The Case For Postpartum Follow-Up BEFORE 6 Weeks
The case for the 3-Week Postpartum Visit is a very obvious one for most people in birth work or maternal health. We are truly not sure who came up with the idea that sending women home for 6 weeks and praying for the best was the right way to go about things. In other countries, this is far from the norm- and interestingly enough, their outcomes are far better than ours! ACOG has recently announced their support of the 3-week Postpartum Visit, and here are some thoughts from us on the topic.
Every day in America, we see another woman falling through the cracks- a husband who had to go right back to work, a single mom trying to do it all solo, no family support, friends who aren't all that helpful. This woman all of a sudden is alone with a newborn baby, no help, no sleep, she hasn't showered in a week, and she is downright miserable.
"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."
Postpartum Healthcare should not be limited to a single one-size-fits-all appointment 6 weeks after birth, but a series of appointments tailored to fit the individual needs of each mother. This gives providers an opportunity to catch things like Postpartum Mood Disorders, Unresolved Gestational Diabetes, and Hypertension before they become very serious issues. In addition, contraception must be discussed as soon as possible after birth. Studies show that a pregnancy less than 18 months after giving birth increases the risks of preterm birth as well as giving birth to low birth weight babies significantly. Women need time to recover in between pregnancies for both their mental and physical well-being.
More on that here from March of Dimes: https://www.marchofdimes.org/pregnancy/how-long-should-you-wait-before-getting-pregnant-again.aspx
With the current postpartum healthcare model in America, if a woman has had any health problems post-delivery, she is likely waiting for that 6-week appointment to see if her body is healing well. Oftentimes, this is just too long after birth to catch potential issues that may have been quick fixes with maybe just a course of medication. By the time many postpartum health issues are found, the mother may even be forced into a hospital stay with a newborn to fix what has now become a major health issue. Waiting 6 weeks is far too long to counsel women on many potentially serious health issues that can occur surrounding pregnancy and birth. The discussion surrounding postpartum care should begin during pregnancy and continue as soon as possible postpartum. Per ACOG:
"Anticipatory guidance should begin during pregnancy with development of a postpartum care plan that addresses the transition to parenthood and well-woman care."
Finally, we must not forget Postpartum Mood Disorders which are RAMPANT in America. Knowing that up to 80% of women experience "The Postpartum Blues" and about 15% experience Postpartum Depression, these disorders must be treated as soon as possible. Sometimes, multiple visits are required for a mental health diagnosis- so starting the discussion at 6 weeks postpartum is not soon enough to get these women help in a reasonable amount of time. Without proper treatment, postpartum mood disorders can last for months or even years. In addition to affecting the mother's mental and physical well-being, they can also interfere with her ability to bond with and care for her baby. This can in turn cause the baby to have issues spanning from poor sleep habits to behavioral issues as he or she grows up. It is absolutely critical that we catch and treat these issues early for the sake of our mothers and children. In addition, this extra postpartum support may even prevent these issues in many mothers Nationwide.