Latest / Life After Birth by Her Health Room / The 6-Week Postpartum Check: What to Ask Your GP and What Happens Next

Transcript

The 6-Week Postpartum Check: What to Ask Your GP and What Happens Next · Life After Birth by Her Health Room

• 0:00
  I'm six weeks postpartum, a mother of three, and an obstetrician.
• 0:03
  My six-week check with the GP is coming up in a few days, and I'm still struggling to figure out what it is I want the doctor to do for me I know that my body's changed, my mind's changed.
• 0:13
  In short, my whole life has changed.
• 0:16
  But what can I realistically expect the doctor to do for me within a 10-minute appointment slot?
• 0:21
  And that for me is a problem with the six-week check.
• 0:23
  It's not that the GPs need a better checklist for this appointment, it's more the fact that the postnatal recovery in and of itself is too big, it's so large for them to be able to solve in one appointment, let alone four or five.
• 0:38
  So in this video I'm gonna walk you through what in an ideal world a six-week check should look like.
• 0:44
  And I want you to take some notes, reflect on your own care, and go to that appointment armed properly to make use of those 10 minutes.
• 0:53
  If you're new here, I'm Remi.
• 0:54
  I'm an obstetrics and gynecology doctor, and I'm building Her Health Room for you to help you navigate the pregnancy and the postpartum period with safety, with clarity, and support.
• 1:04
  I've got a postnatal recovery check-in if you've just had a baby.
• 1:07
  Congratulations.
• 1:08
  Where I want you to take stock of where you are on your recovery journey, what things do you need to focus on in the next seven days or 30 days to make sure that you are making the most of your recovery period I will be hosting a workshop on the 5th of November.
• 1:22
  So click the link down below to register, and we're gonna go through where you are, your body, your mind, and your life at large, and how you can go away from that session with an action plan of how you're gonna tackle those areas to make sure that you're thriving and not just surviving in the postnatal period.
• 1:40
  Thinking about the Her Health Room framework.
• 1:42
  Where am I in my body?
• 1:43
  Where am I in my mind?
• 1:44
  And what are the things in my life that are affecting my recovery?
• 1:49
  And so taking stock of that, is gonna help me go to that appointment with the right focus points, asking the doctor what is within their remit of what they can do for me So first things first most places will offer six weeks, maybe up to an eight-week check.
• 2:03
  But we know that recovery takes longer.
• 2:05
  We know that women don't start to feel like themselves for two years, maybe three years, even seven years after having a baby because so much changes And when you go to this appointment, sometimes it feels like job done, that's it, you're back in the wild.
• 2:20
  But that's not it.
• 2:21
  There are so many things that are not really resolved.
• 2:24
  I've got a video on this channel that talks about cesarean section wound infection, And I've had so many comments of women who are weeks beyond a cesarean section with pain, with a wound opening up, with some discharge.
• 2:37
  So that's evidence enough that even the physical things are never really healed or restored or sorted in the first six weeks And being medically stable isn't the same as recovery.
• 2:49
  Recovery is not complete.
• 2:50
  It is a longer, drawn-out process that requires active participation so thinking about what do I want to achieve from this appointment?
• 3:00
  From a physical point of view, what do I want?
• 3:02
  When I was pregnant, I share quite openly that I was iron deficient.
• 3:06
  I made sure that I had an iron infusion before I went into labor, and then I had an iron infusion after the baby was born because I lost a reasonable amount of blood and I wanted to make sure that I would be going into my postpartum period feeling better than I had done before.
• 3:21
  So after my first baby, my blood count I think was about 92 when I went home, and I just knew that it took longer for the breast milk to come in than it has this time.
• 3:30
  My mood was so low.
• 3:32
  I just felt super tired all the time.
• 3:34
  And this time around, having had the iron infusion, I'm sure I may well be anemic, but just having that slight boost from where I was before, I've actually felt a difference.
• 3:45
  And obviously it's hard to say'cause it might just be that I'm also a third time mom, I'm older, I'm more mature.
• 3:50
  There are so many things at play when it comes to mood.
• 3:53
  But that is a difference that I've noticed, and it'd be silly to completely ignore it Things that came up for me in my pregnancy was the diastasis recti.
• 4:00
  Like, I went for a scan and one of my colleagues, um, scanned me and was like,"Oh, you've got quite a significant deficient recti," blah, blah, blah.
