Postpartum Visit Checklist
Structured prompts for postpartum doula visits — recovery check, feeding, sleep, mental health screen, and household support.
What's inside
- Physical recovery questions
- Feeding observations
- Sleep + rest plan
- Mood / EPDS prompt
- Household + sibling support
POSTPARTUM VISIT CHECKLIST Client: __________________ Days postpartum: ____ Visit #: ____ PHYSICAL RECOVERY - Lochia color/amount: __________ - Pain level (0-10): ____ Incision/perineum: __________ - Hydration / nutrition today: __________ FEEDING - Method: [ ] Breast [ ] Bottle [ ] Combo - Latch / supply concerns: __________ - Output (wet / soiled diapers last 24h): __________ SLEEP - Longest stretch last night: __________ - Plan for nap support today: __________ MOOD CHECK - "How are you feeling emotionally on a scale of 1-10?" - Any thoughts of self-harm? Refer to PMHN if YES. - Consider EPDS at 2 + 6 weeks. HOUSEHOLD - Meals next 48h: __________ - Older sibling support: __________ - Tasks I can complete this visit: __________ NEXT VISIT: __________ DISCLAIMER: This template is provided for informational purposes only and does not constitute legal, medical, or financial advice. Have a licensed professional in your jurisdiction review and adapt it before use.
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