Care Bundles: Enhanced Recovery After Delivery

The care of obstetrics patients has improved dramatically over the past few decades. Unfortunately, rates of cesarean section remain high, and decreasing this rate requires close care and follow-up in the prenatal outpatient setting. Counseling regarding cesarean delivery and vaginal delivery is imperative. Opportunities still exist in helping patients objectively weigh the decision for cesarean delivery versus vaginal delivery. Additional developments have occurred in the intrapartum and the postpartum setting, with an aim to improve patient and neonatal outcomes. Changes have been implemented for patients undergoing cesarean delivery including preoperative and intraoperative treatment of pain, nausea, and vomiting, as well as postoperative care bundles that improve patient outcomes. Innovations have also occurred in the care of postpartum patients after vaginal delivery, again with improvements in patient outcomes. This article summarizes the current evidence, provides care recommendations, and identifies the next steps in improving obstetrics care.