Thriving in the Fourth Trimester: What Moms Need Now More Than Ever
The average number of prenatal visits for an uncomplicated pregnancy is 14.
You will see your doctor 14 times as your body and mind prepare to give birth not only to your child but to your new identity as a mother. This may not seem like a large number in the grand scheme of creating a human. However, given proper medical care, an incredible amount of information is collected and covered at these appointments. From your first visit to your last, you and your baby's physical health will be closely monitored by a team of doctors. You'll be asked about your gynecological and medical history, and you will receive physical exams, lab tests, screenings for fetal abnormalities, ultrasounds to track your babies' measurements, and likely discuss labor and delivery preferences. If you're lucky, you'll also have a doctor or practice who actively listens to your questions and concerns, offering support, advice, and resources where needed along the way.
The average number of postpartum visits for an uncomplicated pregnancy is 1.
You will see your doctor 1 time after experiencing a physically, socially, and psychologically life-altering event.
"My husband and I remember this moment the most. It was around 3 AM and Ian's second night at home. I had difficulty trying to breastfeed my son, and he wasn't sleeping the best because of it. My husband woke up to swap out and found me standing in the guest bathroom shower, the tub full of warm water on my feet, and the shower running because my son would only sleep with that sound at first while I was holding him. I was crying because I was exhausted and felt like a failure. I looked at my husband with tears in my eyes and said, "I didn't know it would be this hard." My husband has since said he's never loved me more than at that moment. I look back now and realize everything I thought I knew about what motherhood would be, was not what it was. And then I started wondering why I had such a distorted idea of what it is. That was a pivotal moment for me, realizing that no one I knew ever talked about the difficult moments in an open, honest, and supportive way." -Megan Sykes
In 2018, The American College of Obstetricians and Gynecologists released new guidelines for postpartum care, stating, "To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman's individual needs. All women should ideally have contact with a maternal care provider within the first three weeks postpartum. This initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth."
While the recommendations for postpartum visits have improved, we have yet to see a mainstream practice of these suggestions come to fruition. According to OBGYN Physician Nicole Sparks, M.D., "The recommendations should be common practice, but many practices are not upholding this yet. Some will see a patient sooner if they have a Cesarean section and later for a vaginal delivery. A patient should be seen within three weeks of delivery to assess many of the things that go along with postpartum care, including fatigue, depression, feeding, contraception, and recovery. They should be seen again by the six-week postpartum time-frame. While coverage does vary, many insurance companies will cover postpartum care under a global fee that includes pregnancy, delivery, and up to six weeks of uncomplicated postpartum care," Sparks explains.
However, instead of a three and six-week follow-up, many women consider the standard practice of a six-week postpartum visit, which also counts as an annual gynecologist exam, as sufficient. Mostly because that's what we're led to believe is normal. While you may have the right to multiple visits within a specific postpartum time-frame, you may only be asked to see your OBGYN one time, over an entire year, after giving birth. And perhaps even more startling, research shows that as many as 40 percent of women don't see a doctor at all.
But why?
"A lot of mothers don't talk about birth or postpartum because it's a vulnerable topic. It's hard to be vulnerable. To be open and honest with yourself and then share it with the world. I grew up in a Hispanic home where sex, pregnancy, birth, and postpartum health were not discussed. I thought my experience would be great, but so many things happened during and after my birth that I didn't even know were possible. My upbringing and my doctors' lack of care left me feeling lost, out of control, confused, embarrassed, and ashamed. When my son was finally born, everyone asked about him. Was he sleeping? Was he eating? Aside from my husband and my mother, no one asked about me. Was I in pain? How did I feel? Had I eaten? The United States is so baby-centric, and that's OK, but mothers matter too. We need to learn how to care for ourselves. After my experience, I think all mothers should make a postpartum kit, find a doula (if that's doable for them), and use their voice to create a comfortable and informed environment. Don't wait to create a village of support for yourself until after you have a baby. Have that village already waiting to help." - Trisha Bobe
In the United States, birth and postpartum care can be described as fragmented, at best. Between shuffling your baby to the pediatrician, sleep deprivation, well-meaning visitors, and adjusting to your new life, body, and identity, we often see mothers take a back seat with their physical, mental, and social well-being. What's worse is that we assume it's supposed to be this way, and we accept it. So, we must ask ourselves; In an environment where mothers feel unseen, unheard, and under-supported, how can we do better?
We can start by sharing our stories more openly and advocating for the proactive, holistic approaches to fertility, pregnancy, postpartum, and parenthood wellness that we see in services like Robyn. Robyn is a platform for the modern-day parent, with the mission of "Making parental wellness and education accessible to all. Including the paths of surrogacy, adoption, birthing as a person of color, with multiples, following trauma, LGBTQIA+, and more."
They offer services from doctors, psychologists, and parental wellness specialists in 14+ categories including, birth education, acupuncture, lactation consulting, infant sleep, maternal mental health, pelvic floor therapy, and doulas for birth, postpartum, and loss, to name a few. They've created community and support for all stages of parenthood, sharing the unique, heartfelt, and healing stories of parents who have experienced the ups-and-downs of fertility, pregnancy, postpartum, and early childhood. But perhaps most importantly, they've fostered the idea of empowering parents through expert-based knowledge with their educational articles and Parentbirth™ class.
A tool to help you plan and advocate for yourself and your child at a time that can be confusing at best and overwhelming at worst, Parentbirth™ is an accessible resource that aims to educate parents on all of their options and how to understand them better. Robyn's three-hour class is taught virtually by an array of accredited providers and unique in that it's described as "Parent-centric" or "focusing on the mind and body changes that happen to the parent, in addition to the education about prepping for birth and baby." At a time of uncertainty and transition, Robyn offers an individualized approach to combining healthcare, education, healing, and growth that is both baby and parent-focused, as any forward-thinking, comprehensive care should be. But we have to take action in planning for it.
We gently dip our toes into pre-through-postnatal healthcare. We track our periods with apps, pee on fertility strips, calculate the best days to have sex, create announcements, host showers, research strollers, highchairs, and cribs, prepare our nurseries, and search "what to pack in our hospital bags." And yet, somehow, through all of this, we forget to invest in ourselves. Who will we be through birth and beyond? And what will we need, not just to support our new baby, but also for the physical, mental, and social shifts of who we are to become?
The birth of your child, whatever that journey may be, will change you. You may grieve the person you once were, at times, feeling unrecognizable in your transformation and yet remarkable in your capabilities. This is why it is imperative that we research, educate, and invest in our whole selves now more than ever. As advocates for demystifying, destigmatizing, and elevating parental health, Robyn and Working Momkind will continue to provide resources, listen to our communities, and encourage the facilitation of open and honest conversations.
