Remarks

• The number, timing and content of postnatal care contacts should be tailored to each woman’s and newborn’s health outcomes and needs, and guided by the recommendations in this guideline, including:
• the woman’s and newborn’s physical well-being and the woman’s emotional well-being;
• the skills and confidence of the woman to care for herself and the skills and confidence of parents/ caregivers/family to care for the newborn;
• the home environment and other factors that may influence the ability to provide care for the woman and newborn in the home, and care-seeking behaviour; and
• the place of birth and the time of discharge from the health facility for a facility-based birth.
• In making this recommendation, the Guideline Development Group considered the following.
• There was insufficient evidence from randomized controlled trials on the effects of more frequent postnatal care contacts compared with less frequent contacts.
• Epidemiological data shows that most maternal and neonatal deaths occur in the first three days after birth, in particular on the day of birth, with another increase during the second week after birth.
• Transition to well-woman and well-infant care will usually occur around week six after birth, including referrals to infant immunization and family planning services.
• Postnatal care contacts, in particular during the first week, can occur at home or in outpatient services (e.g. the health facility or health worker’s office) by skilled health personnel or trained community health workers as per Recommendation 48 in this guideline, according to the preferences of women/parents/ caregivers and the organization of services as per the health system.
• Continuity of care is valued by women and health workers to establish supportive, caring and trusting relationships and improve experience of care. In settings with well-functioning midwifery programmes, midwife-led continuity-of-care models provide an opportunity to ensure continuity of postnatal care, as per Recommendation 49 in this guideline.
• Routine postnatal care contacts may be complemented by phone-based follow-up or the use of digital targeted communication, as per Recommendation 54 in this guideline.