The postpartum battle

KANISA GEORGE

How much do we know about postnatal care? Do we fully appreciate the sheer physical exhaustion and psychological peril that comes with the surge of hormones coursing through the body? Or what a woman has to do to get back on track?

When we think of the journey to motherhood, pregnancy, labour, and delivery quickly comes to mind. Yet most of us seldom fail to think of the "fourth trimester" or the postpartum period after delivery that consists of a little more than staring at your bundle of joy in awe. Unfortunately, there is no user manual for the postpartum experience, and even research found that little is known about what pregnant women expect or how well-informed they feel about the care they will receive during the postnatal period.

Defined as the six weeks after a woman delivers her baby, postpartum is underscored by happiness and excitement but can also be a time where support from family, friends or service providers is crucial.

The do's, don't, and the "I'm not sure what to do" during the fourth trimester can only be conceptualised through experience. And even when you've garnered first-hand experience, it doesn't always prepare you for the full gauntlet of feelings and unique experiences each pregnancy brings.

During the first few weeks after delivery, a woman's life becomes consumed by the needs of her new-born. In many ways, doting on and taking care of their baby's needs is all most women and the support system around her can think about.

Naturally, women are hard-wired to reject self-care and pore every inch of their souls into nesting, breastfeeding, and swaddling, adamantly denying their need to be swaddled. Most women don't readily concede that postal care should also include care for themselves.

Especially for first-time moms, the fourth trimester is a new frontier, a learning period marred by physical, social, and psychological changes.

Importantly, this is a time when women learn to care not only for their babies but themselves after changes in hormone levels and delivery.

For a long time, it appeared women who experienced postpartum challenges were sworn to some misguided oath of secrecy, and struggled to adjust without any real support or others being aware of their plight. Even with all the information currently available on the postpartum period, women are still unable to communicate their needs and access facilities that ensure a support-driven transition.

The World Health Organization suggests mothers and their new-borns should have at least three postpartum visits after delivery. The first should be within 48 to 72 hours after birth, the second between day seven and 14, and the third at six weeks postpartum. Data from the WHO suggest that most maternal and infant deaths occur in the first six weeks after delivery, yet this remains the most neglected phase in providing quality maternal and new-born care.

A massive flaw in providing proper care for women after birth lies in ineffective and, in some cases, overburdened healthcare systems. According to research, most public healthcare facilities don't do enough to provide after-delivery care for women. As a result, the study found that women often felt unsupported, scared and under-prepared to adjust to life with a new-born. And when it came to accessing information on issues that directly affect their babies, like breastfeeding, and their overall health, like depression, a holistic approach coupled with the appropriate support system was preferred but non-existent.

For example, women felt they weren't given enough information on normal postpartum bleeding and lochia. And specific details regarding how much blood loss they can expect, for how long and when bleeding requires urgent care were not provided.

Most of all, what most systems lack is a parent-centred perspective approach that covers all settings (hospital, birth centre, home, and community), with emphasis on content, purpose, timing and location of postnatal care, and the roles and responsibilities of all professionals who may be involved.

Admittedly, without postnatal care, women are simply unable to adjust appropriately to their new role, with severe social implications for both themselves and their new-borns.

Recently, an upsurge in postnatal facilities or hotels/retreats has changed the game in how after-delivery care is provided.

Women and their newborns can check into these facilities for a hefty price and receive around-the-clock postnatal care. These luxury hotels, similar to wellness retreats but with a twist, help women transition between the hospital and home and provide moms with physical, emotional and mental support.

Women who are often mentally and physically exhausted after delivery can delight in a marble bathtub, rainfall shower, Nespresso machine and Swedish Duxiana bed while around-the-clock nurses look in after their baby. These facilities assist women who, though have spent nine months preparing to go home with a baby, are shocked by how little institutional support they receive once they actually do.

For women who can't afford luxury care, public health care support is crucial. When this is lacking, women are often left to their own devices and must find ways to ensure a healthy transition.

Maintaining a healthy diet and sleep are essential during this time, but support from family and friends is also quite instrumental. Help can come in many forms, but it is equally important to ask for it and be ready to accept it.

Also, knowledge about the possible body changes you might experience helps you prepare for some eventualities. For example, constipation, vaginal discharge and bleeding are common after birth, along with pelvic floor changes. Knowing these possibilities gives you the tools to prepare better, learn how to deal with them and know when to seek medical attention.

Understanding the difference between baby blues and postpartum depression is vital as it ensures you know when professional intervention is needed. Symptoms of sadness, insomnia, irritability and restlessness are common after birth, but when these symptoms last more than two weeks, that's usually a sign that your experience might be more than just the baby blues.

Postnatal care that prioritises both mother and baby isn't talked about enough. Instead, women arguably have access to systems that offer little support, especially for the first time and single mothers, who are somehow expected to adjust. Can we do more to provide better support, or should we depend on archaic traditional systems that don't properly support a fast-changing world?