This month’s Brilliant Activities for Birth Educators focuses on the year after a person has given birth, a time period that is not often recognized as a potentially dangerous time for new parents, especially those who are most vulnerable. This activity offers childbirth educators a simple but effective method to highlight risks and share when parents should seek out support from their health care provider after giving birth. You can find all the Brilliant Activities for Birth Educators’ ideas here at this link. 

Introduction

Earlier this month, we highlighted the Blue Band Initiative, a program designed to identify postpartum parents who are at risk of preeclampsia after they have given birth. The Centers for Disease Control (CDC) released a report last fall that 53% of all pregnancy related deaths occurred a week after birth through the first year postpartum. This is a time when follow up care is often lacking and long periods of time may occur where the new parent does not have an opportunity to be seen by their health care provider. Childbirth educators can conduct this activity that highlights the importance of postpartum warning signs that put the parent at risk. Recognizing potential warnings signs means that problems can be addressed quickly and effectively, reducing morbidity and mortality for people after they have given birth.

Materials

In person

A set of laminated cards, with each card printed with a postpartum symptom. Be sure to include both normal and concerning signs.

Virtual

A virtual whiteboard (Jamboard) with a list of postpartum symptoms. Be sure to include both normal and concerning signs. You can use one whiteboard for the entire class or have several identical boards for small group work in breakout rooms.

Potential topics

Intrusive thoughts, lochia, engorgement, afterpains, dizziness, vision changes, breathing concerns, headaches, emotional peaks and valleys, thoughts of self harm, red and warm to the touch area on a leg, incision not healing, hot flashes, sweating, passing large clots, pain in the chest, exhaustion, seizures, high blood pressure readings at home and others that you want to include.

How much time to allow

To cover this topic sufficiently, please allow approximately 10 to 15 minutes for the activity, follow up discussion and responding to questions.

When to conduct this activity

An appropriate time to cover potential physical and emotional concerns during the postpartum period is toward the end of your time together, when you discuss life with a newborn, feeding and lactation, and the fourth trimester.

How to conduct this activity

Share with families that there are normal physical and emotional changes that every person who gives birth may experience. Let them know that this activity will help families to know what to expect and how to help deal with these changes. Share that it is also critical that birthing people and their support team recognize warning signs that may be outside the realm of normal and require support from a clinician.

In person

Distribute the laminated cards to class participants. Invite the class to physically sort themselves into two groups consisting of either normal postpartum experiences or situations that may require medical assistance.

Virtually

Depending on the size of the class, conduct this activity as one group or divide the class into breakout rooms and come back together for a summary. Create a whiteboard or Jamboard with all of the warning signs and changes to be on the lookout for. Ask them to “sort” (virtually move/drag) the items to two groups - normal postpartum changes and concerns.

After the class members have completed their sort, verify that everything has been placed in the proper category. As you highlight each item in the “normal” group, share further information, tips and solutions to increase comfort and support recovery. Invite people to share what they know about handling these typical postpartum situations. Move on to the warning signs group and ask the class to clarify which of these concerning situations might require a 911 call, a trip into an emergency department or contacting their provider immediately or during the next business day. Support each family in asking how they can receive the help that they need and stress the importance of being persistent if their concerns are not taken seriously.

What families appreciate about this activity

Families appreciate the childbirth educator normalizing common postpartum sensations and situations, and soak up the tips on how best to deal with each situation. Birthing people appreciate that their partner or support person can also get a sense about what situations require additional support from a professional. Everyone enjoys sharing their own knowledge and suggestions for handling bodily and emotional challenges that happen after birth. The opportunity to work in small groups or move about the room increases material retention, as these situations may arise weeks or months after class ends.

Conclusion

Many people are unaware that situations can arise during the postpartum period and throughout the year after giving birth that require medical intervention. Not being aware of these serious concerns increases the risk of a significant complication, including the loss of life of the person who gave birth. 53% of all deaths related to pregnancy occur between 7 and 365 days postpartum. Bringing awareness to these situations and supporting families to reach out for help from a medical professional is a vital part of the childbirth education process. This activity is a simple and effective way to cover this important topic.

References

Trost SL, Beauregard J, Njie F, et al. Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017–2019. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2022. 

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