Health Concerns During the Postpartum Period

Postpartum well being is one of the most underreported, studied and monitored life stages in the United States. Women are trapped in a limbo between prenatal care, where they are carefully and diligently monitored by one or more obstetricians and nurses, and general life, where they are cared for by a general practitioner and/or gynecologist. Postpartum women tend to rely on the advice of nurses, family members or just a gut feeling. But when an estimated 10% of new mothers are suffering from some kind of postpartum depression or worse, why aren't doctors getting involved?

Before we get into down and dirty facts, let me share my story. I gave birth to my second daughter in September of 2004. A week after her birth, I was nagged by a constant, burning pain in my abdomen. For a few days, I ignored it, until finally, I couldn't ignore it any longer. I could no longer sleep, eat or even stand. I called my OB, but was told it was nothing, and if it persisted to contact my general practitioner (GP). I was no longer prenatal, so she was no longer my primary care giver. Three days later it flared up again, and I contacted my GP, who instructed me to contact my OB. I was postpartum and that was an OB's field of expertise. This continued for 6 weeks. I would call the doctor, any doctor, and get the same response - call someone else. I would visit the emergency room and be instructed to take antacids and to call my OB (sometimes GP) in the morning. So, here I am, five weeks into constant, continually worsening pain, wracked with the 'baby blues', with an infant to care for, and no doctor to help me.

The end result? My gallbladder had developed severe stones, my liver was shutting down, and I required immediate surgery. For five weeks I was consistently misdiagnosed, when the condition I was experiencing affects nearly 12% of all postpartum mothers! Where were my doctors in all this?

Women tend to slip through the cracks in the postpartum period. After delivery, the focus shifts from the woman's health to the baby's well-being, and rightfully so in many cases. However, postpartum women are at a higher risk for any number of disorders (uterine hemorrhage, anemia, and depression, to name a few), and still need close monitoring. From the time they leave the hospital until the 6 week check-up, women are, for the most part, left to their own devices. Check-ups tend to consist of routine questions, pelvic exams, birth control discussions, and, of course, questions about the baby.

It doesn't help the situation that most insurance companies end the postpartum period at six weeks, despite the medical opinion that it should extend to one year. Doctors rush women to have their exam to ensure it is covered; after all, an early exam is better than no exam at all.

A study published by the National Institutes for Health outlines many of these problems and what governmental steps should be taken to fix them. It has yet to be accomplished, and postpartum women will continue to suffer without adequate treatment opportunities until something is done.

What can a postpartum woman do for herself? Keeping objective, caring help close by is the most important thing a postpartum woman can do to protect herself and her newborn. A mother, sister, aunt or friend can all serve as a whistle blower, a shoulder to cry on, and an emergency baby sitter. Without strong support, the postpartum woman can be ignorant of potentially serious complication, or be prevented from seeking medical treatment with no one to watch her infant. By keeping support close, she will be more relaxed, more assured and always able to care for herself if the need arises; all of which, luckily enough, reduce the severity of postpartum depression.

Women and their families shouldn't have to play doctor. Our postpartum health care system needs to be restructured to ensure the women charged with caring for our nation's children do not become another unfortunate statistic.