Postpartum Care: An Approach to the Fourth Trimester

Heather L. Paladine, Carol E. Blenning, Yorgos Strangas

Research output: Contribution to journalArticle

Abstract

The postpartum period, defined as the 12 weeks after delivery, is an important time for a new mother and her family and can be considered a fourth trimester. Outpatient postpartum care should be initiated within three weeks after delivery in person or by phone, and may require multiple contacts with the patient to fully address needs and concerns. A full assessment is recommended within 12 weeks. Care should initially focus on acute needs and risks for morbidity and mortality and then transition to care for chronic conditions and health maintenance. Complications of pregnancy, such as hypertensive disorders and gestational diabetes mellitus, affect a woman's long-term health and require specific attention. Women diagnosed with gestational diabetes should receive a 75-g two-hour fasting oral glucose tolerance test between four and 12 weeks postpartum. Patients with hypertensive disorders of pregnancy should have a blood pressure check performed within seven days of delivery. All women should have a biopsychosocial assessment (e.g., depression, intimate partner violence) screening in the postpartum period, and preventive counseling should be offered to women at high risk. Additional patient concerns may include urinary incontinence, constipation, breastfeeding, sexuality, and contraception. Treating these issues during the postpartum period is important to the new mother's immediate and long-term health.

Original languageEnglish (US)
Pages (from-to)485-491
Number of pages7
JournalAmerican family physician
Volume100
Issue number8
StatePublished - Oct 15 2019

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Postnatal Care
Postpartum Period
Gestational Diabetes
Health
Mothers
Pregnancy Complications
Urinary Incontinence
Sexuality
Constipation
Ambulatory Care
Glucose Tolerance Test
Breast Feeding
Contraception
Counseling
Fasting
Depression
Blood Pressure
Morbidity
Pregnancy
Mortality

ASJC Scopus subject areas

  • Family Practice

Cite this

Postpartum Care : An Approach to the Fourth Trimester. / Paladine, Heather L.; Blenning, Carol E.; Strangas, Yorgos.

In: American family physician, Vol. 100, No. 8, 15.10.2019, p. 485-491.

Research output: Contribution to journalArticle

Paladine, HL, Blenning, CE & Strangas, Y 2019, 'Postpartum Care: An Approach to the Fourth Trimester', American family physician, vol. 100, no. 8, pp. 485-491.
Paladine, Heather L. ; Blenning, Carol E. ; Strangas, Yorgos. / Postpartum Care : An Approach to the Fourth Trimester. In: American family physician. 2019 ; Vol. 100, No. 8. pp. 485-491.
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