Postpartum University® Podcast

EP 170 What Doctors Don't Know About Postpartum

• Maranda Bower, Postpartum Nutrition Specialist

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The postpartum period is one of the most misunderstood and overlooked phases in a woman's life, and what your doctor doesn't know could change everything. 

In today's episode, we dive into the hidden truths about postpartum care, a crucial topic for every new mother and her family. 

If you've been listening for a while, you know how passionate I am about this conversation and its importance in changing the narrative around postpartum care.

In this episode:

The Gaps in Postpartum Care (00:01:00)

  • Common myths, such as being fully recovered at six weeks, and neglect of mental health and nutrition, leave mothers feeling unsupported.

Personal Experience with Healthcare Failures (00:03:20)

  • Maranda shares a personal story about her daughter's severe rotavirus and the disappointing response from healthcare providers.
  • Emphasis on the need for trustworthy providers during stressful situations and how the lack of support can add to trauma.

Inadequate Training for Providers (00:06:56)

  • Discussion on how OBs and nurse practitioners are only trained in acute care, focusing on preventing hemorrhage and infection, and ensuring baby’s basic needs are met.

Challenges with Mental Health Screening (00:12:35)

  • Standard mental health questionnaires are often impersonal and inadequate, failing to capture the deep emotional struggles new mothers face.

Importance of Holistic Approaches (00:18:05)

  • Critique of the medical training that ignores these aspects and the unrealistic six-week recovery timeline.

Today’s episode sheds light on the critical gaps in postpartum care and the urgent need for a more comprehensive, holistic approach.
From personal stories to systemic issues, it’s clear that the current model is failing many mothers.
By raising awareness and advocating for better education and support, we can hope for a future where postpartum care truly meets the needs of all women.

 If you found today’s episode insightful and helpful, we would love to hear from you!

Please take a moment to leave us a review on your favorite podcast platform.
Your feedback not only helps us improve but also allows us to reach more listeners who could benefit from this valuable information.

Thank you for your support! 

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Maranda Bower:

Depression, anxiety and autoimmune symptoms after birth is not how it's supposed to be. There is a much better way, and I'm here to show you how to do just that. Hey, my friend, I'm Miranda Bauer, a mother to four kids and a biology student turned scientist obsessed with changing the world through postpartum care. Join us as we talk to mothers and the providers who serve them and getting evidence-based information that actually supports the mind, body and soul in the years after birth. The postpartum period is one of the most misunderstood and overlooked phases in a woman's life, and what your doctor doesn't know could change everything. Welcome to today's episode. I'm going to dive into the hidden truths about postpartum care. It's a topic that's not just important, but absolutely crucial for every new mother in her family, and if you've been listening for and for some time, you know how incredibly passionate I am about this conversation. So, while doctors are really skilled at handling the immediate emergencies of childbirth if there are any there's a significant gap in the care and support provided during the postpartum period, from the myth that you're fully recovered at six weeks to the lack of focus on mental health and nutrition and traditional medicine advice. It often leaves us mothers feeling lost and unsupported, and today we are going to uncover what doctors often miss, what they don't know about this approach to healthcare and thriving in postpartum. We know what's happening in postpartum care isn't working. If it was working, we wouldn't have such high statistics for mental health concerns, suicide rates and drug use, and I'm talking about non-prescription and prescription. We have some of the highest prescription drug use and I'm talking about non-prescription and prescription. We have some of the highest prescription drug use in the entire world and a lot of women are using those. Post-birth 7 out of 10 women in pregnancy are prescribed a medication, which is absolutely crazy. So what we're doing here isn't working and the idea that our bodies are failing or that this is just a really difficult time that we're going to have to medicate because we don't fully understand it's got to end, and I want to point this out because so many of us rely on our doctors and providers to support you, to tell us what's going on. We need this. We want to be able to trust our providers and to be able to rely on them, especially when things are occurring that we haven't experienced yet, like changes in our body or our precious baby, like growing a human being, and that's kind of nerve wracking sometimes and really stressful situations. Oh my word, how we need someone else to be there to walk us through what's happening, especially in stressful situations.

Maranda Bower:

I shared a few episodes back about my daughter being in the hospital. She ended up with rotavirus and it was the worst experience ever. It was a time where we absolutely needed our providers. I wanted to rely on my providers. I needed to.

