"Postpartum is a busy time for sure," says Alvin Strasburger III, MD, an OB/GYN at Lexington Women's Care White Knoll. "Everyone thinks that after the baby is born, the hard part's over. But that doesn't mean complications can't arise."
When complications do occur, they can become serious very quickly. Some people are surprised to learn just how long after birth the medical community considers the postpartum period to last.
"We typically consider maternal health to encompass the period from the diagnosis of pregnancy to anywhere between three months to a year postpartum," Dr. Strasburger said.
While many moms-to-be do a great job watching out for their health during pregnancy, they aren't always as mindful of threats that linger afterward.
"Many things can happen during pregnancy to cause issues," Dr. Strasburger explains. "Things can turn on a dime, and an issue can pop up that has never been there before. From blood pressure problems to diabetes that develops during pregnancy to a pre-existing health issue that was undiagnosed before pregnancy – all of those things can come into play."
While advances in care have led to far fewer women dying during childbirth, many are unaware of the potential for serious, even life-threatening complications in the six weeks to one year after giving birth.
"There are a lot of changes in the body during pregnancy," Dr. Strasburger explained. "A lot of hormonal and blood flow changes happen during pregnancy, which means there is a corresponding fluid shift throughout the body after birth. Previously, the body was pumping a lot of blood into the uterus to sustain the placenta and the baby. After birth, that changes, and it takes some time for the body to fully integrate back to where it was before, if it ever does completely."
That is why it is vitally important for new mothers to follow up with their OB/GYN in the year following the baby's birth. In addition to physical health, it's also important to pay equal attention to emotional issues during the postpartum period.
"We hear a lot about the 'baby blues' and postpartum depression, and occasionally news stories about postpartum psychosis, but most often we see issues with postpartum depression," he said. "We like to screen for that consistently throughout prenatal and in postpartum care, particularly."
A screening questionnaire called the Edinburgh Postpartum Depression Scale can help doctors identify postpartum depression. It's a standardized set of questions covering anxiety and depression symptoms. Depending on the score, providers discuss interventions ranging from counseling to medication to more intensive therapy. At Lexington Medical Center, a behavioral health nurse practitioner is also available for assistance.
What's the best way for new mothers to stay healthy during the critical post-birth period?
"The easiest thing is to stay in touch with your provider early and often, both prenatal and postpartum," Dr. Strasburger said. "If you have any questions or concerns, please bring them up. If you suspect there's a problem, contact your provider. And remember to jot down when things are happening because it's easy to forget. So, write it down and talk to us."
Alvin Strasburger III, MD, Lexington Women's Care White Knoll
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