Two-week Postpartum Visits

How I Practice Video Series 
Dr. James O. Heaton, MD, FACOG


Two-week Postpartum Visit: Jason O. Heaton – San Diego, CA from ACOG on Vimeo.

 

Transcript: Two-week Postpartum Visits 

Recently, my academic practice changed our postpartum visit from six weeks to two weeks. This has been fantastic for our patients for several reasons. First of all, I can address depression earlier. My group practice will administer the postpartum Edinburgh questionnaire to our patients at two weeks, and I can review the signs and symptoms of depression with her. It’s so important to address depression early. A little depression is much easier to treat than severe depression. Next, I can address breastfeeding. Many patients will have trials and tribulations that I can encourage her and help her to get through and remind her of all the benefits, not only for the baby, but for herself. At two weeks, I can also remind her about contraception. We know that many women will ovulate as early as three weeks after delivery. I certainly want to give her the opportunity to take control of her family planning. Some of my patients have had an IUD placed after delivery of the placenta, and at this two-week visit I can trim the string and make sure she is comfortable. I also will take a look at her laboratory values, looking at her pap smear. The pap smear guidelines have improved, but it does take a second to remind the patient when her next pap is due. For those gestational diabetics, I really want to make sure they get their glucola testing done in the postpartum state. An easy way for me to organize my thoughts during this visit is from head to toe. First, the head, addressing depression; then, encouraging breastfeeding; then, the uterus, or contraception; and, lastly, looking at the chart. That’s how I practice.

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