The 6-Week GapBy Nilma Black, 23 May 2019
When you're pregnant, every hiccup and kick is awe-inspiring. There is hardly a detail that is insignificant. You tell your friends and medical provider about everything you experience during your pregnancy. You get growth updates and frequent check-ins to ensure your baby's health is on target. Then it finally happens: you have a baby! However, wherever, whenever, with strength and courage, you give birth. You’vegrown and birthed another human being inside yourself. This is no small feat. So what happens now? Amazing things. Like bringing your sweet baby home and learning everything about what it means to have a child, like feeding and caring for your baby and acclimating to the new dynamics of your household. What else happens? Something less amazing. Like most new families, your quality of care (or specifically, frequency of care) diminishes to a non-existent state. You have a pediatrician for your baby, maybe your own family comes to help cook and clean a bit, or maybe you have a postpartum specialists to help care for your baby. Do you notice that something very important is missing? It’s you. You're missing. Your own care is missing entirely. When you were pregnant you called your provider for every one of those new developments of your body. Who do you call after birth? You will be bleeding postpartum, or maybe you're feeling blue, wondering about sex or just not yet used to your new body. Who do you turn to for a support system? Unfortunately, as it currently stands, you most likely won't be seeing your medical provider for 6 whole weeks after your birth! This is huge gap of time. Recently, the American College of Obstetricians and Gynecologists (who are the board of OBGYNs that help establish protocol and new research) drew attention to this issue by putting out a memo telling doctors to see their patients sooner after birth. The postpartum period, or the fourth trimester, cannot be addressed by a single visit to a provider who isn't familiar with this delicate and unique time. Instead, it is an evolving, acute moment in a new family unlike any other. Ongoing care is optimal for everything from mental health to physical healing and newborn support. The 6-week gap must be replaced with frequent visits, phone calls and a network of professional, compassionate care not just for the baby but for the mother/parents and family as well. Most midwives do see their patients sooner than 6-weeks. The gap seems to be mostly related to obstetricians, but it is important to inquire with your midwife too. For example, ask: What is my plan of care after I have the baby? When will I see you? Who will help me with postpartum recovery, my changing body and any other needs that come up? If you haven't checked in with your team about what happens AFTER childbirth and the care you're going to get, please do. Ask them if you can have a few more appointments in between birth and 6 weeks. If that isn't on their radar, do your best to fill in the gap with postpartum doulas, lactation consultants, local new mother's circles, pelvic floor physical therapy and other postpartum professionals, not to mention family and friends.