Postpartum Care: Not just for home birth families anymore!

February 20, 2017 Birthstream

By Rachel Fox-Tierney, LM, CPM

In many countries around the world, new mothers and babies have several midwife visits in the first 4-6 weeks postpartum as a standard benefit of their health care system. Cross culturally, for 40 days post birth, new mothers are expected to rest and eat special healing foods. There is wisdom in this 40 day rest time. Physically, women are better healed and able to resume family and community activities when their six week rest time is completed.

Unfortunately, in the United States new mothers are viewed by society as "back to normal" within a few days after giving birth. Most American women do not get any preventative medical care during the first 4-6 weeks after birth. There is little support or evaluation of their physical or emotional adjustment until their 6 week OBGYN visit.

What I truly appreciate about the postpartum care is the fact it was a home visit. In my culture, a month bed rest postpartum was a mandatory custom. It was believed that it would help with postpartum depression and our health in the long run. So without this home visit postpartum care [with my first two hospital births and American postpartum care schedule], I found myself having to sacrifice and assimilate to Western culture by taking a newborn to physician's office for postpartum checkup. With postpartum care offered by Birthstream Midwifery, I was able to maintain my dignity as Woman of Color and kept my cultural customs in regards to postpartum. I felt so much love and respect. One of the most memorable things I had about the postpartum care was witnessing the beautiful interaction between my midwives and my newborn. How delicate and respectful they were with my newborn when they were performing newborn screen, to the point where my newborn was not traumatized at all. As a third time mom, that ceased my worries and concerns. I would recommend it to all families.

Client who had two hospital births followed by a home birth with Birthstream

In addition, new mothers are expected to leave the house within a few days of giving birth to get pediatric care for their new baby at a time when they are not yet healed from this major life transition. It is not surprising then, that as many as 1 in 7 to 1 in 5 women experience postpartum mood disorders in this country. Although midwifery care alone cannot prevent all postpartum mood disorders, many families have reported that they have felt better emotionally or are able to get the care they needed from mood specialists sooner than after previous births.

Midwives who attend home births have always included extended (or from our perspective basic and necessary) postpartum care for 6 weeks. Typically, midwives provide 4-6 visits in the first 6 weeks, some at home and some at the midwives' office. Birthstream Midwifery Service is unique in that we visit 6 times in the first six weeks and all care is provided in the comfort and convenience of the family's own home.

In the past few years, several families who planned hospital births have contacted Birthstream to request the kind of postpartum care they would have received if they were giving birth in their home country or the kind of care their home-birthing friends have received with us. Some families who had standard American postpartum care with previous babies felt that the patchwork of postpartum care that they had to piece together themselves didn't work out as well as they had hoped.

We understand! Postpartum care from skilled midwives was what all of the Birthstream midwives experienced after we gave birth. This is the kind of care that we think is beneficial to health and well-being for mother and baby and an essential component of comprehensive midwifery care.

By popular demand, Birthstream created a special Postpartum Care package just for families who give birth in the hospital:

· One meeting during pregnancy to meet and discuss postpartum care plans.

· Six scheduled postpartum visits for mother and baby: Day 1, 3, 5, Week 2, 4, and 6...or a personalized schedule, if preferred. Visits average 60-90 minutes in your own home.

· 24-hour availability for urgent concerns.

· Breastfeeding support.

· Postpartum Herbal Kit: Healing Peri-wash herbs, Manuka Honey, and Happy Ducts tincture for breast health.

· Keepsake with baby footprints.

· Placenta encapsulation available for an additional fee.

During each of the 60-90 minute visits, we include a newborn exam and new mother exam.

The Newborn Exam includes: checking baby weight, assessing heart rate and rhythm, evaluating breathing, assessing feeding and diapers. If there are concerns that we cannot address, we refer to a pediatrician of your choice.
The New Mother Exam includes: checking blood pressure and pulse, assessing postpartum bleeding (lochia), assessing tissue healing (especially if sutures placed), supporting lactation and evaluating emotional and psychological adjustment to new parenthood. If there are concerns that are outside of our scope of care, we can refer to physicians/specialists.

We have limited space in our calendar for families choosing this Postpartum Care package. Please contact us if you are interested in finding out more or scheduling a consultation visit.

I often say that while my home birth with Birthstream three years ago was perfect in every way, it was the six weeks of postpartum care -- for both me and the baby -- that was the best part. With our older two children, it was a real struggle in the days and weeks after birth to get the baby and ourselves out of the house and to pediatrician and subsequent OB/GYN appointments. I clearly remember the stress it created with our first child, when I was struggling with breastfeeding and in desperate need of sleep, to have to haul her to the doctor for her regular checks, when really what she (and I) wanted to be doing was lying in bed, working on nursing. As a new parent, hearing my daughter cry in the car seat on the way to the doctor's office was really difficult for me. I worried about my child contracting some ailment from another child in the pediatrician's waiting room. I often returned home feeling defeated after realizing the pediatrician did not know very much about breastfeeding and to positively facilitate that relationship. Visiting the pediatrician felt like a marked intrusion on our attempt to bond and figure out life together as a family -- but, of course, I wanted to make sure my baby was doing okay, so we went. When we had a second child 21 months later, it was even more logistically difficult to get everyone out of the house for all the appointments in the first six weeks, and many tears were shed in the process. (By my children, but many by me.) With our third child, we had a beautiful home birth, and it was a wonderful gift to be able to climb into my bed with our newest arrival immediately after her birth. But what was equally wonderful is that, for every check on the baby and me after that, I was welcome to stay in my bed with my baby! It was so freeing to not have to interrupt nursing and sleeping to get ready to drive to the doctor's office. The wonderful midwives at Birthstream were able to do all of the baby's assessments, as well as mine, for the entire six weeks. It truly made the postpartum period infinitely more lovely and less stressful than having to leave the house. Also, the level of care my baby and I received was extraordinary. The midwives are all kind, loving, respectful, and incredibly knowledgeable. I certainly would have benefitted from their vast array of breastfeeding pointers with my first child! Every check that the pediatrician (or my OB/GYN) would have done, they did, just that this time I was in my pajamas. It was also wonderful how much the midwives included my husband and young children in the visits. Every member of the family felt very included in the process of checking on baby and Mama. The midwives became a part of our family, and I will forever be grateful for all they did to help make this such a beautiful time in our lives. No matter where you opt to give birth, I cannot recommend more highly utilizing Birthstream for their postpartum services. Their care for you and baby at your house will allow for the most seamless transition into your life as a new family. I would add a line after the pajamas: The midwives were also available via text or phone call for any questions I had during this time, which provided an extra level of support and reassurance that I would not have had using a pediatrician or my OB/GYN.

Client who had two hospital births, followed by a home birth with Birthstream