• 4:08
  And I was like,"Yeah.
• 4:09
  Thanks." You know, like I can't do anything about it right now, but the plan is once the baby's out, I'm gonna, uh, fix my core.
• 4:17
  Um, and that's definitely on my to-do list, but not something I can do in the first six weeks.
• 4:22
  So in my head, as well as asking the GP for a repeat blood test to make sure that I know that my iron levels or my blood count is within a reasonable range, it will also be a referral to the physiotherapist to think about my core, looking at this diastasis recti, but also the fact that I've had ongoing back pain since the baby was born in my video about my third trimester, which I link up here or down below in the description, I talk about having worsening pelvic pain into my third trimester, refusing, stupidly, a referral initially, then asking for one at about 38 weeks.
• 4:55
  I'm now six weeks after the fact.
• 4:57
  I've not heard a peep from them.
• 4:59
  So from my point of view, going to the GP and reiterating that, that I've actually had some issues and see if I would be under the remit for help with a physiotherapist.
• 5:09
  And if obviously their answer is no, thinking about can I do anything going down either a private route, so seeing someone independently, going to a postnatal yoga or Pilates teacher to see if they can help with my core strength because I think that's where a lot of my issues have come from.
• 5:26
  Quick deviation.
• 5:27
  There's a video of Ciara, who I know is older than me, on her fifth baby, fifth pregnancy, doing like some crazy dance moves on stage and I'm just like I need to get strong.
• 5:40
  I need to get fit.
• 5:41
  Not because I wanna be doing acrobat in my next pregnancy, if there is a next pregnancy.
• 5:45
  But I just, this pregnancy really, really appreciate the importance of being a strong person, and want to make sure that my postnatal recovery focuses on strengthening my core.
• 5:56
  Look, like I'm even like sitting up.
• 5:58
  Strengthening my core, strengthening my back muscles and just making sure that I'm strong and healthy for the three kids that I have to raise.
• 6:05
  things that have happened after birth as well that I want to bring up are pain for breastfeeding, like it's still an issue.
• 6:12
  Luckily, i've managed to get a referral to, a tongue-tie clinic and that will be within the next few weeks, but also making sure that I bring that up with the GP too.
• 6:20
  And then things around nutrition, like making sure that I've got my vitamin D.
• 6:24
  So I might ask for a test actually, because I know that at the beginning of pregnancy, my vitamin D levels were quite low, and I have been trying to supplement this From the point of view of the mind, I have good days, I have bad days, as is to be expected I'm constantly tracking my mood.
• 6:38
  I've been journaling this time round in a way that I didn't before.
• 6:42
  Taking note of intrusive thoughts, thoughts that don't feel like me or mine.
• 6:47
  And none of that obviously is gonna be enough for a, a diagnostic criteria.
• 6:51
  But I think it's really important that even if you've not got postnatal depression or anxiety or concerns about thoughts or harming yourself and things like that, that you could still be suffering from a mental health point of view.
• 7:04
  And as obviously as a safety note, if you are feeling that you are, increasingly down, wanting to harm yourself, harm anyone else around you, that's obviously red flag symptoms for why you should seek help.
• 7:15
  If the thoughts that you're having feel really foreign to you, but they're taking over, and you're worried about things like a psychosis or depression or anxiety, again, these are things that you need to seek urgent help for.
• 7:28
  And if you're watching and you have someone who is in the postpartum period and you're worried about their thoughts, you're worried about their behavior, then seeking help on their behalf is also really important.
• 7:37
  But it's just a point to note that not everything about your mental health in the postpartum period is something that is a diagnosable condition that requires medication, that requires a doctor.
• 7:47
  Some of it will just be, feeling low at times but not low enough for it to be a diagnosis, or feeling unworthy at times, or feeling overwhelmed at times.
• 7:56
  And you know, because your hormones are changing, your sleep is d- is not as good as it was.
• 8:00
  Like, there'll be so many things also going on for you that taking stock of where you are mentally is really good.
• 8:06
  And so when you go to the GP, hopefully they ask you those questions as, like, safety questions.
• 8:12
  But if they don't, make sure that you prompt them and then you supply them with the answers to how you're feeling, in yourself, how you're feeling in your mood, and what concerns you might have.
