Clinical Edge

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Guidance for Optimizing Postpartum Care

Obstet Gynecol; ePub 2016 Jun; Stuebe, Border, et al

The American College of Obstetricians and Gynecologists’ (ACOG) Committee on Obstetric Practice has issued a committee opinion on optimizing postpartum care, recommending that anticipatory guidance should begin during pregnancy and that during the postpartum period, a single health care practice should ideally assume responsibility for coordinating the women’s care. The ACOG also makes the following recommendations and conclusions:

• Currently, as many as 40% of women do not attend a postpartum visit. Active engagement in patient-centered, maternal postpartum care has the potential to improve outcomes for women, infants, and families and support ongoing health and well-being.

• To optimize postpartum care, anticipatory guidance should begin during pregnancy. During antenatal care, it is recommended that the patient and her obstetrician–gynecologist or other obstetric care provider formulate a postpartum care plan and identify the health care professionals who will comprise the postpartum care team for the woman and her infant.

• Ideally, during the postpartum period, a single health care practice assumes responsibility for coordinating the woman’s care.

• Early postpartum follow-up is recommended for women with hypertensive disorders of pregnancy.

• It is recommended that all women undergo a comprehensive postpartum visit within the first 6 weeks after birth.

• Systems should be in place to ensure that women who desire long-acting reversible contraception or any other form of contraception can receive it during the comprehensive postpartum visit, if immediate postpartum placement was not done earlier.

• Recommended anticipatory guidance at the postpartum visit includes infant feeding, expressing breast milk if returning to work or school, postpartum weight retention, sexuality, physical activity, and nutrition.

• Any pregnancy complications should be discussed with respect to risks for future pregnancies, and recommendations should be made to optimize maternal health during the interconception period.

• At the conclusion of the postpartum visit, the woman and her obstetrician–gynecologist or other obstetric care provider should determine who will assume primary responsibility for her ongoing care.

Citation:

Optimizing postpartum care. Committee Opinion No. 666. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2016;127:e187-92.