All of the Experts You Didn't Know You Needed in Pregnancy and Postpartum—Plus, How to Find Them
For centuries, towns had one or two doctors who handled primary adult and pediatric care, birth, and more. Their patients were friends and neighbors and they were part of the village that helped raise up both new parents and children.
You could call them the good ol' days.
"There has been an erosion of that type of relationship," says Sarah Oreck, M.D., a California-based reproductive psychiatrist. "People don't know their physicians that well."
But moreover, new parents don't just need to know that their C-section incision or postpartum vaginal tears are healing properly. With breastfeeding rates rising—in 2017, 81 percent of women said they had tried breastfeeding, up from 74 percent in 2007—lactation consultants have become more of a necessity. And given that there have been significant increases in postpartum anxiety and depression amidst the COVID-19 pandemic, mental health professionals who specialize in the perinatal timeframe, like Dr. Oreck, are of paramount importance.
After all, while a nurse-midwife or an OB-GYN will be there for you during your pregnancy, after your body goes through the physical, physiological, psychological transformation that is birth and you come home with a baby, you might not see your medical provider again for six weeks or so.
Rachel Nicks, a California-based doula, lactation counselor, and fitness instructor says the story often goes the same way: Women get education and advice throughout their pregnancy, then, after giving birth—a time when most women need more support than they're getting—they tend to fall off the radar. Then? It's not always easy to find the people you need.
Fortunately, databases such as Robyn, Motherfigure, and Boober—which let you find and book prenatal and postnatal specialists from doulas to lactation consultants, dietitians, and more—are trying to fill the gap. They are helping parents find specialists who meet their needs and share their philosophies, and foster closer relationships between patients and providers before and after birth.
Here, a primer on how to find the specialists you may want to add to your (even virtual) village—and how they might be able to help.
How to Find the Experts You Need
Once you realize you might need help with something—abdominal separation (formally known as diastasis recti), pelvic floor issues, mental health problems, breastfeeding struggles—the next step is figuring out where to get it.
Often a good place to start is your OB-GYN or midwife, who may be able to provide help and a referral. You can also ask if they know if the person takes insurance, which can help offset costs, but you'll need to call your insurance company or the specialist to verify.
But as a heads up: Your birthing professional may not always have referrals or the one or two professionals they recommend may not be the right ones for you. "I have found that OB-GYNs aren't always able to roll out next steps," says Dr. Oreck. "There needs to be education within our medical system to extend those referrals and that network."
If your provider doesn't have any suggestions, Dr. Oreck suggests getting warm referrals from friends and family. Dr. Oreck also recommends Postpartum Support International (PSI) for mental health listings and free support groups. After all, specialists cost money and not everyone can afford them.
You might not be as geographically-constrained today either. "One of the small upsides of the pandemic is that telehealth has become more prevalent," says Dr. Oreck. "That can be useful to parents who have young children at home or who are pregnant and having difficulty traveling."
The important thing to remember: You aren't alone and it's OK to ask for help. "Part of being a successful mother is asking for help and having the humility to know we can't do it on our own," says Dr. Oreck. But since navigating pregnancy and postpartum specialists can feel like a whole new world of jargon, let this guide be a starting point to help you learn about some of the experts to consider in your search.
Doulas provide emotional support and advice during pregnancy, labor and delivery, and postpartum. Different doulas may be able to help with various issues that arise during the first through fourth trimesters. "They can often help with nutrition, movement, lactation, and newborn care," says Alli Kasirer, CEO and founder of Robyn.
The best doulas will work with you and your OB-GYN or midwife. If the doula has never worked with your OB-GYN or midwife, you can ask for them to do a virtual meeting or call to ensure everyone is on the same page.
- RELATED: Should You Hire a Postpartum Doula?
Doulas don't typically take insurance—though some states do cover doula services—so be sure to do your research before choosing one. Major Care is also a new service that helps connect parents-to-be with doulas, specifically.
Mental health professionals
A therapist can help talk through postpartum anxiety and depression and any struggles you're having while adjusting to being a new parent. Psychiatrists can prescribe medication, such as antidepressants, as needed. Dr. Oreck suggests trying to find someone who specializes in the perinatal and postpartum periods since it's such a nuanced time. PSI has a provider directory on their site that lists thousands of providers—many of whom provide virtual care—all over the country (and world!). Hospitals also often provide resources for postpartum depression support groups.
Mental health providers often take insurance and insurance companies can provide a list of providers in your network.
Breastfeeding is natural—mammals in the wild nurse, after all—but it doesn't always come naturally. And when you bring a crying baby home and no one has slept, that doesn't always add up to a positive breastfeeding experience, says Nicks. One 2013 study found that 92 percent of women hit snags breastfeeding in the first few days postpartum.
International Board Certified Lactation Consultants (IBCLCs) and Certified Lactation Counselors (CLCs) can get a breastfeeding journey off on the right foot and help you work through any issues, including a baby's latch. They can evaluate babies for tongue and lip ties that may interfere with effective latching, offer advice on increasing and maintaining milk supply, measure you for pump flanges if you plan to pump, and more.
Some lactation consultants may take insurance, but often this can be an out-of-pocket expense.
That said, there are free resources. La Leche League, for example, offers free lactation consultations. A hospital also may provide a list of free breastfeeding support groups, too.
Instagram is also full of professionals who may be willing to answer direct messages—it doesn't hurt to ask. "Most birth workers will talk to someone for free," says Nicks. "I get DMs every day, 'Is this safe? Can I do this?' I respond."
Prenatal and postnatal fitness instructors
The right fitness instructor can help you keep up with and find new exercise habits during and after your pregnancy. Nicks suggests seeking out professionals who can help you take care of your body when you're taking care of another human and working with someone who will provide a phased approach that includes healing (Kegels and breathing exercises to heal your pelvic floor and transverse abdominals), gentle movement (yoga and walking), and functional strength (squats and upper body work).
Pelvic floor physical therapists, who specialize in caring for the muscles of the pelvic floor which can often wind up injured or overworked in pregnancy and childbirth, can also be helpful rehab professionals to look into.
Luna Mother Collective, Peloton, and Obé Fitness all offer great prenatal classes and education online and through their apps. The American Physical Therapy Association and Pelvicrehab.com list pelvic floor physical therapists, too.
Fitness instructors usually require clients to pay out of pocket, but insurance providers or employers may offer discounts.
Like fitness instructors, nutritionists can help you establish and maintain healthy habits during your journey as a parent and help you tackle anything from battling nausea to a gestational diabetes diagnosis, Kasirer says.
"A lot of Robyn's dietitians are also lactation consultants," she says. They can help lactating parents nourish their bodies in a way that doesn't interfere with milk production.
Some nutritionists are covered by insurance.
That old adage, "sleep when the baby sleeps," isn't always possible and no one benefits when a caregiver is chronically exhausted. "If your baby isn't on a regular schedule, a new parent doesn't have time to recover," says Kasirer. "It can be helpful to have a sounding board."
Sleep consultants can advise on sleep-wake windows and different products, such as swaddles and sleepsuits, which may help your baby sleep. Since there are various ways to help a baby sleep, you'll want to think about things like your baby's age and your comfort levels with different methods so you can find a provider who fits with your views.