May 21, 2024

#34: Advocating for Postpartum Health: What You Need to Thrive and How to Ask For It

In this episode, we dive into the crucial importance of advocating for your health in the postpartum period and discover why postpartum is a unique and often challenging phase of a health journey, both physically and emotionally. We’ll also explore common struggles moms face after giving birth and discuss why the current healthcare system may not provide the support needed without proactive asking. Towards the end, we learn how to effectively advocate for our wellbeing, get the help we deserve, and navigate this transformative time with confidence.

About this episode

What you'll learn

  • 10 different ways moms are overlooked in the medical system
  • 6 ways the postpartum period is different from any other phase of life
  • The true definition of "fine" and why it's robbing you of health and happiness in postpartum
  • 3 ways you can advocate for your health after having a baby
  • Lab tests that will help you understand how well you're healing after pregnancy
  • Experts I follow on social media that educate and empower me in my health journey


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Today’s episode is probably one of the most spontaneous, last-minute episodes I’ve published so far but to me that shows how important I think this topic is.

Literally yesterday I was drafting an email to my email list and halfway through I realized I had so much more to say than what could fit in an email so I decided to dive deeper and make it an entire podcast episode!

I want to talk to you about a few different things (don’t worry, they all tie together) in regards to your overall health. Actually, I don’t just want to talk to you, I want to change your mind. I want to open your eyes. I want to empower you to challenge the status quo. I want to help you thrive.

So hopefully our conversation today does that for you. I truly believe that if you internalize and implement what we talk about today, it will completely change your life, especially if you’ve had a baby or plan on having children.

Before we jump into that though, I want to give a quick shoutout to a listener who left a review for my episode about lessons learned from five years of marriage: “This was such a fun episode! The way you two balance each other out, listen to each other, and complement each other is beautiful! Such great advice given! Thank you!”

You’re welcome! We certainly don’t know everything, but Tyler and I have learned a lot since getting married and we love helping other couples see their relationship from a new perspective. 

Mama, if you love this podcast, I’d love to hear it! Please leave a star rating in your podcast app so the podcast can grow and reach new mamas. We have only been on air for 7 months and we’re ranked #102 in the United States in the nutrition category, which is AMAZING, and I need your help to continue to climb the charts!

Expectation vs Reality

I saw this reel on Instagram the other day that depicted someone talking to the healthcare system about maternal care. The gist of the conversation was this, “The baby gets 6-8 visits in the first 12 months of life but the mom who grew the baby, birthed the baby, and nursed the baby gets one visit at 6 weeks postpartum?”

*Punch to the gut* Well when you put it that way…

But it got me thinking, why is that? In whose mind does that make sense?

I think this really highlights what I’ve been saying for a while now and that’s that our “maternal care” is really just “neonatal care” disguised as maternal care. You’d think that the mom would get just as many appointments, if not more, as her baby does, but in reality she’s like Cindy Loo-Who from the Grinch where she is given a cup of water and a pat on the head before being sent off to bed.

Now, if you’re sitting there saying, “wow Brooke, what a cynical way to describe our healthcare system,” let me remind you what the current standard of care is for us moms:

  1. There is no conversation about fertility unless you’ve been having unprotected sex for at least one year with no success, and even if you do get a conversation about it, very rarely are you getting the lab testing done to help you know the root cause of your infertility.
  2. While prenatal appointments are regular and frequent, your appointment lasts 5 minutes and most of your questions are answered with “that’s normal, you’re pregnant.”
  3. A majority of moms are not given options for their care plan unless they do their own research and speak up
  4. After giving birth, you get one visit from a lactation specialist to make sure baby can latch but no education about what it takes to build and maintain a healthy milk supply without sacrificing your health in the process, and if you do need or want additional help, getting insurance to cover it is hit or miss
  5. After giving birth, you get one visit with your doctor at 6 weeks postpartum where the appointment consists of a depression questionnaire and one short vaginal examination to give you the green light for exercise and sex but no referral for pelvic floor physical therapy or guidance for returning to exercise and sex safely
  6. During pregnancy, you’re given a list of foods to avoid but no real guidance on what foods will help you feel your best and you’re given no education about how to choose a prenatal that will actually help you and your baby
  7. While in labor, the hardest and most physically demanding thing you’ll ever do, you’re denied food and water
  8. After giving birth, you’re subjected to eat processed food for up to 3 days with no regard for replenishing lost nutrients from pregnancy and birth
  9. During postpartum, you’re expected to return to society by 6 weeks but not given the help and support you need to remain in society without becoming burnt out and depressed
  10. During postpartum, most symptoms you experience are blamed on your hormones and you’re told to just “wait it out” or go back on birth control

Mama, that’s just the first 10 things that came to my head. That’s just scratching the surface. I didn’t even get into all the stories of dismissing symptoms and disregarding concerns. And trust me, I’ve seen the comments section on dozens of social media posts, it’s more frequent than I thought!

