Postpartum care

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Postpartum care or postnatal care is a service provided to individuals in the postpartum period, to help with postpartum recuperation and restoration.

Contents

Traditional postpartum care

Many traditional forms of postpartum confinement exist throughout the world. Chinese Zuo Yuezi (sitting the month) and European Lying-in are examples.

Korea

Sanhujori is Korea's version of postpartum care. It draws on principles that emphasize activities and foods that keep the body warm, rest and relaxation to maximize the body's return to its normal state, maintaining cleanliness, eating nutritious foods, and peace of mind and heart. [1] The confinement period is known as samchil-il (three seven days). [2]

Modern commercial versions

Traditionally, women were taken care of by their elders: their mother, mother-in-law, sister, or aunt. The lying-in hospitals provided an institutional variation which gave women weeks of bedrest and a respite from household chores. Increasingly, these older women are unavailable or unwilling to take on this role; given the lingering effects of the one-child policy, many older Chinese women had limited experience of newborn babies, having only had one themselves. Replacements for this familial help are commercial services, both in the home and at residential centres.

At home

Agencies provide specialist carers that come to the new parents' home. This job used to be known as the monthly nurse, as she came and lived with the family for a month. Now more common terms are maternity nurse, newborn care specialist, or confinement nanny; the worker is not a registered health care professional such as the word "nurse" usually implies in current English. In Indian English the role is called a "japa maid".

A doula is best known as a birth companion, but some provide practical and emotional post-birth support. A lactation consultant and a health visitor are trained health professionals who may assist the new mother at this time. In the Netherlands, the in-home support is known as kraamzorg , and standard within the national health insurance system.

The use of yue sao, a specialist carer translated in Canada as "postpartum doula", [3] is also very common in China. Yue sao typically are live-in domestic helpers who care for both the new mother and baby for the first month after birth. Salaries as at 2017 vary from RMB8000 to RMB20000 per month depending on city and experience. [4] They are described as "mothering the mother". [5] Australian documentary-maker Aela Callan called them "Chinese supermums" but says they are colloquially known as "confinement ladies". [6]

Postpartum Care Kits

Postpartum care kits are all-in-one packages that contain several postpartum care essentials that a new mom requires right after delivery. These kits may include items like Maternity Pads, Postpartum Underwear, Peri Bottle & more depending on the brand. Postpartum Kits have become quite popular as a part of hospital bags that expecting parents prepare a few weeks before their due date. One of the major advantages of these kits is that it brings all the essentials items at one place, which makes it a very convenient option. Another benefit is that it makes new moms and expecting mothers feel more confident as they step into motherhood. Some of the popular Postpartum Kits available are as follows:

  1. Frida Mom: Chelsea Hirschhorn, the Founder & CEO of Frida (parent company) and a mom of four, launched a range of postpartum essentials dedicated to supporting women through their postpartum journey. The idea came from her personal experience and the lack of support she experienced. Consequently, she decided to overhaul the type of products that were available to women and bring forth a range of Postpartum Essentials.
  2. Bodily: Since its launch in November 2019, Bodily has established itself as a resource for women's health and bodies with products ranging from Pregnancy to Postpartum. Tova Haim, the Founder & CEO of Bodily launched the company as a response to the lack of information, cultural taboo and the lack of quality products relating to women's health. The inspiration came from her own experience after the birth of her first child. Since the initial launch, the company has also expanded as a resource for breastfeeding and pregnancy loss.
  3. Juno Mom: Juno Mom is India's 1st Postpartum Care Brand launched in 2024 by Founder & CEO, Akriti Gupta. The idea struck during her pregnancy as she sought to prepare for the journey ahead. She became fascinated by the forgotten wisdom of Postpartum Care in India & other Asian Countries. The struggle to find the right products for herself made it clear that there was a large gap that needed to be addressed. There wasn't only a lack of quality products but also a lack of information about Postpartum Care among the general consumers. Hence, the company was launched with its first product - Juno Mom's Postpartum Kit, front and center. The aim is to democratize postpartum care for all women in India and make the journey smoother.

