From the Guidelines
A 2-week postpartum visit should prioritize assessing the genitourinary system, including bowel and urinary function, uterine tenderness, pelvic floor dysfunction, and perineal pain, as recommended by the most recent study in The Lancet Global Health 1. The key components to cover during this visit include:
- Assessing for predisposing and precipitating factors for pelvic floor disorders
- Evaluating bowel and urinary function, including the presence of faecal or urinary incontinence
- Checking for uterine tenderness, lochia, or symptoms of inflammation
- Assessing for pelvic floor dysfunction
- Inquiring about vaginal discharge or bleeding
- Evaluating perineal pain and hygiene
- Examining perineal or vaginal tears and the healing of any perineal wound
- Discussing the resumption of sexual intercourse and the presence of dyspareunia, as outlined in the recommended practices for health providers 1. This comprehensive assessment is crucial for identifying potential complications and providing appropriate support and guidance for new mothers, as emphasized in the latest research 1.
From the Research
Key Components of a 2-Week Postpartum Visit
The key components to cover during a 2-week postpartum visit include:
- Physical examination focused on patient symptoms and pregnancy complications 2
- Evaluation of mother's mood, mother-to-child relationship, and breastfeeding troubles 2
- Discussion of contraception and family planning 2
- Promotion of tobacco, alcohol, and illicit drug cessation 2
- Screening for depression using the Edinburgh Postnatal Depression Scale (EPDS) 3
- Assessment of weight loss and encouragement to reach preconceptional weight within 6 months after delivery 2
- Pelvic-floor rehabilitation if urinary or fecal incontinence persists 2
Benefits of Early Postpartum Visits
Studies have shown that scheduling a 2- to 3-week postpartum visit can result in higher visit attendance compared to scheduling a 6-week visit 4 Early postpartum visits can also increase the likelihood of patients attending comprehensive visits 3 Additionally, early visits can provide an opportunity to identify and address postpartum depression and other complications earlier 3, 5
Considerations for High-Risk Patients
For patients with a history of venous thromboembolism, thromboprophylaxis should be considered during the postpartum period 6 Women with a history of pre-eclampsia, intrauterine growth restriction, or intrauterine fetal death should be screened for antiphospholipid antibodies 2 Patients with persistent proteinuria and/or hypertension 3 months after pre-eclampsia should be referred to a nephrologist 2