Why you might not mention it
When CDC asked more than 2,400 women why they held back from raising a concern, the commonest answer was that they thought what they were feeling was normal.
Start with what is not known. No study has ever measured how many women turn up at six weeks with a symptom nobody warned them about. That endpoint does not exist in the literature. If you see a percentage for it, someone invented it.
What has been measured is the other side of the same coin, and it is worse.
CDC surveyed more than 2,400 US mothers in April 2023. 44.7% said they had held back from asking a question or raising a concern. The reasons they gave, in order:
| Reason for holding back | Share of respondents |
|---|---|
| Thinking that what they were feeling was normal | 28.8% |
| Feeling embarrassed, not wanting to make a big deal | 21.5% |
| Having someone close tell them it was normal | 21.2% |
| Worrying that their maternity care clinician might think they were being difficult | 20.7% |
Look at what the top answer means. The most common reason American women do not report a symptom is that they have been taught it is normal. Every reassuring sentence in every leaflet raises that threshold slightly. This guide does it too, and it is worth saying so out loud.
Three other findings sit alongside it. ACOG states that in a national survey, less than one half of women attending a postpartum care visit reported that they received enough information at the visit about postpartum depression, birth spacing, healthy eating, the importance of exercise, or changes in their sexual response and emotions.
In the Australian population survey, a quarter of the women had not talked to any health professional about their own health since the birth. And in one small US study, roughly one in five women fell into the least informed and least prepared group, and those women had worse mental health scores at four weeks.
CDC's own campaign for this problem gives women a single instruction: Continue to share your concerns until you are heard, and your questions are answered.
That campaign is supported through a partnership with the CDC Foundation and funded by Merck, through its Merck for Mothers programme, which you are entitled to know when weighing a public health message.
"I know this is small. I want it in the notes anyway."
"You have told me it is normal. What would it look like if it were not?"