Ep.17: The Current Postpartum Duration is STILL Outdated! Postpartum Should Last 2 Years Instead.

Learn why the clinical definition of postpartum as “six to eight weeks” is outdated, where this timeframe possibly came from, and why redefining postpartum as a two-year period is critical for parents, families, and long-term population health.

In this episode, Dr Kristal Lau breaks down the science, history, and lived experience behind postpartum recovery, briefly explains what the 2023 Lancet maternal health series revealed, and makes the case for extending postpartum care to align with the first 1000 days of life.

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EPISODE HIGHLIGHTS

• The current clinical definition of postpartum and why it falls short
• What the Lancet maternal health series revealed about postpartum complications
• The overlooked role of lived experience in postpartum care
• Where the six-to-eight-week postpartum timeframe likely originated
• Why redefining postpartum as a two-year period makes clinical and public-health sense
• How the first 1000 days of life framework supports this shift

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QUOTES

“The majority of health problems after childbirth start after the six-to-eight-week mark.”

“We rely so heavily on evidence-based data that we forget women have been telling us this for generations.”

“If we don’t change how we define postpartum, no amount of money will fix postpartum or birth-rate problems.”

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P.S. The free membership resource hub is still in development. Check back soon for the link!

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CONNECT WITH DR KRISTAL LAU!

• Website: Bridges In Health
• Buy My Book! 'Postpartum 30: Thirty Days To A Nurtured Fourth Trimester'
• YouTube @drkristallau
• Instagram @mamaswingwoman
• LinkedIn @kristallau

Transcript

Welcome back to The Postpartum Wellness Show with me, your host, Dr Kristal Lau.

Before we start, a very quick disclaimer. I am not your medical provider or medical practitioner, and I’m not here to give you medical advice. So if any of you have a medical concern, please consult your healthcare provider to get advice from them.

As I promised, I’m going to be sharing with you some of the things that I have used in my lectures for my peers in academia, as well as clinicians. So today’s episode, we are going to focus on: what is the postpartum period? How long is postpartum, really? So we first need to understand what’s happening right now.

The current clinical definition is six to eight weeks after childbirth, which means that we expect—we, as in clinicians and physicians—we expect most mothers and birthing parents to take up to six to eight weeks after childbirth to return to as close as possible to their pre-pregnancy state. But I can tell you, that is absolutely not enough time.

Firstly, there is a paper published by The Lancet, a very well-established and reputable scientific journal. They did a whole series on maternal health in December of 2023. In one of the review papers, where they looked across a large amount of research on complications after childbirth—no matter how minor—they found that the majority of health problems after childbirth start to occur after the six-to-eight-week mark.

This is quite jarring. These research papers were systematically reviewed as well. For those of you who understand what that means, great. For those of you who are unfamiliar with the term, it means these researchers looked across a lot of studies and used analysis to combine the data and illustrate the real issue.

And they’ve done it. They showed us that many problems crop up after the six-to-eight-week mark. But what’s interesting to me is that it took this series of papers to show this so clearly only two years ago. All of the research they reviewed has existed for quite some time.

Not only that, we rely so heavily on evidence-based data that we forget humans—women, mothers, and birthing parents—have been going through this for generations, for centuries. They have lived experiences. They have complaints about their health. They have concerns about their health. Yet we are still not listening to the lived experiences of many mothers and birthing parents.

That really baffles me. But I am glad that we now have more data to back up what women and birthing parents have been saying all along.

Another reason the six-to-eight-week mark doesn’t quite hold up is when we look at the potential complications and even minor injuries from childbirth, or even just being pregnant for eight to nine months. There is so much for the body to recover from.

Think about it—just common sense. You as a person, male, female, man, woman, whatever. If you go through such a grueling experience where your entire life force and energy is directed toward growing something or pouring into something for almost a year, and then you go through an intense burst of energy during birth where you have to give it your all, and then within six to eight weeks you’re expected to return to a so-called pre-pregnancy or “before” state—it sounds ridiculous.

We often compare pregnancy and childbirth to marathons or athletic events, and the amount of energy expenditure required. Even athletes—professional athletes, or those of us who participated in sports growing up—are encouraged to have significant recovery time and to be well rested.

That is simply not the case for many mothers and birthing parents.

So we need to ask: is this six-to-eight-week clinical definition still valid today, in 2026? Is it serving mothers and birthing parents? And is it serving us—especially the clinicians providing care?

By clinicians, I don’t just mean OB-GYNs. I mean midwives, nurses, family doctors, general practitioners, physical therapists, nutritionists—all clinicians. You know who you are. And also our non-clinical partners, such as doulas, nannies, babysitters, and confinement nannies within Asian cultural postpartum practices.

