Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
CHAPTER 7: Routine Postpartum Care for the Woman
It is usually a joyful event when a woman gives birth to a baby she wants. Despite the pain and
discomfort, birth is the long-awaited culmination of pregnancy and the start of a new life.
However, birth is also a critical time for the health of the mother and her baby. Problems may
arise that, if not treated promptly and effectively, can lead to ill health and even death for one or
both of them. Nonetheless, the postpartum period is often neglected by maternity care. The lack
of postpartum care ignores the fact that the majority of maternal deaths and disabilities occur
during the postpartum period and that early neonatal mortality remains high.
Postpartum care needs to be a collaborative effort between the woman, her family, community
health workers, facility health care providers, health care managers, community groups, and
policy makers. All members need to be informed of the components of quality postpartum care.
In spite of the fact that so many deaths occur in the postpartum, very few women seek care and
very few providers offer early postpartum services. Providers must offer quality services to
ensure that women use these essential services that can substantially improve their chance of
survival.
This section covers various components of postpartum care. Individual Ministries of Health and
implementing organizations can determine by consensus the priorities to be covered, especially
in the early phases of implementation, depending on funds and time available for training,
follow-up supervision, and monitoring and evaluation.
MALE INVOLVEMENT
In most communities, it is not traditional for men to be included in postpartum and newborn
care, but where men have been encouraged to participate, they have shown that they are willing
to do so. It may take several years before this becomes routine, but vaccination and homebased
child health records also took several years to establish. Even small or busy clinics can
be encouraged to identify a space (even the porch) where men can feel comfortable to wait and
receive information from a trained male staff member about sex in the postpartum and the risk
that unprotected sex outside the marriage holds for their baby, their wife, and themselves.
Both men and women should be aware of the following facts:
• Sexual relations may be resumed as soon as it is comfortable for the woman and she is
ready for it. The couple should use condoms when having sex, particularly if the woman
still has lochia.
• The early weeks of breastfeeding are times when women are at particular risk of
becoming infected with HIV for the following reasons:
o Men may have sex with partners other than their spouse(s) during the period of
pregnancy and childbirth-related abstinence at home.
o Women are more susceptible to HIV for a range of biological reasons at this time.
• The risk of MTCT is much higher when the woman is newly infected with a very high
viral load.
• Mixed feeding carries particular risks for MTCT of HIV and other newborn infections.
Integrated maternal and newborn care
Basic skills course
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