Guidelines and Interventions Related to the Postpartum Visit for Low-Risk Postpartum Women in High and Upper Middle Income Countries
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Objectives A two-part review was undertaken to: (1) summarize current guidelines on the timing and frequency of postpartum follow-up care for generally healthy, non-high risk postpartum women and to delineate the evidence on which these guidelines are based; and, (2) summarize the results of intervention studies focused on increasing utilization of the postpartum visit for generally healthy, non-high risk postpartum women. Methods A review of guidelines from high and upper middle income countries published between 2000 and 2016 in English related to non-high risk postpartum follow-up visits was conducted in 2014–2016 using four databases and additional sources. In addition, articles published between 1990 and 2016 which evaluated interventions from high to upper middle income countries related to increasing attendance at the postpartum visit were gathered using three databases. Results This review located eight guidelines, all of which relied on expert opinion/group consensus as the evidence for their recommendations regarding the timing of the postpartum visit. The review located 19 intervention studies focused on increasing use of the postpartum visit; in 12 there was statistically significant evidence that these approaches improved utilization. However, no intervention strategy was evaluated more than a few times and many of the evaluations were relatively dated. Conclusions Guidelines for the timing of the postpartum visit are variable and are typically based on weak evidence; however, there is support for increased flexibility to meet women’s needs. Additionally, while there is a diverse set of promising interventions to increase utilization of the postpartum visit, there is limited evaluative information. Future initiatives should focus on more rigorous evaluation.
KeywordsPostpartum follow-up care Guidelines Antenatal and postnatal interventions Postpartum visit
The authors would like to thank Gwen Smith and Linda Wheal of the Illinois Department of Healthcare and Family Services for their support for the project on which this paper is based. The authors would also like to thank Tierra Williams for her work collecting articles for this review. This document was developed under grant CFDA 93.767 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. However these contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume endorsement by the Federal Government.
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