Midwives are excellent at postpartum services and care compared to our traditional OB provider partners in the United States. We do home visits usually on days 1 and 5, and office visits 2 weeks and 6 weeks postpartum for mother and baby (baby taken care of by Ped provider at 6-week visit based on the 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 in the first month of the baby’s life. We really do help families adjust to their new little ones.
There is nothing better than allowing a mother to rest in her bed the first week of life with a new baby while the family supports her needs (care for other children, community meal preps, a partner keeping up household chores, and a midwife visiting her directly for checkups). Sleep is so important for a mother and baby, and I truly believe most of our mother’s challenges in the first month of life stem from a lack of hard sleep. Many mothers don’t sleep when their babies sleep and are exhausted by 4 a.m. when the baby is having its day-awaken cycle.
The trouble with breastfeeding and limited bonding cues from the mother towards the baby are preventable in most cases. Spend time prenatally talking with families about the importance of defining each person’s role during the postpartum recovery process. Provide a sign for the house door stating a new baby is in the home, and here is a list of things to help this family out with the new baby. Families want to help but are unsure what exactly to do besides buy baby gifts.
Start a community food list for meals and have designated days that sisters, aunts, and extended family take other kids out for the day. Make the house as quiet as possible during the day so the mother and baby can rest peacefully.
Cadillac of Care
As for the midwife, there are many ways to make 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 your 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, which many new parents aren’t prepared for.
Do extensive education with families around 36 weeks of gestation about the postpartum recovery process and normal or abnormal changes in the 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; stress all the support available; and connect the family with support groups in the area to keep mothers around like-minded individuals.
Our goal as midwives is to improve our communities.
We don’t want to be the family’s 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 provide to mothers. Pelvic floor therapy is needed for most postpartum women. Specific exercises to help get the 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 they pay very well.
Most out-of-hospital midwives provide newborn care. Get a collaborative agreement in place with a great family practice or pediatrician in the area to help with transition after the first month of life and be able to call if there is a baby needing additional services beyond 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), and do the CAD screening and metabolic screening at home. Those are all billable services that help keep mothers and babies away from sick places like hospitals and doctor’s offices.
Postpartum depression is a very real and on-the-rise event in the United States.
We expect so much out of our new mothers that self-care gets dropped to the bottom of their 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 babies decreases.
Our culture needs to change. Many societies provide 6–9 months of maternity care for mothers and fathers. Our society gives mothers 6–12 weeks of postpartum recovery, often unpaid. Our financial pressures from inflation and the cost of living increase, so most families need both parents working to survive. Mothers are forced to return to work far sooner than their bodies are ready.
Many jobs don’t have a place or provide breaks for pumping mothers. As her midwife, be proactive in discussing the financial cost the family will have with recovery and make a monthly savings 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 levels.
Midwives play a pivotal role in families growing their families and supporting this fragile time.
Take that responsibility seriously and give your midwifery practice 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 births 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?
Midwives play a pivotal role in families growing their families and supporting this fragile time. Take that responsibility seriously and give your midwifery practice 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 births 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?
Check out our amazing course at www.midwiferybusinessconsultation.teachables.com
― Ina May Gaskin, Birth Matters: A Midwife’s Manifest