Current Guidelines for Postpartum Care

Of all mentioned benefits and risks involved in postpartum management, the most common guidelines exist for hemorrhage, depression, postnatal care, maternal-newborn discharge, and postpartum contraception. These are briefly listed here with quick-links included for closer examination. Major recommendations listed here are based on the highest level of evidence for treatment with each of the conditions.

Treatment of Postpartum Hemorrhage

• Uterotonic agents should be the first-line treatment for postpartum hemorrhage due to uterine atony.
• Management may vary greatly among patients, depending on etiology and available treatment options, and often a multidisciplinary approach is required.
• When uterotonics fail following vaginal delivery, exploratory laparotomy is the next step.
• In the presence of conditions known to be associated with placenta accreta, the obstetric care provider must have a high clinical suspicion and take appropriate precautions.

Interventions for Postpartum Depression

• Prevention
• Confirming depressive symptoms
• Treatment
• General recommendations
• Education recommendations
• Organization and policy recommendations

Routine Postnatal Care of Women and Their Babies

• Planning the content and delivery of care
• Maintaining maternal health
• Infant feeding
• Maintaining infant health

Breastfeeding Best Practice Guidelines for Nurses

• Exclusive breastfeeding for first 6 months to 2 years
• Peer support and resources for education on breastfeeding

Postpartum Maternal and Newborn Discharge

• Social and medical history
• Essential Assessments: dental and nutritional health, physical/sexual activity, alcohol/drug abuse, tobacco use, domestic abuse, environment, genetic risk factors, medications, transportation, seat-belt use, infant car seat use, childbirth education, adequate social support, coping skills, financial resources, knowledge of available resources, mental health, depression screening, and patient ability to comprehend information care.
• Education and counseling
• Blood pressure, weight, body mass index (BMI), fundal height
• Pelvic exam
• General physical exam

Contraception During Breastfeeding

• Ovulation may occur 3 weeks after postpartum
• LAM (Lactation, Amenorrhea, Bleed) methodology, although effective, is only 95% reliable

Reference:

All titles retrieved from: www.guideline.gov/summary/summary.aspx?

Submitted by: Paula Serrano