Chapter 9 – Preconception Care and Pregnancy

Part 3: Postnatal care

Postnatal check

The purpose of the postnatal visit is to ensure that the mother is coping well both physically and emotionally and identify early any perinatal mental health issues, assess any delays in recovery of the genital tract, assess breastfeeding, ensure that any medical issues are managed and that contraceptive needs are addressed.

Important issues in history taking

Delivery details, including gestation at delivery, mode of delivery and any complications; birth “debrief”- ensure the patient has opportunity for questions to be answered about their birth experience and any concerns addressed. General health since delivery. Do they have any concerns about their health, or that of the baby? Review any pregnancy complications such as gestational diabetes, hypertension, cholestasis or pre-eclampsia. Some pregnancy complications have implications for the future health of the mother.

Patients who have had pre-eclampsia have been shown to have a higher rate of coronary artery disease independent of other risk factors than patients who have not had pre-eclampsia, with the degree of future CVD risk comparable to traditional risk factors for coronary artery disease (see Table 9.6). Aggressive risk factor and lifestyle management is imperative for these patients to manage long term cardiovascular risk.(79)

Table 9.6 Comparative risk ratios for the main causes of coronary ... Buy now

Return of menses

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Post-natal complications

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Postnatal depression

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Postpartum sexuality

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Contraceptive advice

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