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Systematic Review of the Literature on Postpartum Care: Methodology and Literature Search Results


  • Cheryl Levitt is Professor, Elizabeth Shaw is Associate Professor, Sharon Wong is Senior Research Associate, Janusz Kaczorowski is Associate Professor, and Russ Springate is Associate Professor in the Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada; John Sellors is Clinical Professor in the Department of Family Medicine at McMaster University and Senior Medical Advisor, Reproductive Health at PATH (Program for Appropriate Technology in Health) in Seattle, Washington, USA; Murray Enkin is Professor Emeritus in the Department of Obstetrics and Gynecology and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.

  • Source of funding for this research project is the Bureau of Reproductive and Child Health, Laboratory Centre for Disease Control, Health Protection Branch, Health Canada, Ottawa, Canada.

Dr. Cheryl Levitt, Department of Family Medicine, McMaster University, 1200 Main Street West, Room 2V11, Hamilton, Ontario, L8N 3Z5, Canada.


Abstract: Background: The postpartum period is a time for multiple clinical interventions. To date, no critical review of these interventions exists. This systematic review examined evidence for the effectiveness of postpartum interventions that have been reported in the literature. Methods: MEDLINE, Cinahl, PsycINFO, and the Cochrane Library were searched for randomized controlled trials of interventions initiated from immediately after birth to 1 year in postnatal women that were conducted in North America, Europe, Australia, or New Zealand. The initial literature search was done in 1999, using postpartum content search terms, and was enhanced in 2003. In both years, bibliographic databases were searched from their inception. Studies were categorized into key topic areas. Data extraction forms were developed and completed for each study, and the quality of each study was systematically reviewed. Groups of studies in a topic area were reviewed together, and clinically relevant questions emanating from the studies were identified to determine whether the studies, alone or together, provided evidence to support the clinical intervention. Results: In the 1999 search, of 671 studies identified, 140 studies were randomized controlled trials that met the selection criteria: 41 studies related to breastfeeding, 33 to postpartum perineal pain management, and 63 to 11 other key topic areas (Papanicolaou test, rubella immunization, contraception, postpartum support, early discharge, postpartum depression and anxiety, postpartum medical disorders, smoking cessation, nutrition supplements other than breastfeeding, effects of pelvic floor exercise, and effects of early newborn contact).The results of the systematic review of each topic will be summarized in separate papers as they are completed. Conclusions: This systematic search has identified key topic areas in postpartum care for which randomized controlled trials have been conducted. Our ultimate goal is to provide evidence-based guidelines on the use of routine postpartum interventions.