The Missing Patient After Childbirth: A Health-System Framework for Postpartum Continuity of Care in Asia

Maternal survival remains an urgent global-health priority, yet survival does not necessarily imply recovery, wellbeing, or long-term health. After childbirth, women may experience persistent physical, psychological, reproductive, cardiometabolic, nutritional, and social challenges that extend beyond conventional maternity care. Although contemporary postnatal guidance increasingly recognizes maternal wellbeing and continuity, an important operational gap remains between time-limited maternity services and longitudinal women’s healthcare. This narrative review synthesizes peer-reviewed literature, international guidance, and selected national policy evidence to examine the health-system gap between time-limited maternity services and longitudinal women’s healthcare and proposes a Postpartum Women’s Health Continuum (PWHC) to address this transition. Japan, Sri Lanka, Thailand, and Mongolia are used as purposively selected health-system exemplars to illustrate institutionalized postpartum support, community-based continuity, integration within universal health coverage, and adaptation to geographic constraint. We propose a PWHC encompassing six interconnected domains and emphasizing universal early continuity, risk-stratified follow-up, nurse- and midwife-enabled coordination, selective use of digital health, and explicit handover of unresolved or pregnancy-associated risks into continuing care. As 2030 approaches, maternal-health success should be judged not only by survival, but also by recovery and long-term health.