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Obstetrical & Gynecological Survey Feb 2024Postnatal care refers to the ongoing health care provision of both the mother and her offspring and contributes to the timely identification and effective management of... (Review)
Review
IMPORTANCE
Postnatal care refers to the ongoing health care provision of both the mother and her offspring and contributes to the timely identification and effective management of complications in the postpartum period, to secure maternal and infant short- and long-term well-being.
OBJECTIVE
The aim of this study was to review and compare the most recently published influential guidelines on postnatal care practices.
EVIDENCE ACQUISITION
A comparative review of guidelines from the American College of Obstetricians and Gynecologists, the World Health Organization, the National Institute for Health and Care Excellence, and the Public Health Agency of Canada regarding postnatal care was conducted.
RESULTS
There is a consensus among the reviewed guidelines regarding the importance of health care provision in the postpartum period, including home visits and midwifery services, the use of telemedicine for the facilitation of communication with the patient, and the appropriate preparation for discharge, as well as the discharge criteria. All medical societies also agree on the clinical aspects that should be evaluated at each postnatal visit, although discrepancies exist with regard to the contact schedule. In addition, there is consistency regarding the management of postpartum infections, perineal pain, fecal and urinary incontinence, and physical activity guidance. Mental health issues should be addressed at each postnatal visit, according to all guidelines, but there is disagreement regarding routine screening for depression. As for the optimal interpregnancy interval, the American College of Obstetricians and Gynecologists recommends avoiding pregnancy for at least 6 months postpartum, whereas the National Institute for Health and Care Excellence recommends a 12-month interval. There is no common pathway regarding the recommended contraceptive methods, the nutrition guidance, and the postpartum management of pregnancy complications. Of note, the World Health Organization alone provides recommendations concerning the prevention of specific infections during the postnatal period.
CONCLUSIONS
Postnatal care remains a relatively underserved aspect of maternity care, although the puerperium is a critical period for the establishment of motherhood and the transition to primary care. Thus, the development of consistent international protocols for the optimal care and support of women during the postnatal period seems of insurmountable importance to safely guide clinical practice and subsequently reduce maternal and neonatal morbidity.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Postnatal Care; Maternal Health Services; Postpartum Period; Contraception; Obstetrics
PubMed: 38377454
DOI: 10.1097/OGX.0000000000001224 -
Journal of Obstetric, Gynecologic, and... Jan 2019
Topics: Female; Humans; Postnatal Care; Postpartum Period; Quality Improvement; United States; Women's Health; Women's Health Services
PubMed: 30543765
DOI: 10.1016/j.jogn.2018.12.001 -
Archives of Women's Mental Health Dec 2010Childbirth and the immediate postpartum period represent a major transition in a woman's life. This period is considered a vulnerable time for the mother and child in... (Review)
Review
Childbirth and the immediate postpartum period represent a major transition in a woman's life. This period is considered a vulnerable time for the mother and child in most societies, and rituals for this transition are common. In this study, we present some examples of postpartum customs in a cross-cultural and historical perspective. Also, we present the current knowledge on the possible impact of postnatal care on mental health. Systematic literature searches were performed in Medline, PsycINFO, and the Science Citation Index Expanded (ISI) for the time period 1966 through May 2010. Reference lists in books on pregnancy and childbirth from the University Library in Oslo were used to obtain additional information. We found that the postnatal period seems to be universally defined as 40 days. Most cultures have special postnatal customs, including special diet, isolation, rest, and assistance for the mother. The uniformity of customs across different cultures is striking. However, many postnatal customs that were common before 1950 are no longer existent. The focus on rest and assistance for the mother after delivery has gradually decreased. Studies of associations of postnatal care and mental health in the mother are limited and show inconsistent results. More knowledge is needed on postnatal care and mental health.
Topics: Adult; Cross-Cultural Comparison; Diet; Female; History, 20th Century; History, 21st Century; Humans; Mental Health; Mothers; Postnatal Care; Pregnancy; Rest
PubMed: 20680363
DOI: 10.1007/s00737-010-0175-1 -
Obstetrics and Gynecology May 2018The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being. To optimize the health of women and...
The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being. To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman's individual needs. It is recommended that all women have contact with their obstetrician-gynecologists or other obstetric care providers within the first 3 weeks postpartum. This initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth. The comprehensive postpartum visit should include a full assessment of physical, social, and psychological well-being, including the following domains: mood and emotional well-being; infant care and feeding; sexuality, contraception, and birth spacing; sleep and fatigue; physical recovery from birth; chronic disease management; and health maintenance. Women with chronic medical conditions such as hypertensive disorders, obesity, diabetes, thyroid disorders, renal disease, and mood disorders should be counseled regarding the importance of timely follow-up with their obstetrician-gynecologists or primary care providers for ongoing coordination of care. During the postpartum period, the woman and her obstetrician-gynecologist or other obstetric care provider should identify the health care provider who will assume primary responsibility for her ongoing care in her primary medical home. Optimizing care and support for postpartum families will require policy changes. Changes in the scope of postpartum care should be facilitated by reimbursement policies that support postpartum care as an ongoing process, rather than an isolated visit. Obstetrician-gynecologists and other obstetric care providers should be in the forefront of policy efforts to enable all women to recover from birth and nurture their infants. This Committee Opinion has been revised to reinforce the importance of the "fourth trimester" and to propose a new paradigm for postpartum care.
