Within 24 hours
First postnatal assessment
Maternal condition, bleeding, vital signs, recovery, feeding, emotional well-being, danger signs and immediate support.
After birth • Recovery • Follow-up • Long-term health
Maternal Health Follow-Up
A WHO-aligned guide to maternal follow-up after childbirth, covering early postnatal contacts, physical recovery, mental health, breastfeeding, nutrition, contraception, chronic conditions and recognition of warning signs.
WHO-alignedPostnatal careMaternal recoveryMental healthSafety-netting
WHO postnatal schedule
Four key contacts for healthy women and newborns
The minimum schedule is a framework. Women with complications or additional needs may require earlier, more frequent or longer-term follow-up.
48–72 hours
Early recovery review
Physical recovery, breastfeeding/feeding support, mood and well-being, pain or wound concerns, contraception and family support.
7–14 days
Ongoing recovery review
Maternal physical health, infection/wound concerns, breastfeeding, nutrition, mental health and any new symptoms or care needs.
Week 6
Comprehensive follow-up
Recovery, mental health, contraception and reproductive health, breastfeeding, long-term health needs and onward care.
Do not wait for the next appointment if a danger sign develops. Seek prompt medical assessment through the appropriate maternity, emergency or healthcare service when symptoms are severe or worsening.
Maternal assessment
What follow-up should look at
The exact examination and investigations depend on the woman's symptoms, birth history, medical conditions and local protocol.
Vital signs & general condition
Assess overall well-being and clinically indicated vital signs, with attention to symptoms that may indicate infection, hypertension, anaemia, haemorrhage or another complication.
Bleeding & uterine recovery
Ask about postpartum bleeding, increasing or unusually heavy bleeding, clots, abdominal pain and recovery. Escalate concerning symptoms promptly.
Perineum, birth injury & wounds
Where clinically relevant, assess pain, healing, discharge, infection and functional recovery after vaginal birth, perineal trauma or caesarean birth.
Infection assessment
Check for fever, worsening pain, foul-smelling discharge, wound redness/swelling or other symptoms requiring evaluation.
Breastfeeding & breast health
Ask about feeding, attachment, milk transfer, breast or nipple pain, engorgement and symptoms suggestive of mastitis; provide support or referral as needed.
Emotional well-being
Ask about mood, anxiety, sleep, coping, bonding and safety. Persistent or severe symptoms require appropriate assessment, support and referral.
Recovery & healthy transition
- Pain & comfortDiscuss expected recovery and appropriate pain-management options according to the birth, medical history and local protocol.
- Nutrition & hydrationSupport adequate food, fluids and recovery-focused nutrition. Address anaemia, dietary restrictions, food insecurity and other nutritional concerns.
- Activity & restEncourage gradual return to activity according to recovery and clinical circumstances, with rest and practical support for the early weeks.
- BreastfeedingProvide responsive breastfeeding support, address feeding difficulties early and connect the mother with skilled support when needed.
- Family planningDiscuss postpartum contraception and reproductive goals using informed choice and methods appropriate to the woman’s health and circumstances.
- Sexual & reproductive healthDiscuss return to sexual activity, comfort, contraception, birth spacing and concerns about pain or vaginal symptoms without judgement.
- Mental healthUse supportive conversation and appropriate screening/assessment pathways for depression, anxiety or other concerns.
- Chronic conditionsEnsure follow-up of hypertension, diabetes, anaemia, thyroid disease, cardiac disease or other conditions that require continued management.
Follow-up pathway
- Prepare before dischargeGive understandable written/verbal information, medication instructions, follow-up dates, danger signs and contact/referral information.
- First contactConfirm physical and emotional stability and identify problems early.
- Tailor the planIncrease contact frequency or arrange specialist care when maternal health, newborn needs, social circumstances or recovery require it.
- Close the loopDocument referrals, investigations and treatments and ensure important results are reviewed.
- Transition onwardAt or beyond the comprehensive postnatal review, connect the woman with primary care, chronic disease services, reproductive health or other appropriate long-term care.
