Postpartum & Return to Work Pathway — OneVillage Whole Health Pathways

Who this is for

Postpartum members 0-12 mo. PMAD with active SI/HI or psychosis routed to LCSW + psychiatry IMMEDIATELY. NICU graduates supported with extended timeline.

What brings people here

Postpartum (0-12 mo); planned RTW from parental leave; EPDS elevation; member request.

Clinical framework

OneVillage-developed.

How the 8 weeks run

Onboard

Before you begin

Baseline assessments, your first SMART goal, and the 1:1 that sets up everything after it.

Build

Weeks 1 to 3

Specialist coaches rotate in, and sessions come thickest here. One change at a time, in the domains your baseline flagged.

Mid-program

Week 4

Re-score, refresh the care plan, and check in 1:1 on what is and is not working.

Integrate

Weeks 5 to 7

The remaining domains, at a lighter cadence, and the work of making the early weeks hold under pressure.

Maintain

Week 8

Final re-score, relapse prevention, and the plan for what happens next.

When your sessions fall

The program is built in four-week modules. Sessions come thickest at the start, when what you decide matters most, and step down as things settle. That is 5 sessions of 45 minutes across 8 weeks, counting the visit before week 1.

Module	Weeks	Sessions	Cadence
Module 1	Weeks 1 to 4	2	every other week
Module 2	Weeks 5 to 8	2	every other week

Week by week

Before you begin
Before you begin
This pathway is anchored on one instrument, and week 0 is where you actually complete it. Not a mood question in passing. The Edinburgh Postnatal Depression Scale, scored, written down, with a threshold agreed in advance and a clinician on the other side of it.
Week 1
What is actually happening
The phrase "postpartum depression" gets used for everything from a tearful week to a psychiatric emergency. They are not the same condition, they do not have the same treatment, and the difference is worth knowing at two in the morning.
Week 2
Your body's recovery
This week you meet Tonia Burke for a 45-minute virtual pelvic floor therapy session. Postpartum recovery is one of the few areas here where a specific, well-tested intervention exists and is routinely skipped.
Week 3
Sleep, when sleep is not available
Most sleep advice assumes you control when you sleep. You do not. This week is about the parts that can be changed, and about being honest that some of this is simply endured rather than solved.
Week 4
Mid-program, and what treatment looks like
Halfway. This week you repeat the EPDS with Cindy in a 45-minute session and look at the direction of travel rather than a single number. This reading is about what happens if the number is not moving.
Week 5
The return to work
This is the half of the pathway name that almost no program addresses. Postpartum depression gets attention. The return to work gets a checklist about pumping and nothing else. It deserves better, and the evidence here is thinner than for depression, which we will say rather than pad it out.
Week 6
Planning your return
This week you meet Lucy Paulise for a 45-minute career coaching session. The purpose is a plan for the first four weeks back, written down, with the awkward conversations identified in advance.
Week 7
Logistics, and the identity part
The week before you go back, or shortly after. This one is practical, and then it is not.
Week 8
The first four weeks back
Last week of the program. You repeat every measure from week 0 with Cindy in a 45-minute session. This is a handover, not an ending, because the risk period runs to twelve months and the return to work sits inside it.

Who you will work with

Your Whole Health Coach takes your first visit and closes every module, so it is the same person from the first session to the last. The specialists below lead the weeks where their work is the focus.

Cindy Cathcart, RN, MSN, BCPA

Whole Health Coach

Professionally, Cindy has been a clinical nurse for nearly a decade. She served in both clinical and administrative capacities throughout her career and holds a Master's degree in Nursing Leadership. As a staff nurse, nurse leader, and quality improvement specialist, she led multidisciplinary teams in academic medical settings throughout Boston, New York, and Ohio to deliver high-quality care to patients across complex diagnoses.

Tonia Burke, DPT, MDT

Virtual Pelvic Floor Therapist

About Tonia: Tonia is a Doctor of Physical Therapy, Integrative Nutrition Health Coach, and Certified Pelvic Health Specialist (ICE-Certified Pelvic Specialist) with over 25 years of experience helping clients heal from pain, dysfunction, and chronic conditions. She specializes in pelvic floor therapy — supporting clients through pelvic pain, incontinence, postpartum recovery, and pelvic health concerns across every life stage.

