The postpartum period begins upon delivery of the infant; the end is often considered the six to eight weeks after delivery because the effects of pregnancy on many systems have largely returned to the prepregnancy state.

Routine postpartum care has several components, including rooming in, maternal monitoring, pain management, perineal care, and, in some cases, prophylaxis against thromboembolism and Rh alloimmunization.

Postpartum laboratory testing should be based on specific indications, not routine. Pertinent laboratory testing should be reviewed prior to discharge and appropriate immunizations should be offered.

Postpartum care should focus on identifying women at risk for significant short-term morbidity and mortality. Women with headache, new
hypertension, seizure, excessive bleeding, dyspnea or chest pain, or severely symptomatic abdomen or vulva should be evaluated promptly.

A variety of adverse sequelae may occur after delivery, including urinary retention, hemorrhoids, incontinence, neuropathy, anesthesia-related morbidity, and several types of infections.

In accordance with guidelines from multiple organizations, we screen all women for postpartum depression. Programs that combine screening and adequate support systems improve clinical outcomes in pregnant and postpartum women.


 

The contraceptive desires of the couple should be addressed prior to hospital discharge and appropriate prescriptions given.

Outpatient follow-up care should address patient mood, sexual activity, contraception, preexisting medical conditions, infant feeding method, and the timing of future visits for health care screening.

Disorders that may present after discharge or the initial postpartum visit include sexual dysfunction, mental health issues, thyroiditis, and problems with weight control.