Postpartum Toolkit

 

The "Fourth Trimester"

The weeks after birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being. Although childbirth and the postpartum period are exciting life experiences for many women and their families, this is also a period of physical, mental, and social change.

Nearly 70% of women describe at least one physical problem in the first 12 months of the postpartum period. This “fourth trimester” period can present considerable challenges such as postpartum depression, fatigue, lack of sleep, pain, breastfeeding difficulties, lack of sexual desire, and urinary incontinence.

This toolkit, with an introduction by Dr. Haywood L. Brown, includes resources on the key components of postpartum care, including long-term weight management, pregnancy complications, reproductive life-planning, reimbursement guidance, and a sample postpartum checklist for patients to complete before their visit.

  • Download the full Toolkit: PDF

Jump to:

Point of Care
Billing and Reimbursement
Systems
Calls for Research
Codes for Specific Services

Point of Care

This section includes information on important postpartum considerations such as immunization, reproductive planning, and newborn care. It also covers postpartum depression and complications, and includes a helpful postpartum follow-up checklist for patients.

  • Immunization During the Postpartum Period  | PDF
  • Postpartum Complications | PDF
  • Reproductive Life Planning, Contraception, and Sexual Health | PDF
  • Support Team for New Mothers | PDF
  • Newborn Care | PDF
  • Breastfeeding | PDF
  • Postpartum Depression | PDF
  • Substance Use: Opioid Use Disorder, Alcohol Use Disorder, and Tobacco Use | PDF
  • Intimate Partner Violence | PDF
  • Achieving a Healthy Weight in the Postpartum Patient | PDF
  • Chronic Diseases Involving the Cardiovascular and Renal Systems | PDF
  • Long-Term Follow-up from Pregnancy Complications | PDF
  • Sample Postpartum Follow-up Checklist | PDF

Billing and Reimbursement

This section covers coding, billing, and reimbursement for postpartum and obstetric care services. 

  • Billing and Reimbursement | PDF 
  • Coding for Postpartum Services | PDF

Systems

This section discusses systemic issues such as racial disparities in maternal mortality, employment and paid leave, and models of care for low-resource areas. 

  • Racial Disparities in Maternal Mortality | PDF
  • Returning to Work and Paid Leave | PDF
  • Models of Care for Urban, Rural, and Low-Resource Areas | PDF
  • New Paradigms for Training in Postpartum Care | PDF
  • Care Coordination, Referral, and Collaboration with Hospitals and Health Care Systems | PDF
  • Implementation of New Models of Care | PDF

Calls for Research

This section addresses potential areas of future research in postpartum care. 

  • Potential Questions and Areas of Research | PDF

Codes for Specific Services

This section includes detailed information on coding for specific postpartum services.

  • Counseling | PDF
  • Chronic Diseases Involving the Cardiovascular and Renal Systems | PDF
  • Immunization | PDF
  • Intimate Partner Violence | PDF
  • Long-Term Follow-up from Pregnancy Complications | PDF
  • Newborn Care | PDF
  • Postpartum Complications | PDF
  • Returning to Work and Paid Leave | PDF
  • Substance Use: Opioid Use, Alcohol Use, and Tobacco Use | PDF
  • Support Teams for New Mothers | PDF

ABOUT THIS TOOLKIT
This toolkit was developed by the Redefining Postpartum Care Task Force convened by Dr. Haywood Brown during his presidential term, which included Alison Stuebe, MD, MSc; George Saade, MD; Diana Ramos, MD, MPH; Tamika Auguste, MD; Maria Manriquez, MD; Wanda Nicholson, MD, MPH; Carolyn Zelop, MD; John P. Keats, MD, CPE; Mary Rosser, MD, PhD; Martha Gulati, MD, MS; Judette Louis, MD; Elizabeth M. Alderman, MD; Catherine McCarthy, MD; Ira Kantrowitz-Gordon, PhD; Jamille Nagtalon-Ramos, EdD, MSN, WHNP, IBCLC; Florence Momplaisir, MD, MSHP; Zsakeba Henderson, MD; David Chelmow, MD; Stephenie Wallace, MD MSPH; Christine Olson, MD; Tina Sherman; and ACOG staff, including Christopher Zahn, MD; Debra Hawks, MPH; Ijeoma Obidegwu, MPH; Miroslava Rudneva, Donna Tyler; and Nevina Jakopin. The efforts of the task force, individually and collectively, were coordinated by Alison Stuebe, MD, MSc. Please contact postpartum@acog.org with any questions or feedback on the toolkit.

American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188