{"id":314870,"date":"2024-09-18T08:57:13","date_gmt":"2024-09-18T12:57:13","guid":{"rendered":"https:\/\/www.oviahealth.com\/?p=314870"},"modified":"2025-06-11T12:22:37","modified_gmt":"2025-06-11T16:22:37","slug":"what-i-wish-every-person-knew-about-the-postpartum-period-a-physicians-perspective","status":"publish","type":"post","link":"https:\/\/www.oviahealth.com\/blog\/what-i-wish-every-person-knew-about-the-postpartum-period-a-physicians-perspective\/","title":{"rendered":"What I Wish Every Person Knew About the Postpartum Period: A Physician\u2019s Perspective"},"content":{"rendered":"\n

Despite being a women\u2019s health physician, I was not prepared for motherhood. I remember feeling overwhelmed, stressed, anxious, bored and just not myself. I really wondered if having a baby was a huge mistake. My postpartum care consisted of a phone call from a nurse at my OB\u2019s office and an in-person appointment- otherwise I was on my own.<\/p>\n\n\n\n

In the 17 years since the birth of my daughter, I\u2019ve been a part of many of my patient\u2019s postpartum health- and I know that the typical experience for American mothers is far from ideal. We don\u2019t have the home based care common in many other countries, and many of us live far from or don\u2019t have parents or in-laws who can provide the in-home support that most new mothers need. In effect, American women are triaging their own care. This isn\u2019t just a nuisance, it’s a real health risk for mother\u2019s and babies. <\/p>\n\n\n\n

The fact is, women experience high levels of stress and emotional exhaustion that is overlooked and minimized because it\u2019s not considered a \u201creal\u201d medical symptom like prolonged heavy bleeding or cesarean incision tenderness. Our existing model of postpartum care focuses heavily on the physical recovery from childbirth and pregnancy, which has little to do with the complicated emotions and stress that many mothers experience. Given this mismatch, it\u2019s easy to see why as many as 40% of women miss their postpartum appointment.<\/p>\n\n\n\n

For many women there is hardly any time for a woman to recover at all. Just 27% of American workers have access to paid leave, requiring many women to return to work as early as two weeks after childbirth. Given these challenges, it\u2019s no surprise that American women have high rates of maternal suicide and substance abuse, or that 65% of maternal deaths<\/a> occur after the woman leaves the hospital, of which an estimated 90% are preventable. <\/p>\n\n\n\n

The good news is that there\u2019s a growing recognition about the need to change postpartum care. Forty-seven states have expanded Medicaid coverage for postpartum care<\/a>, with others on their way, and many physicians have proactively adopted ACOG recommendations<\/a> to treat the postpartum period as an ongoing process, rather than a one-time visit. However, we\u2019re also seeing the growth of a number of companies offering postpartum solutions that are largely perpetuating a failing model. <\/p>\n\n\n\n

For one, they approach the postpartum period with a tabula rasa mindset, as though the postpartum period is a new, blank state stage where family health histories, gestational or preexisting conditions, and pregnancy complications are magically resolved or reset. This is dangerous. Rather than treating postpartum care as a standalone period, a clinically-sound postpartum solution must consider and incorporate each woman\u2019s level and quality of preconception and prenatal care, as well as the health of her interpersonal and community relationships that directly affect her mental and emotional health.<\/p>\n\n\n\n

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More than one-third of women globally develop long-term health problems after giving birth.<\/strong><\/p>\n\n\n\n

World Health Organization<\/a><\/p>\n<\/div>\n\n\n\n

Additionally, many of these companies only offer telehealth visits, ironically mimicking the exact episodic model that already exists for postpartum care but shifted to a virtual environment. For employers and health plans that are evaluating their postpartum benefits and available solutions, we need to understand how each vendor incorporates preconception health and prenatal care into their postpartum care, and how it\u2019s personalized to each woman\u2019s pregnancy, delivery, and recovery plan. Concurrently, ask how their solution determines when each woman\u2019s postpartum period begins and \u201cends,\u201d and if they are adding arbitrary or artificial gates around this period that may push women out of care when they still need it.<\/p>\n\n\n\n

Postpartum care should create a continuity between what happens before and after pregnancy, not fracture an already fractured experience. As a clinician, I see a number of opportunities to improve the postpartum experience for women:<\/p>\n\n\n\n