When you’re pregnant there are so many medical appointments, and many moms look forward to each one. We want to know what is going on with our bodies and our babies. But once the babies are born, many moms aren’t able to keep their own medical appointments and experts are worried.

New moms are missing key appointments in the critical fourth trimester, or the first three months postpartum, according to a new study from Orlando Health.

Nearly a quarter of new mothers surveyed admitted that they did not have a plan to manage their own health in the first weeks and months postpartum. The numbers are alarming as nearly half of new moms have admitted to feeling their most overwhelmed, anxious and depressed during that time period.

Worse, the incredibly stressful first few days and weeks of their baby’s life is the time when many mothers have admitted to feeling the least supported by their doctors. According to a survey from Healthy Women and 2020 Mom, nearly 30% of women have felt “no support” from their health care provider. This even as the American College of Obstetricians and Gynecologists (ACOG) has recently adjusted their guidelines to suggest that women see their doctors within the first three weeks after birth, rather than the traditionally recommended six weeks.

“Seeing your doctor within a few weeks of delivery and sharing any concerns is critical to getting the care and treatment you need,” Megan Gray, MD, an OB/GYN at Orlando Health Winnie Palmer Hospital for Women & Babies, told Orlando Health. “The fourth trimester can be difficult and overwhelming for women as their bodies go through physical and emotional changes, and this time deserves the same support and attention as the first three trimesters,” Gray said.

Yet, with many women going back to work at six weeks postpartum, up to 40% of moms are missing that first appointment entirely. For most mothers, that represents a rapid and drastic shift in their approach to maternal health care, as prenatal care is full of regularly-scheduled appointments and check-ups. Given that the US remains the most dangerous industrialized country to give birth in, the statistics can’t be ignored. As the survey notes, it is impossible for mothers to take care of their babies without taking care of their own health as well.

Still, the onus shouldn’t be placed solely on new mothers, who are already riddled with exhaustion and anxiety. With doctors and employers failing to support them, it’s hardly surprising that they are struggling to keep up with their appointments or feeling comfortable enough with their doctors to open up about their physical and emotional changes.

In fact, a recent study from Maven reported that as many as 54% of new moms were never even screened for mental health concerns during their pre and postpartum care. Of those who did raise concerns, nearly 30% were not given concrete steps to get treatment.

All of this contributes to the cycle of shame that leads to nearly 60% of new moms experiencing depression and anxiety in silos, only furthering their feelings of extreme isolation. “I thought everything would come more naturally, but it was so much harder than I expected,” one mama, Rachel Kobb, told Orlando Health. “Women have been raising babies forever, and I felt selfish for feeling like I couldn’t handle it,” she said. “I felt very lonely, but I didn’t know how to ask for help,” she added.

Still, there is hope for new moms, even during those incredibly difficult early months. Medical professionals like Gray and the ACOG are continuing to push for proper training for doctors, midwives and doulas to help new mothers cope with the emotional demands of motherhood, in addition to improved programs for mothers like lowering costs for mental health care and urging companies to provide paid maternity leave for at least the first half of the fourth trimester.

Moreover, simply reminding women that they’re not alone is a critically important shift in how society treats new moms who are struggling emotionally.

“There is no perfect mom out there,” Gray noted. “Taking some of that pressure off yourself will help you be the best mom you can be and help you better experience the many joys of motherhood.”

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