OB Guideline 31: Postpartum Care

In-Hospital Care

Patients should be seen by an obstetrical provider every day of their hospitalization. This provider assesses for medical complications and psychosocial issues, addresses any questions or concerns, and arranges for discharge.

Each institution should have a process or program to instruct each patient regarding normal postpartum events, including instructions for the care of the:

• Breasts
• Perineum
• Bladder
• Incision and any signs of complications (if applicable)
• Infant and infant feeding (including the benefits of breastfeeding)
• Subsequent medical examinations for the birthing person and newborn

Verbal instructions should be supplemented with written instructions and reinforced by providers. The need for and timing of follow-up should be clearly communicated to the patient.

Plans for management or referral of ongoing problems should be instituted when appropriate, including evaluation of problems identified during the pregnancy. Vaccine status should be assessed and vaccinations should be initiated if indicated. Contraception should be discussed and a plan established with the patient.

After Discharge

Consideration should be given to an early follow-up postpartum visit for birthing people with medical complications or those at risk for postpartum depression, such as:

• Past episodes of depression
• Family history of mood disorder
• Unusually stressful life events¹

All birthing people, including those with an earlier visit (as above), should be advised to have contact within the first three weeks postpartum.² That visit should include a complete review of the pregnancy and events that occurred during labor, delivery, and the immediate postpartum period for the outpatient medical record if not already completed. The patient should be asked about their recent history and current symptoms. All postpartum patients should be assessed for and counseled about postpartum depression and domestic violence and should be informed about support services offered through the institution or community.³ Use of one of the validated screening tools for postpartum depression may be helpful. All appropriate contraceptive methods should be discussed and an initiation plan established. An appropriate physical exam should be performed including, at a minimum, vital signs and examination of the breasts, abdomen, pelvis, perineum, and extremities.

All pregnancy and post-partum problems needing follow up should be addressed, e.g., hypertension, diabetes, incomplete vaccination series.

1. Wisner KL, Parry BL, Piontek CM. Clinical practice. Postpartum depression. N Engl J Med. 2002;347(3):194-199. doi:10.1056/NEJMcp011542
2. ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstet Gynecol. 2018;131(5):e140-e150. Reaffirmed 2025. doi:10.1097/AOG.0000000000002633
3. Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum: ACOG Clinical Practice Guideline No. 4. Obstet Gynecol. 2023;141(6):1232-1261. doi:10.1097/AOG.0000000000005200