I read on another HB MW site yesterday that PP visits are like 1 and 4 days PP, 1 week, 4 week and 6 weeks (or something like that.) That struck me as really excessive. She said it was to check on BFing & PPD. But, again, that still struck me as excessive to be routine for every single mama (especially those who have BTDT with BFing, as I have BFing through challenges.)
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Some moms do not want all of it, which is fine--but really they are the exception. Most enjoy these visits, whether or not they really 'need' anything. Especially with the 2wk and 6wk visits--we chat, weigh the baby, talk about the birth or the reaction of sibs to new baby, BF, anything at all. Sometimes these visits are pretty short, mostly just a weigh-in. Sometimes they do end up longer, if there are any issues that need sorting. It's a time for a new mom to get some time for herself--someone paying attention to her in almost any way she might enjoy that.
No one is required to take it all, but I do urge fams to accept at least 1dy and 3dy visit (only a rare few even question it) so I can see if baby is transitioning well enough--many of my clients do not plan dr visits until/unless baby gets sick, or vax time arrives @2mos or beyond, so I'm a sort of 'first-responder' in a way.
I believe this plan is why I only rarely see ppd...not only because I'm 'on the lookout' for it--but because as we go along, I can see stressors arising, and help families to find solutions before they get far. So it's not so much any major 'professional intervention' as hearing how all is going, knowing if mom is able to take it easy-enough (for her) following birth for a quick recovery, making suggestions if needed....lots of little things. Some families do need more by way of this sort of observation and support--some don't--by and large my moms/fams like to show off the baby, talk about family stuff, etc...just fun!
I really appreciated and enjoyed that times she came and spent with me after the baby.
Lovin my sweet babygirl 3-17-10 and expecting another in March!
I also agree with Jennica that you spend so much time with them during the pregnancy that it would seem unnecessarily harsh to suddenly stop seeing them---but then again I'm a big birth chatter so my prenatals sometimes went extra long.
Mama to P. born at home 10/09, and W. born in the hospital 2/13
Melissa, wife to Brian, mommy to my home born, breastfeeding, sling-riding, sleep sharing, cloth diapered, intact kiddos Adam 11/09 and Leah 8/12.
If you aren't interested in visits from your mw so often, you could probably just request to skip it -- or find out what she wants to check on each visit: baby weight, signs of jaundice, mama's healing/bleeding, etc... seems like there's always a lot to check at the pp visits.
Mama to 4 girls 5/05, 12/07, 9/09, 3/11
Mama, homeschooler, midwife. DD (13yo), DS (11yo), DD (8yo), DD (3yo), somebody new coming in November 2013.
I am not just on the lookout for PPD, but I am also making sure that the mother's needs are being met so this time can be enjoyable and not stressful or lonely. I want to be sure her pp support is working out the way she planned, that I can give her referrals to anything she needs, that she feels like we are all around her to help her through this transition into mothering this next child. I want to know that if she bled a bit too much or had a tear, that she is healing well from these things and not just waiting for 6 weeks to tell me that she has been miserable. Or if things are going great, sometimes it is just nice to have someone celebrate that with you. I think it also reminds women that they JUST had a baby and shouldn't be pushing themselves too hard.
If a mother doesn't want all of those visits, that is just fine and totally up to her. It is just a suggested schedule of visits that I offer. In my apprenticeship we had many grand multips who simply didn't want that many visits. They wanted the first one for the newborn screen and then would often just say that they would call us when they were pregnant again. I would never force visits on someone who doesn't want them, but they are pretty nice for those who do.
Erika, mama to three beautiful kids (plus one gestating), and wife to one fantastic man.
Or if things are going great, sometimes it is just nice to have someone celebrate that with you.
2. Birth control
We discussed #2 & I felt like a 14 year old! I felt she was being condescending & irritating. Um, yeah, I know if I don't want to conceive another child ASAP & I have sex with my husband, I need to take some action to prevent conception. & yes, I know this whole unprotected-sex-can-lead-to-conception concept still applies after giving birth!
& #3 was an uncomfortable discussion. I had such an awesome birth experience - I was OVER THE MOON! haha! Literally, I couldn't stop thinking about it, I couldn't stop talking about it.
I remember literally struggling to suppress my grin as she discussed PPD in this serious tone of voice. (Because I know PPD IS a serious issue & a real concern.) Again, intellectually I realized PPD is a serious thing, but I felt so overjoyed then, I wasn't worried about it at the time.
She did not share in any of my joy.
A simple, "Congrats! You seem overjoyed. That's fantastic! I'm sure you'll love motherhood! But let's talk about PPD too just in case so you know what to look out for & just in case, you can make sure to get help if you do happen to need it in the future."
No, it wasn't like that at all. It was like, "Meg, get your head out of the clouds, suppress your joy & let's get serious here!"
I couldn't wait for her to get out of my room so I could return to my blissed-out state. Literally, her presence felt like a big rain cloud on my sunny family picnic.
& that is all to say nothing of the AWFUL LCs & her COMPLETELY SAYING NOTHING to me about perineal healing. I had a 1st degree tear, but the other CNM had said it was such a minor tear, she wasn't even going to suture it, but she did since it kept bleeding. So I was thinking it was "no big deal" & nothing to be concerned about. I didn't even know I was supposed to use a peri-bottle after urinating. Ugh!
Of course, now I'm seeing a HB MW & obviously I expect a lot better care! So I need to let the past go & move forward. However, all prenatals are at her home office so I wouldn't assume she'd do as many as 6 PP apts in my home. There is no way I'm driving up there at 2, and 4, and 6 weeks PP. It's 50 min each way for me. That's too much.
I have a series of questions that usually get asked, just to be sure nothing is getting past me that is 'abnormal' that mom may think is 'normal' and just has to put up with...and I am watching mom's/families signs--tones of voice and choices of words, general affect and how the family seems to be doing. But I don't generally mention ppd at all, until/unless I see possible signs arising. I should say, I am more likely to mention it before birth, when we are discussing pp recovery, having help with chores and other kids, bf support. It's my experience that a well-supported pp recovery/babymoon is the best prevention of ppd for most women...and I'm a big believer in wellness focus, and thus prevention of problems.
And I don't mention birth control until the 6wk, unless it looks to me like mom is feeling very frisky before that , or she asks. Again, prior to birth it's most likely that we have discussed bf suppression of fertility and how reliable it is not. Even at 6wks pp, I don't deliver a standard speech, but ask women if they need info on bc. Yeah, they are grown women; I am happy to discuss bc options if they want to, but don't assume they know nothing (including the basic facts of conception!) and don't make them listen to a spiel if they prefer not to.