Supporting Postpartum Women and Their Families by Implementing a Postpartum Return Visit

Abstract

The purpose of this program is to provide assessments of maternal and newborn status and well being 2–3 days after discharge from the hospital. The postpartum return visit (PPRV) is a 30-min appointment that allows for the opportunity to identify complications and provide support and education. During the visit, a registered nurse assesses the vital signs, breasts, fundus, perineum, lochia, incision, elimination, pain, and emotional status of the postpartum woman. In addition, the registered nurse assesses the infant’s vital signs, weight, color, transcutaneous bilirubin, umbilicus, circumcision, elimination, and feeding. Postpartum blues and depression, increased bleeding, urinary tract infections, increased blood pressures, incision or perineal problems, neonatal jaundice, cord issues, feeding difficulties, and weight loss of more than 10% are only some of the issues addressed during the PPRV. If appropriate, a provider is consulted during the visit or a referral to a provider is made. In addition, a lactation consultant is available to address and assist with any breastfeeding concerns. In 2017, 10% of PPRVs necessitated a physician call because of a complication discovered during the visit. The PPRV is an excellent platform to offer postpartum support and resources, such as our institution’s support groups. During the PPRV, patients are given access to their patient portal, which is their online medical record. In addition, AWHONN’s POST-BIRTH Warning Signs handout as well as the Preeclampsia Foundation’s Postpartum Preeclampsia Warning Signs handout are given to women and discussed at length. With a consistent return rate of more than 95% of the new mothers, the importance of this program is ascertained by the patients. Data are being collected on patient satisfaction and whether the patient’s education is being reinforced or given for the first time. Patients are reassured knowing they will have the opportunity to ask questions when they return for the follow up a few days after discharge. Satisfaction of care is enhanced with this service. In 2017, 96% of patients returned for their scheduled visit. The need for advancement in postpartum support and education is growing, and the PPRV program is an exceptional platform for meeting those needs.