Maranda Bower:

My daughter was almost unconscious. She was unresponsive to us, she couldn't look us in the eye. She was mumbling at times. She couldn't look us in the eye, she was mumbling at times, just completely incoherent, and it was really sad and frustrating. The entire experience where, you know, nobody was listening to us. The doctors were trying to push certain things. I was asking questions and then I was getting told why are you asking me questions? Why aren't you doing X, y, z? At one point they had asked us for a fever reduction, which was a great idea. She was running a really high fever and that's really awful, with dehydration, which is a necessary thing to combat when your child is dealing with rotavirus, which I will tell you.

Maranda Bower:

Side note here that I hear so many people say well, what about the vaccine. If you go to the CDC website, it clearly states that rotavirus vaccine does not prevent rotavirus from occurring and it doesn't make it any better. So you know, anytime that a child gets rotavirus, it's not going to reduce the severity just because your child had a vaccine, literally making the vaccine completely mute. There's no point to it whatsoever and a lot of providers are right now not trained in it because they just automatically assume that there is a vaccine and therefore it's okay. I'm actually seeing this across the country and maybe you've seen it too.

Maranda Bower:

We have an outbreak that's occurring right now for rotavirus in your children and it's moving across the States and a lot of providers are simply not aware and it's legit, a life threatening situation, and we were right at that point, and I know so many moms that I've been able to speak with because it was such a dramatic event. Y'all. It was such a traumatic event. But back to the point, this is a time when we really want to rely on our providers and if we can't, it brings so much more stress to the situation. I still am working through the trauma that I experienced through this because I wasn't able to trust the providers that we had, and it makes me nervous, it makes me upset, it's very, very anxiety inducing, and many of the moms that have gone through the same thing in the recent couple of months of this outbreak are experiencing the same exact thing. So when we pulling at this back to postpartum and the postpartum period, we really need our providers. We really need them to also understand about postpartum and I'm going to tell you your OB, your nurse practitioners they are not trained in anything beyond acute care. So acute care is about stopping hemorrhaging, it's making sure your baby is eating and there's no infection or risk of infection. That's it. That's acute care. So if you check those boxes, you're good to go.

Maranda Bower:

I had worked with a nurse practitioner who worked in L&D for 20 years and she actually taught at her nursing school how she taught other LND nurses about postpartum care and her and I. She was actually an employee of mine. I worked with her for over a year and we had developed this most incredible database of research and science and absolutely amazing. I love her to pieces and she helped me a lot on the podcast too. But her work she actually left the field because she was trying to implement strategies that went beyond this acute care, but nobody was hearing her out.

Maranda Bower:

And there was so many other things that were transpiring and taking place within the hospital in terms of certain policies and procedures that were required that were not evidence-based in the least bit, and she was trying to make those changes and nobody was listening and it was not a conversation anyone wanted to have. And, yes, there's a lot of bureaucracy, there's a lot of politics behind it and it's very frustrating and it's very sad. But, all to say that it's something that we have to walk into the situation, understanding and knowing that there just isn't any more information for these LND nurses and for our providers. Really there is nothing beyond making sure that your uterus is doing the correct things to prevent hemorrhage and that you have a piece of paper to tell you whether or not you potentially have postpartum depression or anxiety, so that they can write you a referral to go see someone else. It's it's so frustrating that this exists.

Maranda Bower:

Most providers are not even trained in breastfeeding. That's why the you know many places, many hospitals, have lactation consultants on staff and and there to support that kind of thing, because even breastfeeding is not a part of, you know, necessarily acute care, even if it's a mom's goal, as a matter of fact there's. It's not about breastfeeding whatsoever, it's just making sure your baby's eating. If your baby can eat and take in food and there's nothing going on with baby, then you're golden right and oftentimes baby is a completely separate patient. So even if a mom is not hemorrhaging or not showing a sign of infection or risk of infection or not showing a sign of infection or risk of infection, then and really in reality, that's the acute care for mom and there's nothing more to do. It's so incredibly frustrating. Medical training really just promotes and provides this basic, you know, acute care and emergency situation care, and that's it. That's the end of their education and postpartum health. And this leads me to another topic, which is the standard postpartum care ignores preventative measures and long-term health strategies Again, not a part of their training. As a matter of fact, when it comes to any sort of understanding about the physiology and psychology outside of the uterus and volution and milk ducts, there's really nothing more and that's if they've had that training like that's not even a requirement.

