Clinical Guidelines in the Postpartum Period

During the postpartum period, not only is a new mother adjusting to the needs of her infant, she is also recovering mentally, physically, and emotionally. Physical challenges can include fatigue, back pain, and healing abdominal or perineal wounds. Emotionally, women are also at increased risk for depression and anxiety which may negatively impact health of the mother and infant.

Recent research evaluated 6 clinical guidelines from the United Kingdom, Australia, and the United States for the postpartum period. (The authors point out that maternity care in these countries varies.) The guidelines fit into four main themes: maternal health, maternal mental health, infant health, and breastfeeding. Only 1 of the guidelines was deemed to have enough detail to provide data about both the mother and the infant that would guide the provider regarding care. The article states that "…scarcity of comprehensive guidelines for mothers and infants is a concern because of the stress many women experience at this time, the high burden of maternal morbidity postpartum and the significant interplay between the health of the mother and infant."

This information is valuable to the rehabilitation provider as we work with women in the postpartum period. We can initiate conversations about a woman's energy levels, sleep, and nutrition. We can inquire politely about her infant, about breastfeeding and support that she has at home. Our patients can be encouraged to discuss any concerns or anxieties about her healing or about parenting. If we do not know the answer, we can seek resources or recommend that the patient consult her healthcare team. Many women are not sure how they should be feeling, physically or emotionally, and the new mother should be reassured that any concerns she has are valuable issues to discuss. If she knows that you care about her symptoms and questions, she is more likely to express concern or share information that can help guide care, including referrals to appropriate providers.

The Peripartum series is designed to help the therapist learn about prenatal and postpartum care. Join faculty member Allison Ariail at Houston in June.