The World Health Organization (WHO)
Today released its first global guidelines aimed at supporting women and newborns in the postpartum period, the first six weeks after delivery. This period is critical to ensure newborn and maternal survival, support healthy infant development, and the overall physical and emotional recovery and health of the mother.
More than three in ten women and infants worldwide currently lack access to postpartum care in the first days after delivery, and the majority of maternal and infant deaths occur during this period. At the same time, the physical and emotional consequences of childbirth, from injury to recurring pain and trauma, can be increasingly debilitating if not managed, but often highly treatable if the right care is given at the right time.
Dr. Anshu Banerjee, Director of WHO’s Maternal, Newborn, Child and Adolescent Health and Ageing Division, said, “There is a constant need for quality maternal and newborn care right after the birth of a baby. Indeed, the birth of a baby is a life-changing moment, a time of love, hope and excitement, but it can also bring unprecedented levels of stress and anxiety. Parents need strong health care and support systems, especially women, whose needs are often neglected after the birth of a baby.”
In addition to coping with pressing health issues, the first few weeks postpartum are critical for building relationships and establishing behaviors that may affect the baby’s long-term development and health. The guide includes advice on breastfeeding counseling – to help find the appropriate position and location for expressing breast milk when establishing breastfeeding – and supports parents in providing targeted care for their newborns.
In all, the new guide brings together more than 60 recommendations to help shape a positive postpartum experience for women, babies and families. They include.
- Providing at least 24 hours of high-quality care in a health facility for all women and infants in the postpartum period, with at least three additional postpartum visits in the first six weeks. If feasible, these additional visits should include home visits so that health workers can help with the transition to home care. If the birth occurs at home, the first postpartum visit should be as early as possible and no later than 24 hours after delivery.
- Measures to recognize and respond to signs of danger that the woman or baby presents that require urgent medical attention
help recover and manage common problems women may experience after delivery, such as perineal pain and chest swelling, through treatment, support and advice - Screening all newborns for eye abnormalities and hearing impairments, and administering vaccinations at birth
- Providing support to facilitate family interaction and respond to signals from infants so that they can be close, warm and comfortable
- Conducting exclusive breastfeeding counseling, providing access to postpartum contraception, and promoting health, including promoting physical activity
- Encouraging partner involvement, for example, by being available for check-ups and also providing support for women and care for the newborn
- Screening for postpartum maternal depression and anxiety, and providing referral and management services when necessary.
Recommendations
Detail the minimum length of postpartum hospital stay and provide guidance on discharge criteria, but note that the time required will depend on the circumstances of each woman and baby, the social environment, the birth experience, and any health problems. For healthy women and newborns, additional postpartum checkups are recommended between 48 and 72 hours, between 7 and 14 days, and during the sixth week after delivery. If health risks are identified, additional visits may be necessary and treatment may be required well beyond the first six weeks.
Evidence shows that women and their families want and need a positive postpartum experience to help them cope with the significant physical and emotional challenges that arise after the birth of a baby, while building their confidence in parenthood,” said Dr. Mercedes Bonet, medical officer for the WHO Division of Sexual and Reproductive Health and Research and the United Nations Special Programme on Human Reproduction. Specialized postpartum services should provide important physical and mental health support while helping caregivers provide the right care for their newborns.
These recommendations complete a trilogy of WHO guidelines for quality maternal care during pregnancy, delivery and postpartum, with a focus on meeting the needs of all mothers and their babies. These uphold the right to a good health care experience, where people are treated with dignity and respect, and can actively participate in health care decision-making.”
Description
The guidelines include 63 recommendations, combining relevant recommendations that already exist with 31 new or updated recommendations, and are now the official WHO reference benchmark for all aspects of postnatal care.
