What is Important for Postpartum Healthcare?
Important aspects of your postpartum health and your healthcare treatment
Image source: VitalikRadko
Women’s postpartum healthcare is a hot topic, legally speaking, because it covers many aspects of employment, insurance, and a lack of comprehensive health objectives for postpartum mothers within the government agencies and health facilities. What exactly the primary objectives should be is variable, determined on who you ask. While programs and procedures are in place to protect your baby and see that your baby gets the best start in life, they should also be in place to ensure that those first few weeks of motherhood are supported by postpartum care that tends to the needs of all new mothers.
In light of this, is that you will have to be aware of what is important regarding your health care during this time–and you will have to advocate well for your own health. This article will highlight some of the most important aspects of postpartum healthcare for yourself, some of the issues that may become obstacles, and what you can do to be sure you are cared for in the best way possible.
The postpartum weeks, typically the first 6 -8 weeks, is a crucial time to adapt to changing roles and schedules, and for pain management which can help mother’s to get around and respond better to the cries of their baby. The postpartum weeks and months are difficult enough with lost sleep and the added pressures of a new infant to care for, without the neglect often suspected for one reason or another for new mothers.
Advocating for yourself and for your loved one is the best way to make sure all her postpartum needs, mentally, physically, medically, emotionally etc.–are met. Good rest, good health and nutrition, and pain management are common focuses of postpartum care, but there are other medical concerns that can arise, as well.
The Optimizing Postpartum Care, Presidential Task Force on Redefining the Postpartum Visit Committee on Obstetric Practice Number 736 posted on the website for The American College of Obstetricians and Gynecologists shares some recommendations regarding the transition from postpartum care to more long-term health care for the mother and begins this assertion by stating this: “The comprehensive postpartum visit should include a full assessment of physical, social, and psychological well-being, including the following domains: mood and emotional well-being; infant care and feeding; sexuality, contraception, and birth spacing; sleep and fatigue; physical recovery from birth; chronic disease management; and health maintenance. Women with chronic medical conditions such as hypertensive disorders, obesity, diabetes, thyroid disorders, renal disease, and mood disorders should be counseled regarding the importance of timely follow-up with their obstetrician–gynecologists or primary care providers for ongoing coordination of care.” (Emphasis mine.)
Recently the ACOG has released new guidelines, now advising that women receive postpartum check ups within 3 weeks with a complete checkup no later than 12 weeks, rather than the previously 4-6 week recommendation, and that the postpartum care be extended into longer term healthcare for women. The ACOG directs that women should receive any postpartum care, as needed, on an ongoing basis post-birth, so that doctors can spot any lingering medical concerns, get new treatment plans in place or adjust treatment plans for ongoing medical conditions or diseases, and treat any new medical concerns that should arise after having a baby.
During the first post-birth months, it is important for women to contact their doctor for a post-birth check up and to be sure that check up is thorough, considering all aspects of their physical, mental, and medical care. Important questions you may ask your doctor during this crucial visit may include:
- What if I am having trouble sleeping or not getting enough sleep?
- What if I am feeling anxious or overly weepy, emotional, having flashes of anger or sad thoughts?
- What can I do about weight gain? I feel like I still have “all my baby weight?” (This translates into “What can I do to exercise and maintain good nutrition for my post-baby body?)
- What if I am still in pain? (Tell them what is hurting–where it is hurting–and describe the pain so the doctor can determine if there is cause for treatment, testing, or medication.)
- When can I safely and comfortably have sex again?
- Why is my hair falling out? (Some women experience hair loss post-pregnancy that are related to fluctuating hormones within the body.)
- What should I do about birth control?
- When is this bleeding going to stop? (Be sure to relay any menstrual questions you may have about bleeding or other vaginal discharge or any symptoms that may be of concern.)
Here at the Babienet Parenting Community we understand the value of community. We provide a safe space for you to interact with other parents, as well as a wealth of information to help you to be the best parent you can be. Come and join us! You can also join us on Facebook or follow our Blog.