Maranda Bower:

I was actually just talking with someone new that I had recently met at my daughter's horseback riding. She is the sweetest woman ever and she was asking what I did and was like mind blown. And then here comes you know the million and one questions, which is very, very normal for me hey, what do you think about placenta encapsulation? What? What do you do during this situation? Have you ever heard of this provider? Here was my experience right, and this is this is what I absolutely love about doing this. Uh, because I once the floodgates open, I hear all of the most incredible and also really sad stories.

Maranda Bower:

And she was sharing with me about how depressed she was after the birth of her daughter and she was so scared to get help. And she actually went to her doctor's appointment for the six week checkup, which is really standard, and they had her fill out a form and this is the standard form that is pushed by so many companies and so many. You know, postpartum Support International pushes these forms right Like this is the standard, the go-to. Everybody needs to do these forms. And she said you know what, miranda? It was so impersonal and it wasn't really applicable to how I was feeling inside. I felt like there was a fog. I felt like I didn't know what to do and who I was, and it had nothing to do with anything that was being put on this paper, and it felt so impersonal to be checking boxes yes or no based on how I was feeling inside. It was so deep and raw and the last thing I wanted to do was write it down on a piece of paper that somebody is just going to look at and probably not do much with anyway.

Maranda Bower:

She needed that personal connection and she needed something that was relatable to what she was going through, and those little questionnaires often don't cut it. They often don't cut it, and so she walked away, getting no help, no support whatsoever, and even if she, by chance, had mentioned it and this is what we see so frequently her provider is not trained to work with her and so and oftentimes they're scared, they're scared to pieces. Actually, there was some studies that were done about perinatal mental health and what providers felt in terms of offering some sort of support, offering some sort of support, and they and multitude of studies came back showing that providers were actually very much afraid of dealing with postpartum depression or anxiety or other mental health disorders during this time, and they were so afraid that they were either going to do it wrong, that they didn't have enough training, or that they were going to be sued because they weren't able to help or that they were going to be the person who didn't help in such a way that caused harm in mom or baby or someone else. And so their only strategy that they're willing to do is say here's your impersonal form. And if that comes back saying yeah, you've got something or there's a potential for it, then I'm going to refer you to a mental health specialist, and I'm all for that referring, especially when you lack the training, when you lack the expertise, when we need another professional who understands the postpartum period. And here's another thing right, not all therapists or counselors know postpartum at all, like they're not trained in it. If you go to school to become a counselor or a therapist or a mental health psychotherapist or whatever the case may be, you're not trained in postpartum. You have to graduate and then go to a secondary learning facility to learn that, and that is mind blowing to me. That is absolutely mind blowing. But that's a lot of what your doctors are experiencing too. They have to go to a secondary learning facility and outside of postpartum university, that doesn't exist. That's why so many providers come here to learn about what's truly happening within the body, to get the evidence-based information and to learn beyond acute care. So that is why we exist, right.

Maranda Bower:

But coming back to this, the ignoring of preventative measures is something really pertinent that we have to address, because it's not just a lack of training. Oftentimes, when you have a lack of training, you have a lack of training. Oftentimes, when you have a lack of training, you have a lack of understanding. And when you have a lack of understanding, what you now have is and you're working with postpartum women is you're putting them in harm's way and you're doing it out of not knowing Right, and that doesn't make it any better, right, it doesn't make it any better to cause harm when you are not trained in something because you don't know, and it's so frustrating. These are people's lives, these are women's lives, and we know that suicide rates are high. We know that when we are working with perinatal health in general, it's not just about the moms, it's about the babies and the families too. Anyway, I'm going off my rocker here.

Maranda Bower:

There's so many different components to it, and here's the other thing, too, that the importance of nutrition, mental health support, physical therapy and postpartum recover all of those are often deemed like these holistic approaches to healthcare and, again, that's not something that's being trained. Your medical doctor is not trained in nutrition, even regular nutrition, not even a specializing and postpartum period, just in general. That's not something that's part of their repertoire, their training, their experience or expertise. And often and I hear this, this happens, happens in my inbox more than I like to admit I hear so often well, nutrition is not everything. That's, you know, impossible. Nutrition has no effect on our bodies, right, we can eat whatever we want. I had somebody enter my inbox and was like I hate giving restrictions and I will never do it. We can eat whatever it is that we want, however we want, and we're just going to be fine. And I wish that were true. I really really do, and it's just not. It's not. There's no way that we are going to be able to do that, whether we're postpartum or not. It's just not possible.

