Optimizing Postpartum Care

ACOG Committee Opinion No. 736. American College of Obstetricians and Gynecologists. Obstet Gynecol
2018;131:e140–50.

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.

Optimizing Postpartum Care, May 2018

https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-
Obstetric-Practice/Optimizing-Postpartum-Care?IsMobileSet=false

Retrieved on February 26, 2020

Review Analysis

In an Analytic Study of Postpartum Health Care Service Utilization in the Philippines, 77

postpartum women from 3 hours to six weeks post-delivery with no complications were enrolled
in this study, which was conducted from January to March, 2013.

This study found the following: participants did not receive postpartum health care services at
the appropriate time, those who delivered at home utilized fewer health care services after
delivery compared to those who delivered at medical facilities, and they had a poor overall
understanding of postpartum health issues.

In the Philippines, postpartum health care guidance may be inadequate due to the large
number of deliveries, few skilled birth attendants, and short post-delivery stays at perinatal
medical facilities. As a result, postpartum women may have less knowledge of postpartum issues
and receive fewer postpartum health care services. WHO reported that the first 24 to 48 hours are
the most critical time for postpartum woman. Therefore, it is important to address women’s
knowledge of the postpartum period and related health issues and provide adequate postpartum
health care guidance.

In the Philippines, 40% of women deliver at home with the assistance of traditional birth
attendants rather than medical professionals due to a lack of money and access to medical
facilities. Postpartum women who deliver at home may not have the opportunity to utilize health
care services. Further research will be necessary to focus on postpartum health care services for
women who deliver at home. In the Philippines, there are few skilled birth attendants and a
general lack of guidance regarding health care after delivery due to the large number of
deliveries and short post-delivery stays at perinatal medical facilities. Therefore, it may be
effective to utilize Barangay health workers as health care providers.
 REVIEW ANALYSIS
OF AN ARTICLE
RELATED TO
POSTPARTUM
CARE

Submitted By:

Pascual, Mia Zabelle V.

BSN 2D- Group 3B

Submitted To:

Mrs. Fritzie Dela Cruz, RN, MAN

Level 2 Clinical Instructor