Postpartum Care: A post where you will learn entirely too much about me because I think sharing our experiences matters

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.

Lucky me.

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!

PPD and Me

I said there’d be more to come on my returning BFF postpartum depression/anxiety (PPD) and then I went dark on writing. It’s pretty standard behavior for me. About the time I hit “Publish” on a vulnerable post, I start to sweat and sometimes the room spins and I feel ill. This feeling typically continues for a few days. I also go through this routine any time I publicly advocate for anything too so I hope you understand it takes me a while to build up the moxie to do it again!

To be honest, I feel like a bit of an impostor claiming it because on the scale of PPD, it could be a lot worse. I felt (feel?) off. Disconnected. Disengaged. Foggy. “Meh” and a bit emotionless. I started sleeping less. If I suffered through Postpartum Anxiety with Emma, this felt (feels?) like Postpartum Depression. So I read over the pamphlet I got from the hospital and started taking some vitamins. I’m eating better. I called my therapist.

I love being able to say that, by the way: “I called my therapist.” I have a group of girlfriends who all go to a therapist and talking about mental health is as normal as talking about our weekend plans or eating lunch. “What do you mean you didn’t call your therapist?” It’s so good.

The thing about PPD is there’s a dumb little points test called the Edinburgh Postnatal Depression Scale (EPDS) you can take to score yourself but it’s not like you go get a blood test and the results come back positive. You can pretty clearly be diagnosed if you’re having thoughts of harm or bawling uncontrollably all of the time but the rest are subjective questions that you can fudge a bit, whether consciously or unconsciously.

Did you know they’re finding that men suffer similar symptoms of PPD? It’s true. I read it on the Internet. Actually, it was in my hospital pamphlet and I’m over here thinking “Yes! The conversation is continuing to change and grow and I am here for it!” (And if I’m being honest, I’m also feeling a little bit of “Thank God! Women’s health issues are so often minimized; this could bring changes in standard care!”)

What I’m really coming to believe is that everything is relative and when it comes to mental health and self-care, it doesn’t really matter if you have a clinical diagnoses or not. It doesn’t matter if your bad isn’t as bad as someone else’s. Do you feel off? If you feel off, you already know something isn’t right. You don’t have to have permission to work on righting it. You don’t have to go through it on your own because you don’t feel like it’s bad enough. You don’t have to accept some stunted notion that you’re supposed to feel a little off right now. FORGET THAT NOISE. It’s not for me.

There’s a line at the end of the EPDS test that says “If your total is 12 or higher two weeks in a row, or for any continued emotional concerns regardless of the score, call your health care provider.” [Emphasis theirs]

When you’re hovering around but mostly under 12 or increasing every few weeks but you’re not at 12 or if you know you’re off but you’re not scoring, you read the bold text and you think “Oh, so not me?” You’ll completely read over that second part of the sentence which says, “For any continued emotional concerns regardless of the score, call your health care provider.”

Friends, I’m telling you, make the call. Take the vitamins. Tell your people. Join the group. Whatever it is, speed up the process of healing. Don’t buy into this idea that it’s normal to feel (subjectively) a little crappy in the first year. What does that even mean?

If you were wondering about my self-confidence…

Today I was able to button my pre-pregnancy jeans!

Also today:

Walgreens employee stopping herself mid-sentence while recommending cold medicines: “Unless…” she trails off, staring at my stomach.

“What?” I snap.

“Oh nothing,” she replies, prying her eyes up from my midsection.

“Unless you wanted to ask the pharmacist or something.”



Today’s outfit is brought to you by Motherhood Maternity. They don’t sponsor me or anything but they’re all that [comfortably] fits me right now.