Lucy Paulise

Career Coach

Luciana Paulise, also known as Lucy, is a leadership coach, speaker, and author. Her impressive qualifications include an MBA, ICF Professional Certified Coach, ASQ Quality Engineer, Agile Coach, and Scrum Master. With her expertise, she empowers individuals to shine on their superpowers and overcome imposter syndrome, perfectionism, and lack of self-confidence.

What we work on

Domain	What this pathway does
Nutrition & Metabolism	Postpartum nutrition: protein 1.2 g/kg, iron, hydration (especially lactating). Caloric needs for breastfeeding.
Movement & Mobility	Postpartum-cleared movement. Pelvic floor first. Diastasis recti screen. NOT pre-pregnancy intensity.
Sleep & Recovery	Fragmented sleep is the norm. Nap strategy. Partner rotation. NOT pre-pregnancy expectations.
Stress & Resilience	Identity shift; partner relationship; isolation; mental load.
Mind & Mood	EPDS weekly Wk 0-12; q4 weeks after. PMAD prevalence ~15-20% birthing parent.
Career / RTW	RTW readiness; first 4 weeks back; accommodation conversation; pumping plan.

How progress is measured

These are the validated tools this pathway uses: at your first visit, at the mid-program review, and at the end.

Tool	Cadence	Owned by
EPDS	Weekly Wk 0-12; q4 weeks after	WHC; LCSW reads >=13
C-SSRS	When EPDS item 10 positive; PRN	LCSW
ISI	Wk 4, Wk 12, q4 weeks	Sleep Coach
PSS-10	Onboard, q4 weeks	Stress Coach
RTW readiness checklist	Wk 8	Career Coach + WHC
Lactation goals log	Weekly through Wk 12	IBCLC

The research behind this pathway

Your clinician playbook was built from the guidelines and studies below. They are listed so you can read them yourself: every one is a real, published paper and the number at the end of each line is its PubMed ID.

Guidelines this pathway follows

ACOG Optimizing Postpartum Care · American College of Obstetricians and Gynecologists
The clinical spine of the first twelve weeks. PMID 29683911
Support for healthy breastfeeding mothers · Cochrane review
The dose of breastfeeding support that works, which is what returning to work disrupts. PMID 36282618
Workplace return-to-work interventions · Institute for Work and Health review
Why the workplace conversation is part of this pathway and not a separate errand. PMID 28224415

Key studies

Gavine A et al. (2022). Cochrane Database Syst Rev
Support for healthy breastfeeding mothers with healthy term babies
Cochrane's review of 116 trials and more than 98,816 mother-infant pairs. Scheduled breastfeeding support made women more likely to keep going, and four to eight visits looks like the effective dose. PMID 36282618
Ogbuanu C et al. (2011). Pediatrics
The effect of maternity leave length and time of return to work on breastfeeding
Followed 6,150 mothers. Shorter maternity leave and earlier return to work both predicted stopping breastfeeding sooner. PMID 21624878
Cullen KL et al. (2018). J Occup Rehabil
Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions: An Update of the Evidence and Messages for Practitioners
Reviewed what actually gets people back to work after illness or injury. Multi-domain programs that involve the workplace itself worked; health-care-only approaches did not. PMID 28224415
Carter T et al. (2019). Arch Womens Ment Health
The effectiveness of exercise-based interventions for preventing or treating postpartum depression: a systematic review and meta-analysis
Pooled 18 trials of exercise for postpartum depressive symptoms. The effect was small and the evidence low quality, which is what this pathway says rather than overselling it. PMID 29882074
American College of Obstetricians and Gynecologists (2018). Obstet Gynecol
ACOG Committee Opinion No. 736: Optimizing Postpartum Care
ACOG's committee opinion that postpartum care should be an ongoing process with contact in the first three weeks, not a single six-week visit. PMID 29683911