When extra follow-up is needed
Individualize care for higher needs
Postnatal follow-up should be intensified or extended when clinical, emotional or social needs make the minimum schedule insufficient.
After caesarean birth
Follow wound healing, pain, mobility, infection warning signs and any condition-specific plan. Provide clear advice about when urgent assessment is required.
After postpartum haemorrhage
Arrange individualized follow-up for recovery, symptoms of anaemia, ongoing bleeding and emotional impact, with investigations or treatment according to clinical need.
Hypertensive disorders
Continue appropriate blood-pressure monitoring and medication review where indicated. New severe headache, visual symptoms, seizures, chest pain or breathlessness require urgent assessment.
Gestational diabetes
Ensure appropriate postpartum diabetes follow-up according to local/national protocols and reinforce long-term healthy lifestyle and future pregnancy planning.
Anaemia
Review symptoms, adherence to prescribed iron therapy and follow-up testing when indicated. Persistent severe symptoms need clinical assessment.
Mental health concerns
Provide non-judgemental support and ensure timely referral for significant depression, anxiety, psychosis, self-harm thoughts or safety concerns.
Breastfeeding difficulties
Arrange skilled lactation support when there is pain, poor attachment, inadequate milk transfer, infant feeding difficulty or maternal concern.
Social or safeguarding concerns
Ask privately when appropriate about safety, violence, coercion, practical support and access to food, transport and healthcare; connect to appropriate services.
Safety-netting
Maternal warning signs that should not be ignored
Families should know what symptoms require urgent assessment and where to seek help.
Heavy or increasing bleeding
Heavy bleeding, large clots, dizziness/fainting or worsening weakness can require urgent assessment.
Severe headache or visual symptoms
Persistent or severe headache, visual disturbance, severe upper abdominal pain or other concerning symptoms after birth need prompt medical assessment.
Fever or infection symptoms
High fever, chills, worsening abdominal/pelvic pain, foul-smelling discharge or an infected wound require clinical evaluation.
Chest pain or difficulty breathing
Chest pain, significant breathlessness, collapse or sudden deterioration require emergency care.
Seizure or altered consciousness
A seizure, loss of consciousness or severe confusion is an emergency.
Leg swelling/pain with concerning symptoms
New severe or one-sided leg swelling/pain, particularly with breathlessness or chest pain, needs urgent evaluation.
Severe emotional distress or safety concern
Thoughts of self-harm, harming the baby, severe confusion or psychotic symptoms require urgent specialist/emergency assessment.
Worsening wound or breast infection symptoms
Increasing redness, swelling, pus, severe pain or fever after caesarean/perineal injury or with breast symptoms should be assessed.
Emergency: severe bleeding, seizure, loss of consciousness, chest pain, major difficulty breathing, severe confusion or another rapidly worsening condition requires emergency care.
Practical checklist
Maternal follow-up checklist
Use this as an educational prompt; adapt it to the woman's condition and local clinical protocol.
- Confirm the mother knows the next follow-up date and where to seek care.
- Review the discharge summary, medicines and any pending test or referral.
- Ask about bleeding, pain, fever, wounds, urination, bowel function and mobility as clinically appropriate.
- Ask about breastfeeding/feeding and maternal nutrition and hydration.
- Ask about sleep, mood, anxiety, coping, bonding and social support.
- Review contraception and reproductive-health goals using informed choice.
- Check ongoing conditions and whether prescribed treatment or monitoring is continuing.
- Reinforce maternal and newborn danger signs and emergency contact arrangements.
- Document findings, advice, referrals and follow-up plan.
