Postnatal Care Schedule and Danger Signs
On this page
Direct answer
Postnatal care is a series of planned contacts after birth that check the mother and newborn for bleeding, infection, pre-eclampsia and feeding problems. WHO recommends at least four contacts, the first within 24 hours of birth and the last by six weeks. Maternal danger signs include heavy bleeding, fever, severe headache and convulsions, while newborn danger signs include poor feeding and fast breathing.
What you must remember
- First contact: Within 24 hours of birth, to check uterine tone, bleeding, blood pressure and feeding.
- Second contact: Days 2 to 3, with newborn weight, feeding and jaundice reviewed.
- Third contact: Around day 7, with infection, breast problems and maternal mood checked.
- Final contact: By six weeks, with recovery, contraception counselling and mood screened.
- Maternal danger signs: Heavy bleeding, fever, severe headache, blurred vision, convulsions, breathlessness and calf pain.
- Newborn danger signs: Poor feeding, fast breathing, chest indrawing, convulsions, lethargy, fever or low temperature, and jaundice in the first 24 hours.
- Mood: Screen for postnatal depression at each contact, and refer urgently for any thoughts of harm to self or baby.
Timing and content of each postnatal contact
Each contact has a focus, and the content of the visit depends on what has been learnt at the earlier one. The table gives the usual timing, which should be matched to the local national schedule.
| Timing | Key checks | Counselling |
|---|---|---|
| Within 24 hours | Uterine tone, bleeding, blood pressure, feeding | Danger signs and positioning for feeds |
| Days 2 to 3 | Wound, newborn weight, jaundice | Exclusive breastfeeding and cord care |
| Around day 7 | Infection, breast problems, mood | Nutrition, rest and family support |
| By six weeks | Recovery, mood, contraception | Choice of contraception and return to activity |
Indian home-based newborn and postnatal care programmes deliver several of these contacts through ASHA home visits. Any maternal or newborn danger sign needs referral to a facility that can treat eclampsia, sepsis or severe haemorrhage.
Each contact also reviews the newborn, so the visit is a joint maternal and neonatal check rather than a maternal check alone. Missed contacts should be followed up by the health worker.
Where the exam tries to catch you
Questions test the timing of the first visit, the danger signs and the difference between baby blues and depression.
- Trap: Thinking the postnatal check is complete at six weeks alone. Correct: Most of the risk of bleeding and eclampsia falls in the first days, so the early contacts matter most.
- Trap: Dismissing a severe headache after delivery as ordinary. Correct: Severe headache, visual disturbance or epigastric pain after delivery can indicate eclampsia or postpartum pre-eclampsia, and needs urgent review.
- Trap: Calling persistent low mood normal baby blues. Correct: Baby blues settle within about two weeks, while persistent low mood or thoughts of harm need formal assessment.
- Trap: Missing fever or low temperature in a newborn. Correct: Both are danger signs in the newborn and require urgent referral.
Frequently asked questions
When should the first postnatal check happen?
The first postnatal contact should happen within 24 hours of birth, when the risk of postpartum haemorrhage and eclampsia is highest. The visit checks uterine tone, bleeding, blood pressure and feeding. Early contact allows problems to be caught before the mother goes home.
What are the maternal danger signs after childbirth?
Maternal danger signs after childbirth include heavy bleeding, fever, severe headache, blurred vision, convulsions, breathlessness and calf pain. Any of these needs urgent review. Foul-smelling discharge and a red, painful breast also need prompt assessment.
Which newborn danger signs need urgent referral?
Newborn danger signs include poor feeding, fast breathing, chest indrawing, convulsions, lethargy, fever or low temperature, and jaundice within the first 24 hours. Any of these requires urgent referral to a facility that provides newborn care.
How long do baby blues last, and when is it postnatal depression?
Baby blues usually settle within about two weeks after delivery and do not need specific treatment. Persistent low mood, loss of interest or thoughts of harm beyond this period suggest postnatal depression, which needs formal assessment and support.