You’ve probably heard the popular proverb “it takes a village” in terms of raising a child. The same could be said about maintaining wellness for new moms, yet, culturally in the U.S., postpartum health is rarely the focus. While the current approach is often a quick six or eight-week postpartum doctor’s visit — is that really all it takes to take care of mom’s health? A lot can happen physically, emotionally, and mentally during those first few months after giving birth, and trying to find the right specialists is likely the last thing on a sleep-deprived new mom’s to-do list. If you’re expecting, do yourself a favor and take some time to line up your support system just in case you need the extra TLC down the line. Below, we sat down with different types of experts who explain how exactly they help new moms with their self-care — from dealing with your pelvic floor to breastfeeding advice to navigating baby sleep and more.
How you can find support from a… midwife
There are three levels of midwives: a certified professional midwife (CPM) who has been certified by the North American Registry of Midwives, a certified nurse-midwife (CNM) who are registered nurses who have received their American Midwifery Certification, and a certified midwife (CM) who are non-nurses who are also certified by the American Midwifery Certification Board.
Certified Nurse Midwife (CM) is an advanced-practice nurse who focuses on the care of women. Though they’re often associated with pregnancy and childbirth, they can provide full gynecologic care and primary care to women. “This past year, COVID-19 has certainly changed the experience of getting pregnant, being pregnant, and having a baby. One of the biggest effects the pandemic has had on childbearing women has been a negative impact on their mental health and well-being. Women are already especially at risk of experiencing mental health changes, like depression or anxiety, during and after pregnancy. The fear and worries associated with the COVID-19 pandemic, coupled with the increased social isolation, have left this population even more vulnerable to worsening mental health. But women should know that they don’t have to suffer alone or suffer in silence. There’s help available, and it is possible to feel better,” says Lisa Richards, MSN, CNM, certified nurse-midwife and Ovia health coach coordinator. “Women can seek the care of midwives at any point in their journeys. Midwives can provide family planning care for those not planning to conceive, preconception care before pregnancy to those hoping to start a family, prenatal care during pregnancy, labor and birth care, and postpartum care after birth as well. However, midwives are generally best-suited to provide care to those who are relatively healthy and overall low-risk. For higher-risk care, midwives may need to work collaboratively with physicians, or hand off care to a physician who’s better equipped to manage higher-risk conditions,” she says.
“For those who are lower-risk and good candidates for midwifery care, midwives can often offer a more hands-on approach to healthcare and a closer, more supportive, and more personal relationship. Midwives focus on providing evidence-based informed consent and shared decision-making. They often provide care with a greater emphasis on wellness education, health promotion, and risk reduction. Women who give birth with midwives also generally describe an increased sense of control during their labor and birth experience,” she says.
How does a midwife differ from an OB/GYN or a doula?
“The roles of midwives often overlap largely with the role of an OB/GYN physician, but OB/GYN are more common and midwives are utilized less often, so their role is not as commonly or easily recognized,” says Richards. Midwives usually follow a natural birthing process (no C-sections and little or no pain medication). They can sometimes deliver your baby outside of a hospital and offer alternative deliveries like water births. “Both midwives and doulas can be associated with some benefits like improved outcomes, improved birth experiences, lower rates of unnecessary medical interventions, and higher rates of breastfeeding, but they achieve those outcomes in different ways. Some people think that if you have either a midwife or a doula, you don’t need the other, but neither can fulfill the other’s role. Midwives and doulas often work best as a team, providing both high-quality medical care and high-quality support,” she says.
Can you see me virtually? “Telemedicine can be a convenient mode of healthcare delivery in many circumstances, and when appropriate, midwives can offer certain appointment types virtually. However, many appointments — especially during pregnancy — benefit from remaining hands-on and in-person,” she says.
How you can find support from a… doula
A doula is a trained, non-clinical healthcare professional who provides physical, emotional, and educational support during and after pregnancy. “It is a person who’s there to help you feel your most radiant and also your most supported in the time that is really your most powerful and most vulnerable,” says Latham Thomas, doula and founder of Mama Glow. “There are pregnancy birth doulas, there are postpartum doulas who help you navigate the experience of new parenthood, and there are even sibling doulas now — people who help the children transition into siblinghood. There are also bereavement and loss doulas. So, if you have a miscarriage or loss or abortion, folks who can help you navigate those experiences as well. Many times these are not separate people. I always see all of this work as one continuum and I support people through each of these life events. At Mama Glow, we have a doula training program that provides a lot of evidence-based research to make sure our trainers are able to go into the world or in a space with physicians and understand what’s happening. I would say while credentialing is important and I believe in its value, I do think that a person who is having a baby should have a support person of their choice — and that lived experience could be more important in sharing wisdom and knowledge base,” she says.
