Who Looks After Mothers And Their Families In The Postpartum Period? (The Postpartum Wellness Show: Episode 5)

Selamat Datang and Welcome to the Postpartum Wellness Show

and I’m Dr Kristal Lau, your host and postpartum wellness consultant

In this show, I share insights and knowledge around approaching your postpartum journey through culture, traditions, and modern postpartum care using my combined experiences as a physician with scientific and public health background, an author, a foreign-born US military spouse, and a mom of 2.

Join me in this exploration of motherhood, wellness, and heritage where you will learn how to thrive in your postpartum journey and beyond.

Welcome, welcome to today's episode of the Postpartum Wellness Show. Today, I'm going to talk about who looks after you as a mother and your family during the postpartum period.

But before I dive in, I'd like to explore two things. First, why is it important for us to know who's out there to help us? And number two, what does it mean to have good health in the postpartum period?

And I'll finish the episode by sharing red flags to watch out for when you're seeking help or services. This way, you'll know you're getting the best care for you and your family and stay safe from those who may have forgotten that they're there to serve you and your best interests first.

So let's get started. Why is it important to know who's out there to help you and your family? And who to turn to in your time of need? Let's recall that the postpartum period can be longer than six to eight weeks. So whenever you or your family member needs help for your health or your family's well-being, or you have any concerns after you've met your OB/GYN at the six-week checkup, there are other health practitioners, health providers, and service providers who will be more than happy to help you with any concerns and worries you've got.

Because there are so many of us out there whom you can engage for help, it's good to know who can do what for you. This way, you can choose the best person to see for your concerns or at least know who to see first and get your care plan started. The best part about knowing that there's literally a team of people out there who are able to help you and your family is that you know you're not alone in this journey.

And because I expect a lot of my listeners to come from different parts of the world, knowing the different titles and terms for people and services who can help you is going to help you navigate the system and resources in your country and figure out who will be the best person to contact in case you need any help.

To understand better about who's out there to help you and your family during the postpartum period, it is important to understand what good health means in the postpartum period, or to put it in other words, what does good postpartum health mean for you as a mother and for your family?

In general, the definition of health as per the World Health Organization (WHO) says that to be in good health is to be in a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity. What does this mean, or what is the context for you as a mother and for your family?

So for you as a mother to have good postpartum health, this means that you would have recovered from labor and childbirth, whether you've had a vaginal birth or a C-section birth. And if you had any other medical conditions from labor and childbirth, you should have recovered from that to be in good physical health.

And for you to have good mental health during the postpartum period, that means you would have had the mental health support to manage the postpartum blues, postpartum moods, and if you've been diagnosed with postpartum depression or other postpartum mood disorders and anxiety, you would have had some treatment and management plan and an action plan for that. So that means your mental health and mental well-being have been looked after. And finally, as a mother to have good social well-being during your postpartum period, that means having a decent network of support from family, friends, and other community members around you, plus having access and availability of local resources, wherever you and your family are living.

So this means it really is impossible for you to achieve complete physical, mental, and social well-being within six to eight weeks after giving birth. And that's why in the previous episodes, I always talk about how the postpartum period can be up to a year or even more after you've given birth.

And what about for your family members? Remember, I talked about how your family members also have their postpartum experience. In this case, they may not have gone through a lot of the physical challenges that you have gone through in pregnancy, labor, and childbirth, but their mental and social well-being absolutely need support during this time. So that they can adjust to the changes with you and with your newborn during the postpartum period.

And this is why many doctors and other health providers use the bio-psycho-social model whenever we treat patients and talk to clients about how to help them achieve their health and wellness goals. This model comprises three parts: the biological part of you, the psychological part of you, and the social part of you.

And this model provides your doctors and health practitioners with a holistic blueprint so that they can help you plan to achieve good health in the physical, mental, and social aspects.

So using this model, let's dive into who's out there to help you. We'll also follow a timeline, starting from labor and childbirth, up to a year or more after you've had your baby.

A lot of the care that happens during labor and delivery falls to the midwives who usually lead the entire birthing process. And in a lot of Western countries, some mothers add a labor doula onto their team, who provides nonclinical and nonmedical support during the birthing experience.

And in some parts of the world, like in Australia, in rural or regional areas where there may not be as many midwives and OB/GYNs, there are general practitioners who are specifically trained to also function as rural OB/GYN specialists and emergency specialists, and they take the lead in helping mothers go through labor and delivery.

So where do the OB/GYNs fall in during this time? Let's take a moment to appreciate the specialty where it is really quite unique, even for those of us in the medical field. This is one of the specialties where the doctor provides both medical and surgical care, because they provide both obstetrics and gynecology services, obstetrics meaning related to childbirth, and gynecology meaning related to women's reproductive health.

So in a lot of cases, when the labor process is uncomplicated, which is medical speak for things are going as they should and it doesn't look like there's any intervention that's required, most of the OB/GYN doctors don't really play an active role here. The midwives usually take the lead in this part.

