Thesis: Postpartum care in the US is an absolute joke.
Supporting arguments: Postpartum in the US = the 6 week checkup.
To be fair, I did have two at-home nurse visits after my cesarean. They weren’t really for me, they were mainly for my son, but I did answer some stock questions for postpartum depressing screening; I passed. The nurse also checked my incision and felt to make sure my uterus was still contracting; it was.
6 weeks and then an entire year before I need to go back for my annual checkup because the 6 week postpartum checkup (where they check to make sure the body is healing from a vaginal or cesarean delivery, from incisions or tears or whatever else takes place in the horror that is childbirth) also counts as my annual for the year.
5 years ago and some months, my daughter was born. Also by cesarean. She weighed 10.1 pounds and I pushed for 3 hours before they decided cesarean was my best option. Fast forward 6 weeks or so to my 6 week appointment. My stitches were healing nicely and everything was looking great.
Given the go ahead, I joined my local Fit4Mom group immediately. I loved being able to workout with my daughter in those early months (Seriously, check this group out. So good for normalizing motherhood and experiencing grace as a new mom!). I noticed early on that I couldn’t side shuffle without pain but figured it was part of the normal healing process. I modified my workouts and filed that pain in a forgotten category of things to follow up on – behind getting enough sleep and normal maintenance, like a haircut. When I hit the 3 month mark with no further follow up, I went back to work.
My desk at work was moved from the main floor to the second floor during my leave and I noticed that I had to take each step with my right foot or pick up my left pant at the knee to get my left leg up the stair. My hip ached. I finally reached out to my OB and was surprised to receive a referral to a pelvic floor physical therapist (PT).
I didn’t know pelvic floor specialists existed.
Apparently if you try to actively push a 10.1 lb baby (or whatever size baby – because my experience is not at all unique to mothers of large babies) for 3 hours (or whatever amount of time including none – because same), you may experience what is known as pelvic floor trauma. Yes, trauma. My PT’s choice of words. Not mine.
My son, born 5 years later, was scheduled as a cesarean. This filled me with such immense peace and glee that I waltzed into the operating room. No pushing! This post isn’t meant to be his birth story so I won’t go much further into the details except to say that this time my child weighed 11.9 lbs.
I had my 6 week follow-up appointment 6 weeks and 2 days after he was born. My stitches were healing nicely and everything was looking good.
Fast forward several months. I came across a beautiful mother of triplets on Instagram, @triplets_of_copenhagen, who shared her postpartum journey with pictures. She talked about her struggle with diastasis recti and I thought to myself, “Hey, I’m having a really hard time “bouncing back” (whatever the hell that means…VOMIT). I had a really big baby (the combined weight of some twins). I have general unease around my core muscles and feel like I’m falling apart. And thanks to her vulnerability in sharing her story, I can see that we have visual similarities. Maybe I have diastasis recti too.“
So I messaged my OB provider and they referred me to… (Can you guess?)
A pelvic floor PT!
And that’s where I learned that I have a 3-finger width spread of my stomach wall (diastasis). I also learned that excruciating back pain I’ve starting seeing my chiropractor about recently is likely caused by a combination of the diastasis and the fact that I carry my little (big) guy on my left at all times.
My point is, 6 weeks isn’t enough time to see how a mother’s body is healing. In both of my pregnancies, I was fine at 6 weeks (or rather I wasn’t but hadn’t yet received the go-ahead to start doing any physical activity that would help identify or exacerbate an issue – that go-ahead is a big part of the 6 week appointment after all).
By 3 months with my first, I couldn’t walk up stairs. By 6 months with my second, I can’t lay down flat on a hard surface without searing back pain and I’m currently working through 8 PT sessions and daily homework to get back on track from injuries that would have worsened with traditional abdominal exercises. Yet both times I passed my 6 week checkup with flying colors.
Thankfully my OB, who I love, knew to refer me a pelvic floor PT. When I scoffed 5 or so years ago at his suggestion, he assured me it’s where I needed to be and he was right. This isn’t a critique of him or the care I received at his guidance. It’s a critique on standard postpartum care in the US. It’s a joke and we deserve better.
Please let me know your thoughts and recovery experience by commenting below!