Postpartum Maternal Care — Recovery After Delivery
Postpartum care — the medical and wellbeing support provided to the mother after childbirth — is a critical but often overlooked phase of maternity care. The physiological changes of pregnancy do not reverse immediately after delivery; many complications of pregnancy, including pre-eclampsia and postpartum haemorrhage, can manifest or worsen in the immediate postpartum period. At Balaji Horizon Women’s Hospital, structured postpartum care protocols ensure that every mother’s recovery is systematically monitored from delivery to 6 weeks.
Immediate Postpartum (0–24 Hours)
The first 2 hours after delivery are the highest-risk period for postpartum haemorrhage (PPH) — defined as blood loss ≥500 mL after vaginal delivery or ≥1000 mL after caesarean. All women receive active management of the third stage of labour (oxytocin administration, controlled cord traction, uterine massage) as standard. Blood pressure, pulse, uterine fundal height, and blood loss are monitored every 15 minutes for the first hour, then hourly. Women with significant blood loss receive IV fluids, additional uterotonics, and haemoglobin recheck. Bladder care after epidural or catheterisation is monitored to prevent urinary retention.
Days 1–7 — Transition and Early Recovery
During the first week, perineal wound healing (after episiotomy or spontaneous tears) or caesarean incision healing is assessed. Lochia (postpartum uterine discharge) is monitored for volume, colour, and odour — heavy, bright red lochia beyond 4 days or foul-smelling discharge warrants examination. Urinary symptoms (burning, frequency, inability to void) and bowel function are checked and managed. Women with pre-eclampsia continue blood pressure monitoring and antihypertensives for minimum 6 weeks postpartum as per NICE and ACOG guidance.
Anaemia Management Postpartum
Postpartum anaemia is extremely common in India. Haemoglobin is rechecked at 48–72 hours postpartum. Oral iron supplementation continues for minimum 3 months. IV iron infusion is offered to women with haemoglobin below 9 g/dL or with symptoms of severe anaemia (palpitations, breathlessness, extreme fatigue). Blood transfusion is reserved for haemodynamic compromise or haemoglobin below 7 g/dL with symptoms. Restoring iron stores — not just haemoglobin — is the endpoint of treatment.
Wound Care — Perineal and Caesarean
Perineal wounds are assessed for haematoma, infection, and dehiscence. Sitz baths, ice packs (first 24 hours), paracetamol-based analgesia, and local antiseptic are standard. Caesarean incision care involves clean, dry dressing for 48–72 hours, monitoring for erythema, swelling, and discharge, and clear instructions for home wound care. Wound infection presenting with purulent discharge, expanding redness, or fever requires antibiotic treatment and, rarely, secondary surgical management.
Thromboembolism Prevention
Pregnancy and the postpartum period increase thromboembolic risk 5-fold above baseline. Women assessed as moderate or high risk (based on caesarean delivery, immobility, BMI ≥30, prior DVT, thrombophilia, or multiple risk factors) receive low molecular weight heparin (LMWH) thromboprophylaxis as per RCOG guidelines. Compression stockings and early mobilisation are universal measures. Any calf pain, leg swelling, or sudden breathlessness postpartum warrants urgent assessment to exclude DVT or pulmonary embolism.
The 6-Week Postnatal Check
The 6-week postnatal visit is a comprehensive review covering: general maternal wellbeing and recovery, perineal/incision healing, blood pressure (especially in hypertensive pregnancies), haemoglobin and thyroid function where indicated, EPDS postnatal depression screen, breastfeeding review, contraception planning, pelvic floor symptoms, and resumption of normal activities. Women with gestational diabetes receive counselling on long-term diabetes risk (50% develop T2DM within 10 years) and receive a 75g OGTT at 6–12 weeks postpartum.
Book your postpartum check: Call +91 +91 97234 31544 | Balaji Horizon Women’s Hospital, Science City Road, Ahmedabad.