Postpartum Care and Newborn Care
This domain tests the first 24 hours, the first week and the sixth-week check, plus the small set of newborn interventions that genuinely change survival.
Postpartum contacts
WHO schedules contacts at 24 hours, day 3, day 7–14 and week 6; national practice adds a check before discharge. At each contact ask about bleeding, headache, fever, pain, feeding and mood, and examine the uterus, perineum, breasts and legs with blood pressure.
Newborn essentials
- Dry, hat, immediate skin-to-skin; assess breathing rather than relying on Apgar alone.
- Delay cord clamping 1–3 minutes unless resuscitation demands otherwise.
- Vitamin K 1 mg intramuscularly (0.5 mg if under 1.5 kg) within the first hour.
- Hepatitis B vaccine within 24 hours; BCG and eye prophylaxis per national policy.
- First breastfeed within one hour; exclusive breastfeeding for six months with no water or supplements.
- Warmth, dry cord care (chlorhexidine where neonatal mortality is high), and kangaroo mother care for low birth weight.
Worked example
A woman on day 2 after a normal birth has BP 158/104, frontal headache and 3+ proteinuria, and says she feels fine now the baby is out. Reasoning: pre-eclampsia can present or deteriorate after delivery. She needs admission, magnesium sulfate per protocol, antihypertensive treatment, strict fluid balance and monitoring for 24–48 hours. Calling it postnatal tiredness is a fatal error.
Traps
Discharging before 24 hours; missing secondary postpartum haemorrhage around day 10; giving vitamin K late or not at all; discarding colostrum; and advising water or formula in hot weather.