• 8:22
  I mean, it might be something as simple as you're worried that you're not sleeping as much and that's an okay thing to ask your doctor for help with.
• 8:29
  And then thinking about what things can you do.
• 8:31
  It's really hard'cause all of it would be really variable.
• 8:33
  Going out for walks, taking some fresh air, making sure that you're deliberate with people that you feel safe around, that you can be genuinely yourself around, and sort of put that mask down.
• 8:42
  In the postnatal period, you'll have lots of visitors, and lots of people want to come and see you.
• 8:46
  And even as social as I am, sometimes that feels like a mental strain that you have to be on, for people when you can't think of anything worse to do.
• 8:56
  And so putting some boundaries in place.
• 8:58
  If you're not ready to be on, say no.
• 9:01
  And if you are ready to be on, making sure that you're having a few buffers, making sure that you have a few deadlines.
• 9:07
  So that people aren't overstaying their welcome.
• 9:09
  They're not expecting you to eat, feed, and, and things like that for them.
• 9:12
  And it's always really hard with family, but trying to put some guardrails in place when you have some people round to visit.
• 9:18
  I actually have a video, on, when it's too soon for people to come and visit you.
• 9:21
  So I'll link that somewhere, around here as well And so from my point of view, when I go to the GP, I will prompt them to do the health check and sort of the mental health screen if they don't do it.
• 9:32
  I will think about discussing my sleep with them which actually, no, and I'll think about discussing my previous mood with them, and maybe make an appointment in six months' time.
• 9:43
  Just to check where my mood is at in case it deteriorates,'cause you can't predict the future.
• 9:47
  And I do think it would be good to have some checkpoints, waypoints in your recovery period as to when to check in,'cause it really can sometimes get overwhelming and you forget to take stock of your health.
• 9:59
  From a life point of view, where am I at?
• 10:01
  I've had pay issues.
• 10:03
  I've had issues with my maternity pay, issues with my maternity leave, thinking about work after my maternity leave.
• 10:08
  And so those things have taken up a bit more head space than I would have loved in the first six weeks postpartum.
• 10:13
  I think there's something to be said for going on mat leave knowing that you have a job when you go back to work.
• 10:18
  And being in a camp where I don't know what I'm doing after maternity leave has sometimes caused me stress, has sometimes been okay.
• 10:26
  But from a life perspective, that's where I'm at.
• 10:28
  Thinking about money, budgeting, how long can I go without a job or without a source of income.
• 10:34
  And I think that it's also really important that your, like, that we talk about your financial health,'cause your financial health is a component of health, and wellness to an extent.
• 10:43
  Obviously, I don't expect my GP to help with that, but that's something that I'm taking stock of.
• 10:47
  I'm thinking about my relationship as well with my kids, with myself, with my husband.
• 10:52
  You know, the six-week mark and sex sometimes coming back on the table, like where am I at with that?
• 10:57
  What conversations do I wanna have around that, around when I'm ready to have sex?
• 11:02
  And again, might not be something I bring up with my GP because at the moment I wouldn't have known if it was painful or not.
• 11:07
  But if I was, say, having painful sex, making a note to see the GP early, see if there's anything that can be done, from their point of view, as well as trying things, from home.
• 11:17
  Because, again, I am a doctor.
• 11:19
  I do deal with people who have vulval health conditions and have had issues with painful sex, so that's not something that's outside of my remit when I'm speaking with other patients.
• 11:28
  But again, if I need certain referrals, speaking to a doctor to help me with that If you can't already hear, I have the baby in the background, and I will probably continue to do so to make sure that I'm bringing you content that helps you through the pregnancy and the postpartum period.
• 11:41
  So other things that I would do from a life perspective is, like, friends, getting out the house, when am I gonna start socializing again, as opposed to, like, the cabin fever that I'm having from sort of being indoors all the time, which is self-inflicted, to be honest.
• 11:55
  It just feels really busy with the other two kids, back at school.
• 11:59
  But yeah, from a life perspective, trying to get out, seeing if there are any leaflets in my GP practice, where new moms are gathering, and things like that, would be also really useful.
• 12:10
  And again, just being honest that my life and the things that are concerning me day to day don't fit inside the box that a GP would be able to do in 10 minutes.
