Postpartum Gray Literature

Annotation: This report describes strategies for implementing regionalized risk-appropriate maternal care across the United States through a levels of maternal care (LoMC) classification system. It examines key implementation components including facility assessment and verification, establishment of regional care networks, maternal transport systems, quality improvement processes, and data monitoring approaches. The report highlights challenges faced by rural facilities, the role of telemedicine, and the importance of addressing health equity in maternal care systems. Using case studies from various states and health systems, it provides specific recommendations for building sustainable LoMC systems nationally, including establishing a coordinating center, expanding funding mechanisms, and improving payment structures for obstetrical care.

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Keywords: Classification, Perinatal care, Reproductive health, Risk appropriate care, Risk factors

Annotation: This toolkit provides actionable information, algorithms, and clinical guidance to support detection, assessment, and treatment of perinatal mood and anxiety disorders. Included is a summary of perinatal mental health conditions; patient screening and treatment guidance; a how-to guide on integrating mental health care into obstetric practice; and educational resources for providers, patients, and families. The toolkit was developed by the UMass Chan Medical School and reviewed by members of the American College of Obstetricians and Gynecologists' Maternal Mental Health Expert Work Group.

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Keywords: Mental health, Obstetrical care, Perinatal care, Service integration

Annotation: This web page describes the pathways that states can take to obtain reimbursement for funding immediate postpartum long-acting reversible contraception (IPP LARC) outside of the global obstetric payment. Included is a map and accompanying chart for each state indicating their policies regarding Medicaid reimbursement for IPP LARC.

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Keywords: Contraception, Contraceptive devices, Financing, Medicaid, Policy, Postpartum care, State aid, State legislation

Annotation: This Clinical Practice Guideline includes recommendations on the screening and diagnosis of perinatal mental health conditions including depression, anxiety, bipolar disorder, acute postpartum psychosis, and the symptom of suicidality. Recommendations are classified by strength and evidence quality.

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Keywords: Annxiety, Depression, Diagnosis, Guidelines, Mental health, Mood disorders, Perinatal care, Screening

Annotation: This Clinical Practice Guideline includes recommendations on treatment and management of perinatal mental health conditions including depression, anxiety, bipolar disorders, and acute postpartum psychosis, with a focus on psychopharmacotherapy.

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Keywords: Annxiety, Depression, Disease management, Mental health, Mood disorders, Perinatal care, Postpartum care, Prenatal care, Psychotropic drugs, Therapeutics, Therapy

Annotation: This clinical recommendation shares evidence regarding the benefits and risks of physical activity and exercise during pregnancy and the postpartum period.

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Keywords: Exercise, Guidelines, Physical activity, Postpartum care, Prenatal care

Annotation: This Clinical Practice Guideline includes recommendations on interventions to prevent primary headache in individuals who are pregnant or attempting to become pregnant, postpartum, or breastfeeding; evaluation for symptomatic patients presenting with primary and secondary headaches during pregnancy; and treatment options for primary and secondary headaches during pregnancy and lactation.

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Keywords: Guidelines, Headaches, Perinatal care, Postpartum care, Therapeutics, prenatal care

Annotation: This committee opinion states that IPV screening and counseling should be a core part of women’s preventive health visits. Physicians should screen all women for IPV at periodic intervals, including during obstetric care (at the first prenatal visit, at least once per trimester, and at the postpartum checkup), offer ongoing support, and review available prevention and referral options.

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Keywords: Counseling, Guidelines, Intimate partner violence, Prevention, Referrals, Screening

Annotation: This committee opinion provides recommendations to help pregnant women eliminate or reduce the use of tobacco and nicotine products that can be harmful to their unborn child. It describes the various methods of nicotine intake and discusses effective screening methods and evidence-based interventions that obstetricians-gynecologists can apply in their practice. This opinion was reaffirmed in 2023.

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Keywords: Nicotine, Pregnant women, Prevention programs, Smoking cessation, Smoking during pregnancy, Tobacco

Annotation: This obstetric care consensus for health professionals underscores the need to reduce maternal morbidity and mortality, including existing disparities, by encouraging the growth and maturation of systems for the provision of risk appropriate care specific to maternal health needs. Co-written by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, the consensus provides standard definitions and outlines the required capabilities and type of health care providers needed for base care (Level I), specialty care (Level II), subspecialty care (Level III) and regional perinatal health centers (Level IV).

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Keywords: Guidelines, Health care systems, Maternal health, Perinatal care, Professional education, Regional planning

Annotation: This online resource outlines the “Plan for Appropriate Tailored Healthcare in Pregnancy (PATH)" recommendations developed by an independent panel of maternal care experts convened by the University of Michigan and the American College of Obstetricians and Gynecologists (ACOG). Based on a review of existing evidence, the site provides how-to guidance on prenatal care delivery and links to related resources for providers. An embedded 90-minute webinar presents an overview of ACOG's Redesigning Prenatal Care initiative and a roadmap to engage communities in the process.

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Keywords: Evidence based medicine, Guidelines , Maternal health, Pregnancy, Prenatal care, Professional education

Annotation: This website describes the Postpartum Contraceptive Access Initiative (PCAI)--a training program created to help ensure that all birthing people have access to the full range of postpartum contraceptive methods before leaving the hospital after a delivery. The site outlines the evidence-based research behind the train-the-trainer program design; highlights the importance of collaboration in developing individualized training plans; and emphasizes the importance of patient autonomy and shared medical decision making. Links to additional information on postpartum depression, clinical considerations, contraception counseling, and implementation are included.

