The Importance of Strong Patient-Provider Relationships in Postpartum Care
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By Maria
The postpartum period can present numerous health challenges that demand careful attention and support. When healthcare providers lack awareness or fail to provide adequate care, the consequences can be severe, especially when women’s health issues and symptoms are not taken seriously. Many women experience their concerns being dismissed. This disregard not only invalidates women’s experiences but also contributes to complications that could have been avoided with appropriate care and understanding. It is essential to acknowledge and tackle these challenges to ensure that every woman receives the compassionate and informed care she rightfully deserves.
Here, we delve into how provider negligence and lack of awareness after childbirth can lead to such injuries, highlighting the urgent need for improved responsiveness and education in postpartum care.
A. The Scope of the Problem
I. Historical Context
The care provided during labor and after childbirth should be of the highest quality, grounded in evidence, and centered around the experiences of women, embracing a holistic approach that respects human rights. Unfortunately, women’s health issues have often been neglected or misunderstood throughout history. This oversight stems from a long-standing medical tradition that has been largely influenced by male viewpoints, where women’s health complaints were often dismissed as emotional rather than physical. Additionally, postpartum care in the past and today tends to prioritize the needs of the baby over the mother’s health. This historical bias continues to create significant barriers in effectively addressing women’s health issues, especially during the postpartum phase.
II. Modern-Day Ignorance
Even with the progress made in medical understanding and an increasing awareness of gender biases, many women continue to feel overlooked by their healthcare providers after giving birth. The focus on postpartum care remains significantly less than that on pregnancy and childbirth.
In Sweden in 2024, around 25% of women who experience severe perineal trauma, such as third- or fourth-degree tears, express frustration with the care they receive during the first year after delivery (study results). Research like this shows that postpartum complications are frequently misdiagnosed, dismissed as normal, or inadequately addressed due to a lack of empathy and understanding from healthcare professionals. This neglect can lead to serious consequences, resulting in avoidable injuries and long-lasting health challenges.
B. How Dismissal Leads to Preventable Injuries
I. Pelvic Organ Prolapse
When healthcare professionals overlook reports of pelvic pressure, discomfort, or a feeling of bulging as typical postpartum issues, they may miss the chance to identify and address POP at an early stage. If not treated promptly, the condition can deteriorate, leading to more serious prolapse that may necessitate surgical intervention and can greatly affect a woman’s overall well-being.
“They said it can take up to a year to get better. So, when that year had passed, and before starting to work again, I called different places in the hospital and asked: What should I do now? […] It took several months before I got an appointment with the surgeon for an assessment. And then I had to get a second opinion. So, it took like seven months before I got an appointment at [a specialist clinic].”
Incontinence, whether urinary or fecal, is a frequently disregarded issue that many women face after giving birth.
When women express concerns about incontinence and are told it’s a normal part of childbirth that will resolve on its own, they often miss out on essential referrals for pelvic floor therapy or other treatments. This oversight can lead to ongoing incontinence, which not only impacts physical well-being but also carries significant social and emotional consequences.
You are constantly dismissed, ‘No, but everything looks fine, you have no problems’. Then you start to think you’re imagining things. And then you may not dare to talk about the injuries.”
Many women dealing with persistent pain often feel that their experiences are downplayed or linked solely to psychological reasons, rather than being properly examined. When chronic pain is dismissed as merely a psychological concern or seen as a typical aspect of postpartum recovery, it can hinder women from obtaining the necessary pain relief and rehabilitation. This neglect can result in ongoing discomfort, reduced mobility, and a lower overall quality of life.
“Everything that happens during and after childbirth and related injuries has been a taboo discussion topic, so it has been completely ‘normal’ to suffer from persistent pain.”
Ignoring postpartum health issues can deeply impact a woman’s mental well-being. For instance, a woman struggling with postpartum depression might hear that her feelings are just the “baby blues” and that they will eventually fade away. If her struggles are not acknowledged and treated appropriately, postpartum depression can intensify, hindering her ability to care for herself and her child, and possibly resulting in lasting mental health complications.
“Something broke inside of me that day. I felt entirely omitted; I was close to leaving my son and committing suicide. Nobody understood how bad everything was.”
When women frequently encounter feelings of being dismissed by healthcare providers, it can significantly undermine their trust in the system. This lack of trust may lead them to hesitate or completely avoid seeking medical assistance, which can worsen health issues that could have been managed effectively if caught early. Additionally, this erosion of confidence can deter women from engaging in preventive measures, like routine check-ups and screenings, further impacting their overall health.
Furthermore, women play a significant role in alternative medicine, both as users and as practitioners. The attraction of alternative medicine for women often stems from the lack of attention given to their specific health needs in conventional medicine. This is troubling, as alternative therapies can be quite limited in their effectiveness, which may lead to insufficient healthcare for those who choose these options.
“I sought help from another midwife, as I felt something was wrong. This midwife referred me to the physiotherapist, who referred me to a specialist, who then referred me to surgery and rehabilitation.“
Addressing the stigma surrounding women who face complications during childbirth is vital and raising awareness about the realities of the birthing process is a key step. By educating society on the potential challenges and normalizing these experiences, we can help diminish the stigma and foster a more compassionate environment. To improve awareness and care among healthcare professionals, it is essential to implement systemic reforms in medical education and training worldwide. Providers must receive thorough education on the specific health needs and conditions of postpartum women.
Public health initiatives and educational materials can offer reliable information regarding childbirth complications. Sharing personal narratives from women who have navigated these difficulties can play a significant role in reducing stigma and promoting open dialogue. Training programs for healthcare professionals should emphasize the importance of actively listening to and validating women’s experiences. Incorporating gender sensitivity training into medical school and ongoing professional development/education can help providers recognize and confront biases. This training should include real-life case studies and patient stories to highlight the serious consequences of neglect and dismissal in healthcare settings.
“It’s just that the health services don’t believe you, which makes you feel terrible. It’s a big deal that no one listens.”
It is essential to empower women to take charge of their health. Women need to feel confident in seeking second opinions, asking questions, and insisting on comprehensive evaluations of their symptoms. Healthcare systems can play a vital role by offering resources and support groups for women who face dismissal or negligence. Healthcare professionals should foster an environment where patients feel comfortable voicing their symptoms and worries. By delivering clear information about health conditions, treatment choices, and the significance of follow-up care, we can enable women to actively participate in their healthcare journey.
“I have regained my authority to speak up. It should be out in the open, not withheld.”
Establishing strong support networks for women facing complications during childbirth is crucial. This encompasses providing access to mental health resources, support groups, and caring healthcare professionals. Community resources and support groups can offer a nurturing environment where women can express their feelings and find reassurance and encouragement. Additionally, online platforms can connect women with supportive communities from around the globe. Notably, the rising movements on Instagram led by physical therapists can serve as an excellent starting point for this journey.
IV. Policy and Practice Changes
Healthcare policies should ensure that providers are held accountable when they overlook or disregard women’s health issues. By introducing systems for patient feedback and conducting regular evaluations of provider performance, we can better recognize and tackle instances of negligence. Additionally, healthcare organizations should create straightforward procedures for managing patient complaints related to dismissal and neglect. Consistent performance assessments and patient satisfaction surveys can play a crucial role in identifying those providers who may require further training or support.
“One of my strategies since I got the injury is also to try to influence. Being able to be involved and influence what postpartum care should consist of.”
After childbirth, some women experience pelvic organ prolapse, where the pelvic organs drop from their normal position. This can lead to discomfort, urinary issues, and a feeling of heaviness in the pelvic area (among others). Pelvic floor damage can also result in incontinence and other complications, impacting daily life and…
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