Postpartum Services to add to your Midwife Business
Midwives are excellent at postpartum care compared to our traditional OB provider partners in the United States. We do home visits usually day 1, day 5, and office visits 2wk and 6wk postpartum for mother and baby (baby taken care of by Ped provider at 6wk visit based on scope of midwifery). We are great at catching early challenges with breastfeeding and mental health concerns. We promote family bonding in their own environment versus hospital routine recovery stays with multiple doctor visits first month of baby’s life. We really do help with families adjusting to their new little one.
There is nothing better than allowing a mother to rest in her bed first week of life with a new baby while family supports her needs (cares for other children, community meal preps, partner keeping up household chores, and midwife visiting her directly for check ups). Sleep is so important for a mother and baby and I truly believe most of our mother’s challenges first month of life stem from lack of hard sleep. Many mother’s don’t sleep when their babies sleep and are exhausted by 4am when baby is having its day awake cycle.
Trouble with breastfeeding and limited bonding cues from mother towards baby are preventable in most cases. Spend time prenatally talking with families about importance of defining each person’s role during postpartum recovery process. Provide a sign for house door stating new baby in home and here is a list of things to help this family out with new baby. Families want to help and unsure what exactly do to besides buy baby gifts. Start a community food list for meals, have designated days that sisters, aunts, and extended family take other kids out for the day. Make the house as quiet as possible during day time so mother and baby can rest peacefully.
As for the midwife, there are many ways to get your “Cadillac of care” stand out from the competition. Go the extra mile to customize her postpartum period to her needs. Have a postpartum doula as well as a labor doula on staff with practice. Create a postpartum plan just like a birth plan with family. So much of our culture focuses on birth, birth, birth! The hard part is truly raising the child and taking care of the responsibilities that come along with parenthood that many new parents aren’t prepared for.
Do extensive education with families around 36wk gestation visit about postpartum recovery process and normal/abnormal changes in mother, baby, partner, and children during this time. Older toddlers may revert back to baby features to yearn for parents attention, breastfeeding is a learning curve and stress all the support available, and connect family with support groups in area to keep mother around like minded individuals. Our goals as midwives to improve our communities. We don’t want to be the families strength for guidance. We are only in a family’s life for a short amount of time. Create community connections and have women support each other long term.
There are some great ancillary services midwives can get trained to help mothers. Pelvic floor therapy is needed for most postpartum women. Specific exercises to help get vaginal tone and support back to women’s baseline will help with urinary incontinence, painful sex, and other prolapse symptoms. There are many insurance codes available for these services and pay very well.
Most out of hospital midwives provide the newborn care. Get a collaborative agreement in place with a great Family Practice or Pediatrician in area to help with transition after first month of life and able to call if there is a baby needing additional services than what your practice can offer. Provide the hearing screen (many states have grants for out of hospital midwives to help improve this compliance rate with home births), do the CAD screening, and metabolic screening at the home. Those are all billable services and help keep mother and baby away from sick places like hospitals and doctor offices.
Postpartum depression is a very real and on the rise event in United STates. We expect so much out of our new mothers that self care gets dropped to lowest on her priority list. I stress to families that self care makes families stronger to care for their partners and children. If self care is inadequate, milk supply goes down, tempers get short with family, mental health disorders increase, and bonding with new baby decreases.
Our culture needs to change. Many societies provide 6-9 months of maternity care for mothers AND fathers. Our society gives mother 6-12wk postpartum recovery and many times unpaid. Our financial pressures of inflation and cost of living increases make it so most families need both parents working to survive. Mother’s are forced to return to work far sooner than body is ready. Many jobs don’t have a place or provide breaks for pumping mothers. As her midwife, be proactive in discussing financial cost family will have with recovery and make a monthly savings account to financial account for that additional time for mother and baby to bond before going back to work. Planning ahead versus reacting to problems occurring now will decrease families stress level greatly.
Midwives play a pivotal role in families growing their families and supporting this fragile time. Take that responsibility seriously and make your midwifery practice have access to all the resources and skills needed to care for mothers and babies during the next year of postpartum transition together. We are the keepers of normal birth and normal postpartum recovery transitions. Brag about it and what are all the unique services offered compared to a traditional medical provider in your community!
“The way a culture treats women in birth is a good indicator of how well women and their contributions to society are valued and honored.” “The way a culture treats women in birth is a good indicator of how well women and their contributions to society are valued and honored.” ― Ina May Gaskin, Birth Matters: A Midwife’s Manifesta