“One can dream.”
That’s often a quote we hear when we talk about winning the lottery or landing a job that lets us do something great like being a taster of new ice cream flavors for a living (I wish).
However, what’s sad is that many American moms utter those same words when they think about life after baby. A year of paid maternity leave. Access to a good lactation consultant. Family members who don’t just visit but who actually come to help out. One can dream, but one shouldn’t have to.
As an OB/GYN practicing in the United States, I think we do pretty good things for moms and babies in our country. However, I think there is one huge area where we fail, and that’s in caring for new families in what is known as the “fourth trimester,” the 12 weeks after giving birth that can be such a joyous but also exhausting time for new parents.
A new project out of the University of North Carolina at Chapel Hill is looking to address exactly this time period. They are planning to identify areas where we fall short (mental health, for example) and launch research studies to see how we can do better.
Reading that article made me think: What would the perfect world for a postpartum mom look like? As a women’s healthcare provider and as a mom with a young baby at home, I felt like I could take a stab at this. I might be dreaming, but if we had even a few of these standards in place, the families in our country would be off to a much better start. Here’s what I would recommend, and you can feel free to add your own.
More frequent follow-up
So many new moms are sent home from the hospital not to be seen by their doctors for 6 weeks. A lot happens in 6 weeks! And she just experienced a momentous event, physically and emotionally! In my perfect world, new moms are seen within 3 days after hospital discharge, then at 2 and 6 weeks postpartum — and definitely more frequently if needed. And speaking of these visits …
… most should happen at home! How terrible is it that we ask new parents to try and get out of the house and make it into a doctor’s office when they can barely figure out how to do anything in a reasonable time period with their new babies? And bringing them into an office filled with sick, coughing kids and long wait times? We can do better. Let’s have home visits that allow providers and lactation consultants to have longer visits that are in a comforting environment (and that allow them to really see how life at home is going).
Breastfeeding support that starts in pregnancy and continues on
Speaking of lactation consultants, every expectant family should meet with one during the prenatal period to get accurate facts and have one on speed-dial for those early postpartum days. All breastfeeding moms should be seen by a lactation consultant (and preferably an IBCLC) in the hospital; not just the ones who are having problems. These moms should be visited again shortly after they are sent home, and as frequently as is necessary. All new moms should be given information on breastfeeding support, whether that means local groups, online sites, or hotlines.
Doctors who know more about normal infant weight loss, feeding, and sleeping patterns
Want to know something sad (and a little scary)? Most doctors get very little training on these topics, but this is exactly what new parents expect their pediatrician to guide them on! Instead of doctors setting parents up for failure when they say a two-month-old should be sleeping through the night, or any breastfeeding difficulty means supplementation is needed, let’s improve training in these areas, so new moms are getting the right information. While we’re at it, let’s make sure all pharmacists, radiologists, and anyone who interacts with a nursing mom has appropriate education on the topic, so they don’t keep falsely advising moms to pump and dump or wean for ridiculous reasons like getting a CT scan.
Counseling on the normal physical recovery of childbirth
At all postpartum visits, moms should be asked about their exercise routine, not only to encourage activity for good physical and mental health, but also to make sure she knows what’s considered safe and what is too much (or not enough). New moms should be counseled that the concept of “bouncing back” and losing all the baby weight in a matter of weeks after giving birth is completely false and not healthy. Health care providers should stop commenting on how a woman looks like she never even had a baby, or making other judging remarks, as these are very personal and invasive comments and are not necessary.
Longer, and paid, parental leave
In my dream world (hey, it’s my dream!), all moms can have access to a year of paid maternity leave if they want it, with partners having access to a fair leave time, as well, to provide support. How can we ask moms to breastfeed for at least a year when we don’t help them be with their babies?
Bring back the village mentality, and feed the new moms!
The fourth trimester should be a time when friends and families enjoy meeting a new baby, but still primarily see this as a time when mom still needs extra help. So many other cultures do this better than we Americans. We should automatically see this as a time to bring by meals, set up help with cleaning and laundry, and care for our new moms even when they don’t go out of their way to ask for it.
Mental health check-ups
All new moms should be screened for postpartum depression/anxiety, and not just once. All postpartum visits, lactation consults, and pediatric appointments in the fourth trimester are opportunities to screen for this, the most common of postpartum complications. I would ask that all parents also be given information on signs of this and told where to access help if it’s needed.
Access to birth control
Every mom leaving the hospital should have a birth control plan, whether she opts for abstinence or an IUD, and we should make sure her wishes are put into place. This means making it easy for her to have access to the birth control method of her choice, such as timing her IUD insertion to be done at the same visit as her 6-week postpartum check-up. Get rid of barriers (cost, extra appointments) and help these new moms pick a method that is right for them.
A society that welcomes crying babies (yes, really!)
Maybe a stretch, but like I said, it’s my dream. I would wish for a world where babies are not seen as a nuisance at the coffee shop when they start crying, but rather as a respected member of our community. Let’s help out by holding the door for that mom struggling with her stroller. Rather than shooting nasty glances when a mom is nursing in public, how about giving an encouraging smile? These moms are short on sleep and high on stress, so let’s make this one day in her fourth trimester one that she remembers positively.
Jennifer Lincoln is an obstetrician-gynecologist. This article originally appeared in Bundoo.
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