Postpartum outpatient clinic? A real alternative?
It is increasingly difficult for pregnant women to find a midwife for postpartum care. In Frankfurt and Wiesbaden, only every 2nd woman who wants care can find a midwife (more here, here and here). Are postpartum outpatient clinics perhaps an alternative? It has now been decided by the health insurance companies that visits to such outpatient clinics will now also be covered by the health insurance. I would like to give you my opinion on this development.
What are postpartum outpatient clinics?
A postpartum outpatient clinic is attached to a clinic or a midwife's office. It is where women who have given birth can go to discuss postpartum issues. This involves both the women and the babies. The midwife does not come to the women's homes for this; the outpatient clinic is more like an open consultation.
A real alternative?
It is hardly possible to assess the situation of women in childbed in such a postpartum outpatient clinic, which is visited perhaps once a week. The time in such an outpatient clinic is probably rather limited, so many issues and feelings are likely to be lost. For many women who have recently given birth, it would be a great effort and in some cases hardly possible (at least in the early postpartum period) to visit the outpatient clinic themselves. It means stress, it has to be planned. Stress can also quickly have an unfavorable effect on bonding, the breastfeeding relationship and the healing of possible wounds. For women who have had a cesarean section or perineal tear, it can mean a lot of pain, not to mention the drive and possible waiting time.
Yet rest is always recommended after childbirth, how can that be reconciled with a visit to a postpartum clinic? In addition, some women may need more than a few minutes to open up and admit uncertainties. Women suffering from postpartum depression or feeling low would probably not visit such an outpatient clinic. I see a big risk here, because it is important to recognize such signs early. Midwives are sensitive to these things and recognize possible clues that a new father might miss. Not to mention single moms.
Help with breastfeeding and tips on how to deal with everyday life also cannot find sufficient space in such an outpatient clinic. Not every (new) mom has the peace of mind to breastfeed in an unfamiliar environment and ask questions about baby handling.
Postpartum care at home
In postpartum care with a postpartum mid wife, the situation is different. The midwife comes at least once a day for the first ten days after the birth to check on mom and baby. After that, she still comes and looks after the family until the baby is about twelve weeks old. She examines the woman and looks at scars if necessary. She gives tips on how to deal with everyday life and can more quickly identify difficulties such as postpartum depression, milk congestion or the like. As a result, complications can be lessened or avoided altogether.
I remember how grateful I was when, with our son, my midwife showed me how best to hold him while nursing without him pressing on my C-section scar, and how she showed me how best to hold him while bathing. Those are just two examples, midwives do so much and they do a wonderful job that is rewarded far too little.
But what if I can't find a midwife?
You don't have to put up with that! Turn to your health insurance, turn to politics, make it public. There are so many women who can't find a postpartum mid wife, but politicians and health insurers hear far too little about it. Postpartum outpatient clinics are of course much cheaper for the health insurance companies, but they are simply not a real alternative! Of course, this is better than nothing, but many difficulties remain undetected.
Something has to change, and urgently, because the situation cannot remain as it is at the moment. We must fight for postpartum care by a midwife at home for every woman. We must fight for our health and that of our children.
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