If you've have a baby in the United States, you're aware of how pathetic postpartum care is. And by pathetic, I mean, pretty much nonexistent.
If you deliver in a hospital, they push breastfeeding and rooming in on you, despite whatever level of exhaustion or anxiety you're feeling after your birth experience. They give you pamphlets or show you a video on newborn care that you don't have time to read or watch because you're so exhausted and overwhelmed. If you request one enough times, they bring in a lactation consultant who shows you how "easy" it is to get the baby to latch properly when you have three people helping you. If you're lucky, you get an especially awesome nurse who'll give you a few tips before you get wheeled out the door. But, if you're like me, they barely check your C-section incision one last time before sending you home to fend for yourself.
When other medical professionals slowly backed out of the office door while I was still talking, she sat in my bedroom and actually listened.
When will my milk come in? Should it hurt when I move like that? Is that amount of blood normal? Is the baby eating enough? Why won't the baby sleep at night? Should I let the baby sleep so much during the day? Does that umbilical cord look OK?
There are so many questions — yes, even with your second and third babies — that don't always warrant an office visit or a message to the on-call doctor but could still use answering so you can have even a tiny slice of peace of mind and avoid the terrible, scary place that is Google.
And if you have actual issues, like mastitis, an ear infection, or pus coming out of your incision, you better hope it happens during office hours, otherwise you're headed to urgent care where a person who doesn't even realise you just had a baby six days ago will give you a prescription that they're "pretty sure" is OK to take if you're breastfeeding. So you call your OB to double check, and they tell you to call the pediatrician, and literally no one will give you an answer, nor does it appear anyone really cares that you're in actual pain yourself while still trying to recover from childbirth, learn how to breastfeed, and operate on zero hours of real sleep.
So yeah, pathetic postpartum care.
I'd been through that twice already, and I wasn't about to do it again. So when I was about six months pregnant with my third baby, I started researching and discovered that you can hire angelic humans like midwives and doulas, whose actual job it is to support you before, during, and/or after the birth of your baby.
A colleague recommended a friend who was a midwife, and on our first meeting, we chatted for over an hour. She asked me questions about my pregnancies, deliveries, and postpartum experiences that no doctor ever had. She asked about my feelings, my total well-being, my mental state. She listened to me when I spoke and showed genuine empathy and interest. Needless to say, I hired her to help me with the postpartum period.
Her contract allowed for four visits during the six weeks postpartum, plus one or two meetings before. She would also be available by call or text 24 hours a day for those six weeks (and because mine was particularly awesome, she answered my calls for a number of weeks after that as well). The cost, which was in the thousands, was (fortunately) almost entirely covered by my insurance.
When I came home from the hospital four days after my scheduled C-section, she came to my house to check on me and the baby. I didn't have to get out of my bed, or even change out of my robe. Better yet, I didn't have to wake up my newborn, get her dressed in enough layers to brave the Winter cold, and get to the doctor's office for an appointment that was not perfectly timed between feedings.
She worked around my and the baby's schedule, which meant she stayed until feeding time to help me with my latch. She weighed the baby and confirmed she was gaining nicely, which allowed me to stop waking her up constantly to nurse. She took my blood pressure and checked my incision, which allowed me to sleep that night without worrying I would die from a blood clot. And two days later, when I hit a hormonal cliff and freaked out about everything, she talked me through it on the phone, which allowed me to return to a normal state of sanity so that I could care for my newborn.
Over and over, she reassured me that I was normal and that everything I was feeling was normal. She supported me in focusing on myself and my newborn during this crucial time despite the immense guilt I felt about being so absent for my older two children.
She gave me licence to try and enjoy the postpartum period, to settle in and embrace it for what it was — hard, exhausting, and overwhelming, but also precious and fleeting. I stopped fighting it. I stopped wanting to do more, to be further along in my recovery, to get past it all. Just knowing I had her support changed everything.
It was still hard and exhausting and overwhelming, but having her meant that I wasn't alone in those things.
It was still hard and exhausting and overwhelming, but having her meant that I wasn't alone in those things. It meant that I had someone experienced and with perspective to lean on when I was tired and emotional and second guessing myself. Someone to gently remind me how important it was that I stay in bed to rest and heal when I was eager to get moving or frustrated about my slow recovery. Someone to answer my questions that would have otherwise sent me down an internet rabbit hole. Someone with real medical knowledge who helped me avoid unnecessary antibiotics for mastitis when all I had was a clogged milk duct. Someone who, when other medical professionals slowly backed out of the office door while I was still talking, sat in my bedroom and listened.
Of course, my husband and my family did their best to be helpful during my recoveries, but they were also busy caring for my older children and working on little sleep themselves (not to mention lacking medical credentials!). Hiring the midwife meant that I had someone on my team whose job was to focus on and support me and my baby. To know my history and my worries. To gently guide me — physically, mentally, and emotionally — along the postpartum roller coaster so I could not only survive the dips but enjoy the ride.
I only wish I had known about her with my first.