So, what are some of these postpartum needs? How can you be sure that you won’t be inclined to let these needs go unmet? After all, you are so focused on making your infant the unwavering focus of your attention, that you may try to even “tough out” or pretend everything is ok, ignoring cues from your body that something could be wrong. A trip to the doctor, taking that dedicated time to make and attend an appointment and then following that with asking the right questions, and following your doctors advice, may all help to bring your attention back to your own health or put some preventative or treatment measures in place if any issues should arise in the appointment.
Here’ we’ll cover some of the important things you should pay attention to in these early weeks after childbirth, and a few that sometimes get overlooked.
Postpartum healthcare–important areas of concern
The most common issue women face post-birth is fatigue. It can be mild and last a few weeks, or it can be rather debilitating, making it hard to care for your new infant. According to NCBI, in a study of 10,000 women entitled “Factors associated with maternal postpartum fatigue: an observational study,” the findings on symptoms of fatigue reported (the study was conducted via questionnaire) the link between postpartum fatigue and maternal perception of the infant is alarming and sobering: “Decreasing but substantial proportions of women, 38.8%, 27.1% and 11.4%, experienced fatigue/severe tiredness at 10 days, 1 month and 3 months” and that these numbers “varied significantly by maternal age, level of deprivation, education and parity. Women reporting depression, anxiety, sleep problems and those breastfeeding were at significantly increased risk (eg, OR for depression in women with fatigue at 3 months: 2.99 (95% CI 2.13 to 4.21)). Significantly more negative language was used by these women to describe their babies, and they perceived their baby as more difficult than average (eg, two or more negative adjectives used by women with fatigue at 3 months: OR 1.86 (95% CI 1.36 to 2.54)). (Emphasis mine.)
Treating postpartum fatigue is more than simply dealing with being tired and taking a nap. You should talk with your doctor about postpartum fatigue, be honest and thorough in that discussion, and take this fatigue seriously. It is not a matter of simply pressing through. Your doctor can address the level of your fatigue and advise on ways to manage it so that it does not disrupt or disturb the maternal relationship.
Uterine discomfort, perinea pain, and pain from cesarean section are common complaints of postpartum mothers, and are best managed under a doctor’s care, especially when opioids are involved. Pain during the postpartum period can interfere with a mother’s ability to care for her infant. It can also keep her from getting the rest needed to nurture healing within her body.
The current epidemic of opioid use may interfere with the ability to receive opioid prescription for more serious pain. Or if you have had a history of addiction or have concerns about using these medications post-birth. Discuss pain management thoroughly with your doctor, pain management options that are safe for you and if you are nursing, safe for your baby. You want to remain as clear-headed during this time as possible while also maintaining restful sleep and sometimes pain medications can interfere with that.
Other pain management options
- Cold pack or ice pack for 20-30 minutes to the area (abdomen, perinea, etc)
- Sitz baths
- Over the counter drugs such as Tylenol or Advil (Check with your doctor and be sure to mention if you are breastfeeding or planning to breastfeed.)
- Treatment for afterpains–Ibuprofen, relaxing and breathing techniques, walking, breastfeeding
Vaginal discharge and menstrual care
The vaginal flow after delivery is called lochia and may continue for 2-6 weeks after delivery, beginning as a heavier flow, brighter red and tapering off to a brownish color with a lighter flow.
It is normal to pass clots in the beginning and sometimes these can be rather large, compared to a normal menstrual cycle. If you are passing clots larger than a “tangerine size” or passing these frequently and past the first week, or if you are soaking through a large sanitary pad in an hour’s time, you should call your doctor to see if you need to be examined. As the flow continues over the weeks, it will taper from bright red to brownish or pinkish or even a yellow color. Eventually the discharge becomes more clear and returns to normal.
Here is some more thorough information about care of perinea pain, after cesarean pain, and treatment for hemorrhoids: Postpartum Pain Management.
