title: Guidelines and Interventions Related to the Postpartum Visit for Low-Risk Postpartum Women in High and Upper Middle Income Countries.
abstract: 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.
authors.affiliation: UIC College of Medicine, 808 S Wood, Chicago, IL, 60612, USA. stumbra1@uic.edu.
authors.forename: Katrina
authors.initials: K
authors.lastname: Stumbras
authors.affiliation: Department of Epidemiology and Biostatistics, UIC School of Public Health, 1603 W. Taylor, Chicago, IL, 60612, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Rankin
authors.affiliation: Department of Pediatrics, UIC College of Medicine, 840 South Wood Street, Clinical Science North 440, MC 718, Chicago, IL, 60612, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Caskey
authors.affiliation: Department of Obstetrics and Gynecology, UIC College of Medicine, 840 South Wood Street, Clinical Science North 440, MC 718, Chicago, IL, 60612, USA.
authors.forename: Sadia
authors.initials: S
authors.lastname: Haider
authors.affiliation: Department of Community Health Sciences, UIC School of Public Health, 1603 W. Taylor, Chicago, IL, 60612, USA.
authors.forename: Arden
authors.initials: A
authors.lastname: Handler
mesh_terms: D000553:Ambulatory Care; D003906:Developing Countries; D005260:Female; D017408:Guidelines as Topic; D006792:House Calls; D006801:Humans; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D011181:Postnatal Care / Q000592:standards / Q000706:statistics & numerical data*; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D013997:Time Factors
keywords: Antenatal and postnatal interventions; Guidelines; Postpartum follow-up care; Postpartum visit