A mother of two talks about postpartum wellness and the care she thinks women actually need.
“Childbirth is a huge trauma to the body,” Jesse Truelove of Guymon, Oklahoma, told Good Morning America. There is stretching and tearing of ligaments and connective tissue, and you carried a baby for nine months, too. “
Truelove is a specialist in prenatal and postpartum core and pelvic floor exercises. She is also the head coach of the Move Your Bump app and a postpartum abdominal and rehab training course.
Her career choice was triggered by her experiences giving birth to her two daughters, she said.
“Everything changes in a day because you don’t have the pressure of the baby pressing against your tummy,” Truelove said. “It takes very specific training and procedures to get back from it … but for some reason our society sets this magical number of ‘six weeks’. The idea of even having sex at 6 weeks can be terrifying as a woman [postpartum]. “
In anticipation of the body’s healing process, healthcare providers will typically allow women to have sexual intercourse and begin physical activities such as exercise during their six-week exam, unless directed otherwise by a doctor, based on the birth method.
What should change, say mothers and experts.
In 2018, the American College of Obstetrics and Gynecology (ACOG) announced its goal of optimizing postpartum care in what experts call the “fourth trimester” – a time when women are recovering from childbirth, a major medical event while Address the emotional and physical challenges that come with caring for a newborn.
“They now recommend that postpartum care be an ongoing process,” said reproductive psychiatrist Dr. Alexandra Sacks opposite “GMA”. “Obstetricians / gynecologists are encouraged to schedule appointments with patients for the first three weeks after they are born.”
Sacks went on to add that the maternal mortality rate in the United States is shockingly high when compared to economically similar countries, and even higher among women of color.
“So this is a recommendation in response to both of them to address the mental health issues that arise in that first month after giving birth, including PMADs [perinatal mood and anxiety disorders] but also physical requirements …[such as] Problems with bleeding or blood clots. If they are not managed in the first three weeks, [it] can be disastrous. It’s not just mental at all. “
Truelove gave birth twice by caesarean section. She said the first two weeks after that, her husband had to help her get around – as caesarean sections are major surgery.
“It’s really important to remember that everyone goes through recovery differently,” said Truelove.
On May 11th, Truelove published an Instagram reel in which many obstetricians were asked to give the all-clear. [for sex] in the middle of the postpartum period. Many sounded out on the subject in the comment section.
“I have just cleared the 6 weeks by phone,” wrote one woman. “I wasn’t even asked specific questions about my performance. That pretty much confirms how meaningless it was.”
“After 6 weeks, my doctor told me that I was released when I felt ready and that it was all my decision,” commented another.
“Six weeks became six months for me,” says one mother.
Natasha Eidson from Guymon, Oklahoma, poses with her son Cooper (right) after he was born in July 2019, her cousin Heidi (left), and her other cousin Holly (far right).
During her postpartum period, Natasha Eidson, also from Guymon, Oklahoma, trained with Truelove.
Eidson, mother of a one-year-old child, told GMA that she will have her second child in a few weeks.
She described her first birth experience as “painful” and “traumatic”. Eidson said she pushed for several hours and had vaginal tears during childbirth.
Natasha Eidson from Guymon, Oklahoma, poses with her son Cooper after he was born in July 2019.
“We talk about it a lot, hear the doctor say you are approved for all of these things, and I think, ‘Is that me?'” Said Eidson. “I still remember how tears welled up in my eyes and I asked, ‘You are literally telling me that I can go back to work?'”
Eidson said it took her two additional weeks before she could go back to full work. She also took out a postpartum questionnaire during her postpartum examination.
“It asked, ‘Do you think you are mentally okay to take care of a child?’ At first I thought, ‘No, I’m not.’ I was like, ‘Well what if I answer no? Are you going to take my baby?’ “
Eidson said she had postpartum depression and was offered a prescription for antidepressant drugs, although she thought it wasn’t the best option for her.
Natasha Eidson, from Guymon, Oklahoma, looks down on her son Cooper, who was born in July 2019.