However, should there be any concerns of safety for the mother and the baby during the labor and delivery process, that's when the midwives will call the OB/GYNs, and together with the mother, they will assess the situation as a team and make a decision on what's the next step.

From my second birthing experience, I thought everything was going to go well because I presented to the hospital five centimeters dilated, meaning I was already halfway there. And even my midwives were very pleased with how everything was progressing.

Up until 20 hours later, I was not moving past six centimeters, and my baby was starting to show fetal distress on the monitor. And that's when the OB/GYN doctors stepped in. We had a discussion and decided that it was best for me and my baby to have an emergency C-section.

And this is where the skills and the expertise of the OB/GYNs are absolutely crucial. In cases where emergency C-sections need to happen or some other surgical and medical procedure that is important to preserve the safety of the mother and the baby.

So why is it that mothers only see the OB/GYN at the six-week mark for that one postpartum check, instead of getting more frequent care from them after giving birth? Well, we go back again to the definition of the specialty. The OB/GYN doctors do have a lot of patients to see outside of pregnant mothers. Plus, it is important for them to focus on providing emergency care to mothers who need it during labor, during childbirth, and even in the postpartum period where there is still a chance for any of us who have given birth to develop life-threatening conditions.

This is why in many parts of the world, the postpartum care model is led by the midwives, maternity nurses, community nurses, and other primary care providers. I'll go into more detail on who the primary care providers are in a little bit.

Back in my home country, Malaysia, in Australia, and here where I am right now in Germany, once the mother goes home with her newborn, the midwives usually do home visits to check on the mother's recovery and their newborn's well-being. This is on top of the pediatric care that the newborn baby receives. And in situations where there are insufficient midwives, then community nurses, maternity nurses, and other nursing professionals will take the lead in postpartum care for the mother and the newborn.

It is also during this time in the immediate postpartum period where families in the west have the option of hiring postpartum doulas, overnight nannies, and newborn care specialists who can help with promoting a mother's well-being. And for some families, this postpartum care falls into the responsibility of other family members who step in to help the mother and her family during this time.

In many parts of East Asia, even in Malaysia where I'm from, there are confinement nannies or pui yuet who come and help the family for up to 30 days after the mother's given birth so that she may focus on resting and recovering after childbirth. These nannies also help with nutrition, cooking, cleaning, laundry, breastfeeding assistance, and teaching the parents how to care for their newborn baby.

For families who can really afford it, there are confinement centers that they can check into, which I know sounds really dark and jail-like, but "confinement" is just a word we use in East Asia to describe a postpartum practice of staying at home with our newborn in the first 30 days after giving birth. And these confinement centers are really comfortable wellness stays where the families have everything provided to them so that the mother can focus on resting and recovering.

But what happens after that six-week OB/GYN checkup? What else is out there for you as a mother and your family? Most importantly, after this time, you should establish care with your primary care provider. These professionals are your general practitioners, family medicine doctors, nurse practitioners, physician assistants, and for smaller rural communities, community nurses would be your point of contact.

The type of care that they provide is not limited to only making sure that you're in good physical health, but also to provide you with mental health support and to refer you to other allied health practitioners, providers, and services to improve and maintain your social well-being. They are the team leader for your health team for the rest of your postpartum journey.

And for mental health support during your postpartum journey, you have counselors, therapists, psychologists, psychiatrists, and for those of you listening who are part of the US military community, you have access to your chaplains and your military family life counselors who can offer you support and nonmedical counseling during this time.

You and your family can also engage complimentary therapy practitioners, especially if you have a cultural connection to the traditional medicine that is practiced in your heritage. Just like myself, as much as I am a completely Western and modern trained medical doctor with a scientific background, I still follow traditional Chinese medicine practices, and I do see traditional Chinese medicine doctors from time to time because I use both approaches in my journey towards better postpartum health and overall wellness.

Another form of traditional medicine includes Ayurveda medicine, which is unique to the South Asian, Indian heritage. And in the West, complimentary therapies are also provided by functional medical practitioners and holistic health practitioners. These can add value to you and your family's postpartum health and wellness, especially when you engage them hand-in-hand with your primary care provider, because then you get the best of both worlds, and you will have health practitioners and health providers who are working on the same wavelength, which is to focus on helping you and your family achieve the postpartum health and wellness goals that you want.

But wait, that's not it. There are more health providers and service providers who can help you with maintaining your physical, mental, and social well-being during the postpartum period. It is absolutely essential to engage a physiotherapist or physical therapist or a personal trainer who is specialized in pelvic floor rehabilitation because after nine months of growing a baby and going through childbirth, or if you've had a C-section, which is a major surgery, your pelvic floor muscles, your abdominal muscles, your core muscles absolutely need some help. Not to get back to shape, but just to get their strength back so that you can go about and do your daily things without worrying about pain or leaking urine.

