Éléanor and her partner leave a public hospital in Paris. They just finished their fifth day of postpartum care after a surprise, emergent c-section at 41 weeks, and are expecting their out-of-pocket expenses to only be about 3% of their just over $5,000 bill. Éléanor will get around 26 weeks of government-mandated, paid maternity leave, adjusted, due to her two older children, from the 8-16 weeks guaranteed for first-time mothers.
She will soon attend the first of 12 prescribed pelvic floor physical therapy sessions, avoiding chronic dysfunction of the soft tissues impacted by pregnancy and birth, and will have an in-home nurse checking on her emotional and physical well-being regularly throughout the postpartum period, like every mother in France. A massage therapist referred by Éléanor’s physical therapist may teach her how to massage her c-section scar, to help increase blood flow and prevent painful and restrictive adhesions from forming in/on her abdomen. Her doctor may even recommend a product like Cicalux, which uses infrared heat, medical grade silicone, and tension-relief tape to gently maximize the healing process of scar tissue. These are all examples of how she can be holistically supported (mind, body, spirit) by a medical team while she heals during the sacred postpartum period.
Jennifer and her partner leave a different public hospital, in America, having spent 5 days there after a surprise c-section of their own. Induced at 41 weeks because her baby’s head was apparently measuring large, and unable to withstand the pitocin-heightened intensity of contractions, she was unable to have the natural, physiologic birth she wanted. She isn’t sure how much of her $30,000 bill will be covered by insurance, but the majority of her postpartum care will have to come out-of-pocket. Jennifer will still have her former job in two months, but her maternity leave is not paid.
Jennifer’s first and only prescribed postpartum checkup will be an hour-long in-office appointment 6 weeks after giving birth. By that point, she may unknowingly be experiencing postpartum mood disorders. With no knowledge of pelvic floor physical therapy, just like countless moms before her, she will think her stress incontinence just comes with the territory, and she may not know if her abdominal muscles have properly reintegrated. Her support team consists of her partner and anyone they know who is willing and able to assist.
The maternal mortality rate in France has been either declining or steady over the past two decades. There are myriad reasons why the US has increasing rates, but it’s impossible to ignore the gaping lack of holistic postpartum care. When birth was taken from community midwives to surgeons in hospitals, there was no care shown to adopt the spiritual and emotional support from the more traditional practices, forcing most women to blindly start their motherhood journey at a deficit. Truly addressing these rates and protecting our mothers will take large cultural shifts at every level of society. God bless America’s ornery individualism for making large shifts seem possible.