PP-022 A comprehensive review of major guidelines on postnatal care

The aim of this study was to review and compare the most recently published influential guidelines on postnatal care practices, as the ongoing health care provision of both the mother and her offspring helps to timely identify and effectively manage any arising complications and therefore secure maternal and infant short- and long-term well-being.

A comprehensive review of guidelines from the American College of Obstetricians and Gynecologists, the World Health Organization, the National Institute for Health and Care Excellence, and the Public Health Agency of Canada regarding postnatal care was carried out.

All the reviewed guidelines underline the importance of postnatal health care provision, including home visits and midwifery services and the use of telemedicine for the facilitation of communication with the patient, and agree on the appropriate preparation for discharge and the discharge criteria. There is also agreement on the clinical aspects that should be evaluated at each postnatal visit, although discrepancies exist with regard to the contact schedule. In addition, there is consensus concerning the management of postnatal infections, perineal pain, fecal and urinary incontinence, and physical activity guidance. Clinicians should address mental health issues at each postnatal visit, according to all medical societies, but routine screening for depression is not recommended universally. As for the optimal interpregnancy interval, the American College of Obstetricians and Gynecologists recommends avoiding pregnancy for at least 6 months postpartum, whereas the National Institute for Health and Care Excellence recommends a 12-month interval. Discrepancies were identified with regards to the nutrition guidance, the recommended contraceptive methods, and the postpartum management of pregnancy complications. Of note, the World Health Organization is the only one to provide guidance regarding the prevention of specific infections during the postpartum period.

Although the puerperium is a critical period for the establishment of motherhood and the transition to primary care, postnatal care remains a relatively underserved aspect of maternity care. Therefore, it is crucial to develop consistent international strategies for the optimal care and support of women during this period to safely guide clinical practice and subsequently reduce maternal and neonatal morbidity.