There are several other companies like Healofy, Mama & Wish & more offering a range of postpartum essentials varying from skincare and nutrition to physical recovery products

Residential facilities

Companies have sprung up to offer extended postpartum care outside the home, sometimes in a hotel-like environment. Luxury options are a business. [7] Private postpartum care centres were introduced to Korea in 1996 under the name of sanhujoriwon . [8] Within the Chinese tradition, specialist businesses such as Red Wall Confinement Centre charge up to $27,000 for one month. [9] In Taiwan, postpartum nursing centres are popular, for those who can afford them. [10]

Birth tourism centres operating under the radar in the United States for Chinese women offer "sitting the month". [11]

Research

Modern postpartum care in Western countries is typically delivered through family, peers, professional consultants, coordinated care teams , or via information and communication technology.

Outcomes during the postpartum period that have received the most research attention include breastfeeding , greater attendance at postpartum visits, readmissions and emergency room visits, anxiety and depression , oral glucose tolerance testing, hemoglobin A1c testing and contraceptive use. [12]

Based on the 2023 meta-analysis conducted by the Patient-Centered Outcomes Research Institute, in the United States more comprehensive health insurance is likely associated with greater attendance at postpartum visits and may be associated with fewer preventable readmissions and emergency room visits. [12]

General postpartum visits

Evidence suggests that postpartum visits from home/by telephone vs. at the clinic are associated with similar levels of depression or anxiety symptoms up to 1-year post pregnancy.

There is also no reliable evidence that integration of care across multiple types of providers has an impact on depression symptoms or substance use up to 1 year post pregnancy.

Breastfeeding support

Breastfeeding support is one of the most common forms of postpartum care in both the US and Canada. Research evaluating its effectiveness has shown that peers as well as professional lactation consultants can be effective in promoting breastfeeding during the postpartum period. [12] Compared with no peer support, having peer support for breastfeeding has been found to be associated with higher rates of any breastfeeding at 1 month and 3 to 6 months and of exclusive breastfeeding at 1 month. Based on a meta-analysis of randomized control trials and nonrandomized comparison studies , peer support is not related to breastfeeding outcomes past 6 months post pregnancy. [12] Compared with no lactation consultant, breastfeeding care provided by a lactation consultant is associated with higher rates of any breastfeeding at 6 months but not at 1 month or 3 months post pregnancy. The use of information or communication technology for the delivery of breastfeeding care is not associated with higher breastfeeding rates in the months following pregnancy. [12]

Testing reminders

Provision of reminders for testing has been found to be associated with greater adherence to oralglucose tolerance testing up to 1 year postpartum but not random glucose testing or hemoglobin A1c testing. [12]

Research Limitations

Research on postpartum care is almost exclusively based on healthy postpartum individuals. Little is known about the impact of postpartum care on those individuals at high risk of postpartum complications due to chronic conditions, [13] pregnancy-related conditions [14] or systemic bias in health care provision. [15]

See also

Related Research Articles

<span class="mw-page-title-main">Postpartum depression</span> Mood disorder experienced after childbirth

Postpartum depression (PPD), also called postnatal depression, is a mood disorder experienced after childbirth, which can affect men and women. Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns. PPD can also negatively affect the newborn child.

A doula is a non-medical professional who provides guidance for the service of others and who supports another person through a significant health-related experience, such as childbirth, miscarriage, induced abortion or stillbirth, as well as non-reproductive experiences such as dying. A doula might also provide support to the client's partner, family, and friends.

<span class="mw-page-title-main">Postpartum period</span> Time period beginning after the birth of a child and extending for about one month

The postpartum period begins after childbirth and is typically considered to last for six weeks. There are three distinct phases of the postnatal period; the acute phase, lasting for six to twelve hours after birth; the subacute phase, lasting six weeks; and the delayed phase, lasting up to six months. During the delayed phase, some changes to the genitourinary system take much longer to resolve and may result in conditions such as urinary incontinence. The World Health Organization (WHO) describes the postnatal period as the most critical and yet the most neglected phase in the lives of mothers and babies; most maternal and newborn deaths occur during this period.