For breastfeeding mothers, you've got lactation consultants, IBCLCs, who can help you on your breastfeeding journey. IBCLCs are board-certified lactation consultants who go through quite a rigorous training program to get certified, and they are a wealth of resources for anything related to breastfeeding. You can also engage the La Leche League, especially if they've got a local meetup in your community.

And what about service providers? I've mentioned a lot of people who are health providers and health practitioners who can help you and your family during the postpartum period. And service providers? They are also absolutely crucial in helping you maintain and improve your social well-being and your mental health. These are babysitters, dog sitters, dog groomers, cleaning services, food delivery services, grocery delivery services, daycare, and even laundry services.

But how, how do these people help you and your family? I mean, shouldn't you guys be doing all these things anyway at home, by yourselves? Well, yes, we can absolutely do our laundry, cooking, cleaning, caring for our pets, and for those of us with other children, we're already caring for them and helping them adjust to the changes during this time. But honestly, it can get exhausting. Exhausting to a point where your mental health can get severely affected, exhausting to a point where both you as a mother and your spouse, husband, and partner are both at risk of postpartum depression and anxiety because it can absolutely be overwhelming to do it all just by yourselves.

So if you and your family have the financial capacity to hire help, especially if you don't have family and friends or other community members around you to help you during the time when you really need some additional hands-on deck, then yes, please hire these services to help you out. Hire these services to give you a little bit of that mental and physical break so that you can rest and recharge and start going through the chaos again once you regain some energy. Because it is absolutely true that it does take a village to raise a child. But it also takes a village to nurture a mother and to nurture families, plus honor our elderlies as they get old.

Getting into the habit of asking for help and receiving help and utilizing resources and the community around you, it's only going to benefit your physical, mental, and social well-being that will lead you and your family towards good postpartum health.

Which is why it's very important that I share with you things to look out for in health practitioners, health providers, businesses, and services that you engage with. Red flags to look out for, where you may want to consider getting a second opinion or stop engaging with this person or business entirely.

The biggest red flag to look out for is if someone tells you not to trust your medical doctor or medical health provider and if they discourage you from engaging with modern medical healthcare. This is unethical, irresponsible, and downright dangerous. Why? The postpartum period carries its own risk for mothers after giving birth, even up to six to eight weeks later. This part of postpartum physiology, of what happens to your body after giving birth, I will cover in another episode.

And with the rise of postpartum depression in our modern society, if someone tells you that you shouldn't see your medical doctor, a medical health provider, it makes me worry whether they truly have your best interests at heart. A health provider, health practitioner, and service provider who truly has your best interest and safety in their hearts will understand if they have any limitations to serve you for a specific problem that you have.

Which brings me to the second red flag to look out for when you seek help. Be cautious of people who claim that they know everything. It is very good when you meet a professional who knows what they don't know, but it is absolutely dangerous to meet someone who doesn't know what they don't know. And this attitude and behavior can be present in medical doctors, medical health providers, nurses, midwives, doulas, functional medical practitioners, holistic health practitioners, traditional Chinese medicine doctors, and in any other service provider out there. If you meet someone who claims that they have the answers to everything and that the so-called "other" professional will not be able to help you, I highly recommend you seek a second opinion, even from a different practitioner within that same field.

Because there are always limitations in everything that we have today, despite how modern and advanced we are. We still have limitations. Modern medicine still has its limitations because there's so much to health and wellness, especially within those of us who have a lot of cultural norms and traditions that we carry in our medical decision-making. And traditional medicine and complimentary therapies absolutely have their limitations as well because there are conditions that they absolutely cannot help with, and modern medical healthcare is there to help you and your family.

This is a very nice spot to wrap up this episode, actually. Because from everything that we've discussed today, that I've talked about today, you can see that postpartum health, that health in itself is pretty complex. There is no one-way street towards good health. You need to take into account your physical well-being, your mental health, and your social well-being. Which is why this ties back to my tagline from a couple of episodes ago, where I shared that postpartum care and wellness is not a luxury. It is an absolute necessity.

You need a team. And this team should serve not only you but your family because your wellness is also intertwined with your family's wellness. So I've got two big call-to-actions today for you. If you are a mother, have a think about what you really need. Think about what counts as good postpartum health for you when you think about your physical health, your mental health, and your social well-being.

Because once you get thinking about what you really need, you'll start to see how you can take the next step towards achieving the postpartum health and wellness that you deserve. And if you are a health provider, a health practitioner, or a service provider who's listening in, I'd like you to think about how you can apply the bio-psycho-social model into your practice so that you can better serve mothers and their families.

And if any of you want to book a free call with me to have a chat about your postpartum wellness or how I can help your organization or business take postpartum care to the next level, go to my calendar and book a free 15-minute call with me at www.mamaswingwoman.com/free-call. Go and book a time right there, and I'd love to have a chat with you.