Why we need to start prioritising postpartum care

With some studies suggesting as many as six out of seven women miss vital postnatal visits, FemTech World investigates why we need to change the narrative around postpartum recovery.

Sandra Wirström was working in the digital health sector in Sweden when she had her two daughters. She experienced birth injuries both times and she was surprised by the lack of data and support around post-natal care.

“I had to fight for every single piece of information and every single doctor appointment. I was extremely frustrated that nothing has been digitalised when it comes to the postpartum care,” says Sandra.

Sandra’s experience applies to hundreds of women across the UK. Recent figures show that six out of seven new mothers in England are not getting a check-up of their health six weeks after giving birth, despite such appointments becoming a new duty on the NHS. Of those who attend one, only 15 per cent have a dedicated consultation with a GP to discuss their physical and mental health, according to the National Childbirth Trust (NCT).

Another US study from the American College of  Obstreticians and Gynecologists revealed that as many as 40 per cent of women do not attend a postpartum medical visit after giving birth.

“Nothing has been done when it comes to postpartum digitalisation,” says Sandra. “So, about a year ago when I was on one of my walks with my second daughter, I thought ‘okay, we need to do something about this and change the narrative around postpartum care’.”

Soon after that Sandra met Astrid Gyllenkrok Kristensen, who was as passionate about women’s health as Sandra and like so many other mothers out there, struggled with the physical and emotional recovery process after giving birth.

They decided to set up LEIA, an app co-developed with midwives and medical experts that offers women personalised physical and mental health support during the postpartum months, also known as the fourth trimester.

“There are hundreds of apps to help you during pregnancy and everyone asks you how you feel,” says Astrid. “Post-delivery, you are left on your own in what seems to be the most overwhelming and sometimes traumatising time of your life. Out of 140 million women giving birth each year 90 per cent will experience emotional or physical difficulties, from breastfeeding complications to postnatal depression and pelvic dysfunction.

“When we started looking into this, we found that there were a couple of key issues leading to women struggling in silence,” Astrid continues. “The lack of digitalisation that Sandra mentioned is one of them, along with the lack of medical experts. Women do not get the information they need. They end up self-diagnosing and they have no idea who to turn to. There’s no structure and globally, the healthcare chain is very fragmented.

“There’s also a massive stigmatisation in society surrounding postpartum. The narrative, especially in Sweden, is that you’re supposed to give birth, and then within a week, go for power walk and have friends over.”

A study from the polling company Survation, revealed that 85 per cent of the 893 mothers in England interviewed over a month said their appointments were mainly or equally about the baby’s health and they did not get the chance to talk to the GP about their mental wellbeing.

Astrid says: “One of the problems of women are not getting the health care they need is because the healthcare system is not focused on the women’s perspective and is not based on their needs.

“Studies show us that suicide is now one of the leading causes of death in new mothers, up to one year after giving birth and this is something that shows the acceleration of the problem. The system is broken.”

The pandemic has only amplified this. Research by the Maternal Mental Health Alliance shows that more mothers than usual have been struggling during the pandemic because restrictions on social contact means they have been denied support from family and friends, which has led to more anxiety and loneliness.

LEIA is an app based on science and self-lived experiences of motherhood. Astrid explains that: “Together with both private and public health care, we created a medical advisory board to make sure that we achieve our primary focuses to create a solution and meet the needs of new mothers.”

“Before going into the product, what we wanted to do was to create an app that would help by giving women AI or data driven insights about their emotional and physical health, to help understand what’s going on in their head, what’s going on in their body and what the recovery process in the fourth trimester is.

“But we also wanted to include the partner within that experience, because men are also getting diagnosed with depression. Seeing it as a unit and not just pinpointing the woman, is something that we feel is integral for a healthy recovery.”

Astrid highlights how crucial postpartum check-ups really are when it comes to mental health.

“One of the key things during these visits is to screen women for postnatal depression, which is normally done face-to-face with a questionnaire called EPDS – Edinburgh Postnatal Depression Scale. With LEIA, we’ve digitalised screening models for both postnatal depression, but also pelvic dysfunction, identifying women in risk at a much earlier stage. This means even before giving birth, we’ll be able to identify women at risk of postnatal depression.”

However, changing the narrative around postpartum care is as important as offering women the support they need.

Astrid says that: “Most people understand the first three trimesters and the changes in the women’s bodies because that narrative has been established.

“So, we want to establish a narrative around postpartum as well. People need to know that there’s a physical recovery and it takes a year for the body to recover after childbirth. We think that by educating people about the recovery process we can normalise it and start breaking down the stigma.”

Sandra adds: “There’s been a boom in the femtech market focusing on fertility and pregnancy.

“In the past years, there has been a digital transformation in areas such as fertility,  period tracking and menopause. However, there are still a lot of things to do, especially when it comes to postpartum care. We’re still not getting educated enough about what is happening in our body after giving birth.”

LEIA’s data-driven approach aims to influence improvements in public health.

Globally, research data on postpartum care is limited. Amid a lack of awareness of postpartum conditions, however, investment in further studies and in developing options which address postpartum symptoms is also limited, says Astrid.

“We all know that politics is driven by economics,” she says.

“By collecting this data, we will be able to show how the lack of investment and support is actually affecting women. We have to put a number on the problem before they actually start looking into it.”

Sandra agrees: “It’s not only our perspective and our motivation, we are in fact putting the mothers in focus in everything we do by building an app for the mothers out there.”

Clearly, fundamental changes will be required to adequately address postpartum challenges in future. The success of LEIA in starting a conversation around postpartum care is, however, an important first step in driving this change.

Find out more about LEIA here.