Home birth post-partum care

During the days and weeks following delivery you will:

• Be available to parents for any concerns or problems in the first week. Refer to mother's physician or baby's pediatrician as needed.
• Examine mother and infant within 72 hours of birth.
• Weigh baby and discuss infant feeding and parental adjustment.
• Evaluate infant for jaundice including identifying risk factors and obtaining transcutaneous or serum bilirubin levels as needed. Arrange for timely repeat jaundice checks based on levels and risk (following standard nomogram).
• Perform initial newborn screen.
• Perform depression screening for mother.
• Offer the mother a clinic visit at three weeks post-partum for education and evaluation.
• Encourage breast-feeding and provide information if needed. See Benefits of breastfeeding.
• File a completed birth certificate with county vital statistics office.
• File a sentinel birth defect report if indicated.
• Facilitate referral for circumcision if parents so choose.

You should examine the mother at approximately six to eight weeks post-delivery, which includes:

• Counseling regarding breast-feeding; infant care and feeding; mother's emotional well-being; sexuality; need for adequate rest, nutrition, and exercise; and community resources for new parents.
• Assessment of mother's weight, blood pressure, and laboratory studies as needed.
• Pelvic examination.
• Cervical cancer screening with pap smear unless mother has had previous test within the last 3 years if under 29 years old or 5 years with HPV co-testing if over 29 years old.
• Discussion of family planning and consideration of LARC (Long Acting Reversible Contraception) as appropriate.
• Instructing seronegative women to contact Kaiser Permanente for vaccination to prevent subsequent varicella (chickenpox) infection. (The two-dose vaccine should be initiated between six weeks post-partum and within a few months of delivery.)

At this time, you also need to submit the required information outlined in Home birth maternal and newborn medical records.

The six to eight week post-partum examination concludes the home birth episode. Please refer the mother to her primary care provider or personal physician for ongoing care, including routine well-adult care, pap smears, and ongoing contraceptive care.