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Advocating for proper postpartum care

Proper Postpartum Care is Crucial to Prevent "Ghostpartum"

Today we are addressing “Ghostpartum,” which may sound like a Halloween ghoul or goblin, but is actually a term used to describe the postpartum period where many do not receive appropriate care as they transition from pregnancy to parenthood. In fact, according to the American College of OB/GYN (ACOG), up to 40 percent of postpartum folks do not even seek proper postpartum care.

While healthcare professional organizations like the ACOG are doing their part encouraging practitioners to advocate for proper postpartum care, this article is meant to help individuals advocate for themselves and advocate for any pregnant person and new parents in their lives.

Who is in your care team?

  • Friends and Family can help with new infant care, help out around the house (make a meal, do laundry), take care of older children (take them on an outing), and provide advice and emotional support (especially if they are parents also).

  • Primary maternal care provider: The OB/GYN, certified nurse midwife, midwife or women’s health nurse practitioner who provided prenatal care should provide a postpartum check within the first 3 weeks after delivery, and a comprehensive check up at no later than 12 weeks postpartum.

  • Infant Health care provider: A pediatrician, family physician, or pediatric nurse practitioner should be lined up to be the primary care provider for your new baby.

  • Primary Care provider: An OB/GYN or primary care physical should help manage any ongoing health issues like diabetes, thyroid issues, high blood pressure, and depression.

  • Lactation Support: Professional lactation consultants (IBCLC) can help with any feeding issues. Community organizations including La Leche League (https://www.llli.org/), connect mothers and families with education, encouragement, and information- their organization includes IBCLCs, lactation counselors, peer educators, and peer support via community support groups.
  • Pelvic Floor Therapist: A trained pelvic floor therapist can help you return to activities/exercise safely, improve pelvic floor strength, flexibility and coordination, address any pelvic pain (pain with sex, toileting), incontinence (bladder and/or bowel), prolapse, scar tissue sensitivity, as well as improve posture and provide education on body mechanics with childcare. We recommend every woman receive at least 3 visits postpartum.

Common Postpartum Issues

The transition from pregnancy to parenthood can be tough. Labor and delivery is physically exhausting in and of itself, and having a new person to care for can be overwhelming. Here are some common postpartum issues to look out for and don't be afraied to bring up with your healthcare practitioner.

  • “Baby blues,” depression, anxiety, irritability and mood changes
  • Pain with sex and perineal pain- according to some studies, 41-89 percent of women have dyspareunia or pain with sex within the first two to three months postpartum. Twenty-four percent have persistent dyspareunia six months later.
  • Family planning and questions about birth control
  • Low libido
  • Incontinence
  • “Falling out feeling,” in the vaginal canal or visible prolapse
  • Pelvic floor dysfunction
  • Pain at site of vaginal tearing or episiotomy
  • Sleep deprivation and fatigue
  • Postural pain with feeding and lifting/holding baby
  • Hormone issues
  • Vaginal dryness
  • Lactation issues

Racial, Ethnic, and Income Disparities in Access to Postpartum Care

  • Black women are three to four times more likely to die from pregnancy-related conditions such as cardiac issues and hemorrhage and to bear the brunt of serious complications as well. That risk is equally shared by all black women regardless of income, education or geographical location.

  • According to the Centers for Disease Control and Prevention, nearly 60% of maternal deaths in the United States are preventable and most (44%) occur within 42 days of the postpartum period.

  • Self-advocacy is important for women of color. According to the American College of Gynecologists, implicit bias may affect the way obstetrician–gynecologists counsel patients about treatment options such as contraception, vaginal birth after cesarean delivery, and the management of fibroids.

  • Doula Care can help, people with doula support are two times less likely to experience birth complications and four times less likely to have a low-birth-weight baby, according to this fact sheet by the Southern Birth Justice Network.

Takeaways and general postpartum recommendations:

  • Ask for support- Many cultures prescribe a 30–40-day period of rest and recovery after labor and delivery, with the parents and newborn surrounded and supported by family and community members. Ask for support -- food trains and support for day-to-day household tasks as well as emotional support. It’s also great to have other parents around who have navigated the journey between pregnancy to parenthood and who can offer stories, tips, and understanding.

  • Assemble your care team before you have the baby- Have a list of family, friends, and healthcare providers that you can contact when you need extra support, and know who to contact if any health issues come up for you or the baby.
  • Schedule your postpartum visits in advance- it’s important to prioritize your health and healing as well as your new baby’s. Ideally have contact with your maternal care provider within the first 3 weeks postpartum and at least one comprehensive postpartum visit no later than 12 weeks after birth.

  • Advocate for yourself and bring up any issues relating to sexual health, incontinence, prolapse, lactation issues, anxiety, and depression with your maternal health provider. Ask for a referral from your maternal health provider.

  • As a partner, friend, or family member- offer to help and remind your new parent friends to take care of themselves as well as their new baby.


Rahman, S. (2019). Ghostpartum: Why Many Women Don't Get the Sexual Health Care They Need.

McDonald EA, Gartland D, Small R, Brown SJ. Dyspareunia and childbirth: a prospective cohort study. BJOG 2015;122:672–679.

ACOG Committee Opinion No. 729 Importance of Social Determinants of Health and Cultural Awareness in the Delivery of Reproductive Health Care. (2018). doi:10.1097/aog.0000000000002459 . Retrieved from: https://journals.lww.com/greenjournal/Fulltext/2018/01000/ACOG_Committee_Opinion_No__729___Importance_of.42.aspx

American College of Obstetricians and Gynecologists (ACOG). (2018). ACOG Committee Opinion: Presidential Task Force on Redefining the Postpartum Visit The Committee on Obstetric Practice. Retrieved from: https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Optimizing-Postpartum-Care

What Our Patients Have to Say


Testimonial by Lauren B.

Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

Read more: Testimonial by Lauren B.

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by Mary L.

I started seeing Heather to treat my Interstitial Cystitis in November 2016. At this time, I was extremely miserable, in constant pain, and felt as though no one was listening or understood what was going on with my body. I have just finished my last appointment and I can honestly say that my life has completely changed for the better because of Heather and her team of PTs! I live almost completely pain free, and when I do have flare ups, I am able to treat them at home on my own. I am so grateful that this office was recommended to me a honestly cannot recommend them enough!

Read more: Testimonial by Mary L.

Testimonial by S.B.

As someone who suffered the debilitating physical and emotional effects of vaginismus (as well as a complicated history of back injuries) for more than 15 years, I thought a "normal" life was just a fantasy. Then I found Heather.

Read more: Testimonial by S.B.

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

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