A Multicentre Assessment of Postpartum Recovery Using the STanford Obstetric Recovery checKlist (STORK)

Outpatient postpartum recovery remains poorly understood. We aimed to characterize postpartum recovery and compare recovery by delivery mode and parity using the newly validated STanford Obstetric Recovery checKlist (STORK).

After institutional review board approval, English-speaking adults were recruited from 3 U.S. academic centres. Demographic and clinical data were collected. Participants completed STORK (47 items covering physical, mental/emotional health, motherhood experience/social support, sleep/fatigue domains), at 2, 6, and 12 weeks postpartum. Chi-square, 1-way analysis of variance, and Kruskal-Wallis tests were used to compare categorical and continuous variables.

A total of 498 participants were included (Asian 14%, Black 7%, White 63%, Other 5%, declined to disclose 10%), with a mean age of 33 ± 5 years. The median gestational age was 39 weeks (IQR 2), and 46% were primiparous. Spontaneous/induced vaginal delivery, scheduled cesarean delivery, intrapartum cesarean delivery, and operative vaginal delivery represented 52%, 27%, 18%, and 3% of participants, respectively. Total STORK, physical health, and sleep/fatigue scores improved from the inpatient postpartum period to week 12 postpartum (P < 0.001) for all delivery modes, with a 22% increase in median total scores. Mental health and motherhood experience scores improved until week 6 (P < 0.001). Physical recovery scores differed significantly between delivery modes, with best scores after spontaneous/induced vaginal delivery and lowest scores after operative vaginal delivery up to week 2. Overall recovery was better in multiparous patients than in primiparous patients up to 6 weeks postpartum, although these differences resolved by week 12.

Postpartum recovery continues up to at least 12 weeks and varies by delivery mode and parity. Future studies are needed to determine clinically meaningful differences to inform thresholds for targeted interventions.