Breaking News: American College of Obstetricians and Gynecologists (ACOG) Redesigns Postpartum Care

We've discussed whether or not exercise is safe during pregnancy here, but lately a bigger conversation has been happening about postpartum care and how it needs to improve - for mama's mental, sociological, and physical well-being.

Did you know over 40% of women do not return to their OBGYN or doctor for their routine postpartum follow-up visit? (ACOG, 2018).


Photo by Michelle Mattox Photography

This week, the ACOG released a revised Committee Opinion, reinforcing the importance of the “fourth trimester,” and proposing a new model for postpartum care. Redefining postpartum care is an initiative in place by ACOG President Haywood L. Brown, M.D. (ACOG, 2018).

FIT4MOM was founded by a woman and mother, Lisa Druxman, is run by working mamas at our corporate headquarters, and is full of franchise owners who are all moms and mompreneurs, so when it comes to pregnancy and knowing postpartum care needs, we've all been there, first-hand.

If you asked any mom if she feels postpartum care TRULY makes her feel supported and understood as a new mom, she would probably say no.

ACOG previously recommended a comprehensive visit within the first six weeks postpartum (ACOG, 2018).

So, basically, you give birth to a baby, become a new mom, and are pretty much left in the dark when it comes to routine follow-up postpartum care. My mom friends and I always sarcastically said, "So basically we only have a follow-up postpartum check-in so we hear it's okay to have sex again and that's it? What about how I'm doing?!"

I, myself, suffered from postpartum anxiety, having NO clue that was actually a real "thing." I also had a C-section and didn't feel like my body was even close to feeling somewhat normal until 8 MONTHS postpartum. I remember at my 6-week check-up, my OBGYN looked at my incision, said everything looked fine, asked a generic, "How are you?" to which I replied, "I'm good."

And that was the end of it. I was sent away, marked as "all-clear", and never saw that OBGYN again.

"ACOG now recommends that postpartum care should be an ongoing process, rather than a single encounter and that all women have contact with their ob-gyns or other obstetric care providers within the first three weeks postpartum" (ACOG, 2018).

Alison Stuebe, M.D., lead author of the Committee Opinion, states, “New mothers need ongoing care during the ‘fourth trimester.’ We want to replace the one-off checkup at six weeks with a period of sustained, holistic support for growing families...Our goal is for every new family to have a comprehensive care plan and a care team that supports the mother’s strengths and addresses her multiple, intersecting needs following birth" (ACOG, 2018).

THIS IS HUGE. There is an "urgent need to reduce severe maternal morbidity and mortality" (ACOG, 2018), and the only way to accomplish this is to have doctors, friends, family, employees, and society really, truly ask HOW mom is doing - diving deeper into asking more questions and assess not only mom's physical well-being, but also her emotional well-being. New moms don't know what is "normal" and doctors can be intimidating. We put a certain level of trust into our practitioners, and if they think we're "okay," we think we're "okay."

But what does "okay" really mean?

After childbirth, women experience a huge change in hormones, emotional needs, concerns, feelings and, of course, physical trauma. Whether you delivered naturally, via C-section, etc., a woman's body goes through significant change. The early postpartum period is absolutely critical for a woman and her baby.

"During this time, 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. Postpartum care visits with ob-gyns or other obstetric care providers can help women navigate the new challenges of motherhood. To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual needs; timely follow-up is particularly important for women with chronic medical conditions" (ACOG, 2018).

According to ACOG, "The initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth. This visit should serve as a transition to ongoing well-woman care and the timing of the visit should be individualized, woman-centered and the follow-up should include a full assessment of the following":

  • mood and emotional well-being
  • infant care and feeding
  • sexuality contraception and birth spacing
  • sleep and fatigue
  • physical recovery from birth
  • chronic disease management
  • health maintenance

Dr. Brown, via ACOG states, “As the nation’s leading group of physicians providing health care for (all) women, we must use the postpartum period as gateway opportunity to counsel women on long-term health implications.”

There aren't many OBGYNs or physicians who take the time to really counsel their moms-to-be with the advice and guidance that outlines true postpartum needs, worries, guidelines, safety, and just overall information, in general, during pregnancy. "Prenatal discussions should include the woman’s reproductive life plans, including the desire for and timing of any future pregnancies" (ACOG, 2018).

It's time we focus on moms' well-being inside and out. It's time we can trust our doctors and OBGYNs are going to ask vital questions, truly actively listen, and be part of the community we need as mothers.

What do you think of ACOG's recent press-release and its statements? How do you feel new moms need to be supported during and after pregnancy?