Subject: Returning Postpartum Clinic Visits

POLICY: Postpartum care in The Birth Center continues for the six week postpartum period of care.  This policy refers to routine care.  Emergency care has been covered in another policy.  Routine care in the postpartum period decreases the possibility of emergencies for mother and infant.  All clients will have access to telephone contact with a midwife for the duration of their postpartum period and will have follow up visits as needed to assure the health and welfare of mother and infant.

GUIDELINES: 1. Women will be seen in office at 48 hours following delivery with their baby, then a visit at one week post birth, two weeks post birth, and six weeks post birth.   If they have had hospital delivery, they will be seen in office following discharge, and continue the normal schedule of visits.  Each visit will encompass the following key elements of postpartum care:

·         Breastfeeding

·         Involution

·         breast care

·         fever

·         s/s infection

·         lochia/ blood loss

·         pain

·         blood pressure/ s/s postpartum hypertension and headache

·         mood changes

·         s/s danger, warning signs

2.  The practice has 24-hour on-call coverage to respond to any postpartum emergent need.  Some emergencies may be handled in office, or the client may be referred out to ED care or referral to OB care or Primary Physician as indicated.

PROCEDURE: 1.  Vital signs will be done with care taken to watch for signs of increased blood pressure, temperature, or heart rate.

2.  Mothers will be made comfortable in the triage room or

other area where the mother and infant diad can breastfeed comfortably.

                    3.  The mother will be asked questions as they pertain to

 the

post-partum form (attached).  Mothers will be allowed to take the time to explain their concerns and questions. 

    4.  The mother will have an examination appropriate to her

        Post-partum stage and her recovery process.

                    5.  The infant will receive a full examination at the 2 day, 1

                        week, and 2 week examinations as well. 

                    6.  Referrals will be made as appropriate to other health care

providers including IBCLC’s

                    7.  All portions of the post-partum form will be completed as

                        appropriate.