<span class="mw-page-title-main">Lactational amenorrhea</span> Post-partum infertility due to breast feeding

Lactational amenorrhea, also called postpartum infertility, is the temporary postnatal infertility that occurs when a woman is amenorrheic and fully breastfeeding.

<span class="mw-page-title-main">Breastfeeding difficulties</span> Medical condition

Breastfeeding difficulties refers to problems that arise from breastfeeding, the feeding of an infant or young child with milk from a woman's breasts. Although babies have a sucking reflex that enables them to suck and swallow milk, and human breast milk is usually the best source of nourishment for human infants, there are circumstances under which breastfeeding can be problematic, or even in rare instances, contraindicated.

<span class="mw-page-title-main">Breastfeeding</span> Feeding of babies or young children with milk from a womans breast

Breastfeeding, variously known as chestfeeding or nursing, is the process where breast milk is fed to a child. Breast milk may be from the breast, or may be pumped and fed to the infant. The World Health Organization (WHO) recommend that breastfeeding begin within the first hour of a baby's birth and continue as the baby wants. Health organizations, including the WHO, recommend breastfeeding exclusively for six months. This means that no other foods or drinks, other than vitamin D, are typically given. The WHO recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond. Of the 135 million babies born every year, only 42% are breastfed within the first hour of life, only 38% of mothers practice exclusive breastfeeding during the first six months, and 58% of mothers continue breastfeeding up to the age of two years and beyond.

A postpartum disorder or puerperal disorder is a disease or condition which presents primarily during the days and weeks after childbirth called the postpartum period. The postpartum period can be divided into three distinct stages: the initial or acute phase, 6–12 hours after childbirth; subacute postpartum period, which lasts two to six weeks, and the delayed postpartum period, which can last up to six months. In the subacute postpartum period, 87% to 94% of women report at least one health problem. Long term health problems are reported by 31% of women.

<span class="mw-page-title-main">Breastfeeding promotion</span> Activities and policies to promote health through breastfeeding

Breastfeeding promotion refers to coordinated activities and policies to promote health among women, newborns and infants through breastfeeding.

Dysphoric milk ejection reflex (D-MER) is a condition in which women who breastfeed develop negative emotions that begin just before the milk ejection reflex and last less than a few minutes. It is different from postpartum depression, breastfeeding aversion response (BAR), or a dislike of breastfeeding. It has been described anecdotally many times, yet one of the earliest case studies on the condition was only published in 2011, and not much research was done prior to that. Even in 2021 when the first review of published literature was done the authors noted that health care providers were still "barely [able to] recognize D-MER."

<span class="mw-page-title-main">Lactation consultant</span> Health professional

A lactation consultant is a health professional who specializes in the clinical management of breastfeeding. The International Board of Lactation Consultant Examiners (IBLCE) certifies lactation consultants who meet its criteria and have passed its exam.

Antenatal depression, also known as prenatal or perinatal depression, is a form of clinical depression that can affect a woman during pregnancy, and can be a precursor to postpartum depression if not properly treated. It is estimated that 7% to 20% of pregnant women are affected by this condition. Any form of prenatal stress felt by the mother can have negative effects on various aspects of fetal development, which can cause harm to the mother and child. Even after birth, a child born from a depressed or stressed mother feels the affects. The child is less active and can also experience emotional distress. Antenatal depression can be caused by the stress and worry that pregnancy can bring, but at a more severe level. Other triggers include unplanned pregnancy, difficulty becoming pregnant, history of abuse, and economic or family situations.

