This post examines how a lack of postpartum care affects mothers’ sense of safety and confidence in their bodies and lives.
Anyone undertaking a big project will know the last few steps are the hardest and most tedious. Despite how far you have come, it can be difficult to see progress. A chasm has opened as I stare down the finish line of my master’s thesis. I took to Mt Lofty in search of perspective and grounding, and it delivered. Nature does that; we can forget its power when caught up in the daily grind.
Ascending Mt Lofty, I was reminded of my insignificance and place in the bigger system. The plants cannot germinate without the sun, and they cannot grow without rain. We all play our part, and we must trust in nature’s seasonality and the seasonality of our lives.
The last time I sought out the mountain was when my youngest was in his first year. I felt untethered. The dynamics of my life had changed with the introduction of another child, and the ground felt shaky with the demands of Covid. I could not walk far, my body still weak from pregnancy and birth, and my baby was still strapped to my body. I breathed in the mist as the water fell over the hillside, the certainty of the flow soothing my tired brain.
I did not set any records on my most recent pilgrimage, but my progress was confirmed. Mother’s bodies undergo dynamic change to gestate our babies; we grow and stretch, and our brains are permanently altered. We are fundamentally different from before. Yet, there is an expectation that we will bounce back to our former selves. After my first child, my body was not the same, and after my second, the changes made me feel flawed.
My second child sat low in my body. The evidence of this position remains in the imprints he left, creases like the ones that now line my face each morning. I delivered him without any of the tears his brother’s birth created, but my pelvic floor felt weak. The weakness in my body made me feel weak in other ways, too. Often, we turn to the body when the mind feels unsteady.
After both of my births, I sought out the support of a women’s health physiotherapist. She provided reassurance, guidance, and advice. I had treatment to soften my scars and strengthen my pelvic floor. I can comfortably reach the peak of Mt Lofty now, confident in my body’s ability to hold me. I have spent thousands of dollars for this confidence. None of my physio treatments were covered by Medicare, and only a percentage by private health insurance.
I work with mothers who emerged from birth with severe injuries. They have since spent many years and thousands of dollars trying to heal. Their injuries have seriously affected their health, wellbeing, relationships and sense of self.
The pelvic floor is our base; in Ayurveda, the ancient Indian system of medicine, the root chakra (Muladhara) represents our foundation for life. When our foundations are compromised, our sense of security can feel threatened.
Our health system fails mothers. For too long, the only measure of a successful birth has been our baby’s health, with less regard for how we fare. Pelvic health care is underfunded, and the Australasian Birth Trauma Association says many women receive no pelvic health follow-up after birth. In their 2021/2022 pre-budget submission, the Australian Physiotherapy Association called on the government to fund Medicare-subsided access to physiotherapy assessment and management for pregnant women. A petition to fund postpartum pelvic health assessment and treatment attracted over 40,000 signatures. The government has not acted upon these calls for pelvic health care reform.
The ABC Birth Project has examined birth in Australia since 2022. Their investigation has uncovered stories of birth trauma, birth injury and health care provider violence. The NSW Select Committee on Birth Trauma has just closed for submissions from mothers, families and health care professionals. For many mothers across Australia, participating in these inquiries will be the first time they have shared their birth story. For some, it will be a story of support and empowerment, but for too many, it will be a source of grief and disbelief at a system with high induction rates, caesarean and intervention. It won’t necessarily be the acts themselves but the lack of consultation and care associated with them.
We are on the brink of a birth revolution. Evidence shows that midwifery care improves mothers’ physical outcomes, feelings about their birth experience and their baby’s health. The National Strategic Approach to Maternity Services recommends midwifery continuity of care as best practice, yet this care arrangement is only available to eight per cent of Australian mothers.
I am one of the eight per cent of Australian mothers who received midwifery-led continuity of care. I am one of the 0.5 per cent of Australian mothers who birthed at home. I know what it feels like to emerge from birth feeling supported and empowered, and I want it for every mother and baby.
Soon, I will reach the finish line for my thesis on matrescence and public policy. I want to use my work to be an effective advocate for mothers. I am looking for opportunities to share my learnings. Please reach out if you have a platform where we can chat – email me.