When I read the title of this article in this month’s Journal of OB/GYN (the ‘green’ journal), I literally laughed out loud. This could be because, at the time I was holding a fussy 2 month in my left arm while holding my green journal in my right hand, walking the room. I was trying to read, console baby and keep 6 year old entertained, all at the same time, so husband could finish working on a project upstairs. How can I prepare my patients better for their ‘postpartum experience’ when I can’t prepare myself, I thought?
As I read the article further, it mainly discussed the physical symptoms associated with post partum such as bleeding, hemorrhoids and breast tenderness, with just a small aside on anxiety and mood swings, written blandly in technical writing. I laughed again. Seeing someone try to quantify the emotions that go along with having a baby in a ‘prospective longitudinal cohort study’ seemed absurd.
There is nothing that can fully prepare you for having a baby. No amount of books or advice. Not even being board certified in OB/GYN. When my oldest was born I was a 3rd year resident. I could rattle of the top of my head the physiology of delivery, risk factors for postpartum depression and I could have resuscitated/intubated my newborn if needed. I thought I knew what I was doing. I had read books on baby care and breast feeding. Then after a difficult delivery, I was home with a newborn, who did not ,in fact, read the same books that I had read on how he was supposed to act! I remember being so sleep deprived I literally couldn’t see straight. I had reasoned before delivery that if ANYTHING could prepare you for postpartum, then it was residency, but the truth is that NOTHING can truly prepare you. I finally let him occasionally take a bottle so I could sleep and recover from my cesarean section. After a couple weeks I got into a flow and he did eventually get on a schedule…. Sort of. I learned to be less anxious and just enjoy every minute with him.
We recently adopted baby #2 and the ‘postpartum’ time has been significantly better. Some of this is the lack of physical recovery of course, but I think a lot of it is just knowing what to expect. Additionally I now live closer to family and have more social support.
In my practice I think the people who have the hardest transition to postpartum are the women who have it the most “together.” The executives with their blackberries who have everything all planned out and the nurses who know it all already and won’t ask for help. These are the patients that I try to take the extra time with to prepare for postpartum. Usually they smile and nod patting their baby books on their lap, thinking NO not me! But at their postpartum visits they almost always say you know, you were right! This is the hardest thing I’ve ever done.
I’m not sure that being a mom makes me a better doctor, but it definitely helps me understand/ counsel the postpartum patient. When my staff asks if I’ll see a postpartum patient that has shown up late for their appointment, I ALWAYS say yes. Just making it out of the house with a baby is difficult, let alone making it on time. Actually, I usually even will see them first, even if others have been waiting longer.
No offense to the author of the article. It was a well done study and she's right we do need to better prepare our patients for postpartum issues. I just don't think an extra brochure is going to do the trick.
I would love to hear our readers input on their personal “preparation” for their postpartum recovery (especially any OB/GYN’s out there).