The World Health Organization (WHO) on Wednesday launched the first ever global guidelines to support women and newborns in the postnatal period – the first six weeks after birth.
The apex public health body noted that worldwide more than 3 in 10 women and babies do not currently receive postnatal care in the first days after birth - the period when most maternal and infant deaths occur. Meanwhile, the physical and emotional consequences of childbirth – from injuries to recurring pain and trauma - can be debilitating if unmanaged, but are often highly treatable when the right care is given at the right time.
The guidelines include recommendations for breastfeeding counselling to aid attachment and positioning as breastfeeding is established and to support parents in providing responsive care for their newborns. The guidelines include 63 recommendations, combining relevant existing recommendations with 31 that are new or updated. These are now the official WHO reference points for all aspects of postnatal care.
The WHO noted that postnatal period is a critical time to ensure the survival of both the newborn baby and mothers and for supporting healthy development of the baby as well as the mother’s overall mental and physical recovery and wellbeing.
“The need for quality maternity and newborn care does not stop once a baby is born,” said Dr Anshu Banerjee, Director of Maternal, Newborn, Child and Adolescent Health and Ageing at WHO. \
“Indeed, the birth of a baby is a life-changing moment, one that is bound by love, hope and excitement, but it can also cause unprecedented stress and anxiety. Parents need strong health care and support systems, especially women, whose needs are too often neglected when the baby comes,” Banerjee said.
The recommendations include high quality care in health facilities for all women and babies for at least 24 hours after birth, with a minimum of three additional postnatal checkups in the first six weeks. These additional contacts should include home visits if feasible, so that the health worker can support the transition to care in the home. In the case of a home birth, the first postnatal contact should occur as early as possible, and no later than 24 hours after birth, the WHO recommended.
The WHO has further recommended steps to identify and respond to danger signs needing urgent medical attention in either the woman or the baby, treatment, support and advice to aid recovery and manage common problems that women can experience after childbirth, such as perineal pain and breast engorgement. Further recommendations include screening of all newborns for eye abnormalities and hearing impairment, as well as vaccination at birth and screening for postnatal maternal depression and anxiety, with referral and management services where needed.
The recommendations detail the minimum length of hospital stay after birth and provide guidance on discharge criteria, but note that the time needed will depend on individual women and babies, social context, birth experience, and any health concerns. Additional postnatal contacts are recommended for healthy women and newborns between 48 and 72 hours, between seven and 14 days, and during week six after birth. If health risks are identified, more contacts will likely be required, with treatment needed potentially well beyond the first six weeks.
“Evidence shows that women and their families want and need a positive postnatal experience that helps them navigate the immense physical and emotional challenges that occur after their babies are born, while building their confidence as parents,” said Dr Mercedes Bonet, Medical Officer with WHO’s Department of Sexual and Reproductive Health and Research and the UN Special Programme, Human Reproduction (HRP).
“Dedicated postnatal services should provide vital physical and mental health support, while helping caregivers thrive in providing the right care for their newborns,” she added.
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