Why Do We Care More About New Babies Than New Moms?

July 21, 2017lectinfreemama
Blog post

 

It’s an important question, and before you yell “Because adorable innocent baby, DUH,” I’m not talking about why we take more pictures of babies or why we all want to touch babies or why we turn into singing, cooing weirdos around babies.

I’m talking about healthcare.

These are the well-check appointments a new baby receives (at no out-of-pocket cost, with insurance):

  • 2 weeks
  • 2 months
  • 4 months
  • 6 months
  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • 2 years.

Few could argue that this many well-checks is not appropriate. Everything changes so quickly in those first months of baby’s life. My daughter’s pediatrician will spend 10-15 minutes asking me everything about her–what her interests are, her sleep habits, her eating habits. And I understand why–the baby can’t speak for herself. These well checks are critical times for early health practices and prevention.

In stark contrast, these are the well-checks a new mom receives:

  • 6 weeks postpartum

And that’s if she’s lucky, and they can even manage to get her in. In my case, my ob/gyn was so booked solid, they couldn’t book me until 12 weeks postpartum, and they had to categorize my appointment as “annual physical/pap smear” so they could get me in then. I didn’t get to see any of the doctors or midwives who’d actually participated in the birth. In fact, the nurse practitioner had no clue I’d even given birth at all. She asked if I was currently sexually active, and I ran from the room screaming (figuratively).

This I don’t understand. A woman’s body changes at least as rapidly as her baby’s following birth, yet no one thought that checking in on that process every few weeks would be beneficial in preventing serious health issues? I realize we mothers can speak for ourselves, and we can make doctors appointments if we need them. We can clearly communicate our problems to a healthcare practitioner.

Or can we?

I consulted a group of 23 moms with toddlers from all over the country. I asked them whether they’d had the time, energy, and capacity of mind to schedule and attend all the doctor’s appointments they thought they needed for themselves in the months following birth. The response: 43% said they got some help but not as much as they needed, and 30% said they didn’t have the time or energy to make any appointments for themselves.

Even if they had been able to schedule appointments, there’s no guarantee anyone would have known how to proceed in caring for a patient who’s recently given birth. There is no specialty that specifically addresses postpartum healthcare–no medical field that recognizes issues that are most likely to occur post-birth. The fact that I had recently given birth became a horrible, frustrating curse that every doctor used as a fallback excuse when they couldn’t figure out what was wrong with me.

You're just a tired mom. This is normal.It will get better--just give it time.Every mom is tired--you didn't realize this was gonna be so exhausting, did you-How about if I punch you in

 

 

Our healthcare system is failing new mothers.

Of course, babies need all the concern we can muster, but a mother’s health is critical to her baby’s. Why would we not be equally, if not more concerned for the health of mothers after birth?

And I’m not only talking about the immediate six weeks following birth, though those are a beast, for sure. I’m talking about a whole two years following birth. Or hell, how about a lifetime following birth? The much-touted 6-8 week recovery is a joke–a woman’s body is never the same once she’s given birth. Pregnancy changes our bodies in ways scientists are only just beginning to grasp. There are hormonal changes during and after pregnancy that can cause long-term affects to the immune system, resulting in diseases with postpartum onset, that are often dismissed as “normal” or something that “will get better with time.”

These hormonal changes are mind-boggling. Postpartum depression, a serious condition that wouldn’t be hard to diagnose with a proper screening, is something that affects up to 1 in 5 women, yet only 15% of women who experience symptoms seek treatment. How could that be?

There are no postpartum well-checks.

And because there are no well-checks, there simply isn’t a clear path for how to seek help. My ob/gyn told me to seek help with my family doctor. My family doctor told me to seek help with a psychologist. The next available appointment to see a psychologist that participated in my insurance was six months later. That may as well be six years in new baby time. Symptoms of depression are exacerbated by sleepless nights, a crying baby, and the unbelievable amount of stress brought on by new responsibilities and changing hormones. Hearing that no one can help for six months is enough to make anyone spiral downward into dangerous territory.

Only 10 states in the US have centers for intensive perinatal psych treatment. In May 2016, the Centers for Medicare and Medicaid Services issued an informational bulletin emphasizing how important it was to screen early for maternal depression. They allowed state agencies to cover maternal depression screening as part of a well-child visit. After all, maternal depression absolutely affects the child’s health, right? Apparently not, because as of the publication date, only 13 state Medicaid programs were providing coverage for one of these screenings.

What can we do?

Bless my birth center, they tried. They sent me home with a folder 2 inches thick full of resources that I could use post-birth. I had the energy to read exactly none of it. I had no presence of mind to research, and no brain power to figure out what was wrong with me. I needed someone else to be proactive when I couldn’t be.

Here are some actions we can take now to help mothers receive better postpartum care:

  • Tell your child’s pediatrician that, as of Jan 1, 2017, there is a Current Procedural Terminology (CPT) code of 69161 for the administration of a caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument. In plain english, this means a standardized maternal health assessment can be performed at a baby’s well check and be billed under the child’s name.
  • Tell your ob/gyn to advise pregnant mothers to establish with a psychologist during pregnancy, so they have someone to call if they need immediate postpartum care
  • Reach out to your state’s policy-makers to advocate for postpartum well care and health screening coverage and payment.
  • Reach out to your state’s Medicaid program about a plan that advises physicians on maternal screening tools, billing help, and options for referrals.
  • Join a state medical or specialty society or a parent or family advocacy group in your state to support increased access to maternal health screenings.
  • Be aware of existing community resources for maternal health before giving birth.

 

If you have thoughts of harming yourself and/or your baby, call the National Suicide Hotline at 1-800-273-TALK (1-800-273-8255), 911, or other emergency services right away.

