Improving Postpartum Care: Why It’s Essential, Not Optional

Is Postpartum Care Optional?

Rethinking Postpartum Care: The Shocking Reality

I was recently visiting a friend who works at a local OBGYN practice. While I was waiting for her, I noticed a poster titled “Your Prenatal Care.” It outlined the visits a pregnant person should expect to receive during pregnancy and then at the bottom, there were two lines for postpartum visits: a two-week video visit and a six-week video or in-person visit, which was labeled as “optional.” In the middle of the hallway, I made an audible gasp, drawing glances from the others in the waiting area.

Some of my midwifery training took place in hospital practices, so I have some familiarity with the slim offerings for postpartum care in most settings. However, I had never worked or trained anywhere that described the six-week postpartum visit as ‘optional.’ How could this be? How could anyone offer just one virtual visit and an optional six-week visit and call it ‘postpartum care?’

Prioritizing Postpartum: Honoring the Importance as Equal with Prenatal Care

The average person who has complete prenatal care gets anywhere from 10-13 prenatal care visits during pregnancy (and sometimes much more). This frequency is important. It’s important to take certain measurements and tests to make sure that the pregnancy is progressing normally. It’s important to check in with the pregnant person to make sure they feel prepared emotionally and physically and to make sure they are feeling supported. It’s important to review information related to self-care, nutrition, and physical activity to ensure a healthy pregnancy. This takes time. More time than even that which is available in the dozen or so fifteen-minute prenatal care visits.

I want to be clear that I think prenatal care is very important. And in that same breath, I feel that postpartum care is just as, if not more, important. The postpartum period is a vulnerable time. Everything feels new. A newly changed body, which is often uncomfortable as it heals and experiences big hormonal shifts. A new baby, who has simple but near-constant needs. Not to mention shifting dynamics with partners and support people. All the while, sleep deprivation makes learning new skills, like nursing and infant care, feel incredibly complicated.

Support Matters: The Impact on Nursing Success

New parents who are not adequately supported in the postpartum period are forced to make difficult decisions just to feel like they can survive. This is repeatedly demonstrated by nursing statistics. In 2019, 83.2% of parents started out nursing their babies. A number that dropped to 55.8% of babies at six months who were receiving some human milk and just 24.9% of six-month-olds who were exclusively fed human milk, in alignment with CDC recommendations. Many parents do not nurse their babies as long as they had hoped or intended to.

Beyond Nursing Support: Addressing Comprehensive Postpartum Needs

There are many, many reasons why this is true. But a common theme among many of those reasons is a lack of support. Whether it was a lack of support in establishing nursing after birth, or lack of support from family members in maintaining exclusive nursing, or an early return to an unsupportive work environment that forced the nursing parent to begin supplementing with human milk alternatives – these common causes for nursing cessation are preventable with good support of the postpartum person.

Breaking the Silence: Advocating for Better Postpartum Care

Okay, you may say, but doesn’t the pediatrician’s office offer help with nursing support? Maybe. Some of the better ones certainly do. But what about the rest of the postpartum person’s needs? When do we make time to talk about how healing is progressing? Is the pelvic pain you’re feeling normal? Are your stitches supposed to feel that way? Is that persistent headache you’ve had for a week because you’re sleep-deprived or is it something more serious? Are the blood clots you’ve passed normal? Why can’t you make it to the toilet without peeing a little? Will that last forever? The list goes on and on. And despite all of these questions, we haven’t even asked about your mood. Is it baby blues? Is it postpartum depression? Are you feeling so down that reaching out for help feels too overwhelming? These questions deserve thoughtful consideration and personalized answers. 

Your postpartum body and mind have done the amazing and remarkable work of bringing a new life into the world. Such a big task is bound to require some extra TLC. Even if your postpartum period is relatively smooth, the work of caring for an infant with around-the-clock needs is challenging. How are you supposed to have your questions and concerns tended to over one video visit and an optional six-week visit?

Creating Change: Building Momentum for Improved Care

It isn’t that prenatal care providers don’t understand how challenging the postpartum period is. The uncomfortable truth is that insurance providers reimburse incredibly poorly for postpartum care. That’s it. There’s nothing else to it. Without adequate reimbursement, health systems are required to limit their postpartum care offerings.

How do we change that? That’s a tough question. Community midwives have been changing this on smaller scales for a long time, with added visits to families’ homes and support groups among their clients. This is wonderful for the select few who can participate in this model of care, but it doesn’t do much to change things on a larger scale.

Social media is full of stories that share tragic details of individuals who received less than adequate postpartum care with devastating consequences. These stories, while heartbreaking, begin to break the silence around inadequate postpartum support. More and more professionals in the birth world are creating systems of care to address inadequate postpartum support, like Postpartum Support International, which offers a large selection of free and low-cost support groups. The momentum is slow but increasing and those of us with a lot of passion for postpartum care will continue to bang the drum.

Sharing Experiences: Empowering Others in Their Postpartum Journeys

If you had amazing postpartum care, share your experience widely and help others have a similar experience. If you had a terrible postpartum experience, get healing support and share your story – hearing your experience can help people plan ahead for their own journeys. If you’re planning for your postpartum now, seek out ways to get individualized support, whether through intentional planning with your family and friends or personalized care from postpartum care experts (like midwives, doulas, and lactation consultants). Make a plan and begin building connections with other families in your community.

Personalized Postpartum Care with Hatch: A Comprehensive Approach

If you’re planning postpartum care with Hatch, we’ll have an hour-long prenatal visit to make a personalized care plan for your postpartum period, access to a lactation preparation class, plus access to a midwife to continue to ask your postpartum planning questions before your baby arrives. Once you’re home, we’ll have three home visits together to work on lactation and to care for your healing body. We’ll continue to see each other at three and six weeks postpartum to make sure you’re healing and transitioning into parenthood well. We’ll also have a final visit at your choosing to support your next transition – this typically happens around the time you return to work or school, or perhaps when an important support person returns to work – you get to choose. And perhaps most importantly of all, we will bring you into the fold of our postpartum support groups (beginning April 2024), where you will build connections with families going through what you’re going through. 

Wherever you are in your journey towards the postpartum, if you’d like to talk more about what personalized support can look like, please contact us for a free phone consultation. We would love to meet you and talk about ways we can help you and your family. 

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