Maranda Bower:

We know food really really influences our overall health. It influences our mental health too, and our physical health as well. So it's so important that we have these you know, quote unquote holistic approaches, but often they're just approaches to health that are deemed, you know, a preventative measure, and often that preventative care is what's often considered. You know that holistic approach and therefore it's not something that's a part of their training. And here's what gets even more challenging. Okay, oftentimes postpartum is considered that first six weeks and that's it. And so we have this common belief that women are fully recovered by the six week postpartum checkup. And we all know the story right, you walk into your six week checkup, they ask you a couple of questions, maybe give you a form on mental health, and and then you're, you're left with, you're good to go, and that timeline is so unrealistic and it's so harmful for so many women to walk into that appointment expecting you know to or being told that it's going to be okay, and this is just the way it is. And your postpartum is done, carry on with sex. Consider birth control, and that's really the main part of the, the, the entire appointment is what's your birth control? Don't do this again, right? It's so sad, it's so frustrating, and what we really really need is more connection. We need more understanding that.

Maranda Bower:

Hey, guess what? It's not just about your uterus returning to its pre-pregnancy state, which is how the six-week mark became the thing. It is solely based on the uterine involution and returning to its pre-pregnancy state. And that's not true. We know it takes a solid two years for brain changes to finish. Your brain changes significantly not just the gray matter but the neurotransmitters about and so many other components. That is worth an entire post postpartum university episode in and of itself.

Maranda Bower:

But you know so many components are shifting and changing within our bodies. Ligaments don't return to their pre-pregnancy state until around nine months postpartum Hormones don't even begin to balance until three to four years after having a baby and that's dependent on how long someone has breastfed. And it takes emotionally a solid six years to feel like you are returning to a normal within your body again after motherhood. And that's studies after study after study being done. And there's so many more components to our bodies and to our beings and just those things. And we're not taking into account any of it, none of it.

Maranda Bower:

In the six-week checkup or in the postpartum period we're literally saying see you later, you can have sex. Now. Here's your birth control. That's so unfair, so incredibly unfair, and there's so much more that we could be doing. And but that's, that's legit. What providers are being trained in? And that's all they're being trained in. That is this the summary of acute care, and after that there's nothing more.

Maranda Bower:

I recently I was chatting with somebody online who messaged me asking for support and she was telling me how she had been having some issues with her stomach and she was having some major hair loss and all of these things and experiencing some really strong anxiety. And she went and reached out to her OB and it was the three month postpartum mark and her OB says you can't contact me, that I can't do anything for you. You need to go find another, your, your primary care provider. And that was so frustrating because she was coming to me saying my provider doesn't know anything about postpartum, like they don't have any. I thought my OB would know and it's like, no, that's not their thing, that's not what they can do. So hard right.

Maranda Bower:

And I'll tell you what the hardest part here is. There just isn't a lot of science. Unless it's related to the perinatal mental health or breastfeeding, it isn't really studied. And if it's not really studied, it's never, ever going to become a part of their training. And this is crazy to me because women are generally not studied at all, and I don't think that's necessarily surprising, especially if you've listened to this podcast for some time.

Maranda Bower:

I share all the time about how, in particular when it comes to, say, nutrition, those studies about what we need, our daily recommended allowances, are based upon numbers, studies done on men. Those numbers are are are data derived from men and then reduced to fit a smaller human being, which is a female, and and it was done by a panel of men too, right? So a bunch of people, a bunch of men, sat around at a round table and they were looking through all of the studies that were done on nutrition, and the studies were all done on men. And then they looked at them and said, oh great, and we're going to just reduce this by this amount and this will represent a female. Oh, and then, if a female is pregnant, we're just going to add in 300 to 500 extra calories and we're going to call that good, because that's the reflective of that tiny human being and their growth needs, and that's it.

