Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women - A scoping review.

BACKGROUND: The postpartum period is a critical phase for both maternal and infant health. In many healthcare systems, postpartum care is limited to a single six-week visit, often leaving women with inadequate support as they undergo the physiological, psychological, and social adjustments required for motherhood. AIM: This scoping review maps the characteristics, delivery approaches, reported outcomes, and evidence gaps of nurse- and midwife-led continuity-of-care interventions that include care or follow-up beyond six weeks postpartum. METHODOLOGY: Following Arksey and O'Malley's framework and the Joanna Briggs Institute (JBI) guidance, five electronic databases and gray literature sources were searched for studies published between 2013 and 2025. Eligibility was assessed using the Population, Concept, and Context (PCC) framework. Data were charted according to intervention characteristics, setting, provider, delivery mode, outcome measures, and reported findings. Methodological limitations were appraised using design-appropriate JBI critical appraisal checklists, and the findings were synthesised narratively. RESULTS: Fifteen studies met the inclusion criteria, of which ten were randomized controlled trials (RCTs). Interventions were heterogeneous and delivered in hospitals, communities, homes, primary care, and digital settings. Several studies reported reductions in depressive or trauma symptom scores, improved breastfeeding outcomes, and increased contraceptive and service uptake. Evidence of cardiometabolic recovery and long-term quality-of-life outcomes is limited. Small sample sizes temper interpretation in several studies, self-reported outcomes, lack of comparison groups in some non-randomized studies, attrition, and limited feasibility of blinding for behavioral and service-delivery interventions. CONCLUSION: The reported findings suggest that nurse- and midwife-led models may improve continuity and selected maternal outcomes beyond six weeks postpartum. However, heterogeneity and methodological limitations preclude strong conclusions about comparative effectiveness. Extended nursing and midwifery follow-up should be integrated with obstetric, primary care, mental health, and other services, with implementation tailored to local workforce, health system, and financing contexts.