UBC Objectives: Maternity Care

​By the end of postgraduate training, using a patient-centred approach and appropriate selectivity, a resident, considering the patient’s cultural and gender contexts, will be able to...

• Provide comprehensive post-partum care in the hospital, community, and office

My approach to postpartum care is by following the trusty 10Bs, no matter the setting. 

1. Baby (Does mom have any concerns about baby? Address them accordingly. Moms have a million different types of concerns.)
2. Breastfeeding (Is mom breastfeeding and how is it going? Any concerns with feeding or nipple/breast pain?) See this post for an approach to breastfeeding concerns.
3. Belly or bottom pain (aka pain after C-section or vaginal delivery. Is it well-controlled, and what is she taking? Post-op pain is often morphine, and then is stepped down to an NSAID as the healing progresses and pain lessens. Perineal pain after vaginal delivery usually is resolved by 6 weeks postpartum)
4. Bleeding/lochia (Any excess bleeding or foul-smelling lochia? The quantity of bleeding should approximate that of a normal or slightly heavier period)
5. Bladder (Any difficulties voiding urine? And is mom able to get up to ambulate to the bathroom on her own?)
6. Bowels (Is she passing flatus? And has she yet had a bowel movement? Is she tolerating food? Constipation and nausea are common concerns in the immediate postpartum period. Flatus is reassuring that things are at least moving along a bit)
7. Blues (How is mom's mood? Does she have social supports? How about risk factors for postpartum depression requiring close follow-up?)
8. Blood pressure (Postpartum risk for preeclampsia is greatest between days 3-6 postpartum. Checking mom's blood pressure to make sure it's normal is reassuring)
9. Bloodwork (Is there any postpartum blood work to follow up on? Ex: CBC and ferritin if there is a history of anemia of if she experienced a postpartum hemorrhage. Also think about wether he needs a postpartum rubella vaccine, or Rh immune globulin.)
10. Birth control (Not as important immediately postpartum, but important to address early on so that mom can make an informed choice by the 6 week postpartum checkup. I refer patients to check out the sexandu.ca Contraceptive Methods Booklet)