Postnatal and Postpartum Care

Postnatal Care for the Infant

Skin-to-Skin Contact

Skin-to-skin contact (often called kangaroo care)kangaroo care is the practice of holding an infant against your bare chest. This skin-to-skin contact has been shown to provide numerous benefits for both the infant and caregiver (e.g., Campbell-Yeo et al., 2015; Jones & Santamaria, 2017; Moore, 2013), including:

• Promoting more regular heart beat and breathing rate in the infant
• Reguating infant’s body temperature
• Promoting breast feeding
• Reduced infant crying
• Promoting better sleep in infant
• Reduced stress in parents
• Reported increased feelings of attachment and bonding from the parent

Though kangaroo care is often discussed as a tool to help premature infants, this practice can be used with full term infants as well.

Caring for Parents After Birth

Much of the focus after birth is on the newborn and its care. However, birth mothers are still recovering and need postpartum care as well. In the United States, they will often have a follow-up appointment to assess their physical recovery, but they also need help coping with the stress of caring for a newborn while healing. In Ghana, birth mothers often did not realize that they, too, needed care during the postpartum period (Yenupini et al., 2023). The lack of such care is thought to contribute to high mortality rates for birth mothers (Yenupini et al., 2023).

According to the American College of Obstetricians and Gynecologists (2018), postpartum care should be viewed not as a single-visit issue but as a long-term process with consequences for the future health of both birth mother and infant. The focus should also be on social and emotional health, not just physical health, and should assess the mother’s emotional well-being, sleep, and any issues related to feeding and caring for the newborn (American College of Obstetricians and Gynecologists, 2018). Postpartum care is beneficial in reducing a variety of emotional and physical health risks in both birth mothers and adoptive parents (Lopez-Gonzalez & Kopparapu, 2022; Mott et al., 2011).

Parental Leave

Newborns require constant care, and this often means a caregiver needs time off work. Most industrialized countries offer some variation of paid parental leave policies, often with government-subsidized allowances that let caregivers stay home to care for their infant. Employers are also able to add time to the governmental benefits if they so choose (Hernandez, 2018). In the United States, no federal policy mandates paid leave for parents, though twelve weeks’ unpaid leave is offered, and some states offer paid leave for various lengths of time (National Conference of State Legislatures, 2024).

Postpartum Depression

New caregivers must also adjust to new roles within their relationship and learn new caregiving tasks. Their success can be hampered by lack of sleep and the need to adapt to new priorities. Caring for a newborn is not always easy, and some aspects of parenthood might not be what they expected. In addition, there can be stress to “get it right” and feelings of guilt when things inevitably don’t go as planned. New mothers often struggle with self-blame and maternal guilt if they feel they are not meeting expectations (Derella & Milan, 2021), so finding support and help is also important.

Often, however, new caregivers do not seek practical and/or emotional help early, and the stress of trying to cope by themselves can build up over time. Feelings of sadness and/or anxiety, often called the “baby blues,” are common among new caregivers, and they can also slow the process of bonding (Trigo, 2021). Baby blues is estimated to be present in up to 80 percent of new caregivers (March of Dimes, 2021). If these feelings don’t fade after several weeks, or if they become more severe, a birthing mother may be experiencing postpartum depression. Following are symptoms of this condition:

• intense feelings of sadness or despair
• anxiety or excessive worry experienced for no discernible reason
• loss of interest in activities previously enjoyed
• inability to sleep, eat, or maintain a daily routine
• feelings of panic
• frequent crying
• thoughts of harming self and/or the baby

Postpartum depression can disrupt the bonding process as well as interfere with daily life and quality of life for the mother (Hahn-Holbrook et al., 2018). It can occur at any time during the first year but typically appears around one to three weeks after birth (Hahn-Holbrook et al., 2018). Though the exact cause is not known, the onset might be related to  hormonal changes that occur after birth, feelings of doubt about becoming a new parent, lack of support from family, and fatigue (Hahn-Holbrook et al., 2018). Fathers can suffer from postpartum depression as well. Some of the father’s risk factors are whether they or their partner has depression or anxiety, stress due to low socioeconomic status, an unhealthy partnership, lack of social support, and issues with substance use (Wang et al., 2021).

Research has estimated the prevalence of postpartum depression to be almost 18 percent of births globally (Hahn-Holbrook et al., 2018). It occurs most frequently in countries with higher levels of wealth inequity, decreased access to postnatal care, and new mothers working full time, which can increase stress on them (Hahn-Holbrook et al., 2018). In addition, a higher risk of postpartum depression exists for new caregivers living in disadvantaged neighborhoods, new caregivers of lower socioeconomic status, and Black mothers (Floyd James et al., 2023; Onyewuenyi et al., 2023). Early intervention and prevention efforts also tend to be less available for individuals facing neighborhood disadvantage or racial disparities (Liu et al., 2022; Onyewuenyi et al., 2023). Beyond postpartum depression, new caregivers may struggle with a range of emotions and/or mental health concerns (including anxiety, obsessive-compulsive disorder, and post-traumatic stress disorder) following the addition of a newborn (Meltzer-Brody et al., 2018). In any case, talking to a health-care provider or mental health expert can be a wise decision to support a healthy new family for all. It is also recommended that health-care providers specifically screen for symptoms of postpartum depression and other health needs both before discharge from the hospital and at postpartum medical visits.