The World Health Organization (WHO) revealed that worldwide more than three in 10 women and babies do not currently receive postnatal care in the first days after birth – a critical time for ensuring newborn and maternal survival and for supporting healthy development of the baby as well as the mother’s overall mental and physical recovery and wellbeing. Meanwhile the physical and emotional consequences of childbirth – from injuries to recurring pain and trauma - can be debilitating if unmanaged, but are often highly treatable when the right care is given at the right time. With an aim to extend support and improve quality maternity and newborn care, the apex public health body recently released its first ever global guidelines to support women and newborns in the postnatal period – the first six weeks after birth.
The guidelines include recommendations for breastfeeding counselling - to aid attachment and positioning as breastfeeding is established - and to support parents in providing responsive care for their newborns.
Over 60 recommendations that help shape a positive postnatal experience for women, babies and families.
These include:
• High quality care in health facilities for all women and babies for at least 24 hours after birth, with a minimum of three additional postnatal checkups in the first six weeks. These additional contacts should include home visits if feasible, so that the health worker can support the transition to care in the home. In the case of a home birth, the first postnatal contact should occur as early as possible, and no later than 24 hours after birth;
• Steps to identify and respond to danger signs needing urgent medical attention in either the woman or the baby;
• Treatment, support and advice to aid recovery and manage common problems that women can experience after childbirth, such as perineal pain and breast engorgement ;
• Screening of all newborns for eye abnormalities and hearing impairment, as well as vaccination at birth;
• Support to help families interact and respond to babies’ signals, providing them with close contact, warmth and comfort;
• Exclusive breastfeeding counselling, access to postnatal contraception and health promotion, including for physical activity;
• Encouragement of partner involvement, by being part of checkups, for instance, as well as providing support to the woman and attending to the newborn;
• Screening for postnatal maternal depression and anxiety, with referral and management services where needed.
The recommendations also detail the minimum length of hospital stay after birth and provide guidance on discharge criteria, but note that the time needed will depend on individual women and babies, social context, birth experience, and any health concerns. Additional postnatal contacts are recommended for healthy women and newborns between 48 and 72 hours, between seven and 14 days, and during week six after birth. If health risks are identified, more contacts will likely be required, with treatment needed potentially well beyond the first six weeks.