to know how to calm down your crying infant when you feel like you’ve done everything according to the book. Or why does all of a sudden, you feel as if your hormones are all messed up and the feeling of loneliness and shame so quickly cloud your brain that you feel it is better to isolate yourself from the world and others.

If any part of this resonates with you, please KNOW you are NOT ALONE!

Unfortunately, this is the reality of thousands of women as there is a gap in Maternal Postpartum Care in the United States. Postpartum care is one of the most neglected areas of a women’s health. Interestingly, this should be at the forefront of a woman’s health. How do you expect a mother to “mother” a child when she is not being Told HOW to become the best version of herself and not given the tools to do so? 

An article written in 2006 by the Journal of Perinatal Education, “Postpartum Maternal Health Care in the United States: A Critical Review” shows that the major focus of the routine 6 or 8 week postnatal checkup by the OBGYNs are for vaginal exams and discussion of contraceptives. A National survey showed that one third of mothers were discontent with their 6 week appointment, as they felt as if their individual health concerns weren’t addressed.

This study showed that the standard care offered to moms usually focused on their physical changes that can be addressed medically rather than their emotional and psychosocial health. Emerging studies have been showing that mothers want help with self-care postpartum and want to learn more about exercise, proper nutrition, how to deal with fatigue, how to recognize different illnesses, and just basic child care.

Why is there such a disconnect here?

Did you ever think it was interesting that doing your pregnancy, you saw your OBGYN or your provider at least every few months for ultrasounds and for check-ups. As you got closer to your due date, the frequency of your appointments grew to check on the baby’s health and heartrate as well as your own health. You might have attended some childbirth education classes, Lamaze classes etc as well. Then the moment came for the time to give birth and you may have worked with a midwife and a doula or just an OBGYN. After birth, you saw a lactation consultant and then 6 weeks later, you saw your doctor to get cleared. Just like that: your care ended.

How can care for a mother who just endured the most vulnerable 9-10 months of her life suddenly come to a halt? How is postpartum care not emphasized, not deemed as important or necessary?

To say the least, there has been a lack of comprehensive studies and reports studying postpartum women as well as a lack of resources and education. NO national policies are instilled to encourage women to seek out and find postpartum care. The World Health Organization (WHO) recommends that postpartum care be more individualized towards mothers as well as focused on family support, holistic health and appropriate to different cultures. Things that should be addressed postpartum should be properly assessing medical complications, mental health, the attachment between a mother and infant, breastfeeding, family planning and support from a community, spouse and family.

This my friend is where I have a huge passion to share, to educate and to help women in this journey find resources to help them find their voice and their identity. As a personal trainer who specializes more in pre and post natal, I have been amazed at the stories my clients and friends have shared with me as well as their questions and concerns coming back to exercise and “normal activity” after giving birth. Some have been blessed with great midwives and doulas who have been great resources for them in healing emotionally and physically. Some have had great OBGYNs who have actually listened to their struggles and helped them understand the postpartum journey.  Some have come to me being frustrated with the lack of care they received and, therefore are eager to start the healing journey. Some women have shared their hearts with me wishing they would have had the knowledge and support to choose a vaginal birth over a C-section or maybe a birthing inn over a hospital. Every woman is different and has their own story and their own needs of emotional, physical or mental support.

Pelvic floor physical therapists, chiropractors, acupuncturists, massage therapists, dieticians and counselors are just the beginning of great sources during this journey. Each woman may need a different form of postpartum support and my goal is to shed light on all the resources we as woman should utilize while providing proper education on exercise pre and postpartum, the importance of healing the pelvic floor and healing the mindset and mental state.

As a mother, you shouldn’t be left to figure out how to raise a child on your own or let alone get the postpartum care you need. Your care should be at the forefront of healthcare because you are raising the next generation. Yes, it takes a village to raise a child, but if we are not caring for the mothers than we are neglecting the women who put everything on the line to raise us, to nourish us and to nurture us.

We must find ways to bridge this gap of maternal postpartum care and focus our attention on healing the woman and coming alongside her with support so she can become the best version of herself for her OWN self, her spouse, her family and her community. postpartum

 

Resources: Cheng, Ching-Yu, Fowles, Eileen, Walker, Eilieen. “Postpartum Maternal Health Care in the United States: A Critical Review.” Journal of Perinatal Edcuation (2006) 15 (3):34-42.

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