Why I Offer One Year of Postpartum Care
The care we give postpartum folks in the first days, months and year can lower rates of postpartum depression and anxiety.
The answer to this is simple. I offer one year of postpartum care to midwifery clients because the average 1-2 postpartum visits offered by OBGYN’s and average 3-4 visits offered by midwives aren’t enough for many new parents. It is common for me to hear that new families desired care beyond the standard 6 weeks. Rainbow Midwifery offers up to 9 postpartum visits spanning from 1 day to 1 year after birth.
Did you know that extended postpartum care has benefits like:
screening for diastasis recti during the optimal window of (at least) 6-12 weeks postpartum. Any earlier than 6 weeks is too early and 7-8 weeks or more is ideal.
screening for Postpartum Depression and Anxiety which can present any time in the first year but often do not appear until 2-3 weeks postpartum.
helping transition back to work or discussion of sibling dynamics/adjustment.
discuss things such as babywearing, sleep, parent connection, family planning, creation of a support network, community building with other families, etc.
midwife available for birth processing throughout that first year.
a smoother transition postpartum because your midwife can share a variety of resources and referrals as needed well beyond 6 weeks.
Postpartum care in the United States has traditionally been limited to immediately after the birth and a check up at six weeks postpartum. That has left American mothers and birthing people with limited access to guidance and support from the time they leave the hospital until they go to their 6 week check up. In 2018, the American College of Obstetricians and Gynecologists (ACOG) updated their recommended postpartum schedule to include a 3 week check up and a comprehensive check up by 12 weeks postpartum (McKinney et al., 2018) Unfortunately according to a 2022 systemic review by Attanasio et al, many women do not attend even one postpartum check up. Most common complications first emerge during this critical time and this is the time that interventions and support are needed most.
Contrast that to Switzerland, as one example, where they have some of the best maternal and infant health outcomes. If you live in Switzerland you can expect to be seen regularly at home by midwives for the first few weeks after giving birth. The Swiss midwifery model of care allows for up to 16 home visits after the birth of a first child and up to 10 home visits for subsequent births. In most cases, midwives focus on the birth experience, common physiologic signs and symptoms, assessment for possible birth injury, nutritional interventions, lactation support, physical assessments of the birth person and newborn, checks for hyperbilirubinemia, newborn growth and development, sleep, contraception, sexual health, transitions to parenthood and communication is available with the midwife between visits (Edmonds et al. 2024).
The US could learn a lot from the Swiss system of midwifery care and other countries with significantly superior health outcomes among their birthing populations. I, for one, am committed to taking one tiny step by offering families in my care extended postpartum care in the community setting. My dream and my wish is for this level of care to become more available to the people giving birth throughout the United States because one tiny ripple has the potential to be a catalyst into the mainstream.