More and more organizations are realizing that providing fertility benefits is essential to support and retain employees who are looking to start their family-building journey. However, a key period may be getting overlooked in the process: postpartum. How are organizations supporting employees after they give birth and return to work?

During a From Day One webinar, experts from Ovia Health discussed the pregnancy and postpartum risk factors that can influence long-term health outcomes, as well as the ways employers can invest in meaningful end-to-end digital health solutions that support employees throughout their entire care continuum.

Health in the ‘Fourth Trimester’

Moderator Sarah Begley, director of member content at Atria, says that the postpartum period is often referred to as “the fourth trimester.” This time can require just as much special care and attention as the months of pregnancy. “The government has expanded [the postpartum period] to 12 months,” said Corrinne Hobbs, general manager and VP, employer market organization at Ovia Health. This is a significant and relatively recent change in thinking.

“When we originally thought about postpartum, it was geared toward the six weeks after birth, whether that was vaginal delivery or C-section,” said Leslie Saltzman, chief medical officer at Ovia Health. “At the end of that period, the mother would go back to their OBGYN or their nurse midwife, be cleared and told ‘everything’s fine. You can go back to your normal life.’” In reality, Saltzman says, the first six weeks, when everyone is giving the mother time and attention, is the easy part. It’s what comes next that can be the challenge. “The exhaustion in those periods after can be worse,” she said, as can the complications that appear later after the stress-test of childbirth.

“In the U.S., many of us have heard about the high rates of maternal death that we have compared to our peer nations. 65% of those deaths actually happen in the postpartum period,” Saltzman said, noting that fatal complications can arise when mothers are back home and more or less alone. She notes infections, high blood pressure, cardiovascular complications like cardiomyopathy or blood clots, and mental health issues like postpartum depression or psychosis are conditions that need to be monitored and addressed during this period. And complications diagnosed during pregnancy such as preeclampsia or gestational diabetes can increase the risk of cardiovascular disease in women for the rest of their lives.

What Postpartum Care Looks Like

The American College of Obstetrics and Gynecology recommends that every person that has a delivery has contact with their provider, whether that's OBGYN or a midwife, within three weeks, with ongoing care as needed up until a final visit at around 12 weeks. “What that’s translating to for most people is a phone call followed by a single visit,” Saltzman said. Only about 60% of people even go to that postpartum visit, Saltzman says. Many people don’t even have 12 weeks off for parental leave, making it even more challenging to attend the appointment. Most daycare centers won’t even accept children until they are at least six weeks old. “You’re still trying to figure out how to feed your baby at that point,” Begley noted. And because we’re living less and less in multigenerational homes, Salztman says, essential knowledge in baby care is not being passed down.

Among those that do attend the checkup: “After you have that visit with your OBGYN and you get clear that your cervix is normal, your incision looks okay, and talk about ongoing needs for birth control… New mothers are then left in the system where it is their responsibility to identify if they have a complication and try to figure out whether that needs care or not. And then have to make the appointments and go,” Saltzman said. “This is where the existing system doesn’t really meet the needs.”

How Digital Solutions Can Bridge the Gap

Digital healthcare programs through an employer can provide structured and personalized access to information on health and baby care at this crucial time in a parent’s life that gives them, Hobbs says. A digital solution can help a person record their symptoms and then provide insight into what might be happening and whether to seek care, potentially saving them the time and expense of a doctor’s visit, Saltzman says.

These digital solutions, Hobbs says, should include information on physical recovery and support, postpartum depression screenings, lactation coaching, sleep training, and appointment management for the parent and the baby, including vaccination schedules. “A tool that can help you manage all of that while you're going through this physical, emotional, and mental transition would be tremendously helpful,” Hobbs said.

Ovia Health’s Postpartum Solution

In addition to the digital solutions mentioned above, Hobbs says Ovia Health’s platform also provides information on potential pregnancy complications and associated risk factors, such as atherosclerotic cardiovascular disease, which is “one of the most expensive health conditions.” The platform incorporates all potential aspects of life tied to pregnancy. “Our solution addresses reproductive life, planning and contraception, pelvic floor recovery, return to work, social and financial planning, social determinants to health and equity, and navigation of care,” Hobbs said.

“Our solution starts with recovery, so we are meeting people where they are in their individualized journey,” Hobbs said. Symptom trackers encourage people to engage with the platform’s dashboard daily to provide checklists and guidance along every step of the way. Behind the tracking are clinical algorithms primed to notice an impending issue. Critical alerts let the person know right away if something is abnormal, with care team members, who are licensed clinical staff, ready to respond and guide the parent through next steps.

The platform also encourages a segue back from OBGYN care to primary care and routine screenings since. Mothers often neglect their own basic non-pregnancy related healthcare once children arrive, Saltzman says.

Building an Inclusive Postpartum Policy

Employers, Begley says, should be “shifting their workplace culture to be more inclusive of those returning from maternity leave, parental leave, or being a new parent.” This includes several key factors, as described below.

Paid parental leave is crucial to postpartum recovery. “It really helps women to overcome or traverse the physical, emotional, and mental needs of being a parent,” Hobbs said. “Living in the United States, there's not a standard or universal paid parental leave requirement. So, employers are left to decide whether they can and will offer that.” This means women especially are often required to return to work during those first 12 months when they are still physically and mentally recovering. It’s worth noting, Hobbs says, “that women who take paid parental leave have lower rates of postpartum depression. And women of color are more likely to have jobs where paid leave is not offered at all.” Employers looking to cultivate a diverse workforce would do well to invest in paid parental leave whenever possible, for as long as possible.

Flexibility and inclusivity in spaces also matters. Physical space for pumping and breastfeeding also builds a welcoming and safe environment for employees who are in-person. Flexible scheduling to allow for childcare, healthcare appointments, and other issues is another way employers can support new parents–without cutting into their sick time.

Management training is important to make sure leaders understand parental policies and how to interact with workers in an inclusive manner, regardless of their family situation, can ease the process for the whole team. In turn, employees also need to be trained on how to communicate their needs.

Lastly, transition plans should be put in place to allow employees on leave to be able to ensure their continued professional development and assignments. “We're often afraid to step away because we feel like it might set us back. Adjusting the culture to support the employee and having that manager training to create that inclusive environment related to situations like this are critically important,” Hobbs said. “It really improves the workforce culture around [pregnancy] and postpartum.”

Editor's note: From Day One thanks our partner, Ovia Health, for sponsoring this webinar. 

Katie Chambers is a freelance writer and award-winning communications executive with a lifelong commitment to supporting artists and advocating for inclusion. Her work has been seen in HuffPost and several printed essay collections, among others, and she has appeared on Cheddar News, iWomanTV, On New Jersey, and CBS New York.