During this time, they are vulnerable to depression, incontinence, high blood pressure and even infections that could endanger their health and future pregnancies.
New mothers need to have their first appointment sooner after giving birth, new guidelines from the American College of Obstetricians and Gynecologists urge. In the US, women are inundated with care while they are pregnant, but have not been expected to see a doctor for up to 12 weeks after delivering.
The American College of Obstetricians and Gynecologists has released new standards of care encouraging doctors to more closely monitor and consistently counsel vulnerable women, beginning three weeks after they give birth.
New mothers die at appalling rates in the US where they often wait 12 weeks after birth to see a doctor. But new ACOG guidelines are aiming to change that, calling for three-week follow-ups
The US continues to lag behind other countries in the care of new mothers.
Obstetricians and gynecologists have not previously been expected to see new mothers for up to 12 weeks after they give birth. Yet most doctors recommend that they can return within six weeks after delivering a baby – before many will even have seen their doctor.
Each year, about 700 women die in childbirth in the US – more than in any other developed nation. As maternal mortality has steadily fallen in countries like the UK, France and Canada since 1990, more American women actually died in childbirth in 2015 than did in 2000.
Black women die during and immediately after childbirth at three times the rate that white women do in the US. Surviving childbirth does not mean that these women are out of the woods, either.
More than 50,000 women that give birth in the US each year go through severe and often life-threatening complications of their pregnancies. Postpartum depression was once waved off as ‘baby blues’ and dismissed as the least of the terrors confronting new mothers.
But we now know better.
Postpartum changes and depression stands in the way of a woman’s ability to function, care for her child and return to work – yet she is expected to do so ‘devoid of formal or informal…support’ the American College of Obstetricians and Gynecologists (ACOG) committee writes.
‘The weeks following birth are a critical period for a woman and her infant…during this period, a woman is adapting to multiple physical, social and psychological changes.
‘She is recovering from childbirth, adjusting to changing hormones, and learning to feed and care for her newborn.’
Between 11 and 20 percent of American women experience postpartum depression as they adjust to life with a baby and after pregnancy. Yet, according to previous guidelines, the first postnatal follow-up appointment for women was not required for between four and six weeks after she gave birth.
What’s more, less than half of women even show up to these first appointments. A baby’s first appointment, on the other hand, is supposed to come within the first week of its life.
But mothers, the new guidelines make plain, are just as vulnerable as their children during this time.
‘This “fourth trimester” can present considerable challenges for women, including lack of sleep, fatigue, pain, breastfeeding difficulties, stress, new onset or exacerbation of mental health disorders, lack of sexual desire, and urinary incontinence,’ the committee acknowledged.
The group is now calling for postpartum care to ‘become an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual needs’ in order to ‘optimize the health of women and infants.’
Now, the association is asking that doctors assess new mothers within the first three weeks after they deliver, but leave their guidance open to a ‘woman-centered,’ individualistic approach.
The doctors of ACOG also called for changes to insurance plans – which broadly cover the care of pregnant women and newborns – to extend a woman’s covered care to the first 12 weeks after she gives birth.