Maranda Bower:

And how ridiculously sad is that One day our children are going to look back our grandchildren, our great-grandchildren, and be like man. What were they thinking? Just like we can look back at some of the things that they had did just back in the 60s. Right, they were practicing lobotomies back then and, honestly, that's not that long ago, it's less than a hundred years and we can look back and be like, wow, they did that to women. Or you know the way they treated women in childbirth and the medications that they gave? Or spraying our children with DDT and like all of the crazy things that we had, you know, our parents' generation or grandparents' generation had dealt with, that were the norm, that were considered safe, that were just a part of their life, and how they dealt with health and wellness, especially around pregnancy and postpartum. And one day our kids are going to look back at us and be like what in the world? Like this was crazy. Our grandchildren, our great grandchildren, they're going to think we are absolutely nuts for doing the things that we do, and I hope, I hope that's the case. I hope it's going to be so significantly shifted.

Maranda Bower:

And then we finally have studies done on women. And here's the thing it's women are quote unquote hard to study because we have these hormonal needs and we are often deemed in scientific studies too complex because of our hormones. And this is the exact reason why we need so much more nutrient value than men and so much more during pregnancy and in postpartum that go well beyond just a little extra increase. It's mind blowing to me that we still do these things, and this is the sad part, it's just again, it's not generally studied. So when we have women who are not necessarily studied, and then we have postpartum, which is hardly studied at all again, unless it's dealing with mental health or breastfeeding, which a lot of money goes to. Why? Because pills can be developed, medications that you can go on for life sustaining somebody's company, and bottom line gadgets for breastfeeding can be created, and we see it all the time. And the same with formula companies, right, and so the more money goes into it, the more things that they can produce which can make money. It's all about the money. It into it, the more things that they can produce which can make money. It's all about the money. It's always about the money. If you want to know about what's happening in the world or what's really important, just follow the money. So, again, not very surprising.

Maranda Bower:

I was actually just having a conversation with somebody recently on social media and she works with postpartum women in nutrition and she was telling me that this was an area that she wasn't specifically trained in, but she wanted to understand a little bit more about some of the things that I had been posting and it was really in relationship to gluten and dairy. She was like I don't wanna include restrictive foods, and so we got into this beautiful conversation. It was so fun and so enlightening for both of us. I love her approach. I was in love with her social media stuff and just forming a really great relationship, but she was really wanting to know and just super curious and asking all the questions Like why would we limit, why would we restrict? And again, such a great question because there are so many women who've really, really suffered from eating disorders and things like that. So restrictive dieting is not something that we want to always promote.

Maranda Bower:

And it's probably one of my least favorite parts about postpartum nutrition and this is coming from somebody who has suffered immensely with not eating disorders but postpartum depression and anxiety, and I actually hit 81 pounds after my second, so I have quite a bit of experience with this. Anyway, long story short, talking about the inflammatory markers that occur in the inflammation that occurs in the postpartum period and how that affects the gut and how that, you know, in turn affects hormones and the, the amount of stress that we also have coupled with the digestive changes that are just a normal physiological part of postpartum, and like blending all of these pieces together and how we have to go to different sciences, you know, because there is no science on postpartum, it just like it doesn't exist. But if we go to psychoimmunotherapy treatments, if we look at what happens to patients after a significant surgery or event in their life, even if we look at abdominal surgeries, like what happens to individuals after that time period, and we have so much data and so much information and so many studies that can talk about these things, but never do we ever apply it to postpartum. Even if it's like major abdominal surgery, the biggest surgery ever, the cesarean, we're like we're not even comparing, we're not even applying. It's absolutely asinine to me that we do this. And so it was such a beautiful conversation, going back and forth, talking about the lack of science, how women are so understudied and that we have to go beyond. You know a specific study that says X, y, z, because oftentimes it doesn't exist. We have to go pull our information elsewhere. And another missing component to this is is the culture and traditions that have been done for thousands of years. I think we're finally making this shift and this turning point into something so much more when it comes to the science and the revelations that we're experiencing.

Maranda Bower:

I'm getting off my rocker here. I was talking with a colleague about biology and the field itself that's my background in biology and how it's coming to an end Like there's nothing much more outside of a couple of components, like it's almost becoming, especially when it comes to medicine. Like there's, we're almost at a standstill, there's not much occurring unless it's creating more pills, but that's not getting to the next level, that's not moving beyond where we've come to. Like this stagnation of where we're not moving forward. We're just creating more of what we already have.

