Caring for the Whole Woman: A Case for a Comprehensive Postpartum Assessment Index

The six-week postpartum visit remains the primary — and often only — formal clinical encounter a woman receives following childbirth in the United States. Despite recommendations by the American College of Obstetricians and Gynecologists (ACOG) that this visit be broadened into a comprehensive postpartum care model, most providers continue to rely on a narrow set of single-domain screening tools that collectively fail to capture the full scope of postpartum experience. The Edinburgh Postnatal Depression Scale (EPDS), the most widely administered postpartum instrument, screens for depression alone. Other validated tools address anxiety, PTSD, bipolar spectrum disorder, or pelvic floor dysfunction in isolation. No existing instrument integrates physical recovery, psycho-emotional wellbeing, birth trauma, relational identity, energetic depletion, and the capacity for meaning-making and awe into a single, clinically usable framework. This paper introduces the Comprehensive Postpartum Assessment Index (CPAI), a novel multi-domain screening instrument grounded in the panchamayakosha model from the yoga therapy tradition — a five-layered framework that understands the human being as physical body, breath and energetic body, psycho-emotional realm, discernment body, and capacity for awe. The CPAI draws on validated, open-source items from existing instruments where applicable and introduces original items in domains that are currently unaddressed in clinical practice. It is designed to be administered by obstetricians, midwives, or other postpartum providers as a starting point for whole-person assessment and targeted referral. This paper reviews the current landscape of postpartum screening tools, articulates the clinical and humanistic gaps they leave unaddressed, introduces the theoretical framework underlying the CPAI, and presents the instrument itself. While formal psychometric validation studies are beyond the scope of this initial work, the CPAI is offered as a rigorously grounded foundation for future research, clinical pilot testing, and iterative refinement. Keywords: postpartum care, postpartum depression, comprehensive screening, panchamayakosha, yoga therapy, birth trauma, matrescence, pelvic floor, postpartum PTSD, body awareness, bodily dissociation, whole-person assessment