The Importance of Primary Care Postpartum

The weeks and months after having a new baby can feel exciting for new parents, but this “fourth trimester”, or the 12 weeks or so after giving birth, is also an important time for the health of new moms.

Positive postpartum care, including a close connection with your primary care provider, can help ease this transition. Christina Johnson, MD, a family medicine physician with Atlantic Health System, shares more about the fourth trimester, what healthy recovery looks like after childbirth and how primary care can help.

Managing Care in the Fourth Trimester

After delivery, you should see your obstetrician within the first three weeks of delivery and have a final visit at the 12-week mark. Primary care providers are looped in throughout this process. They are notified when you deliver and told about any complications so they can provide a coordinated approach to care.

During the fourth trimester, your OB/GYN and primary care provider will be looking for certain physical changes, especially if you had any complications in pregnancy such as preeclampsia, hypertension, thyroid disorders and gestational diabetes that may be associated with dangerous cardiovascular, bleeding and mental health conditions.

Your provider will also screen mental and emotional health, including checking for stable mood, safe relationships and healthy stress management.

What is a ‘Normal’ Pregnancy Recovery?

A healthy recovery from pregnancy and childbirth can feel complicated. That’s because it includes physical, mental, emotional and social changes – not to mention the adjustment to having a newborn in the home.

“The fatigue is something that can overwhelm new parents,” says Dr. Johnson. “Similarly, many parents find the need for extended communities and networks to support them in the postpartum period.”

You may also experience:

• Bladder and bowel control problems, especially following a C-section or surgical repair after giving birth
• Bleeding or pain as the uterus shrinks back to its normal size
• Changes in breasts, menstrual cycle and mood as hormones rebalance
• Cosmetic changes, including stretchmarks, overhanging skin and hair loss
• Rising blood pressure shortly after giving birth
• Weight changes from nutrition, level of activity and breastfeeding

You can always call your primary care provider with questions about your symptoms, says Dr. Johnson, but some conditions may require visiting the emergency department. These include:

• Feeling like you want to harm yourself or others
• Fever, pain or excessive bleeding
• Headache, blurry vision or feeling faint (especially if it doesn’t go away with hydration or Tylenol)
• Severe leg swelling (e.g., shoes no longer fit, socks leave an indent in the leg)
• Urinary tract infections that are not going away despite treatment

“A lot of patients don’t believe what they’re feeling because of their fatigue or because they think their symptoms mean something else,” says Dr. Johnson. “But it’s not being overreactive to make a phone call if something is out of range for you.”

Moving Beyond the Fourth Trimester

New parents can manage some aspects of postpartum care from home, including:

• Gradually increasing physical activity
• Managing stress
• Monitoring diet and nutrition
• Practicing financial management
• Scheduling annual primary care exams

“We want patients to be as healthy as possible going into and coming out of their pregnancy from a physical, mental and psychological perspective,” says Dr. Johnson. “Their primary care team will follow them throughout their life and health – we’re not just looking out for this period. Our goal is to always empower patients to talk with their provider to make medical decisions.”