“I think it really helped me the most being around people,” she added. “And being with others who have just been through this. My wish for women is to do whatever makes you happy … it’s okay to ask for help, be it from a doctor, a friend, or a family member. That awareness needs to be more there. ” . “
There are more than three categories of postpartum adjustments
Sacks said women with postpartum depression should be treated by a professional.
Sacks said that about 80 percent of women experience what are known as “baby blues” in the first two weeks after having a baby – a self-limiting experience that often goes away on its own. A mother with baby blues may be more nervous or tearful than usual, have mood swings, and is the “least severe form of postpartum depression,” according to the American Pregnancy Association.
“It’s an immediate breakdown in the hormones of estrogen and progesterone, which are elevated during pregnancy,” said Sacks. “And so some theories suggest that baby blues has a lot to do with hormonal adjustment.”
Sacks said that some women are breastfeeding, which with the rise in oxytocin leads to another major hormone shift.
There are also other biological changes that affect your hormones, such as sleep deprivation, physical pain after giving birth, impersonating a parent, and adjusting to a new child to care for.
Women can have postpartum mood and anxiety disorders, which are clinically diagnosable mental health problems and require treatment.
According to the Anxiety and Depression Association of America (ADAA), approximately 10% of postpartum women develop anxiety.
However, there is no category for it in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) of the American Psychiatric Association. Instead, postpartum anxiety is often grouped under major depressive disorder with peripartum onset, which according to the ADAA affects around one in seven women.
Sacks said that women can have different postpartum experiences depending on the person and different risk factors, and there are more than three categories of mood adjustments related to identity shifts and birth trauma.
Sacks said if you have any questions about your experience, ask your doctor.
“No woman should suffer or be ashamed in silence,” added Sacks. “And the sooner you get help, the healthier it is for you and your family.”
Sacks said the ACOG’s recommendation for earlier postpartum care is a step in the right direction when it comes to responding to physical and mental health needs.
“You deserve a functioning body too.”
Women are also subject to physical changes and can remedy the situation with tailor-made aftercare.
Tailored exercises can help mothers rehabilitate the muscles affected during pregnancy and childbirth – something that a doctor is not solely responsible for, Truelove said.
After having a baby, women sometimes leak when they sneeze, cough, laugh, or play sports. Truelove suggested that this could be a sign of a dysfunctional core and pelvic floor.
While women have the option of having surgery for a weakened pelvic floor, Truelove said a medical event other than such shouldn’t be the only option.
“You deserve a functioning body too,” she said. “You deserve to feel confident because your body is able to do what it is supposed to do.”
Truelove says women can improve their pelvic floor and core through functional movements, and the ACOG says mothers can do these gentle exercises as soon as they feel ready.
“Doing 1,000 crunches and 1,000 kegel exercises isn’t how you fix pelvic floor function,” she said.
Truelove said that when a baby is in the womb, the baby presses on the diaphragm, preventing deep breathing.
“It changes the muscles and the pelvic pooch’s mothers think they’ll get stuck on them,” she said, adding that certain exercises can help correct posture and breathing after birth. “The baby also puts pressure on the abdominal muscles, which can stretch the connective tissue, causing the excessive diastasis and abdominal detachment.”
“Recovery is not a one-size-fits-all for mothers.”
In addition to previous postpartum exams, Truelove said, doctors should modernize the language they use when chatting with patients.
For example, “There are other ways to be intimate,” she added. “And it won’t even be discussed at your six-week appointment.
“[Women] come to us already vulnerable, “said Truelove.” They are trying to figure out how to make their bodies feel like their bodies again. It’s also a mental recovery. Not only did you give birth to a baby, but you also gave birth to a mother. “
“You’re trying to find out who you are now.”
Before participating in postpartum exercise, educate yourself about your options and speak to your gynecologist and / or health care provider.
If you are unsure of what you will experience after giving birth, speak to your doctor about visiting a therapist or contact the Postpartum Support International international helpline at 1-800-944-4773.