I can’t believe I'm writing this post. But I have to, because I've had too many conversations with incredible moms about how they knew that their postbirth complications were bad, and wow...the stories I heard.
Here's what I learned.
- Seeing a momma for the first time a full six weeks after birth is entirely inadequate. Some women are seen prior to six weeks, but if the space between feels too long- it probably is.
- Medical staff, for a variety of reasons, don't always take mom's concerns too seriously, and women are often put off from being seen the moment complications arise. This rarely ends well for mom.
- Moms aren't well informed of what "normal" and "abnormal" feels like, and therefore aren't sure how seriously to take themselves.
- Things get missed. A lot. And way too many mothers suffer needlessly as a result. (Example: story after story of missed retained placenta-- this particular complication is incredibly dangerous and far too common. With the most expensive birth costs in the world- we can do better. Another post, another time.)
America has one of the poorest maternal mortality rates in the world. Most of these deaths happen in postpartum- as in: “Mom has baby, everything seems okay, mom dies.” 900 mommas a year. 65,000 more nearly die. So the obvious question becomes: What the...?!? Especially since most of these deaths are preventable.
Here’s 'what the': Most people- including most obstetrical nurses- are ill-informed about what to look for, and what to warn moms about. And therefore, they’re not taking us seriously enough when moms say “something isn’t right.” That's IF moms say it at all- we tend not to make much of ourselves after baby. We power through, we expect pain and difficulty, and we don’t know what’s normal and what’s past that point.
So first things first- let’s establish what’s normal by looking at what's not. This list, however, isn't all inclusive for what's abnormal- if it feels wrong, it probably is.
And secondly- Momma, I need you to make them listen. I need you to advocate for yourself. I need you to work with me to reduce that number down to zero- starting with you and your precious life.
Here’s how to get what you need the minute complications come creeping round the bend.
Do your research.
Here are the complications that require immediate attention. If you’re experiencing any of these- you need to be seen immediately, and honestly whether or not they can fit you in doesn't matter much here. They'll need to.
Say “I can’t wait.”
Insist on being seen today. If they tell you there’s nothing available,
Go up the chain.
If you're not getting an appointment in a reasonable timeframe (within the next 24 hours, sooner if it's anything on the emergency list), ask to speak to a supervisor. Explain your symptoms, tell them when you’ve had a baby and that you feel it absolutely necessary to be seen today.
Here I'm going to address a specific complication: If you’re dealing with scary/harmful thoughts toward you or baby and you’d rather not tell the receptionist, get on the phone with the nurse or even a supervisor to let them know. If receptionist says no one is available, tell her “It is extremely urgent. I’m sorry, but I absolutely must speak with (Nurse/Doctor/Supervisor). I am not comfortable divulging personal information to anyone but them.” Again, if you stall here- go up the chain: “May I speak with your supervisor”? If they give you runaround, call back and ask directly for a supervisor. (Hopefully this won’t be necessary).
If you can’t bring yourself to fight at that moment, call this number. Don’t let them schedule you for a week from now, or even three days from now. You must get the care you need immediately.
An ambulance- expensive as it is- will get you seen. Here are the conditions that require an immediate 911 call. If the other symptoms on the list are present and you’re not being heard, head to the ER.
A note about urgent care facilities:
While these places can be cheaper and more convenient, they are almost always ill-equipped to deal with the special nature of postpartum care and complications. It is highly likely that they might treat your symptoms as they do anyone else, being ill-informed about the special dangers of your symptoms in postpartum. This is especially likely if it’s been a number of months since birth. If at all possible, be seen by someone skilled in obstetrics or who is knowledgeable about these things. If this is your only option, come in armed with information- found here- to show them, in hopes that they’ll explore your symptoms more deeply.
Tell them you had a baby
Whomever you talk to, you must let them know your symptoms AND that you’ve had a baby within the year. Taken alone, some of these symptoms may be treated as benign. Be sure that the gravity of the situation is understood by telling whomever you’re speaking with the date of birth.
You are a momma. You have a special, carefully curated innate intuition that allows you to protect yourself and your children. Trust your gut. When it comes to postpartum health and complications, you will need to put those big girl pants on and get bossy and demanding on behalf of you and your people. And you have reason to do so, considering the abysmal outcomes of postpartum mommas around here.
Demand to be seen.
You are not being dramatic. You are not being high maintenance. You are being smart. You are being alive. Keeping this aliveness is the thing we’re after, whether or not it feels that dire, and whether or not the people you're talking to think it's a big deal. Get what you need. You can do this.
Are you feeling a little stronger about advocating for your care? Tell us how it goes in the comments below!