Communication & continuity
Make every follow-up contact useful
| Area | Ask / assess | Action |
|---|---|---|
| Physical recovery | Bleeding, pain, fever, wounds, urination, bowel function, mobility and general condition as appropriate. | Provide advice, treatment or referral according to findings. |
| Breastfeeding | Feeding frequency, attachment, nipple/breast pain, engorgement and concerns about milk supply or feeding. | Provide skilled support or referral when problems are identified. |
| Mental health | Mood, anxiety, sleep, coping, bonding, social support and safety. | Support, assess and refer when symptoms are significant or persistent. |
| Reproductive health | Contraception, return to sexual activity, pain, birth spacing and future pregnancy intentions. | Offer informed choice and appropriate contraception/reproductive-health care. |
| Chronic conditions | Blood pressure, diabetes, anaemia or other ongoing conditions and medication needs. | Coordinate investigations, treatment and longer-term follow-up. |
| Social needs | Safety, family support, food, transport, finances, housing and access to care where relevant. | Connect with available community, social or safeguarding services. |
Frequently asked questions
Maternal health follow-up FAQs
When should maternal follow-up occur after birth?
WHO recommends a minimum of four postnatal contacts for healthy women and newborns: within 24 hours, between 48 and 72 hours, between 7 and 14 days, and during week six after birth. The timing and number should be tailored to individual needs.
Does every woman need exactly four visits?
Four is the WHO minimum schedule for healthy women and newborns. Women with complications, ongoing symptoms, higher-risk conditions or additional needs may require more frequent or longer-term follow-up.
What should be checked during maternal follow-up?
Follow-up should address physical recovery, bleeding, infection, wounds when relevant, breastfeeding and nutrition, emotional well-being, contraception and reproductive health, ongoing medical conditions, and danger signs. The exact assessment depends on the woman’s needs and local clinical protocols.
Should blood pressure be checked after delivery?
Blood-pressure assessment is clinically important when indicated, especially for women with hypertension or hypertensive disorders of pregnancy. New severe headache, visual symptoms, seizures, chest pain or significant breathlessness require urgent assessment.
What if the mother feels well at six weeks?
A six-week contact is still an opportunity to review recovery, mental health, contraception and reproductive health, breastfeeding, chronic conditions and longer-term health needs. Ongoing care should then be individualized.
Can follow-up happen at home?
WHO allows postnatal contacts to occur in appropriate home or health-facility settings depending on the health system and needs. Digital or telephone contact can complement, but not automatically replace, clinical assessment when in-person evaluation is required.
What should a mother do if a danger sign develops between visits?
Do not wait for the next scheduled appointment. Seek prompt medical assessment through the appropriate emergency, maternity or healthcare service, particularly for heavy bleeding, severe headache/visual symptoms, seizures, chest pain, difficulty breathing, high fever or severe emotional/safety concerns.
How long does maternal follow-up continue?
The first six weeks are a key postnatal period, but care does not have to stop at six weeks. Women may need ongoing follow-up for chronic disease, mental health, contraception, pelvic-floor concerns, anaemia, breastfeeding, diabetes, hypertension or other needs.
Guideline references
Evidence base
Key WHO resources supporting this educational page.
WHO Recommendations on Maternal and Newborn Care for a Positive Postnatal Experience (2022)
WHO recommends a minimum of four postnatal contacts for healthy women and newborns and emphasizes individualized physical and emotional care, breastfeeding support, family planning, danger-sign recognition and timely referral.
WHO postnatal care guideline
WHO Recommendations on Maternal Health, 2nd edition (2025)
This consolidated resource summarizes WHO maternal-health recommendations across pregnancy, childbirth and the postnatal period and supports individualized follow-up according to clinical needs.
WHO maternal health recommendations
WHO: Getting the health services you need after childbirth (2022)
WHO emphasizes postnatal contacts, respect and dignity, maternal and newborn danger signs, sexual and reproductive health information, family support and keeping health records.
WHO after-childbirth guidance
WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience
ANC is part of the continuum of care and provides opportunities for health promotion, screening, prevention and preparation for the postnatal period.
WHO ANC guideline
Educational information: This page is for health education and service-planning purposes. It does not replace individualized clinical assessment, emergency care, local protocols, national guidelines or professional judgement. The number, timing and content of follow-up contacts should be adapted to the mother's health, birth circumstances, newborn needs, social context and local health-system arrangements.