HIV in pregnancy is the presence of an HIV/AIDS infection in a woman while she is pregnant. There is a risk of HIV transmission from mother to child in three primary situations: pregnancy, childbirth, and while breastfeeding. This topic is important because the risk of viral transmission can be significantly reduced with appropriate medical intervention, and without treatment HIV/AIDS can cause significant illness and death in both the mother and child. This is exemplified by data from The Centers for Disease Control (CDC): In the United States and Puerto Rico between the years of 2014–2017, where prenatal care is generally accessible, there were 10,257 infants in the United States and Puerto Rico who were exposed to a maternal HIV infection in utero who did not become infected and 244 exposed infants who did become infected.

<span class="mw-page-title-main">Postpartum confinement</span> Cultural practice

Postpartum confinement is a traditional practice following childbirth. Those who follow these customs typically begin immediately after the birth, and the seclusion or special treatment lasts for a culturally variable length: typically for one month or 30 days, 26 days, up to 40 days, two months, or 100 days. This postnatal recuperation can include care practices in regards of "traditional health beliefs, taboos, rituals, and proscriptions." The practice used to be known as "lying-in", which, as the term suggests, centres on bed rest. In some cultures, it may be connected to taboos concerning impurity after childbirth.

This article provides a background on Nepal as a whole, with a focus on the nation's childbearing and birthing practices. While modern Western medicine has disseminated across the country to varying degrees, different regions in Nepal continue to practice obstetric and newborn care according to traditional beliefs, attitudes, and customs.

The maternal mortality rate is 224 deaths per 100,000 births, which is the 23rd highest in the world. The mean age of mothers at birth is 19.3 years old, and the fertility rate is 5.72 children born per woman, which is the 7th highest in the world. The contraceptive rate is only 40.8%, and the birth rate is the 4th highest in the world at 42.13 births/1,000 population. Infectious disease is a key contributor to the poor health of the nation, and the risk is very high for diseases such as protozoal and bacterial diarrhea, hepatitis A, typhoid fever, malaria, dengue fever, schistosomiasis, and rabies. The adult prevalence rate of HIV/AIDS is 12.37%, which is the 7th highest in the world.

<span class="mw-page-title-main">Trevor Kirczenow</span> Canadian politician

Trevor Kirczenow is a transgender health researcher and diabetes healthcare advocate. He is an author and community organizer in the field of LGBTQ lactation and infant feeding. He has run twice as a candidate for the Liberal Party of Canada.

The postpartum physiological changes are those expected changes that occur in the woman's body after childbirth, in the postpartum period. These changes mark the beginning of the return of pre-pregnancy physiology and of breastfeeding. Most of the time these postnatal changes are normal and can be managed with medication and comfort measures, but in a few situations complications may develop. Postpartum physiological changes may be different for women delivering by cesarean section. Other postpartum changes, may indicate developing complications such as, postpartum bleeding, engorged breasts, postpartum infections.

This article documents traditional and some modern childbirth practices in Korea. Korea has some special cultures in terms of childbirth. An interesting fact about Korea’s childbirth is that Korea reached 0.95% birthrate in 2019, which is the lowest among OECD countries. Most of the women go to the hospital for childbirth these days. There is a special place for the postnatal care center, which is called Sanhujori center.

<span class="mw-page-title-main">Breastfeeding and mental health</span>

Breastfeeding and mental health is the relationship between postpartum breastfeeding and the mother's and child's mental health. Research indicates breastfeeding may have positive effects on the mother's and child's mental health, though there have been conflicting studies that question the correlation and causation of breastfeeding and maternal mental health. Possible benefits include improved mood and stress levels in the mother, lower risk of postpartum depression, enhanced social emotional development in the child, stronger mother-child bonding and more. Given the benefits of breastfeeding, the World Health Organization (WHO), the European Commission for Public Health (ECPH) and the American Academy of Pediatrics (AAP) suggest exclusive breastfeeding for the first six months of life. Despite these suggestions, estimates indicate 70% of mothers breastfeed their child after birth and 13.5% of infants in the United States are exclusively breastfed. Breastfeeding promotion and support for mothers who are experiencing difficulties or early cessation in breastfeeding is considered a health priority.