• 12:19
  And like I said, it's not that they need a better checklist, it's just unreasonable to expect them to be able to point you in the right direction to all the services that you might need in the postpartum period So in my 10-minute appointment, I'm gonna make really good use of it for my physical symptoms.
• 12:35
  I'm going to remind myself to check in at six months about my mental health symptoms.
• 12:41
  Once I start having sex, I'm gonna see how that feels, and if there's any pain or anything involved, I'm gonna go back to the GP for either an assessment or a referral in regards to that.
• 12:50
  and then because I'm already on, like, the pathway for sort of pain for breastfeeding, if I wasn't, that would be something I'd bring up there.
• 12:57
  I expect the GP to talk about contraception.
• 13:00
  and to be fair, it's not something that I've actually thought about myself yet.
• 13:04
  but I will think about that before I go to the appointment so that I can have an informed decision or discussion with them and go away with a prescription, or not.
• 13:13
  I'm not sure if I'm ready for that yet, but actually it, it will be something that I think about.
• 13:17
  And I would expect them to signpost me to relevant services, that might be useful for me in this season of life.
• 13:23
  And so if I had the money and a magic book as to how a woman should be served in the postnatal period for the first two to three years of her baby's life, what would I do?
• 13:34
  Going through my body, mind, and life framework.
• 13:36
  Where are they in their recovery journey along that section?
• 13:41
  And making sure that the care that is provided to them is individualized.
• 13:44
  And so no, the doctor isn't this person that sits on top that tells you what to do for the next two to three years of your life they're ideally someone who walks alongside you over your recovery period.
• 13:56
  And I'm not necessarily saying this needs to be a GP, but someone who can assess you from a holistic point of view and individualize your recovery over the next few years.
• 14:05
  Thinking about what do you need in your body to feel well, and also to feel strong, like are you even prepared for the next stage of life?
• 14:13
  What do you need from a mental health point of view to help with your recovery, but also to prep you?
• 14:18
  What things do you need?
• 14:20
  I've been very open about the fact that from my last two pregnancies I've needed therapy after the baby was born.
• 14:26
  Not because I had a diagnosable condition, but just because I needed that extra support.
• 14:30
  And from a life perspective, friendships, relationships, money, work, return to work, all of those things would need to be considered over a longer time period.
• 14:39
  Not a one appointment, but, constant check-ins, navigating and pointing you in the right direction so that professionals can help you with the certain things that are coming up for you And to finalize with a plan.
• 14:50
  So a plan at each stage.
• 14:51
  Are you someone who's had diabetes in pregnancy, so you need your first check at 12 weeks, and then you need a blood test every year, or you've had high blood pressure?
• 15:00
  There are so many things that can be done properly in the postnatal period.
• 15:04
  So if I was designing care, it would look like an ongoing process over the next two to three years.
• 15:10
  So if you do have your six-week check coming up, take a moment to reflect.
• 15:13
  Go through where you are from a body perspective, mind perspective, and a life perspective, and what needs your focus now.
• 15:19
  And to help you do that, actually, I've got a postnatal recovery check-in which is down below in the comments, and it will tell you what you need to focus on for the next seven days.
• 15:27
  If you do want to dive deeper, I'll be holding a workshop on the 5th of November, so sign up for that down below, we'll be going through this framework as a group looking at where you need to focus on in the next 30 days, 90 days to ensure that you are recovering as best as you can through the postnatal period.
• 15:44
  And the link for that will also be down below share it with a friend that you know is in this season of life and may well benefit from it too.
• 15:50
  So when I go and see my GP in a few days, I don't expect them to fix everything in that 10-minute appointment.
• 15:56
  I do expect them to focus on the things that I've identified as being urgent for the next steps in my physical recovery, and then taking stock of my mental health and my life at large.
• 16:05
  And it isn't realistic for one clinician to do all the things that are required in the postpartum period and that's why I'm here on Her Health Room to help you navigate that season effectively, doing it safely, with clarity and with support.
• 16:19
  So whilst you're here, why don't you go and watch a video on my channel why six weeks is not enough, just to further hammer home the point that so much of our recovery happens after the six-week period, and therefore we cannot limit ourselves to six weeks or 40 days, and we have to be open and active in the idea that the postpartum recovery can take two years, three years, or whatever.
• 16:42
  Subscribe to this channel, and until next time