The American College of Obstetrics and Gynecology updated postpartum care recommendations in 2018. They now recommend that women be seen by a provider at 3 weeks postpartum in addition to the 6 week postpartum. Why the change? Well, they are finally acknowledging that too many mothers are dying in the postpartum period from childbirth related issues, 50% or more of all maternal deaths in the US occur in the postpartum period. The hope is that by checking on mothers at 3 weeks, more issues will be caught sooner, and mothers can get vital help sooner. Whie this recommendation has been out for a few years, women in the areas I serve are still not being seen before 6 weeks. Being seen once at the 6 week postpartum is even the practice at teaching hospitals which I would expect to be implementing the latest recommendations as soon as they come out.
In my midwifery practice, I see clients in person 4 times in the 6 weeks after birth. The first two visits are at the client's home because I want the client to be able to rest and focus on recovery in the first few days after birth instead of dragging themselves and a newborn out to get care. By seeing my client so soon after birth, I am able to help with any nursing issues, assess bleeding, and be sure my client isn't going into preeclampsia in the postpartum period. I have a better sense of how my client's recovery is going with those visits than if I waited to see them at three weeks after birth.
I want my clients to thrive during the postpartum period. For me, that means seeing them twice in the first week after birth, as well as two more visits in the first 6 weeks postpartum and making myself available by phone to them. I feel strongly that mainstream medical care is failing women in the postpartum period, and it shows in the maternal mortality rate. I can make a difference, one client at a time.