Speak up for yourself, speak up for your health
As a new mother, even if you already have other children, you may be experiencing some physical symptoms for the first time in your life, or you may be feeling emotions in a way that is unusual for you. On the other hand, you might be feeling exactly the same way you did before you became pregnant!
What is normal?
One of the greatest and most empowering tools you can have as a new parent is “knowing what’s normal”. This applies both to your new baby’s developmental milestones and also to your own postnatal health and experiences, physical, mental and emotional.
If things have changed in a way that are uncomfortable, frightening or upsetting, or even overwhelming, it’s important to find out whether these symptoms are a normal part of life after having a baby or whether they are unusual and may require further support, investigation or treatment.
In order to make an assessment, you will need to start a conversation with your healthcare professional, depending on where you live, this could be your community midwife, a public health nurse or your local doctor.
Who to have this conversation with?
Find out what services are available in your area, and keep a list of these and their contact details, at home.
In Ireland, the State provides a free healthcare scheme for new mothers and babies. This scheme is administered by participating General Practitioners (doctors), it starts during pregnancy and continues until six weeks after you have your baby. At six weeks postpartum you will be offered a mother and baby check which marks the end of perinatal care. The six-week check is an opportunity for you to raise any issues you feel you might have.
The purpose of this check-up is to review your health and your baby’s health, but women often find that this check-up is focused almost entirely on the baby, with little or no time or attention given to the health and health concerns of the mother. Therefore, it is a good idea to tell your doctor that you would like to discuss your own health before you move onto your baby’s health. That way you and your needs won’t be forgotten or tagged onto the end of a short appointment!
Your appointment should cover your physical and your emotional and mental wellbeing. If your doctor does not mention these issues at your visit then you should, and must, raise them yourself. This can be daunting, but nonetheless it is essential.
Outside of this six-week check, it is good for you to know that some medical practices have practice nurses working alongside them and you may feel more comfortable discussing some issues with a nurse. It is worth making a follow-on appointment with one of them if you feel your doctor’s visit left you still wondering about certain things.
Other appointments in the postpartum period include routine visits from a community midwife or Public Health Nurse. Use these as opportunities to discuss your own health. You may also be attending a Well-Woman clinic; this can be another opportunity to speak with a doctor or other healthcare professional who specialises in women’s health.
How to start this conversation?
Starting a conversation can be difficult, especially if your healthcare professional does not bring up questions around intimate issues, how sexual relations are for you, leaking urine or faeces, your perineal health or your mental wellbeing. It is important for you to be prepared to start the conversation.
It can be helpful to draw up a list of things you would like to discuss that are important to you. You can use the downloadable Checklist available in the Downloads section, or you can just write your own and use it as a guide to having your conversation, make sure to put your biggest concern first, so that you can have enough time to discuss that. You can use the checklist, or your own written list as a memory prompt for yourself or you can print it out, and give it to your healthcare professional at the start of your visit to have them direct the conversation accordingly.
Having some knowledge about what is or is not normal around a health concern can support you if you feel that your health care professional is not listening to you or dismissing your concerns. Use the information in this course and information from other trusted sources, to become informed about what is and is not normal.
You could keep a brief record of your symptoms, when they started, how they make you feel and how they affect your everyday life. You can show this to your healthcare professional to help them understand the symptoms, severity and impact on your life.
Talk with a loved one: getting a difficult conversation started with someone you trust can help you sort out what you want to say. Start by saying the words out loud, to yourself first then to a trusted partner, friend or family member can help you find the words you need to open up to a healthcare professional.
If you feel you need support in attending your visit, you can ask your partner or a friend to come with you. Some mothers prefer a closer friend as they don’t want to discuss aspects of their physical or emotional health in front of their partner and other mothers prefer that their partner attends with them.
No matter how awkward a topic may seem to you, your healthcare professional will have heard it a thousand times over, and is always there to help you optimise your postnatal experience, so try to bear that in mind if you feel embarrassed or nervous.
Remember, in order to look after your baby and your growing family, you need to be well physically, emotionally and mentally yourself.
Was I able to say everything I wanted to say?
Hopefully, you will feel listened to and that you are a partner in your care at every step along your antenatal, labour, birth and postnatal journey. If, however, you feel you were not listened to, then it’s important to seek a consultation with a second healthcare professional so that your needs can be met. This might be another doctor in your local practice, a completely different doctor, a private midwife or an obstetrician in your local maternity hospital.
Where else can I go for support?
There is a variety of private options in terms of seeking assistance with your physical and mental health. For example, women’s health physiotherapists specifically in postpartum symptoms. In some maternity hospitals, you can self-refer to women’s health physiotherapists up to six months after the birth. In other places, you will need a referral from a doctor, so find out how you can get an appointment in your area.
There are many talk therapies available that might help with emotional issues. Some counselling services can be accessed through your local doctor, but you can also schedule to see a counsellor or psychologist of your own choosing. In Ireland you can find a local register counsellor or psychologist through the Irish Association for Counselling and Psychotherapy or the Irish Psychological Society. AIMS Ireland also offer free one to one support for postnatal queries and issues especially associated with emotions after a birth and run a free birth-healing group.
|Dr Krysia Lynch, maternal health expert of AIMS Ireland.|
© Trinity College Dublin