<span class="mw-page-title-main">Delayed onset of lactation</span>

Delayed onset of lactation (DOL) describes the absence of copious milk secretion (onset of lactation) within the first 72 hours following childbirth. It affects around 20–40% of lactating women, the prevalence differs among distinct populations.

References

  1. ↑ Kim, Jeongeun (March 2003). "Survey on the Programs of Sanhujori Centers in Korea as the Traditional Postpartum Care Facilities". Women & Health. 38 (2): 107–117. doi:10.1300/j013v38n02_08. ISSN   0363-0242. PMID   14655798. S2CID   26722305.
  2. ↑ Dennis, Cindy-Lee; Fung, Kenneth; Grigoriadis, Sophie; Robinson, Gail Erlick; Romans, Sarah; Ross, Lori (July 2007). "Traditional Postpartum Practices and Rituals: A Qualitative Systematic Review". Women's Health. 3 (4): 487–502. doi: 10.2217/17455057.3.4.487 . ISSN   1745-5065. PMID   19804024.
  3. ↑ Quan, Douglas (January 15, 2017). "Underground industry serves moms who follow Chinese custom of 'sitting the month' after childbirth". National Post. Retrieved 28 October 2017.
  4. ↑ "Yue Sao". Ayicheng. Archived from the original on 2017-10-13. Retrieved 2017-07-24.
  5. ↑ "ownyourbirth". ownyourbirth. Archived from the original on 30 October 2018. Retrieved 17 April 2018.
  6. ↑ "China's Supermums". News. SBS (Australian TV channel) . Retrieved 17 April 2018.
  7. ↑ "Where a new baby means relaxation". NewsComAu. 21 September 2015. Retrieved 17 April 2018.
  8. ↑ Michiyo, Nomura (2016). "A Study on the Continuance and Variation of Korean Traditional Postnatal Care in a Modern Postpartum Care Center". The Korean Folklore Society. 63: 37–77. doi:10.21318/TKF.2016.05.63.37.
  9. ↑ Levin, Dan (October 2015). "Red Wall Confinement Centre". New York Times. Retrieved 2017-07-24.
  10. ↑ Yeh, Yueh-Chen; St John, Winsome; Venturato, Lorraine (1 June 2016). "Inside a Postpartum Nursing Center: Tradition and Change". Asian Nursing Research. 10 (2): 94–99. doi: 10.1016/j.anr.2016.03.001 . hdl: 10072/100393 . ISSN   1976-1317. PMID   27349665.
  11. ↑ Ni, Ching-Ching (25 March 2011). "'Birthing tourism' center in San Gabriel shut down". Los Angeles Times. Retrieved 14 April 2018.
  12. 1 2 3 4 5 6 Saldanha IJ, Adam GP, Kanaan G, Zahradnik ML, Steele DW, Danilack VA, Peahl AF, Chen KK, Stuebe AM, Balk EM. Postpartum Care up to 1 Year After Pregnancy: A Systematic Review and Meta-Analysis. Comparative Effectiveness Review No. 261. (Prepared by the Brown Evidence-based Practice Center under Contract No. 75Q80120D00001.) AHRQ Publication No. 23-EHC010. PCORI Publication No. 2023-SR-01. Rockville, MD: Agency for Healthcare Research and Quality; June 2023. doi : 10.23970/AHRQEPCCER261.
  13. ↑ Appleton, Sarah (May 2018). "Postpartum Care of Women With Chronic Health Conditions: A Review". The American College of Obstetricians and Gynecologists: 875–886.
  14. ↑ Creanga, A. A., Syverson, C., Seed, K., & Callaghan, W. M. (2017). Pregnancy-Related Mortality in the United States, 2011-2013. Obstetrics and gynecology, 130(2), 366–373. https://doi.org/10.1097/AOG.0000000000002114
  15. ↑ Williams, D. R., & Rucker, T. D. (2000). Understanding and addressing racial disparities in health care. Health care financing review, 21(4), 75–90.
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