Maranda Bower:

This actually happened from. You know, we we've seen this happen in another science as well Physics. This happened in physics and I think it was back in the early sixties and seventies and maybe I've gotten those dates wrong. I'd have to verify that. But physics did something. Very similar is where, you know, all of these theories were created and then all of a sudden it was like there's not much more to discover, there's not much more that we could find about how the world works. We're kind of at a standstill here.

Maranda Bower:

And then in came this more philosophical approach where it was more of the spiritual aspect, where we were legit combining science and God or science and religion or science and spirituality, and we were coming together and then boom, we have quantum physics. And quantum physics is one of the fastest growing sciences in the world today and it's such a beautiful science and it's like growing exponentially and it's so fascinating and eventually, hopefully, that's going to occur within the biological sphere as well, where we start combining these other aspects and realizing that our bodies are operating at a very different level than just here's these cells and here's how they work together and here's the nutrients that go into the cells and then you die and that's basically, I know, a very simplified version of biology, right, and maybe we could throw in a couple of genetic things in there and call it good, but that's, that's really there's. There's this whole other level that we're missing, that we don't understand and that we will never understand, no matter how many studies that we do. And that is one of the things that my work trying to bring back the sacredness that is postpartum, that we will never fully, truly understand through the science. So even I wish the science existed I truly do. It would be so validating on so many levels for a lot of women who are having a hard time hearing anything, or a lot of providers who need to know more, but they are stuck in that I must have a scientific journal or a study that's done in order to prove it's correct, in order for me to even care about studying it and sharing it with my clients it's correct, in order for me to even care about studying it and sharing it with my clients. It's never going to happen. If we don't have the studies to support, we will be stuck here for a while, but then there will become a time when even that isn't enough, because we will still recognize there is this missing gap, there is this missing piece, and it will never be fulfilled by some study, just as it was in physics. We can know all of the things, have all of the studies, have all of the you know explanations and theories, and it will never be enough. It will come to a dead end, and that's exactly what's happening in medicine right now.

Maranda Bower:

Okay, so here's all of the things that your provider just doesn't know, and I highly highly recommend that you do your research above and beyond your provider and, of course, be careful of where you research and who you talk to. I see this so often in Facebook groups and DMs. A lot of providers I've been following, some who have been so interesting. I'm like, wow, why would you say such a thing? Be really, really careful and cognizant, do your research and your due diligence and don't just follow anyone willy-nilly. And if you need support, if you need direction, don't hesitate to reach out. I have so many things that I can share with you. Likely and I'll be the first to tell you I don't have all the answers, but I can guarantee you I don't have all the answers, but I can guarantee you I can find someone who does have what it is that you're needing. So find other support, educate yourself and all of the things.

Maranda Bower:

If you're a provider, it is a must to make sure that you're staying on top of all of the things and going well beyond the science and the data that currently exists. We know there needs to be more. We know there needs to be more. Okay, so postpartum it's not the six week sprint to bounce back. It's a marathon of transformation, of healing, and what our doctors don't tell us is that true recovery involves more than that physical checkup. It demands emotional, mental, nutritional support that honors this profound change that we're going through, and so we need to not only embrace this journey but really seek out that holistic care.

Maranda Bower:

And if you're not sure where to go, message us. Go to postpartumucom and search articles. I can guarantee you we likely already have something and you don't even have to PM me. Just reach out, figure out other areas and avenues to get the information that you need. Because if you're going to heal in postpartum, if you're going to feel good in postpartum, if you're going to experience a smooth transition, then you're going to have to do the hard work to get there.

Maranda Bower:

And I know that's so frustrating because, again, what we really need during this time is someone to mother us, someone who's gonna do the work for us, and I've shared this before. That might not be the case right now for us, which is very unfortunate, but if we do the work right now, then our daughters and our sons and our children will have this. They will have this for themselves if we do the hard work for ourselves now. I am so grateful you turned into the Postpartum University podcast. We've hoped you enjoyed this episode enough to leave us a quick review and, more importantly, I hope more than ever that you take what you've learned here, applied it to your own life and consider joining us in a postpartum university membership. It's a private space where mothers and providers learn the real truth and the real tools needed to heal in the years postpartum. You can learn more at wwwpostpartumucom. We'll see you next week.

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