Photo courtesy of Amanda Bacon, Bits O’ Bacon Photography

Postpartum Mesh Underwear Is Having A Moment

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They arrive in your life amid those confusing, bleary-eyed first postpartum days when you’re feeling sore, exhausted, moody and trying to figure out how to keep a child alive and fed, all while dealing with the equivalent of the longest period of your life. Postpartum mesh underwear look like fish netting that was cut into the shape of high-waisted boy shorts, and because there’s no elastic, they comfortably stretch over your hips and stomach and won’t press against any tender areas or incisions. The hospital-issued version are also disposable, eliminating the hassle of dealing with leakage. So while they may not look like much, they’re actually a kind of a saving grace that makes life more bearable during a time when you’re at your most vulnerable.

They also suffer from an accessibility issue. After running out of postpartum mesh underwear after the birth of my second child in 2017, I went to several pharmacies and a Target, naively thinking surely one of my local stores would have the goods. Coming up with nothing, I made a desperate trip back to the hospital I had checked out of just a couple days prior, but they would only give me one measly pair of disposable underwear since I was no longer a patient. In the end I decided to wear each of my remaining pairs for several days (since the hospital-issued ones come with no instructions, it’s hard to say how long you’re supposed to wear them).

Those in the know will tell you to take as many pairs as you can from the hospital.

In the last few years, mesh underwear have been embraced as a symbol for postpartum health and identity. In 2016, there was “The Secret, Magic Underwear That Only Moms Know About,” writer Edan Lepucki’s ode to postpartum mesh underwear in The Cut. In 2017 and 2018, celebrities leveraged their followings to get the word out. Kristen Bell used the hashtag #meshpanties to talk about her birth and postpartum experience. Comedian Ali Wong compared the underwear to netting-wrapped Korean pears. Then Chrissy Teigen referenced Korean pears while posing in the underwear, and other celebrities like Jessica Alba, Jamie King and Jordin Sparks clapped back, extolling the garment’s virtues. After giving birth this year, Amy Schumer even decided to take a walk outside in them to raise awareness of the realities of the postpartum experience.

This kind of open talk is part of how women are taking charge of their health. Studies have shown that people who give birth in the U.S. do not feel adequately prepared for many different elements of postpartum recovery, with focus groups convened for a paper in Obstetrics & Gynecology citing a lack of knowledge about postpartum health, postpartum depression, incontinence, parenting skills and postpartum sexual satisfaction. Feeling unprepared is associated with early postpartum depressive symptoms and dissatisfaction with obstetric clinicians.

“If you understand what the postpartum experience is like, you go into it with more awareness and can get more prepared. I feel like maybe in return it can help with different postpartum issues like postpartum depression and anxiety,” says photographer Amanda Bacon, whose 2016 photo of herself in mesh undies went viral.

As recognition of the postpartum experience has grown, so have the number of postpartum underwear options. The Frieda Mom postpartum line, which is carried at Target, online retailers and some pharmacies, launched in August, selling disposable mesh underwear, perinatal bottles, instant ice maxi pads, perineal witch hazel cooling pad liners, witch hazel healing foam, a postpartum recovery essentials kit, and a delivery and nursing gown. In addition, medical supply companies now sell postpartum underwear online, and companies solely dedicated to making more high-end postpartum underwear (with options like nicer material, no seams, a specially made pouch for ice packs, et cetera) have also been emerging.

Even so, postpartum undies can be hard to come by at retail stores. Those in the know will tell you to take as many pairs as you can from the hospital. A friend of mine took this advice very seriously, asking every nurse she came across for a new supply. But even then it’s difficult to estimate how many you’ll need because bleeding varies in length and amount.

The people responsible for continuing the human race should not have to make do when it comes to postpartum bleeding and tissue recovery.

“You may get some at the hospital, but some women can bleed up to five or six weeks. And if you are really active, your bleeding can come back. So if you think of women that have to go back to work really fast or have other kids and don’t have other support, then it’s even more of a need,” says Edan Lepucki, author of that viral essay on postpartum underwear and some books too (Woman No. 17, California, and If You're Not Yet Like Me).

Because of this, many women struggle to piece together their postpartum hygiene routine with what’s on hand: Depends, Thinx, or maxi pads. Although these are easier to find, none are designed for the unique needs of the sensitive postpartum body. The people responsible for continuing the human race should not have to make do when it comes to postpartum bleeding and tissue recovery.

Only one study has looked at postpartum lochia through cessation. Ever. Photo credit: Shutterstock

Brief Transitions owner Mary Clavieres and PartumCare owner Sara Selbert Savov had this thought in mind when they began their companies. Meanwhile, longtime friends Mia Clarke, Aubrey Howard and Eden Laurin, were unsatisfied with the amount and variety of postpartum underwear options out there, feeling like nothing really met their needs, so they created Nyssa.

“I got frustrated that such a basic and necessary item was not available to me at a pivotal and vulnerable time in my life,” says Mary Clavieres, owner of Brief Transitions.

Although postpartum underwear has been long ignored, Clavieres said that women today are demanding better options.

“I think this hasn’t been sufficiently addressed partly because we are used to the status quo and it wasn’t really questioned, and partly because women’s voices have not been heard and given priority for a long time,” she said.

