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Optimizing postpartum care. Obstet Gynecol ;e— Women's Health Care Physicians. Anticipatory guidance should begin during pregnancy with development of a postpartum care plan that addresses the transition to parenthood and well-woman care. All women should ideally have contact with a maternal care provider within the first 3 weeks postpartum. The timing of the comprehensive postpartum visit should be individualized and woman centered.

The comprehensive postpartum visit should include a full assessment of physical, social, and psychological well-being. Women with pregnancies complicated by preterm birth, gestational diabetes, or hypertensive disorders of pregnancy should be counseled that these disorders are associated with a higher lifetime risk of maternal cardiometabolic disease.

Introduction The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being.

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Redefining Postpartum Care Following birth, many cultures prescribe a 30—day period of rest and recovery, with the woman and her newborn surrounded and supported by family and community members 7. Prenatal Preparation To optimize postpartum care, anticipatory guidance should begin during pregnancy with development of a postpartum care plan that addresses the transition to parenthood and well-woman care 15 Table 1. The Postpartum Care Plan Beginning during prenatal care, the woman and her obstetrician—gynecologist or other obstetric care provider should develop a postpartum care plan and care team, inclusive of family and friends who will provide social and material support in the months following birth, as well as the medical provider s , who will be primarily responsible for care of the woman and her infant after birth Transition From Intrapartum to Postpartum Care The postpartum care plan should be reviewed and updated after the woman gives birth.

The Comprehensive Postpartum Visit and Transition to Well-Woman Care Visit Timing The comprehensive postpartum visit has typically been scheduled between 4 weeks and 6 weeks after delivery, a time frame that likely reflects cultural traditions of 40 days of convalescence for women and their infants Visit Components The comprehensive postpartum visit should include a full assessment of physical, social, and psychological well-being, including the following domains Box 1 : 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.

Adverse Pregnancy Outcomes and Cardiovascular Risk There are risk factors for cardiovascular disease that appear during pregnancy, and these risk factors are emerging as an important predictor of future arteriosclerotic cardiovascular disease ASCVD risk. Chronic Health Conditions Women with chronic medical conditions, such as hypertensive disorders, obesity, diabetes, thyroid disorders, renal disease, mood disorders, and substance use disorders, should be counseled regarding the importance of timely follow-up with their obstetrician—gynecologists or primary care providers for ongoing coordination of care.

Pregnancy Loss For a woman who has experienced a miscarriage, stillbirth, or neonatal death, it is essential to ensure follow-up with an obstetrician—gynecologist or other obstetric care provider. Transition to Ongoing Well-Woman Care During the postpartum period, the woman and her obstetrician—gynecologist or other obstetric care provider should modify her postpartum care plan to identify the health care provider who will assume primary responsibility for her ongoing care in her primary medical home.

Policy and Postpartum Care Optimizing care and support for postpartum families will require policy changes. For More Information The American College of Obstetricians and Gynecologists has identified additional resources on topics related to this document that may be helpful for ob—gyns, other health care providers, and patients.

Nurs Sci Q ;— Urinary incontinence in the month postpartum period. J Perinat Educ ;— Clinical guidelines for postpartum women and infants in primary care-a systematic review. BMC Pregnancy Childbirth ; Womens Health Issues ;S13—8.

Medical Disorders in Obstetric Practice

Global, regional, and national levels and causes of maternal mortality during a systematic analysis for the Global Burden of Disease Study [published erratum appears in Lancet ;]. Lancet ;— Postnatal care: a cross-cultural and historical perspective. Arch Womens Ment Health ;— The fourth trimester: a critical transition period with unmet maternal health needs. Am J Obstet Gynecol ;— Utilization of primary and obstetric care after medically complicated pregnancies: an analysis of medical claims data.

J Gen Intern Med ;— Predictors of compliance with the postpartum visit among women living in healthy start project areas. Matern Child Health J ;—6. Reducing postpartum depressive symptoms among black and Latina mothers: a randomized controlled trial. Obstet Gynecol ;—9.

An intervention to extend breastfeeding among black and Latina mothers after delivery. Am J Obstet Gynecol ; Postnatal care. Quality standard. Manchester: NICE; Views of women and clinicians on postpartum preparation and recovery. Matern Child Health J ;— Birth spacing and risk of adverse perinatal outcomes: a meta-analysis.

JAMA ;— Family planning in a healthy, married population: operationalizing the human rights approach in an Israeli health service setting. Am J Public Health ;—3. Shared decision making—pinnacle of patient-centered care.

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N Engl J Med ;—1. Report of a WHO technical consultation on birth spacing. Geneva: WHO; Sterilization of Women: Ethical Issues and Considerations. Long-acting reversible contraception statement of principles. The views of mothers and GPs about postpartum care in Australian general practice.

Optimizing Postpartum Care - ACOG

BMC Fam Pract ; Hypertension in pregnancy. Hypertensive disorders in pregnancy. Guideline summary. Timing and Risk Factors of Postpartum Stroke. Maternal, newborn, child and adolescent health. Prevalence and risk factors for early, undesired weaning attributed to lactation dysfunction.


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J Womens Health Larchmt ;— Implementation and randomized controlled trial evaluation of universal postnatal nurse home visiting. Am J Public Health ; suppl 1 :S— Telephone support for women during pregnancy and the first six weeks postpartum. The editor has succeeded in his aim to make the book a model of clarity" Aus. Reviews of the Second Edition I found de Swiet's work an excellent textbook that will serve obstetricians and internists well as an authoritative reference. Liddle Margaret R. If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account.

If the address matches an existing account you will receive an email with instructions to retrieve your username. Skip to Main Content. First published: 1 January Walker and Marc A. Approach to the use of glucocorticoids in pregnancy for nonobstetric indications Kenneth K. Chen and Raymond O. Chien and Silvia Degli Esposti. Approach to fetal assessment, optimization of neonatal outcome, mode of delivery and timing for nonobstetric readers Michael Peek, George J.

Mangos and Mark A.

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Promoting safe care for women with medical problems during pregnancy Raymond O. Powrie, James A. It covers many aspects of medical diseases and problems in pregnancy. I would definitely use this book as a reference and I do recommend it to others. Undetected location. NO YES. About the Author Permissions Table of contents Reviews. Selected type: Hardcover. Added to Your Shopping Cart. View on Wiley Online Library. This is a dummy description. Pregnancy affects the physiology of women as their bodies adapt to the growing life within them; but how does this affect how you manage general, or pre-existing medical complaints?

Permissions Request permission to reuse content from this site. Table of contents List of contributors. Thyroid disease in pregnancy Erin Keely and Brian M. Pituitary and adrenal disease in pregnancy Mark E.


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