Our Services

Postpartum Care

Redefining the Postpartum Period as Recommended by ACOG

The postpartum period is an important time to focus on your health. Moms experience multiple physical, social, and psychological changes in the weeks following the birth of their child. We are here to support you during this period of change.  ­­­

Recently, the American College of Obstetricians and Gynecologists (ACOG) issued new care guidelines for moms during the postpartum period. More touch points including blood pressure checks, depression screening and ongoing management/support of moms health and well-being is critical.  

  • One of our designated nurse practitioners will visit with you before leaving Brigham and Women’s Hospital.  During this visit, our nurse practitioner will assess your individual care needs and develop a plan.  Our nurse practitioner will also help you schedule your upcoming postpartum visits with our office.

    • Your next visit will be scheduled for approximately 10 days after the birth of your baby.

    • All patients will also be scheduled for a routine postpartum wellness visit approximately six to eight weeks after delivery.

  • Vaginal Delivery
    Mom’s will receive a call from a member of our nursing team to review any questions or concerns. If you have a need for an in-person visit (third or fourth degree tear/laceration, blood pressure check, etc) we may schedule you for an in-person visit with a provider in our office.

    Cesarean Delivery
    All mom’s who deliver via c-section will have an in-person appointment with a provider in our office 7-10 days after delivery.

  • All moms will have a routine wellness postpartum visit six to eight weeks after the birth of their baby. This visit should be scheduled with your primary obstetrician or the obstetrician that delivered your baby. The wellness visit will include a blood pressure check and physical exam. You will also have the opportunity to discuss any new concerns, your physical recovery after birth, chronic disease management, sexuality, contraception, birth spacing and your general health maintenance.

  • Breastfeeding Support
    Jen Harper, NP, CLC also offers one-on-one appointments for patients that require more extensive, individualized breastfeeding support. Please call our office at 617-731-3400 Option 2 to speak with our nurses.


    Mental and Emotional Support
    We are here to support moms with mental health concerns and connect moms with resources in their community. This may involve a visit with one of our providers and/or a referral through MCPAP for Moms to a mental health provider. We will also routinely ask expecting mothers to complete the Edinburgh Postnatal Depression Screening (EPDS) during pregnancy and the postpartum period.


    Existing Medical Conditions
    Moms with preexisting medical conditions may require more frequent visits to our office or to another specialist or your primary care.


    Problem Appointments
    New gynecological concerns may also arise during the postpartum period. Please call our office to speak with our team of nurses who can help evaluate your concerns over the phone. You may need to be seen by one of the providers in our office or we may refer you to an outside specialist.

Postpartum Resources

  • The EPDS is a widely used screening tool to evaluate postpartum depression. The EPDS is also recommended for use throughout pregnancy. We routinely screen patients between 12-13 weeks and 26-28 weeks pregnant during scheduled prenatal visits and again during the postpartum period. Early identification of mental health care needs ensures that we are able to connect patients with resources in their community.

    In Massachusetts, Governor Deval Patrick signed into law, An Act Relative to Post Partum Depression, Chapter 313 of the Acts of 2010.

    This legislation authorizes the Department of Public Health to “develop a culture of awareness, destigmatization, and screening for perinatal depression” and establishes a special legislative commission to investigate and study postpartum depression. In an effort to be inclusive as possible, the DPH established a PPD Legislation Implementation Working Group, inviting key stakeholders from across disciplines and the Commonwealth to provide guidance and assistance to the DPH through this process.

    This report is focused on two requirements in the legislation for DPH to:

    • Develop standards for measuring effective screening for postpartum depression

    • Make recommendations for health plans and health care providers for data reporting specific to postpartum depression screening.

    DPH worked collaboratively with the PPD Legislation Implementation Working Group, and specifically health care providers and health plans, on the following recommendations and standards. Further information on stakeholder engagement is described in the Department’s “Annual Summary of Activities Related to Screening for Postpartum Depression”, which was sent to the Legislature in October 2011.

  • Whether you are a first-time mom or becoming a mother again, you are about to experience one of the most amazing, rewarding and challenging times of your life. As you know, your baby needs nourishment to grow. Ultimately you will decide which feeding method is best for you and your baby. If you choose to provide breast milk for your baby, there are many ways to do this either by exclusively nursing at the breast, providing breast milk in a bottle, or providing some breast milk with formula.

    We want to provide you with some tips to help guide you along this journey should you choose to breastfeed.


    Stages of Milk Composition

    Colostrum (First stage of Milk)

    • Early days after birth

    • Small amount, thick, yellow, sticky

    • Protein rich, low fat, low sugar, packed with antibodies

    • Natural laxative effect to help initiate those early stools

    • Breasts will feel soft with colostrum

    Transitional Milk

    • Produced on average day 3-4 after birth (when milk comes in) until 10-14 days

    • Creamy milk after colostrum

    • More calories and larger volume than colostrum

    • Breasts will feel fuller/larger

    • You may experience engorgement. This can make latching the baby to the breast more challenging, as the nipple may become short as the breast tissue around it becomes harder. Seek help, if you are having difficulty.

    Mature Milk

    • Produced toward the end of the second week

    • Thinner and more watery (sometimes appears blueish)

    • Constantly changing for babies needs

    • Changes flavors to what mom is eating

    Milk Production

    • The only way your body knows that there is a baby to feed is by removing the milk.

    • The best breast pump is your baby – the baby is much better at removing breast milk than any artificial breast pump. This is, of course, if the baby is latching.

    • You can produce more milk by frequently and efficiently removing milk.

    Self-Care

    • One of the most important things that you can do for your baby is to make sure you are well taken care of.

    • We are not meant to do this alone. Use the support people around you!

    • Let your support system do anything and everything – they can do the grocery shopping, the laundry, prepare food, burp, diaper, rock and clean the baby – while you sleep, shower, or take a little time for yourself.

    • Let them be the gate keeper for visitors. You will need to rest any chance that you can get.


    Additional Resources

    Llli.org
    La Leche League International

    Lowmilksupply.org
    Diane West and Lisa Marasco’s website

    Kellymom.com
    Kelly Bonyata’s website

    Zipmilk.org
    Breastfeeding support in your area (by zip code)

    Vitalvillage.org
    Breastfeeding groups calendar

    New England Mothers First
    One-to-one lactation support (Zoom and in-person)

    New England OB-GYN offers appointments with our Certified Lactation Counselor and Nurse Practitioner Jen Harper. Our triage nurses can also help evaluate any problems over the phone and schedule an appointment if necessary.

  • MCPAP for Moms offers additional resources for moms in Massachusetts. Talk to our providers today if you would like help utilizing these services.

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