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Can you see me virtually? “You can do virtual, you can do in-person, you can do virtual learning and have virtual attendance at birth. There are so many ways you can go about it,” says Thomas.
How you can find support from a… dermatologist
Of course, having a dermatologist on speed dial is important no matter what stage you are in life, but if you don’t have one lined up yet, now’s the time to look for someone you trust. Thanks to pregnancy and postpartum hormones, new skin issues can arise that you’ve never had to deal with before. Most may go away on their own with time, but others you may want to get treated or get advice on how to tweak your existing skincare routine. You can experience “increased darkening of the skin from hormones — including melasma, acne that appears in the first and early second trimesters when the androgen hormone levels rise and cause increased sebum, leg or facial veins from increased blood volume, skin tags, stretch marks from the skin stretching quickly to accommodate your changing body, and postpartum hair loss,” says Dr. Robyn Gmyrek of UnionDerm in New York and clinical instructor of dermatology at Columbia University. Your dermatologist can also advise what kind of ingredients you should avoid during pregnancy. “It’s important not to attribute all the changes in your skin to being pregnant. For instance, changes in moles, birthmarks, or beauty spots should get evaluated. While skin cancers are not more likely to occur during pregnancy, they can still occur. Of note, it is safe to have your dermatologist biopsy a suspicious area if needed,” she says.
Can you see me virtually? ”Yes – the technology has improved, allowing for sharper images and more secure platforms to provide medical care. In addition, the general population’s use of the technology has improved making it easy to connect, allowing for more convenient initial and follow-up consultations,” she says.
How you can find support from a… lactation consultant
Lactation consultants are nursing experts who help with breastfeeding. “There are many levels of training, each of which denotes a slightly different title. The acronym IBCLC stands for International Board Certified Lactation Consultant, which is the most in-depth certification requiring a college degree, 500 to 1,000 hours of clinical practice, and more, compared with a five-day to a six-week class that other trainings required. IBCLC is the only certification that uses the term lactation consultant,” says Amy Peterson, BS, IBCLC, co-author of Balancing Breast and Bottle, and an infant feeding consultant for Evenflo. “We want parents to have the skills they need to navigate infant feeding before the baby arrives. When feedings don’t go as planned, lactation consultants work with families to get things back on track. This may include latch and positioning, milk supply concerns, tips to work through a traumatic birth experience, questions about infant sleep and milestones, starting solids, and eventual weaning. Many times a feeding difficulty is the first sign of a medical problem. IBCLCs know how to differentiate between normal feeding difficulties and when a referral to a health care provider is needed for further evaluation,” she says.
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What’s the most common issue your clients have experienced lately?
“One of the biggest challenges I’ve seen this year is lack of community. So many families have been isolated due to the pandemic, so moms haven’t had the opportunity to talk shop with their peers. For this reason, a lot of appointments are for normal feeding behaviors, meaning there isn’t a problem at all, just a lack of confidence. Another frequent challenge this year has been bottle introduction. The pandemic allowed parents to work from home, so many babies have been exclusively breastfed. But now that parents are returning to work and babies are going to childcare, a lot of babies are refusing to accept a bottle. Babies need to eat during separation, so a lot of consults have been scheduled from a place of panic,” she says.
Can you see me virtually? “Many lactation consultants work virtually by video. Meeting with someone face-to-face is preferred, but not always possible,” she says.
How you can find support from a… pelvic floor therapist
Pelvic floor therapy is a type of physical therapy (PT) that targets the pelvic floor muscles, tissues, and ligaments that support your uterus, bladder, and bowels. “Most people think of pelvic floor therapy for incontinence (leaking urine) I think because there is so much advertising around products to help with this. But there are so many other reasons it can be helpful. Some of the lesser-known ones — or ones that people don’t usually correlate with pelvic health — are lower back pain, diastasis, pelvic pain, painful sex, recurrent UTI’s, digestive issues, difficulty with orgasms, or even just to connect more deeply to your core,” says Allison Oswald PT, DPT, WCS. “Now more than any other year, I have worked with women with pelvic floor tension, especially pregnant women preparing for birth. A healthy, well-functioning pelvic floor should be able to contract and lengthen, but sometimes it can remain contracted more than not and cause pain in the pelvic floor, hip pain, and other symptoms. Leading up to birth, I guide women to lengthen their pelvic floors to prepare for delivery, but that has been more challenging as their bodies seem to be holding more tension in their pelvic floor muscles. I personally attribute this to the high amount of stress we have all been managing this pandemic, but especially that of women who are pregnant,” says Oswald.