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Keywords: Access to care, Contraception, Postpartum care, Professional Education, Training

Annotation: This patient education infographic from the American College of Obstetricians and Gynecologists outlines key members of a postpartum care team and their roles in supporting new mothers and infants during the initial months after birth. It identifies four essential team components: the maternal care provider (ob-gyn or other obstetric provider), the baby's primary care provider (pediatrician), family and friends who provide practical support, and other healthcare professionals such as lactation counselors and social workers. The infographic emphasizes the importance of assembling this support network before birth and maintaining an accessible list of team members' contact information.

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Keywords: Patient education, Postpartum care

Annotation: This consensus document presents guidelines on interpregnancy care—the healthcare provided to women between pregnancies. It explains that interpregnancy care aims to maximize women's wellness not just between pregnancies but across their life course, serving as a continuum beyond postpartum care. Key recommendations include reproductive life planning, depression screening, vaccination, chronic disease management, and education about future health. The document details specific clinical components such as breastfeeding support, optimal interpregnancy intervals (advising against intervals shorter than 6 months), and management of medical conditions, including diabetes, hypertension, obesity, and mental health disorders. Included are detailed tables presenting specific health condition recommendations together with their corresponding evidence grades using the Society for Maternal-Fetal Medicine's grading system.

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Keywords: Health promotion, Maternal health, Perinatal care, Postpartum care, Prevention, Screening, Women's health services

Annotation: This online resource serves as guide for new mothers navigating the postpartum period, offering support for what can be a time of mixed emotions and physical changes. Key content areas include Postpartum Healing and Support, which covers topics like pain management, your care team, postpartum depression, pelvic support problems, exercise after pregnancy, and the importance of a postpartum support network. New mothers can also find guidance on breastfeeding and newborn vare, including how to prepare for breastfeeding, FAQs on breastfeeding, newborn screening tests, and newborn male circumcision. Additionally, the site addresses medical problems after pregnancy, such as preeclampsia, heart disease, pelvic support problems, and postpartum depression, and offers information on birth control after pregnancy, including postpartum birth control, long-acting reversible contraception (LARC), and postpartum sterilization. The website also features interactive tools like "Ask ACOG" for common questions and a "My Postpartum Care Checklist".

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Keywords: Infant care, Patient education, Postpartum care

Annotation: This Clinical Consensus document offers guidance for maternity care professionals and their teams on implementing a transformative approach to prenatal care delivery for pregnant and birthing individuals. It mandates conducting a comprehensive prenatal needs assessment, including medical, social, and structural drivers of health, ideally before 10 weeks of gestation or when the pregnant individual first presents for care, and utilizing shared decision making to develop individualized care plans. The consensus details recommendations across three core areas for modernizing care: addressing unmet social needs by coordinating assistance and adjusting care delivery to improve accessibility; tailoring the frequency of prenatal visits and monitoring schedules based on the individual's medical and social needs; and incorporating alternative care modalities such as telemedicine and group prenatal care. Developed using a Clinical Consensus methodology informed by systematic reviews, the guidance seeks to improve access, experience, and health outcomes, particularly for individuals marginalized by racism, socioeconomic status, and geography, in an effort to promote health equity

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Keywords: Access to care, Guidelines, Pregnancy, Prenatal care, Risk factors

Annotation: This multiyear initiative and collection of tools and resources from the American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC) seeks to enhance the identification and management of pregnancy-related emergencies in nonobstetric settings, addressing missed opportunities identified by maternal mortality review committees among practitioners in emergency departments, EMS/911, and urgent care facilities. The resources help enhance readiness to identify and respond to life-threatening complications that can occur during pregnancy or up to one year postpartum, including (1) cardiovascular conditions such as cardiomyopathy, (2) hypertensive emergencies like preeclampsia, eclampsia, and stroke, and (3) conditions related to mental health such as suicide and overdose. ACOG provides tailored resources for each setting, offering algorithms and pregnancy status signs (in English and Spanish) for Emergency Departments, model guidelines for EMS covering conditions like postpartum hemorrhage and elevated blood pressure, and algorithms and guidelines for Urgent Care focusing on acute hypertension and cardiovascular disease. Additionally, the initiative compiles supporting resources from other organizations covering maternal mortality education, mental health (including the National Maternal Mental Health Hotline and 988 Suicide and Crisis Lifeline), and substance use disorders.

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Keywords: Emergency medical services, Guidelines, Models, Obstetric emergencies, Perinatal care, Resources for professionals, Therapeutics

Annotation: This web page presents an interactive map and accompanying chart below that detail the status of state action to extend postpartum Medicaid coverage.

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Keywords: Access to health care, Interactive media, Maps , Medicaid, Policy development, Postpartum care, State legislation

Annotation: This FAQ webpage from the American College of Obstetricians and Gynecologists provides information for individuals with postpartum depression to help distinguish the condition from "baby blues" and understand contributing factors such as hormonal changes, fatigue, and lifestyle stressors. It outlines medical treatment options, including the medication zuranolone and various antidepressants, while addressing considerations for breastfeeding and potential side effects. The resource also details the role of psychotherapy—including individual, group, and family talk therapy—and offers guidance on establishing support networks and seeking preventive care. A substantial glossary defines key terms related to reproductive health and mental health treatment.

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Keywords: Patient education, Postpartum depression

Annotation: This Committee Opinion from the American College of Obstetricians and Gynecologists (ACOG) provides comprehensive clinical guidance on optimizing postpartum care delivery. It outlines a new paradigm that reimagines postpartum care as an ongoing process rather than a single encounter, recommending initial contact within 3 weeks after birth followed by a comprehensive visit by 12 weeks postpartum. The document details essential components of postpartum care including physical recovery, emotional wellbeing, infant care, contraception, and chronic disease management, while emphasizing the importance of tailoring care to each woman's needs and circumstances to improve maternal health outcomes and reduce disparities.

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Keywords: Guidelines, Postpartum care, Resources for professionals