But, this is a soap box that I could stand on all day everyday, so I’ll stay focused here. What I’m trying to illustrate is the stark difference between expectation and reality. We expect that we are going to be taken care of during the most vulnerable and important time in our lives and instead we are getting the bare minimum with many outdated recommendations, practices, and policies.

But that begs the question: if this is the standard of healthcare set in place by the American College of Obstetrics and Gynecology and all the other organizations, am I the crazy one? Are my expectations too high? Or have we just gotten so used to sub-optimal care that it seems like it’s enough?

Well, like always, there are lots of opinions, and you know I’m going to share mine. Before I answer that question, let me give you some facts about postpartum that will help you see how unique it is and why the level of care needs to be unique and distinct from other types of healthcare. 

Postpartum is Unique

The first thing you need to understand is that postpartum is not the same as “pre-pregnancy” and it’s not just “you’re not pregnant anymore.” I also want to clarify that although technically, medically, postpartum is defined as the period immediately after birth that lasts up to 8 weeks, you could talk to any woman and she would say otherwise.

Now I’m not saying doctors are wrong, but I think they’re using the wrong metric to measure such a sensitive and significant period of time that is so much more nuanced and multi-faceted than just however long it takes our uterus to go back to its original size.

Postpartum involves nutritionally replenishing our body from pregnancy and birth, helping our organs, muscles, and ligaments return to their normal size and location, and rebalancing all of our hormones, all while caring for a newborn baby with minimal help around the house because our partners have to go to work or we have to return to work. 

Along with the obvious scenarios, let’s go through some facts about postpartum that clarify why its so unique and why it deserves more attention:

  1. Because birth is so traumatic on the body, your body can remain in fight or flight mode for up to 4-6 weeks after birth. This impacts nutrient absorption, hormone reproduction, and circadian rhythm.
  2. According to an article published by PubMed in 2022, 1 in 7 moms will develop postpartum depression, but over half of the cases go undiagnosed, so really it’s way more than that (NBK519070).
  3. You lose grey matter in your brain during pregnancy and it takes up to 2 years to build it back up, but up to 7 years to feel like yourself again.
  4. 95% of women who take a prenatal vitamin enter postpartum nutritionally depleted.
  5. It is estimated that 35 percent of new mothers experience urinary incontinence after  childbirth, and 20 percent of first-time moms experience severe pelvic floor muscle injury after a normal pregnancy and delivery. And that’s only first time moms.
  6. According to an analysis published in PubMed last year, “[As of] 2018, only 25.8% of infants were breastfed exclusively for 6 months, [35.9%] were breastfed to any extent at 1 year, [and] a remarkable 60% of mothers stop breastfeeding sooner than they planned” (PMC1077369)

And yet, in 2024, we still only get one appointment at 6 weeks after birth with no guidance or referrals for breastfeeding support, nutrition education, or pelvic floor physical therapy.

You’re probably sitting here thinking, “Ok Brooke, I get it. I see that we deserve more and we are extremely underserved. But we can’t do anything about it because the entire system needs an overhaul. The entire mentality of modern medicine needs a paradigm shift and we are just two women, two moms. We can’t change anything.”

You’re sort of right. We definitely can’t overhaul the medical system, unfortunately, as much as I wish we could, but there is something we can do.

We can educate ourselves about what we need to thrive as moms and speak up. We can find doctors who will listen to us and go farther than the bare minimum standard of care to take care of us. We can come to the table as an active participant in our healthcare rather than a passive observer.

Proactive vs. Reactive Care

A recent conversation with my dad rekindled the fire inside of me about why advocating for your health and speaking up is ESSENTIAL for your well-being.

For context, my dad has been an E.R. physician for over 20 years and is now a surgeon. He knows a thing or two about medicine. He's the first person I call when something happens and he's always helped me navigate the parts of my health that I don't understand.

However, these last few years have taught me that the medicine my dad practices isn't the only type of medicine out there, and it's certainly not the end-all-be-all of medicine either. And the system he's been working in has holes in it that leave certain demographics at a major disadvantage…

One of them being us moms.

