Post-partum care covers the period immediately following birth up until approximately 6 – 8 weeks. This remains a time during which immense changes occur both in the physical and, sometimes, emotional wellbeing of the woman.
Women with medical conditions pre-existing pregnancy are particularly vulnerable post-partum, with the care and communication between the hospital specialists and their general practitioners often being fragmented. In addition, it is important that women who developed a medical condition during pregnancy, such as pre-eclampsia or gestational diabetes, are followed up to ensure full resolution or monitor for any longer-term sequelae of that condition.
Post-partum care pathway
All women should receive a routine appointment with their GP within 8 weeks following birth. The NICE guideline provides information on the routine care women should receive through their GP at this appointment.
a) Women with category B or C health conditions should have a multidisciplinary plan documented prior to birth in their notes for post-partum care.
b) Medical conditions developed in pregnancy that include:
- pre-eclampsia/eclampsia,
- pregnancy-induced hypertension,
- obstetric cholestasis,
- gestational diabetes,
- acute fatty liver of pregnancy.
- thromboembolism
- peripartum cardiomyopathyMost women who develop medical conditions in pregnancy can be managed and followed up by their GP.
The following women should have a postnatal appointment at their hospital of birth or at the NCL maternal medicine centre, UCLH, within 8 weeks of birth:• All women with category C pre-existing medical conditions
- Diagnosis of preterm preeclampsia before 34 weeks’ gestation
- Obstetric cholestasis with bile acids >100
- Any woman requiring ITU admission
- Acute fatty liver of pregnancy
- Peripartum cardiomyopathy
- Thrombocytopenia (platelets <50) with haemolysis (this will include any women with HELLP, TTP, HUS)
Please click here to complete a referral form for specialist postnatal clinic appointment at the hospital of birth. If you are unsure of the hospital of birth or the woman has received care at UCLH for her medical condition, then please click on UCLH.