So, this is the big week that the American College of Obstetricians and Gynecologists (ACOG) announced their updated guidelines for postpartum care. According to the May, 2018, published ACOG Committee Opinion Paper,
“The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being. To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual needs. It is recommended that all women have contact with their obstetrician–gynecologists or other obstetric care providers within the first 3 weeks postpartum.”
On the surface, this looks like great news! The midwifery model of care advocates ongoing care during the first three weeks postpartum as standard practice. While postpartum schedules of care vary by midwife, typically we see clients twice at their homes in the first week, once in week two at home or in the office, possibly have a phone call in week three, and office visits at four weeks and six weeks after birth. If that schedule is not the best fit for particular clients, we adapt it to fit their needs.
One of the things I love about midwifery is that our good practices often precede changes to the dominant medical system and eventually come into use by that system. In this way, Midwifery, though it serves a relatively small set of the U.S. population, drives the adoption of healthier practices for all pregnant and birthing people. Take for example the practice of continuous fetal monitoring vs. intermittent auscultation of fetal heart rate in labor. Home birth midwives have not used continuous fetal monitoring. Not only is it an impractical device to tote around from house to house, but it would defeat several advantages of home birth including, freedom of movement, minimal changes to natural living environment, and paying close attention to the person in labor not a machine.
Oak Grove Midwifery, LLC 