Transcripts
Hey mama.
Trish:Welcome to postpartum unpacked, the realest place on the internet to talk about life after baby.
Trish:I'm Trish, labor nurse mama, mom of seven.
Trish:And now that we've walked through pregnancy together, it's time to unpack the wild, beautiful, emotional rollercoaster of postpartum from birth recovery to year one, and everything in between, we're talking healing hormones.
Trish:Eating, sleep, sex, mental health, mom rage.
Trish:Nothing is off limits.
Trish:I'm gonna be interviewing some of my Calm Mama Society members and we're gonna talk about real situations, so hit follow, leave a review and let me know what you want to hear more of.
Trish:I'll be here each week cheering you on through it all.
Trish:Let's do it together.
Trish:You are getting ready for your postpartum checkup and you're thinking to yourself, this is where everything gets fixed, where all your questions get answered.
Trish:You finally get cleared for normal life.
Trish:But here's what I want you to know.
Trish:As a LI and delivery nurse of over 16 years and a mom of seven.
Trish:Waiting six weeks for one appointment is not enough.
Trish:And even though the American College of Obstetricians and Gynecologists agree with me, I'm gonna tell you exactly why and what you need to do about it.
Trish:So they recommend three weeks, and we're gonna talk about that.
Trish:I'm Trish, labor Nurse Mama, and if you're waiting for a six week visit.
Trish:And you feel dismissed or confused, then this is for you.
Trish:So you're going to know exactly what ACOG actually recommends for postpartum care versus what most women are actually getting, and some critical things that should be covered but are more than often missed.
Trish:I'm gonna give you some specific questions that you should ask to actually get the care you deserve.
Trish:And how to navigate a really broken system.
Trish:And I get it.
Trish:It's failing.
Trish:It's failing women in general, but stick with me because this information could be the difference between struggling for months and actually healing.
Trish:Here's the truth, mama, you just went through one of the most physically transformative events your body will ever experience until you have the next baby.
Trish:Pregnancy and birth causes massive changes to your musculoskeletal system, your hormones, your pelvic floor, your mental health, and what most people don't realize is acog, the American College of Obstetricians and Gynecologists, the organizations that set the guidelines for postpartum care actually updated the recommendations.
Trish:They recognize that the old way we've been doing it forever does not work.
Trish:The one standard one visit at four to six weeks after birth.
Trish:And that was it.
Trish:But ACOG now says, that's not enough.
Trish:Postpartum care should be an ongoing process with multiple checkups during the 12 weeks after birth, not one visit at six weeks, multiple visits starting earlier.
Trish:ACOG now recommends that your first checkup should be within three weeks after birth, three weeks, not six.
Trish:And that earlier visit gives your provider a chance to find out how are you really feeling and help with any problems early on when the intervention really matters the most.
Trish:If you've had high blood pressure during pregnancy, you should have a checkup even sooner, like three to 10 days after birth.
Trish:Then additional visits should be scheduled as needed before a final comprehensive checkup around 12 weeks, and that is what ACOG recommends.
Trish:But here's the problem.
Trish:A lot of practices have not implemented yet.
Trish:Most women are still getting scheduled for one visit at six weeks, and that's it.
Trish:The guidelines change, but the system has not caught up.
Trish:So let me tell you what's still happening.
Trish:For many moms, especially, I've heard from a lot of moms in my membership.
Trish:You wait six weeks, you're struggling with leaking pain, feeding challenges, exhaustion, maybe feeling really, really sad.
Trish:But you wait because you think that's what you have to do.
Trish:You have to wait until that six week appointment, and when you finally get there, your provider rushes in, rushes out, does a quick physical exam.
Trish:They check your incision if you had a C-section or your perineum, if you tore or had stitches, and they might even do a pelvic exam.
Trish:They ask if your bleeding is stopped.
Trish:They ask how you're feeling.
Trish:Then if everything looks, and I say it in quotes, normal, you're cleared.
Trish:They clear you, clear for exercise, clears for sex, cleared for normal activity, appointment done maybe 10, 15 minutes total, and you walk out thinking.
Trish:Okay.
Trish:I guess that's all normal.
Trish:I guess I'm fine.
Trish:I guess this leaking when I sneeze is just my new normal.
Trish:I guess this pain is something I just have to live with, but you shouldn't have had to wait six weeks in the first place and one rushed visit isn't enough.
Trish:Here's what should be happening.
Trish:According to ACOG's updated guidelines, you should be seen within three weeks for that first check-in.
Trish:Now remember, if you're high risk of any kind, sooner.
Trish:At that visit, your provider should assess how you're feeling, how you're feeling physically, how you're feeling emotionally, how you are healing and catch problems early on.
Trish:Then you should have additional visits as needed based on your individual situation, and around 12 weeks you should have a comprehensive visit that covers everything, not a scoot in, scoot out.
Trish:So what should be covered in these postpartum checkups?
Trish:Your provider should do a full physical exam, including a pelvic exam, to make sure you're healing well from your birth, and that's whether you've had a vaginal or C-section.
Trish:They should ask about problems with feeding newborn care.