I asked him if I could keep my OB as my primary care doctor because I'm in my childbearing years, I'm recently postpartum, and he's seen me more than any other doctor has, so he knows my history and individual needs really well.

His response was “most OBs don't have time for women after they give birth and they'd rather just stick with pregnant women. Why do you think you need an OB right now?

“Well, I only had one visit with him after giving birth and I want to check in with my basic health markers now that I'm 6 months postpartum. I want to make sure I'm healing well and I want to get some bloodwork done.”

“You don't need any of that," he replied. “95% of women are fine after 6 weeks and if they aren't, they're treated accordingly. Besides, if nothing is obviously wrong right now, why bother getting bloodwork done?"


THIS is why us moms slip through the cracks. Because healthcare providers have a very low-standard, generalized definition of “fine" when it comes to women, and especially postpartum women.

(This is not a hate email about my dad, this is to illustrate a larger point about our healthcare system. My dad and I have a great relationship and we had a healthy conversation.)

Before I tell you what I think “fine” means, I want you to pause and ask yourself what your definition of “fine” is.

  • Is it “not dead?”
  • Is it “able to move unassisted?”
  • Is it “tired all the time but not I'm bedridden yet so it can't be that bad?”
  • Is it “I've got aches and pains but I'm getting older so there's nothing I can do?”
  • Is it “as long as I take my 9 different medications or supplements every single day I'm functioning?”
  • Is it “my hormones are all over the place but I've just learned to give myself grace and my family is just really patient with me?”
  • Is it “I can get a lot done in a day but deep down inside I feel empty?"
  • Is it “good but I wish my default was better than just good?"

Last time I checked, “fine” means “Freaked out, Insecure, Neurotic, and Emotional." (It's a thing, look it up!)

And Gary Brecka says that “good is the enemy of great.”

So how are you really, mama?

If you answered “good,” “fine,” or anything less than “fine,” please know three things:

  1. You are not alone.
  2. You deserve better.
  3. Better is possible.

But HOW do you feel better? Where do you start? How do you get the help you need?

What you can do

I have some suggestions. First, talk to your doctor about setting up another follow up appointment around 6 months postpartum. This is to assess how you’ve been healing physically, mentally, and emotionally, and give space for questions and concerns. 

Once that appointment is in place, plan to order some tests through your doctor at that appointment. There are a few different labs that will give insights into how your body is doing after pregnancy and birth that are worth the extra time and money even if you don’t feel any dramatic symptoms yet. Those tests are:

  • Iron/ferratin levels
  • Vitamin D levels
  • A full thyroid panel
  • Hormone panel
  • Hemoglobin A1C levels
  • Homocystine levels

You can also find functional practitioners to run additional tests like an HTMA test, a GI map, and DUTCH test to dive deeper into your nutritional health. If you want to learn more about HTMA testing and my experience with it, listen to episode 17 with my friend Allegra.

Next, ask your provider if they know any local pelvic floor physical therapists they can refer you to. Every mom should see one, regardless of what birth she had or how “smooth” her birth was and if it’s referred by your doctor, you should be able to get insurance to cover a majority of the cost.

Lastly, learn from other experts like myself that teach you about holistic health for moms. Your experience will dramatically improve if you begin to see your body as an entire, interconnected system rather than isolated parts. By learning from personal trainers, physical therapists, dietitians and nutritionsts, and perinatal psychologists, you’re addressing every part of your health and nurturing your body as a whole.

Besides The Well Nourished Mama, I recommend you learn from:

And those are just some of my favorites! There are so many more I could refer you to if you wanted to chat more.

Before we close, I just want to leave you with one small phrase that has changed the way I see myself as a patient and person:

“Your body is the best doctor in the room.”

You know yourself better than any doctor ever could. You know when something’s off. You know when something doesn’t feel right. If you’re not getting the help, attention, or answers you need, don’t give up until you find someone who can give that to you.

Sure, you might not have a medical degree, but your doctor doesn’t have your body. By working together, combining their expertise with your experience and self-education, you’ll get the care you need. 

We might not be able to change the system, but we can change the care we receive within the system. And hopefully as more of us speak up and ask for more, the system will realize that the standard of care needs to improve.

If you aren’t quite sure how to have a civil, respectful conversation with your doctor, message me and let’s chat. If you have more questions after our conversation today, message me and let’s chat. I want to be a resource for you in your health journey so you can feel your absolute best.

Alright, that’s it for today mama. I’ll see you in the next episode.