Topics: Delivery of Health Care; Female; Health Policy; Humans; Infant, Newborn; Needs Assessment; Organizational Innovation; Postnatal Care; Pregnancy; Quality Improvement
PubMed: 29683911
DOI: 10.1097/AOG.0000000000002633 -
The Canadian Journal of Nursing... Dec 2022The postnatal period remains unstandardized in terms of care and postnatal visits with a dearth of information on the experience from Canadian women.
BACKGROUND
The postnatal period remains unstandardized in terms of care and postnatal visits with a dearth of information on the experience from Canadian women.
PURPOSE
To explore (1) with whom and how often women receive postnatal follow-up visits and (2) the postnatal care experiences of Canadian mothers.
METHODS
Using a cross-sectional design, women who had given birth within the past 6 months were recruited to complete an online survey. Frequencies were computed for quantitative outcomes and thematic analysis was used for qualitative responses.
RESULTS
A total of 561 mothers completed the survey. Women saw on average 1.9 different postnatal healthcare providers, primarily family doctors (72.4%). 3.2% had no postnatal visits and 37.6% had 4 or more within 6 weeks. 76.1% women were satisfied with their postnatal care. Women's satisfactory care in the postnatal period was associated with in-person and at home follow-ups, receiving support, and receiving timely, appropriate care for self and newborn. Unsatisfactory care was associated with challenges accessing care, experiencing gaps in follow-up visits, and having unsatisfactory assessment for their own recovery.
CONCLUSION
There is considerable variation in the timing and frequency of postnatal visits. While many women are experiencing satisfactory care, women are still reporting dissatisfaction and are facing challenges.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Male; Postnatal Care; Cross-Sectional Studies; Canada; Mothers; Surveys and Questionnaires
PubMed: 34704508
DOI: 10.1177/08445621211052141 -
Nursing Standard (Royal College of... Oct 2014
Topics: Continuity of Patient Care; Female; Health Services Needs and Demand; Humans; Infant, Newborn; Midwifery; Patient Care Planning; Postnatal Care; Risk Factors; United Kingdom
PubMed: 25294462
DOI: 10.7748/ns.29.6.20.s25 -
Lancet (London, England) Jan 1999
Review
Topics: Female; Humans; Infant Welfare; Infant, Newborn; Maternal Welfare; Mother-Child Relations; Postnatal Care; Pregnancy
PubMed: 9950436
DOI: 10.1016/S0140-6736(05)74945-X -
PloS One 2021The days and weeks after childbirth are crucial for both the mother and her newborn child leading for the majority of maternal and perinatal mortalities. The World...
BACKGROUND
The days and weeks after childbirth are crucial for both the mother and her newborn child leading for the majority of maternal and perinatal mortalities. The World Health Organization recommends at least three postnatal visits within 42 days after birth. However, postnatal care utilization remains low worldwide. Quantitative findings revealed low utilization of postnatal care in Ethiopia, however, no study explored the barriers for postnatal care. This study aimed to assess the barriers to postnatal care service utilization in East Gojjam Zone, Northwest Ethiopia.
METHODS
A community-based, mixed type cross-sectional study was conducted from December 15, 2018, to February 15, 2019. The quantitative data was gathered using the interviewer-administered interviewing technique from 751 women who gave birth within one year prior to the study selected by multistage sampling. The qualitative data were collected from purposively sampled women, facility leaders, and health extension workers using in-depth interviews and focused group discussions. The quantitative and qualitative data were analyzed using logistic regression and by the thematic content analysis method, respectively.
RESULTS
The study revealed that postnatal care service utilization was 34.6%. The odds of using PNC services were greater in women aged 25-34 years and used maternity waiting home. In contrast, women who were muslim religion followers, had normal or instrumental birth, not aware of the PNC services and whose partners were not supportive of the use of MCH services were less likely to use PNC services. According to the qualitative findings, lack of awareness, traditional beliefs and religious practices, distance and transportation, environmental exposure, and waiting time were identified as barriers to PNC service utilization.
CONCLUSION AND RECOMMENDATION
The study showed low utilization of PNC services in East Gojjam zone, northwest Ethiopia. Improvements in personal health education, in construction of relevant infrastructure, and to transport, are needed to remove or reduce barriers to PNC service use in East Gojjam Zone, Northwest Ethiopia.
Topics: Adult; Cross-Sectional Studies; Delivery, Obstetric; Educational Status; Ethiopia; Facilities and Services Utilization; Female; Health Knowledge, Attitudes, Practice; Health Services Accessibility; Humans; Infant, Newborn; Logistic Models; Parturition; Postnatal Care; Pregnancy; Religion; Rural Population
PubMed: 34403425
DOI: 10.1371/journal.pone.0256176 -
The Practising Midwife Jan 2005
Review
Topics: Clinical Competence; Delivery Rooms; Female; Humans; Infant, Newborn; Midwifery; Nurse's Role; Nurse-Patient Relations; Nursing Education Research; Nursing Methodology Research; Nursing Staff, Hospital; Postnatal Care; Practice Guidelines as Topic; Pregnancy; Quality Assurance, Health Care; Students, Nursing; United Kingdom
PubMed: 15690886
DOI: No ID Found -
Midwifery May 2018
Topics: Adult; Female; Health Care Costs; Hospitals; Humans; Labor, Obstetric; Length of Stay; Nurse Midwives; Postnatal Care; Pregnancy; United Kingdom
PubMed: 29482175
DOI: 10.1016/j.midw.2018.02.006