We need to seriously ask whether this six-to-eight-week definition is still valid.

To do that, we also need to go back in time and ask: where did this six-to-eight-week definition come from?

We live in a time that is very data-driven and evidence-based. To change a guideline, you are often required to show extensive proof. But where did this timeframe originate? Were there studies done in the past proving that recovery only takes six to eight weeks?

When you actually break things down—changes to the heart, changes to the hematological system, blood vessels, hair, skin, lochia (which is the vaginal discharge after childbirth), changes to the vagina, pelvic floor, abdominal muscles, the brain, breasts, muscles, and bones—you see that each system recovers on a very different timeline.

Looking across these systemic and organ changes, there is a huge variation in how long it takes to return to a pre-pregnancy state. So why do we still say six to eight weeks?

I tried very hard to find solid evidence or data pointing to who decided on this timeframe, and I could not find a clear answer.

The most insightful conversation I had was with a midwife researcher, Dr Andrew Simon, who is now retired and was previously with the University of Dundee in the UK. A lovely man—I really enjoyed our conversations. I asked him directly why the postpartum period was defined as six to eight weeks.

Even he could not provide a definitive source. The best explanation he offered was that the origin of the six-to-eight-week postpartum timeframe may come from a traditional Catholic ritual. Historically, around four to six weeks after childbirth, mothers would attend a church ceremony for purification and thanksgiving for the safe delivery of the baby.

This blessing ritual appears to be the most plausible origin.

And when you hear that, it kind of clicks.

Which means—and I’m being very blunt here—that even in our modern Western medical system, the six-to-eight-week postpartum definition is very likely rooted in a religious tradition. This is not surprising when we consider how modern medicine evolved from historical Western practices.

This is not a history lesson, and I’m not a historian, but we know enough to recognize that many scientific and medical frameworks evolved from older traditions.

So let’s pause and think. Six to eight weeks is not enough based on what we now know about postpartum.

Postpartum does not only affect the mother-infant dyad. It affects the birthing parent, the non-birthing parent, fathers, adoptive parents, and families formed through surrogacy. There is still a postpartum experience because it is about the arrival of a child, regardless of how that child is born.

During this time, there are social, physical, and physiological changes. Physiological meaning how your body responds as you engage with and care for your child.

We’ll explore this further in future episodes.

So I want you—especially those of you who are clinicians or who sit on boards influencing policy—to challenge this definition. Let’s work toward redefining the postpartum period.

My proposal is simple: postpartum should last up to two years.

This is not based solely on social media trends suggesting postpartum should be two years. There is a strong public health and early childhood development rationale.

Briefly, consider the first 1000 days of life. This concept spans from conception until the child is two years old. If we can provide the best environment—nutrition, care, and support—during these first 1000 days, children have a significantly higher chance of thriving mentally, physically, socially, and even economically later in life.

Redefining postpartum as two years directly aligns with this framework. Supporting parents during the child’s first two years allows us to optimize outcomes for the entire family, regardless of family structure.

This is why two years makes sense.

It also aligns with the WHO recommendation of waiting at least 18 months between pregnancies. It gives mothers and birthing parents time to recover physically, physiologically, and mentally, and to prepare for future changes or future children.

It does not rush families into having more children.

Yes, in the past people did things differently—but we didn’t know better. Pregnant women smoked. People smoked around pregnant women. Thalidomide was given to pregnant women before we understood its effects. Practices change as knowledge evolves.

That is the beauty of science and modernity: identifying what is not working and making changes.

We do not need to wait for more evidence. The evidence is already there—scientific and social. Parents, especially new parents, are asking for more support. We see this reflected in decisions to delay having children or not have children at all.

If we don’t change our clinical definitions and healthcare perspectives, no amount of funding will fix postpartum or birth-rate issues. The root problem is that we still treat postpartum as only six to eight weeks, requiring little thought beyond that.

I hope this episode has been an eye-opener, or at least confirmed what you already feel—that six to eight weeks is not enough.

I will upload images of the slides I referenced in this episode and also provide access to the Lancet paper. I’ll upload them directly to my free membership vault so you can download them easily.

If you have thoughts, please comment wherever you’re listening or send me an email. I’m sure many of you have insights to share. When I presented this to my peers, many of whom are parents of young children or teenagers, it immediately resonated.

As with all change, we need collective momentum. I hope this change comes sooner rather than later.

If this episode has inspired you and you’d like to collaborate, please reach out. I’m always open to that when my schedule allows.

Thank you so much for listening, and I’ll see you in the next episode.

Take care.