In a recently unearthed set of guidelines that was published in May 2018, the American College of Obstetricians and Gynecologists recommends the first postpartum checkup after giving birth (also known now as the “fourth trimester,”) should occur with the OB/GYN at 3 weeks and not the 6 weeks that is presently the standard practice.
“The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being. 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. It is recommended that all women have contact with their obstetrician–gynecologists or other obstetric care providers within the first 3 weeks postpartum,” ACOG says.
According to co-author of the ACOG opinion, Dr. Alison Stuebe, said the new advice was “in response to the fact that maternal mortality is rising in the U.S., and women are more likely to die of pregnancy-related causes after the day of delivery than during pregnancy or birth.”
“We also know that problems like postpartum depression and breastfeeding difficulties are more likely to get better if mothers get support in the first few weeks after birth, rather than muddling through until six weeks postpartum,” Dr. Stuebe told Parents.com
Although it is widely reported that there is no paid maternity leave in the United States, that is untrue. Sort of. The Family Medical Leave Act call for 12 weeks UNPAID time off, which many people just can’t afford to take advantage of. Also, it depends upon the state, your job, hours worked etc if you are available for anything else. Growing Family Benefits offers a more detailed breakdown by state.
I spoke with Lisa Tremayne, President of the Bloom Foundation for Maternal Wellness, who stated 3 weeks is a good start, but the culture around maternal mental health and wellness needs to change in many ways.
“Our country is starting to adopt the “fourth trimester” term which means people are beginning to understand there is a whole lot more to attend to after a mom leaves the hospital. Women spend so much time planning for their birth they quickly find themselves alone, isolated, and recovering from an enormously taxing 9 month ordeal. It is akin to planning for your wedding day and completely ignoring the marriage after the bride walks down the aisle. The marriage, to be successful, needs a lot more attention.
Healthcare providers are beginning to realize mental health is just as important (or more so) as physical health, however they are finding it difficult to establish qualified referral pathways for their patients when symptoms of perinatal mood and anxiety disorders present themselves.
“The Bloom booth was inundated with providers requesting evidenced based training for PMADs at the recent PSI conference in Portland, OR. As legislation continues to change to support mothers in the fourth trimester, healthcare providers are becoming overrun with patients needing assistances.” says Tremayne. “We are working to address that at Bloom and the 3 week decision is a great start, but we have a long way to go!”