Postpartum care: we can and should do better

Extensive physiologic, endocrine, and immunologic adaptations occur in the mother in response to the demands of pregnancy, which includes support of the fetus, preparation of the uterus for labor, and protection of the mother from potential cardiovascular injury at delivery. Although these demands increase incrementally over many months, resumption of the prepregnancy physiologic state after childbirth occurs at a far more rapid pace. The postpartum period, which is also referred to as the postnatal period (Latin for “after birth,” from post meaning “after” and natalis meaning “of birth'”) or puerperium (Latin for “after childbirth,” from puerperal meaning “a woman in childbed”), refers to the period that begins immediately after delivery and continues for the next 6 weeks. Why this time period is defined as 6 weeks rather than 4 weeks or 8 weeks is not clear and appears to be a result of convention rather than science, although it may be related to the fact that uterine size and menstruation typically return to normal by this time.