Posptartum and the Great Abyss
The postpartum period is a critical time for the health, attachment and emotional adjustment for both mother and baby.
It has become the expected norm that women are left with very little medical or care provider support/assistance in handling the many norms, transitions and stumbling blocks that present in the first 6 weeks postpartum with her and her baby.
The general exception to this rule are women who birth at home with a midwife or in a free standing birth center where the rest of the perinatal period has several (approximately 6 visits) scheduled for follow-up care for both mother and baby. In this case, a family practitioner or pediatrician is unnecessary unless a need outside the norm arises.
Sadly with the majority of American women birthing within the hospital environment, she will leave the hospital with a stack of papers, a resource list, perhaps after viewing a newborn video and be left to her own devices until that 6 week appointment with her care provider (yes, some hospitals offer a visiting nurse once or maybe twice after birth, but is not the norm).
This is so stunning to me. Absolutely hair raising the lack of care women get. It is akin to entering the open sea with a poorly written map and expected to find the “New World” successfully and without setback.
As a doula and educator, I field emails, texts and calls from my clients and students asking questions, needing breastfeeding feedback and help navigating life. WHERE ARE THE hospital care providers in this time? Even without being able to offer home visits (except there could be a staff nurse, PA or NP to fill that roll), why are OB’s and hospital CNM’s not having their patients come in to the office at regular intervals post birth? For example, days 3, 7, 14, 21, 30 and then at 6 weeks? This sort of practice could address both emotional, physical needs and very well catch many other things BEFORE they become issues.
The longer I am in the birth professional, I am simply appalled by what passes as good care. No wonder so many women have recovery needs, postpartum mood disorders missed and breastfeeding problems. After months of constant contact and appointments (albeit not usually comprehensive), a woman is dropped into the abyss of postpartum without a safety net.
One practical solution is for a mother to secure a labor doula who would work with her prenatally through the early postpartum period and then hire a postpartum doula to continue care and assist in the rest of the perinatal period.
Another is for the mother to have a trusted, knowledgeable and skilled family member or friend come and stay with in her home from the birth through at least 6 weeks post birth. This person would help the mother learn to mother and not be “nannying” the baby similar to that of a postpartum doula.
Lastly, for truly comprehensive care, there is always the option to switch to a provider that offers it or one never knows what would happen if it is simply requested as part of the maternity care package of her hospital-based provider.
I hope you found this food for thought invigorating! I look forward to your comments.