Trish:Are you struggling with breastfeeding?
Trish:Are you overwhelmed with your baby care?
Trish:They should ask about your sleep.
Trish:Your fatigue, your pain, your bleeding.
Trish:Not just how are you feeling, but specific questions about what you are experiencing.
Trish:They should ask about urinary problems.
Trish:Are you leaking?
Trish:Do you have pain?
Trish:Are you leaking poo?
Trish:Like any of it, right?
Trish:Because, uh, bowel incontinence is also a thing.
Trish:Do you have pain when you urinate?
Trish:Do you have sudden urges to go?
Trish:They should ask about gas and constipation.
Trish:These are common postpartum issues that might affect your quality of life.
Trish:Like you don't wanna be tooting all the time, right?
Trish:Because you have fetal incontinence.
Trish:You don't wanna be pooping in your pants, you wanna be peeing, you don't wanna be told.
Trish:These are all normal things.
Trish:They also should assess your need for emotional support and help with childcare, chores, transportation, meals.
Trish:They should ask about your basic needs.
Trish:Do you have food?
Trish:Do you have diapers?
Trish:Can you pay your bills?
Trish:These social determinants are also a health matter.
Trish:They should ask about your sexual health.
Trish:When is it safe to have sex?
Trish:What do you do if you have pain or concerns about lack of interest?
Trish:What do you like?
Trish:You just don't want it anymore.
Trish:Birth control options and timing for getting pregnant again, most women should wait.
Trish:Now I say this even though I didn't do it, should wait at least 18 months between pregnancies for your own wellbeing.
Trish:But girl, you do you.
Trish:They should screen for long-term health risks.
Trish:This is critical.
Trish:Pregnancy is a window into your health for the rest of your life.
Trish:So if you had high blood pressure while pregnant, your risk for heart disease later in life might be higher.
Trish:If you had gestational diabetes.
Trish:Your risk of developing diabetes in the future increases your provider should explain what's.
Trish:What ongoing care you need for any medical problems, and they should also help you connect with specialists who provide it.
Trish:You should not be shooting in the dark girl.
Trish:They should be helping you.
Trish:That's what should happen.
Trish:But what often gets missed, especially when you're only getting one quick visit at six weeks, pelvic floor dysfunction and research shows that even in the best case scenario, the pelvic floor withstands immense strain dur.
Trish:That's obvious.
Trish:They had to research that right after any woman who's had a head go through her vagina could have told 'em that.
Trish:And between 24 and 42% of women report to stress from prolapse, urinary or colorectal symptoms, and at least 45% of women report pelvic girdle pain or low back pain.
Trish:But how many of us actually get a proper pelvic floor assessment?
Trish:And how many actually get referred to a pelvic floor physical therapist?
Trish:I'll tell you the answer hardly any.
Trish:Now in France, patients automatically receive a prescription for 10 physical therapy visits to rehabilitate their abdominal and pelvic floor muscles after childbirth 10.
Trish:That is standard in the United States.
Trish:Most women don't even know pelvic floor physical therapy exists until they've been suffering for months or years.
Trish:Let that land, like how sick is that?
Trish:Mental health screening also is pretty superficial.
Trish:Postpartum depression affects up to one in seven women.
Trish:It's the most common complication after birth, but proper screening takes time and the right questions and going through a hurried little rushed appointment.
Trish:If you say you're fine because you're embarrassed or you don't wanna seem like you're not coping, or you're not coping, and you just can't even answer questions, that's it.
Trish:End of conversation.
Trish:And if you're only being seen at six weeks, symptoms that started earlier might have been missed entirely.
Trish:Another thing is diastasis recti, and that is a separation of your abdominal muscles, which affects a huge percentage of postpartum women.
Trish:But most providers don't check for it.
Trish:They don't measure it.
Trish:Don't give you guidance on how to heal it.
Trish:You're just told you're cleared to work out, and then you start doing crunches and make it worse.
Trish:Sexual function and pain all get brushed aside.
Trish:If you even mentioned pain during sex, you might get told that's normal.
Trish:Give it more time, you just had a baby or use more lube.
Trish:But pain during sex is never normal.
Trish:It can be a sign of pelvic floor dysfunction, scar tissue, hormonal changes, or other treatable issues.
Trish:You deserve real help, not dismissal, and it just, I'm, this, this is making me really emotional as I was preparing for this episode, because I never got this, I never got real help.
Trish:I, I always had the one six week checkup.
Trish:Okay?
Trish:Another thing is comprehensive feeding support.
Trish:Now, we, we will just put out there, I'm not a pelvic floor specialist.
Trish:I'm not a breastfeeding expert.
Trish:I have breastfed most of my life, but that does not make me an expert.
Trish:But whether you're breastfeeding or formula feeding.
Trish:Like you don't get feeding support if you're still struggling at three weeks.
Trish:Waiting until six weeks to get help can really mean weeks of unnecessary pain and stress, and you need support early.
Trish:So what do you do?
Trish:What do you do?
Trish:How do you get the care you need?
Trish:Here's my plan for you first, before your baby is born, find out what your insurance covers.
