World Health Organization Releases New Recommendations on Maternal Postnatal Experience
By Rebecca Levine, MPH
Senior Maternal Health Advisor, USAID
The postnatal phase, defined here as the first six weeks after delivery, is a critical time for mothers, newborns, partners, parents, caregivers, and families; however this period of significant transition remains the most neglected phase in quality maternal and newborn health care.
On March 30th, the World Health Organization (WHO) launched global guidance for a positive postnatal experience. A total of 63 recommendations are made.
This guideline updates and expands upon the 2014 WHO recommendations on postnatal care of the mother and newborn and are intended to inform the development of relevant national and subnational health policies, clinical protocols and programmatic guides.
This consolidation of both new and existing recommendations aims to improve the quality of essential, routine postnatal care for women and newborns in any resource setting with the ultimate goal of improving maternal and newborn health and well-being. It recognizes a “positive postnatal experience” as a significant end point for all women giving birth and their newborns, laying the platform for improved short- and long-term health and well-being.
A positive postnatal experience is defined as “one in which women, newborns, partners, parents, caregivers and families receive information, reassurance and support in a consistent manner from motivated health workers; where a resourced and flexible health system recognizes the needs of women and babies, and respects their cultural context.”
For the first time ever, the guidelines included recommendations for screening and prevention of postpartum depression and anxiety.
Recognizing that the postnatal phase is a period of significant transition characterized by changes in self-identity, the redefinition of relationships, opportunities for personal growth, and alterations to sexual behavior as women adjust to the new position both as parents and as individuals within their own cultural context, it is imperative that postnatal care includes a focus on maternal mental health and well-being.
The specific maternal mental health recommendations included are:
Screening for postpartum depression and anxiety using a validated instrument is recommended and should be accompanied by diagnostic and management services for women who screen positive.
Psychosocial and/or psychological interventions during the antenatal and postnatal period are recommended to prevent postpartum depression and anxiety.
Each recommendation also includes a detailed summary of the evidence utilized to determine the recommendations and additional considerations such as feasibility, acceptability, and resource requirements.
It is my hope that the inclusion of these recommendations for prevention of and screening for postpartum depression and anxiety in this global guidance will lead to the adoption of these services in settings around the world so that mothers everywhere receive the respectful and nurturing care they need and deserve.
Read more about the WHO recommendations here.