Postnatal Care

Introduction

Postnatal care (PNC) is the care given to the mother and her newborn baby immediately after the birth and for the first six weeks of life. This period marks the establishment of a new phase of family life for women and their partners and the beginning of the lifelong health record for newborn babies (or neonates — a term often used by doctors, nurses and midwives). Although for most women and babies, the postnatal period is uncomplicated, effective postnatal care (PNC) is also about recognising any deviation from expected recovery after birth, and evaluating and intervening appropriately in a timely fashion.

Your role as a Health Extension Practitioner is therefore vitally important in improving this situation, identifying danger signs and reducing the adverse outcomes for mothers and newborns. In all countries, the postnatal period is often marked by specific cultural practices. Understanding the beliefs and cultural practices in your community is fundamental in ensuring appropriate postnatal care. In this first study session, you will learn why care in the postnatal period is so important, and about the need for community participation and involvement for optimum PNC. We briefly summarise some methods of community mobilisation, and how to establish partnerships with the key gatekeepers who can help you look after new mothers and their babies.

Why is effective postnatal care so important?

The time when effective postnatal care can make the most difference to the health and life chances of mothers and newborns is in the early neonatal period, the time just after the delivery and through the first seven days of life. However, the whole of the neonatal period, from birth to the 28th day after the birth, is a time of increased risk. Deaths during the first 28 days of babies who were born alive is reported by all countries in the world as the neonatal mortality rate (the number of babies who die in the first 28 days) per 1,000 live births. Similarly, reports of maternal mortality include deaths of women from complications associated with postnatal problems, not just problems arising during the birth. Both these rates are important indicators of the effectiveness of postnatal care.

When do most mothers and newborns die in the postnatal period?

Mothers and their newborn babies are at highest risk of dying during the early neonatal period, especially in the first 24 hours following birth and over the first seven days after delivery . As you can see from the table, 45-50% of the mothers and newborns who die do so in the first 24 hours after birth, and 65-75% of the maternal and neonatal deaths occur within one week of birth. This is compelling evidence to provide optimum and integrated maternal and newborn care during the first few days after delivery.

What do mothers and newborns in the postnatal period die from?

The main purpose of providing optimal postnatal care is to avert both maternal and neonatal death, as well as long-term complications. To be effective you therefore need to know the major causes of death in the postnatal period, so that you can provide quality and timely postnatal care at the domestic and Health Post level.