CE/CME

Postpartum Health: Screening and Intervention

Welcome to the training on Postpartum Health: Screening and Intervention provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).

Credit Hours: 1.25 CE

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  1. An Overview of Maternal Mortality and Morbidity in Texas
    1. Maternal Mortality and Morbidity Result from a Complex Set of Factors
    2. Prevention Strategies from the Texas Maternal Mortality and Morbidity Review Committee
    3. Preventability of Pregnancy-Related Mortality
    4. Urgent Warning Signs of Maternal Health Issues
    5. Initiatives to Reduce Maternal Mortality and Morbidity
    6. Section Summary
  2. Identifying and Addressing Maternal Health Risks in Primary Care
    1. The Fourth Trimester: Childbirth through 12 Weeks Postpartum
    2. Providing Continuity of Care
    3. Assessing, Screening and Treating Maternal Mental Health
    4. Screening and Management of Chronic Health Conditions Postpartum: Diabetes
    5. Screening and Management of Chronic Health Conditions Postpartum: Hypertension
    6. Screening and Management of Chronic Health Conditions Postpartum: Cardiovascular Disease
    7. Screening and Management of Chronic Health Conditions Postpartum: Behavioral Health
    8. Screening and Management of Chronic Health Conditions Postpartum: Smoking
    9. Section Summary
  3. Ongoing Support for Mothers and Infants
    1. Promoting Patient and Family Education
    2. Promoting Interpregnancy Care
    3. Integrated Behavioral Health Care for Postpartum Women
    4. Section Summary

Appendix of Resources for Health Care Providers

Academy of Breastfeeding Medicine. (2023). Clinical Protocol #21: Breastfeeding in the Setting of Substance Use and Substance Use Disorder. 

Alliance for Innovation on Maternal Health (AIM). (n.d.). Safety Bundles.

American College of Obstetricians and Gynecologists. (2022). My Postpartum Care Checklist for patients.

American College of Obstetricians and Gynecologists. Patient Education FAQs. Includes Annual Well-Woman Exam, Your Postpartum Care Team, Postpartum Birth Control, Alcohol and Pregnancy, Tobacco and Pregnancy, and Using Long-Acting Reversible Contraception Right After Childbirth.

American College of Obstetricians and Gynecologists. (2019). Practice Bulletin 212: Pregnancy and Heart Disease.

American Diabetes Association. Lifestyle Change Programs.

California Maternal Quality Care Collaborative. (2017). Improving Health Care Response to Cardiovascular Disease in Pregnancy and Postpartum Toolkit. (The toolkit is free to download, sign-in required.)

International Lactation Consultant Association.

La Leche League International, Breastfeeding support. 

Postpartum Support International. 

U.S. Agency for Healthcare Research and Quality (AHRQ). (n.d.). Team STEPPS, an evidence-based framework to improve communication and teamwork.

Postpartum Mental Health

American Academy of Pediatrics. (2022). Integrating Postpartum Depression Screening in Your Practice in 4 Steps. High-level, stepwise guidance for successfully incorporating PPD screening in clinical practice. 

Health Resources and Services Administration. (n.d.). National Maternal Mental Health Hotline. Text or call 1-833-TLC-MAMA.

The University of Texas System. Texas Child Mental HealthCare Consortium. (n.s.). Perinatal Psychiatry Access Network (PeriPan). Text or call 888-901-2726 for clinician-to-clinician mental health consults to serve pregnant and postpartum women Monday through Friday, 8 a.m. to 5 p.m.

Medication Safety During Lactation

National Library of Medicine. (2025). Drugs and Lactation Database.

Texas Health and Human Services. (2025). Health Care Provider’s Guide to Breastfeeding.

Texas Health and Human Serviced. Texas WIC. (2025). Texas Lactation Support Centers and Hotline. Lactation Hotline: 855-550-6667.

Texas Tech University Health Sciences Center. (2025). Infant Risk Center. 1-806-352-2519

References Featured in Course

Academy of Breastfeeding Medicine. (2015). Clinical Protocol #13: Contraception During Breastfeeding. Breastfeeding Medicine (2015) 10:1, 1-10.

Academy of Breastfeeding Medicine. (2015, updated 2023). Clinical Protocol #21: Breastfeeding the Setting of Substance Use and Substance Use Disorder. Breastfeeding Medicine 2023 18:10, 715-733.

Academy of Breastfeeding Medicine. (2015). Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers. Breastfeeding Medicine. Breastfeeding Medicine (2015) 10:6, 290-299.

American Academy of Pediatrics. (2022). Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics (2022) 150(1):e2022057988.

American College of Obstetricians and Gynecologists. (2020, reaffirmed 2023). Tobacco and Nicotine Cessation During Pregnancy Committee Opinion Number 807, May 2020.