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Do I need a pelvic floor therapist even if I don’t have a specific issue?
“Absolutely. Pelvic floor PT should be considered wellness and prevention. Learning about the pelvic floor and daily functions that can contribute to long-term pelvic health are so helpful. There are things women might be doing now that could eventually result in symptoms,” she says.
Can you see me virtually? “Yes. As a therapist, being able to touch and facilitate women with hands-on is so beneficial. But, there can be some much accomplished and achieved on a digital platform. I also find that it puts a bit more responsibility on the patient in a good way. Virtually I am able to see the patient and listen to her story, I am also able to educate easily with visual aids, which is almost exactly like being in person. We can practice movements together and send them on their way with a video home program. Because patients are in the comfort of their home, some women have told me that it’s easier for them to talk about some of the more personal concerns/symptoms,” she says.
How you can find support from a… baby sleep expert
If the baby’s not sleeping, it means mama’s not getting her sleep, either — a challenge that Carolynne J. Harvey, founder of Dream Baby Sleep, personally resonated with. “I started Dream Baby Sleep because I needed [this program] when my daughter was an infant. Back then, I broke nearly every ‘rule’ in the book: I nursed her to sleep, I rocked and shushed her to sleep, I co-slept until she was almost a year old. I was a single mom dealing with undiagnosed postpartum depression — every minute of sleep I could get was precious, but neither of us was getting enough,” she says. “Healthy sleep is not a luxury, it’s a life necessity as most of the human growth hormone is produced at night during consolidated sleep. The human growth hormone is what helps boost overall immunity, wellness and helps prevent juvenile diabetes. Sleep is critical to the entire family’s wellness, but especially for mom,” she says.
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What ages do you treat?
“My team and I work with newborns to four years old. We’re toddler wizards, many consultants only work with babies up to two years old. I’ve created a proven method that empowers, validates, and praises toddlers for long-term success. I’ve mastered and simplified 4 gentle sleep training methods. We offer our clients choices when sleep training based on the age of their baby, their cry tolerance and parenting style,” she says.
Can you see me virtually? “Our practice is 100% virtual and always has been for the last nine years. It really helps keep the cost down and enables me to work with clients on their schedule,” she says.
How you can find support from a… therapist
A therapist is a broad term that applies to a range of people who are medically trained to evaluate and treat mental or emotional disorders. You can find one that specializes in family issues, particularly when a child is brought into the home. “It is vitally important for new mothers/primary caregivers to get as much support as possible when it comes to their mental health. The primary parent to a baby is this tiny person’s lifeline to the world. When a parent is mentally and emotionally stable they are able to provide a solid foundation of comfort and caring which in turn allows the infant to feel safe and secure. When a child feels safe, loved, and secure their body and brain grow exponentially, especially during the first two years. A parent who is mentally healthy is able to meet the ever-changing needs of their young child in positive and growth-oriented ways,” says Bethany Cook, PsyD, HSP, MT-BC. “This past year has left expecting and new mothers/parents feeling isolated, alone, scared and concerned on a level greater than previous years. Being pregnant and having a baby during a global pandemic takes the word “stress” to a whole new level. Issues experienced during the past year are similar to what all new parents experience just with an added layer of “obstacles”. These obstacles include but aren’t limited to: decreased physical support from family and friends due to travel restrictions, difficulty getting appointments due to decreased office hours for many doctors offices, difficulty getting certain baby supplies due to availability, and increased anxiety and depression to name a few,” she says.
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Should I see a therapist even if I don’t have a specific issue?
“Absolutely yes. All parents can benefit from seeing a therapist even if they aren’t in an acute crisis. I actually think seeing a therapist outside of crisis is the best time to work through issues. Many times a crisis situation can stem from many seemingly unimportant small unresolved issues from the past. So, why not work on preventing future problems by resolving smaller ones,” she says.
Can you see me virtually? “Yes, my office has been thriving using the telehealth platform. I find many parents (especially those with young children) enjoy the ease of online sessions,” she says.”
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