Few symptoms are overlooked as much as your emotional well-being after having a child. In order to care for your child empathetically, with focus, and clarity, you need to be able to think clearly, and remain calm in some challenging and stressful situations. When you are struggling to think or struggling with overwhelming emotions, it directly impacts the level of care you are able to provide, or can interfere with the maternal relationship and bonding process.
If you are having problems with your emotional or mental well-being after having your baby, do not let this important aspect of your health go unchecked. Be sure to bring it up with your doctor and express your concern. Ask for treatment options and support options to help you adjust to the new challenges of motherhood and the changes to your family structure.
Birth control, sexual health, and birth spacing
After you have a baby, your doctor will likely encourage you to plan for birth spacing and discuss birth control. Prioritizing your sexual health after your baby is born will help to prevent overtaxing your body before you are healed but also help you to have more control over your family planning, with a greater confidence and peace of mind. These issues will likely be addressed in your first post-baby doctor appointment but if it is not, be sure to advocate for yourself and ask the questions you need to get the answers and plan you are comfortable with. Ask about when it is ok for you to resume sexual activity.
Ask about birth control options that are safe for you and if you are nursing, whether you need to begin birth control. If you are having concerns about your sexual health, please do not write these off as unimportant. Reproductive health is a large reason why it is now being recommended for postpartum healthcare to continue into longer term women’s healthcare.
Chronic disease management
Pregnancy and childbirth can impact your health on many levels but when it comes to chronic disease management, it is even more important to monitor your condition, collect new data or observations, and adjust your course of treatment. Some of these conditions include asthma, autoimmune diseases, Fibromyalgia, hypertension, epilepsy, HIV, chronic pain, diabetes, obesity and mental health conditions such as depression or bipolar disorder. Some conditions, diseases, or disorders may not actually present until after you have gone through pregnancy and childbirth, partially due to age of onset and the physical strain that childbearing can put on your system, or because you have had to discontinue certain medications while pregnant. Post-birth, there needs to be a thorough assessment and adjustment to the treatment plan.
Keep a journal of observations to share with your doctor in that first postpartum appointment and be sure to follow the treatment plan–even though it is easy to let your own health slide after the baby is born. It is more important now than ever to manage your chronic condition for the sake of yourself and your child.
Good nutrition and Exercise
Your doctor may be able to recommend some dietary changes you can make or exercise programs for you, but good nutrition and exercise are really a way of life and commitment to your health.
There’s no time like the present to make nutrition important for the whole family. Equally, there’s no time like the present to get moving and get some exercise. Make it a whole family change and it is easier to stick to your commitment. Many women find that postpartum time period to be a good time for a fresh start with their dietary needs and exercise routines. While the healthcare system may not provide the plan for you, they can direct you to supportive programming that may be able to help or at least get you pointed in the right direction. Ask your doctor during your early postpartum visits when it is safe for you to begin a new exercise regimen.
Barriers to postpartum healthcare
There are a lot of reasons why women have trouble receiving postpartum healthcare or simply do not pursue it. This can allow smaller issues to become larger medical problems later on.
Many women are:
- Too tired or not motivated to pursue it.
- Too busy with the baby.
- Do not have access to good insurance.
- Women who didn’t get adequate prenatal care are often at risk for postpartum healthcare avoidance.
- Think it is not all that important.
It seems counterproductive to deny oneself healthcare after a baby is born, due to the rising need for your health to be a priority. When a baby is in your care, it is even more important for you to be well-rested, healthy, pain-free, stable and mobile. Postpartum issues can complicate this, so for whatever reason you may be reluctant to go–consider this your encouragement. Your baby needs you healthy and well–it is really as simple as that. If you are having problems finding healthcare after your baby is born, contact your local health department to see what postpartum services they provide, or contact your insurance company to see what they cover. Find out what is available–and make that appointment to take care of yourself.
Resources / for Further Reading:
Christina M. Ward,
Babienet blog contributor
Mother and grandmother
What is Important for Postpartum Healthcare? Provides some information on healthcare needs of the postpartum mother and postpartum healthcare challenges.