PartumCare owner Sara Selbert Savov would eventually like to see postpartum care have its own shelf space, just like menstrual products do.

“I could not figure out why no one had created something for new moms, during a time when we are the most sensitive that we’ll ever be,” she says. “If women were running hospitals and big box retail companies, postpartum underwear, and anything else related, would have its own aisle.”

Clarke, Howard and Laurin all gave birth within a year of each other in 2017, and were shocked by how little was available to help them with their postpartum recoveries.

“There are some options out there but it’s not like you can just go to your local store and get what you need for your postpartum recovery,” says co-founder Clarke.

So while Frida Mom’s new postpartum care line and the increasing number of options we have are major wins, they’re also a wake-up call for every brand that offers menstrual products to start offering postpartum mesh underwear, so we can find them easily and quickly, no matter where we shop.

This isn’t just a matter of comfort (although that’s important too). The lack of availability and dearth of options in postpartum underwear and other postpartum supplies are emblematic of the inadequate postpartum care in this country, which contributes to our horrifically high maternal mortality rate.

Blood and tissue on their own aren’t considered nearly as gross without the addition of the uterus, vagina and, of course, sexism.

The U.S. has the highest maternal mortality rate in the high-income world, with Americans three times and nine times as likely to die as Canadians and Norwegians, respectively, and black women in the U.S. three to four times more likely to experience a pregnancy-related death than white women. We lag behind many other countries when it comes to postpartum care practices that prioritize people who give birth, like knowledge preparation for postpartum recovery, in-home postpartum care possibilities, pelvic floor therapy, mandated parental leave, earlier and more frequent postpartum visits (there is some improvement due on that front, with updated postpartum visit guidelines issued by the American College of Obstetricians and Gynecologists in 2018 slowly filtering through to practices), and on the list goes.

There also need to be more studies on postpartum bleeding, or lochia. According to a systematic review on research that studied lochia patterns, only one (one!) study followed postpartum bleeding to its cessation. Reliable, consistent methods of assessment for postpartum bleeding haven’t been established either. Considering postpartum hemorrhage is one of the leading causes of maternal mortality (with 70 percent of these deaths deemed preventable), it’s especially necessary for medical workers and patients to become well versed in determining and discussing normal patterns of postpartum bleeding and signs of hemorrhage and infection.

The way we treat people who give birth can be traced to the way we treat uterine lining, discarded or otherwise, in general. It makes up the building blocks of life itself, yet with the way it’s looked upon — with disdain, shame, and often ignorance and neglect — you’d think it was some malevolent force laying in wait to get us. Blood and tissue on their own aren’t considered nearly as gross without the addition of the uterus, vagina and, of course, sexism.

That particular key ingredient clouds women’s health issues in an air of mystery, leading to a serious lack of knowledge and a plethora of adverse effects. We have period commercials with mysterious dripping blue liquid and taxes on menstrual items (while the FDA considers them medical devices, the IRS does not, so SNAP and WIC don’t cover them; meanwhile medicated condoms and Viagra are considered medicine and thus tax exempt). Women’s sexual health and wellness products are too racy for the advertising world but men’s aren’t, and vitally important products for postpartum recovery like maternity pads and postpartum underwear are generally not known about or as readily available as they should for the nearly 4 million people who give birth and experience postpartum bleeding each year. (And the potential market for postpartum underwear needn’t be contained to just the people who’ve given birth — postpartum underwear would be useful, and often has been used, for people who’ve had hysterectomies and abortions, and conditions like endometriosis and PCOS.)

The reactions Savov got when talking to pharmacies about carrying PartumCare postpartum underwear also illustrate this point.

“One person told me women do not come to pharmacies to buy underwear. Someone else asked, ‘Don’t women already own their favorite underwear?’ and when I explained they would not be able to necessarily fit comfortably into the ones at home, the response was that women buy underwear at lingerie stores,” says Savov.

It’s for a specific part of the population, but it’s a huge population of people. And people should know about them even if they’re not going to use them.

You can even see this attitude in how long it took me to get this article printed. It took months and dozens of outlets until it was accepted here. I’m not alone. Remember that viral 2016 essay that Lepucki wrote? It took her some time to place hers as well.

“When I was trying to pitch this essay, a publication said postpartum underwear does not apply to enough people — it’s not just women, it’s women who’ve had babies,” says Lepucki. “Of course it’s for a specific part of the population, but it’s a huge population of people. And people should know about them even if they’re not going to use them.”

People who give birth deserve better than this. We deserve to have our health prioritized, not just our children’s. Right now we have more choices and accessibility options when it comes to baby wipe warmers than we do for postpartum underwear.

“The idea that you could go to a drug store and buy them makes a lot of sense,” says Lepucki. “Then it moves out of the medical space and into the everyday, normalizing what it means to have a baby, (which can be pretty tough on your body no matter what kind of birth you have),”

That can have a ripple effect that could improve postpartum health for generations to come.

“It would be great if it was at every drug store, especially for women who don’t know this is what to expect after you have a baby,” says Bacon. “I know when the picture I put up went around, there were so many people saying, ‘I had no clue.’ Maybe for a mother walking down the aisle with her daughter, it would open up a conversation.”