American College of Obstetricians and Gynecologists. (2016, reaffirmed 2021). Severe Maternal Morbidity: Screening and Review. Obstetric Care Consensus Number 5, September 2016.

American College of Obstetricians and Gynecologists. (2019). Practice Bulletin 212: Pregnancy and Heart Disease. 

American College of Obstetricians and Gynecologists. (2018, reaffirmed 2021). Committee Opinion No. 736: Optimizing Postpartum Care.

American College of Obstetricians and Gynecologists. (2018). Postpartum Health Care Toolkit.

American College of Obstetricians and Gynecologists. (2016). Committee Opinion No. 654: Reproductive Life Planning to Reduce Unintended Pregnancy.

American College of Obstetricians and Gynecologists. (2019). Committee Opinion No. 792: Clinical Guidelines and Standardization of Practice to Improve Outcomes.

Berry, D., Boggess, K., & Johnson, Q. (2016). Management of Pregnant Women with Type 2 Diabetes Mellitus and the Consequences of Fetal Programming in Their Offspring. Current Diabetes Report, 16(5):36.

Buschur, E., & Polsky, S. (2021). Type 1 Diabetes: Management in Women From Preconception to Postpartum. The Journal of Clinical Endocrinology & Metabolism, 106(4):952-967.

Centers for Disease Control and Prevention. (2025). Tobacco and Electronic Cigarettes.

Centers for Disease Control and Prevention. (2024). Preventing Pregnancy-Related Deaths (Topic sheet). September 25, 2024. 

Centers for Disease Control and Prevention. (2024). Maternal Mortality Prevention: Preventing Pregnancy-Related Deaths. 

Centers for Disease Control and Prevention. (2023). Tobacco Product Use Among Adults – United States, 2021. Weekly / May 5, 2023 / 72(18);475–483.

Centers for Disease Control and Prevention. (2023). Vaccination Safety for Breastfeeding Mothers.

Centers for Disease Control and Prevention. (2022). Four in 5 pregnancy-related deaths in the U.S. are preventable (press release). (September 19, 2022).

Centers for Disease Control and Prevention. (2022). The National Intimate Partner and Sexual Violence Survey: 2016/2017 Report on Intimate Partner Violence.

Centers for Disease Control and Prevention. (2017). Intimate Partner Violence Prevention Resource for Action.

Chen, J., Cox, S., Kuklina, E. V., Ferre, C., Barfield, W., & Li, R. (2021). Assessment of Incidence and Factors Associated With Severe Maternal Morbidity After Delivery Discharge Among Women in the US. JAMA Network Open, 4(2):e2036148.

El Sayed, N., Aleppo, G., Aroda, V., Bannuru, R., Brown, F., Bruemmer, D., et al. on behalf of the American Diabetes Association. (2023). 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2023. Diabetes Care 1 January 2023; 46 (Supplement_1): S254–S266.

Parikh, N.I., Gonzalez, J.M., Anderson, C.A.M., Judd, S.E., Rexrode, K.M., Hlatky, M.A., et al. for the American Heart Association Council on Epidemiology and Prevention; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; and the Stroke Council. (2021). Adverse Pregnancy Outcomes and Cardiovascular Disease Risk: Unique Opportunities for Cardiovascular Disease Prevention in Women: A Scientific Statement From the American Heart Association. Circulation. 2021 May 4;143(18):e902-e916.

Texas Collaborative for Healthy Mothers and Babies. (n.d.).

Texas Collaborative for Health Mothers and Babies. (n.d.). MEWS Badge Buddies. 

Texas Department of State Health Services. (n.d.). Texas Health Data (dashboard).

Texas Department of State Health Services. (2022). Texas Health Data. Severe Maternal Morbidity.

Texas Department of State Health Services. (2024). Texas Maternal Mortality and Morbidity Review Committee and Department of State Health Services Joint Biennial Report 2024.

U.S. Agency for Healthcare Research and Quality (AHRQ) Academy for Integrating Behavioral Health & Primary Care. (n.d.). Pregnant and Postpartum Women and Behavioral Health Integration (topic brief). Accessed 4/22/25.

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2030: Social Determinants of Health. (Retrieved 4/22/25.)

U.S. Department of Health and Human Services. (2020). The Surgeon General’s Call to Action to Improve Maternal Health. 

U.S. Preventive Services Task Force. (2018). Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: US Preventive Services Task Force Final Recommendation Statement. JAMA, 320(16):1678–1687.

Ying, W., Catov, J., & Ouyang, P. (2018). Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk. Journal of the American Heart Association, 7(17), e009382.

Medical Definitions

The medical definitions in this module were obtained or adapted from the American Academy of Pediatrics, National Institutes of Health, Postpartum Support International, Texas Department of State Health Services and World Health Organization.