Trish:The change to multiple postpartum checkups is still new, so your insurance may not cover more than one visit.
Trish:Find out now so you can plan.
Trish:Ask your provider's office, do you follow the new ACOG guidelines for multiple postpartum visits?
Trish:Will I be seen within three weeks or do I have to wait six weeks?
Trish:If they only schedule one visit at six weeks, ask why.
Trish:Ask if you can schedule an earlier visit, especially if you had any complications or worries.
Trish:Second, know your options.
Trish:You can ask about telehealth visits if getting to the office is difficult.
Trish:Phone video calls are far more common now.
Trish:Y'all are lucky.
Trish:Ask.
Trish:About bringing your other children to the visit if you need to, don't let logistics keep you from getting care and don't wait for your scheduled appointment.
Trish:If you're struggling, if you're having problems at two weeks, three weeks, four weeks, whatever, call your doctor.
Trish:You do not have to suffer.
Trish:While you wait, you don't third advocate for yourself at your visit.
Trish:Don't just say fine.
Trish:When you're asked how you're feeling, be specific.
Trish:Say I'm leaking urine.
Trish:When I cough, say I'm feeling sad and overwhelmed Most of the days say, sex is painful.
Trish:Say I'm having trouble.
Trish:Make sure your provider addresses things specifically.
Trish:Fourth, ask for proper screening and assessment.
Trish:Ask, can you assess my pelvic floor function?
Trish:Not just look at it at healing, but check if I can contract and relax my pelvic floor muscles properly.
Trish:And they probably need to send you to someone and hopefully they will.
Trish:Do I have diastasis recta?
Trish:Can you measure it?
Trish:Can you screen me for postpartum depression and anxiety using a validated screening tool, not just asking how I'm feeling.
Trish:And if I had gestational diabetes or high blood pressure during pregnancy, what ongoing care do I need?
Trish:What are my long-term health risks?
Trish:Can we make a graded return to exercise plan?
Trish:Like with specifics, not just blanket.
Trish:Yep, you're cleared.
Trish:fifth, ask for referrals.
Trish:Ask for a referral to a public floor specialist Asks, especially if you have any leaking, heaviness, pain, or if you want just proper assessment.
Trish:You don't have to wait until you have a problem, ask for a referral to a lactation consultant, and we're gonna link to.
Trish:Some that do virtuals because you don't necessarily have to have a referral, but get help.
Trish:Ask for mental health resources.
Trish:If you're struggling, your provider should be able to refer you, but otherwise, take charge, get help.
Trish:Here's what I want you to understand.
Trish:The fact that standard postpartum care has gaps is not your fault.
Trish:ACOG has acknowledged this.
Trish:They changed the guidelines because waiting six weeks for one visit isn't enough, but the system is slow to change.
Trish:Most practices are still doing it.
Trish:The old way, but you don't have to accept inadequate care.
Trish:You don't have to.
Trish:You can advocate for an earlier visit.
Trish:You can ask for multiple visits.
Trish:You can seek out specialists if you need them.
Trish:Your body went through something so incredibly amazing, but also so traumatic.
Trish:You deserve comprehensive, compassionate, ongoing care.
Trish:Now I know all of this is overwhelming, and hopefully I'm not overwhelming you.
Trish:I know you're already exhausted.
Trish:You're taking care of a baby.
Trish:Now, I'm telling you that you need to coordinate your own care, advocate for yourself.
Trish:Navigate insurance, find specialists.
Trish:I get it.
Trish:That's exactly why I created the Postpartum Recovery Roadmap.
Trish:It's a comprehensive guide that I wish every mom had, and in fact, if you join my birth classes, the complete birth bundle, so if you're listening, you're pregnant.
Trish:Go to labor nurse mama.com/calm and you can grab the complete birth bundle and you'll get my postpartum recovery map free.
Trish:If not, if you're in postpartum and you wanna know what to expect, what's normal, what's not, when to call the doctor, when to see the specialist, how to troubleshoot.
Trish:You can grab our postpartum roadmap.
Trish:It is one place for everything, so you don't have to figure it out alone.
Trish:It normally sells for 1 97.
Trish:You can grab it for just 22.
Trish:Go to learn dot labor nurse mama.com/.
Trish:Postpartum and get your roadmap today.
Trish:If you want ongoing support, not just support just one time.
Trish:We also have our Calm Mama Society that is my membership community, where you get access to me and hundreds of other mamas navigating postpartum together, and we have a postpartum doula inside of there.
Trish:You deserve so much better than waiting for six weeks for one rushed appointment, like you deserve the care that ACOG says you should be getting.
Trish:I really.
Trish:I want you to know that you deserve more.
Trish:You deserve more, period.
Trish:If this episode helped you, save it, share it, leave me a review, write a comment.
Trish:Tell me your situation.
Trish:When was your postpartum visit?
Trish:Was it three weeks, six weeks?
Trish:Did you get multiple visits?
Trish:Do you feel like you were cared for enough?
Trish:Leave a comment, leave a review.
Trish:Let us know, and we will see you again next week.
Trish:As always, bye for now.
Trish:I adore you.
