Thoughts on the 12-week Postpartum Appointment and the Lack of Mental Healthcare Support in New Moms

You're 12 weeks postpartum and the day finally arrives... your postpartum OB appointment. While I have many thoughts on the absurdity of our country's single 15-minute postpartum appointment at 12 weeks and the content most providers primarily focus on during that time, this post will focus on the mental health aspect of the visit.

If you're lucky, you will receive a general depression questionnaire upon checking into your postpartum appointment for you to fill out in the waiting room and give to your nurse when she brings you to your room. This questionnaire, mind you, isn't specific to postpartum depression, isn't considered the best assessment for postpartum depression, nor does it examine any other perinatal or postpartum mental health issues such as postpartum anxiety, OCD, pyschosis or birth trauma, to name a few. It is quite literally the bare minimum and in my professional opinion, a slap in the face to new moms. I truly believe most providers only include this as a way to avoid liability if something were to happen to the new mom.

And for most women, that's it. No follow up on your responses, no discussion on what you should look out for, names of therapists or other community resources that might be helpful as you navigate this huge life transition of caring for a tiny human.

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Yet, perinatal mental health issues are extremely common. And it's well documented that mothers carry a huge role in a child's life yet are very often undersupported in many ways in our country from our policies to the lack of preventative care we give new moms. There are huge systemic issues in our country around maternal mental health care, not to mention the disproportionate amount of women of color who shoulder the cost of maternal mental illness.

Many OBs treat the physical component of a new mom's healing progress in what feels like a push to get back on birth control and get clearance to have sex again. There is little to no mention of "how are you really doing?" or "do you have enough emotional support?" from providers in these sessions. This absence in care can send the message to a new mom that struggling with mental health is something to hide, be ashamed of, not to mention, or something uncommon. None of which are true.

For many moms, this can feel reminiscent of her personal life. Our society doesn't help new moms and for the most part, focuses on baby. Good pediatric care is not individualistic care, though. Good pediatric care includes care of the mom and that includes her mental health, too. When new moms are supported, set up for success, and really asked about how their mental health is doing postpartum, both mom and baby are more likely to do well long-term.

If you are struggling postpartum and feel unheard or confused about what is or isn't considered worthy of being a postpartum mental health concern, you aren't alone. It is confusing because providers (and, yes, insurance companies who have the power over providers) have made it confusing. The truth is, there's nothing wrong with you for struggling postpartum or being confused. It's common and you deserve care. For some, that's medication and for others, that's something like individual, couples or group therapy.

If you think you're fine and don't have any "real issues" postpartum, you still qualify for postpartum mental health care, no matter how postpartum you are. As a perinatal mental health provider, I can help you understand your unique postpartum experience and if necessary, can even look at (much better) assessments to see how you're doing. Only this time, there will be follow up which is something all new moms really need from their providers, whether they think they're struggling, doing better than ever or somewhere in between.

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