The World Health
Organization (WHO) today launched its first ever global guidelines to support women
and newborns in the postnatal period – the first six weeks after birth. This is
a critical time for ensuring newborn and maternal survival and for supporting
healthy development of the baby as well as the mother’s overall mental and
physical recovery and wellbeing.
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
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.”
In addition to addressing
immediate health concerns, these first weeks after birth are crucial for
building relationships and establishing behaviours that affect long-term infant
development and health. 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.
Over 60 recommendations
that help shape a positive postnatal experience for women, babies and families.
These 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;
● 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 ;
● Screening of all newborns for eye abnormalities and hearing impairment, as well as vaccination at birth;
● Support to help families interact and respond to babies’ signals, providing them with close contact, warmth and comfort;
● Exclusive breastfeeding counselling, access to postnatal contraception and health promotion, including for physical activity;
● Encouragement of partner involvement, by being part of checkups, for instance, as well as providing support to the woman and attending to the newborn;
● 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, HRP. “Dedicated
postnatal services should provide vital physical and mental health support,
while helping caregivers thrive in providing the right care for their
newborns.”
These recommendations
complete a trilogy of guidelines from WHO for quality maternity care through
pregnancy and during and after childbirth, centred on meeting the needs of all
those who give birth and their babies. These uphold the rights to a positive
healthcare experience, where people are treated with dignity and respect and
can participate actively in healthcare decisions.
Source: WHO