Sources

American Academy of Pediatrics: Maternal Depression Screening: Medicaid and EPSDT Coverage

AAP News: CPT Code Changes for Health Risk Assessments Take Effect Jan 1

Naturopathic Currents: The Postpartum Period – Incidence and Risk Factors of Autoimmune Diseases

Postpartum Progress: The Statistics

Postpartum Support International: Intensive Perinatal Psych Treatment in the US

26 Comments

  • stayathomemombaker

    July 28, 2017 at 3:02 am

    I agree 100% with this post!!

  • chrissyak

    July 28, 2017 at 3:18 am

    Thank you for sharing this info. Wish I had, had this when I had my first baby. Hope this helps lots of moms.

  • micaehmtice

    July 28, 2017 at 3:23 am

    This is so well-written and I completely agree! Thanks for sharing what we can do within our own community!

  • Lisa

    July 28, 2017 at 11:00 am

    Great recommendations and suggestions on how to help. I had two C-sections…I had two appointments after each – 1 to remove the staples and the other for a check on the incision at 6 weeks. That was it. I was on my own mostly…

    1. lectinfreemama

      July 28, 2017 at 3:53 pm

      Isn’t that insane? I had more follow up care when I had surgery on my big toe!

  • Lisa

    July 28, 2017 at 12:53 pm

    Great info! I’m sure it will help many new moms.

  • kristin | life of stones

    July 28, 2017 at 2:24 pm

    This is pretty eye-opening! I have to admit, I had never given this much thought….I guess I was pretty lucky with my health after each child of mine was born that it wasn’t much of an issue for me. You made some really great points though!

    1. lectinfreemama

      July 28, 2017 at 3:54 pm

      I’m so glad it went smoothly for you. That’s what we all hope for, but I think most of us expect it to go smoothly, so when it doesn’t, we are unprepared.

  • waneklychaoticlife

    July 28, 2017 at 2:50 pm

    Couldn’t agree more.. especially with all the cases of postpartum depression, and unfortunately those dealing with that are often less likely to ask for help because of the stigma around it.

    1. lectinfreemama

      July 28, 2017 at 3:55 pm

      It’s so true–and not even a stigma, but just having the capacity of mind to know that you need to seek help isn’t there. Luckily, my husband and family were SO supportive and understanding. That was, sadly, not the case for some of my friends who went through it.

  • Kamie Berry

    July 28, 2017 at 3:32 pm

    This is spot on! Imagine how much misery we could prevent if we allowed as much care for new mothers as we do for their infants. If we were proactive in treating things like postpartum depression, patients would not only be mentally and physically better off, but there would be some significant cost savings as well.

    1. lectinfreemama

      July 28, 2017 at 3:56 pm

      Exactly. I fail to see how this isn’t a win-win for everyone involved!

  • Traci at Petite Chef

    July 28, 2017 at 4:29 pm

    Great reminder that new moms need just as much care as new babies! 🙂

  • Joanne

    July 28, 2017 at 7:26 pm

    This is a great post, so much important information. I hope many new moms get to see it & learn from it. Thanks for writing this

  • shelbrown

    July 28, 2017 at 8:32 pm

    What a great article! Hopefully, this article will help a new mom.

  • Gina

    July 28, 2017 at 9:05 pm

    Even as someone who is not a mom, I strongly feel that we do not pay enough attention to our mothers post-birth. I’m not surprised because we live in a country that doesn’t take mental health seriously, but I I agree.

  • kiersten

    July 28, 2017 at 9:09 pm

    I was so focused on each of my babies after they were born, I didn’t really pay much attention to or worry about my own health. I’m so happy to see someone highlight the importance of a mom’s health!

  • Stacey

    July 28, 2017 at 9:18 pm

    This article makes a lot of good points. I hope this willinfp will help new mothers, and maybe the screening can be available to all mothers at well-child check-ups soon!

  • Lori

    July 28, 2017 at 10:59 pm

    Your experience sounds awful, and it looks like a lot of moms agree! I realize even more now how lucky I was to find my practitioner and that he may have really been a needle in a haystack.

    1. lectinfreemama

      July 29, 2017 at 2:06 am

      That is a beautiful thing! It can make a world of difference.

  • Melissa

    July 28, 2017 at 11:15 pm

    Granted it’s been 14 yrs since my last birthing experience, but I can remember (all too well) how scary a place it was to be inside both my mind and body. So many changes, emotions, feelings and impulses that no new mother could ever expect! I agree with you on this. It’s so important to have new moms (or recurring moms for that matter) getting prompt and frequent medical care!

  • Michelle Kunkel

    July 29, 2017 at 1:02 am

    This is a very good point. I know I only have only had one doctors appointment in the past 2.5 after giving birth, and that was my six week check up. I had a traumatic birth, and a looong painful recovery, and felt like I would never heal, and be able to be there 100% for my daughter.

    1. lectinfreemama

      July 29, 2017 at 2:07 am

      That is such an awful feeling to think that you will never heal. It’s just so different for everyone, which is why a “one-size-fits-all” system of care isn’t working.

  • Rachel

    July 29, 2017 at 1:21 am

    Well written. What a great read. Postpartum is more prevalent than most people know.

  • Lisa

    July 29, 2017 at 2:06 am

    This never occurred to me at all. Such a great point. I was way to tired, overwhelmed and mushy-brained to do more than make sure that the baby was taken care of and that I ate once in a while. We really do need to make sure the moms are better taken care of!

  • AutumninAtlanta

    July 30, 2017 at 7:36 pm

    Great post! I completely agree!

Comments are closed.

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