Postnatal Care – A Brief

 Congratulations!!! Being a MOM must be sinking in, and you’d also be riding a roller coaster ride on the hormones that pregnancy has embedded in you. If you are feeling stressed out and vulnerable, its because your body has just delivered and it needs time to recover. Add to that the new-born and his constant demands – your mind and body are working too hard and also need some care. Postnatal care, also called the puerperium, the refers to the care given to the mother for 6 weeks after the delivery of the baby. Following the birth of the baby various physiological changes occur that gradually help the mother to get back to her non-pregnant state.

Here is a list of some of the important changes that occur during postnatal period.

• The vaginal wall which becomes swollen and bluish reverts back to its toned non-pregnant state.
• There is subsidence of perineal oedema.
• The uterus regains its original shape by the end of puerperium.
• After delivery lochia or vaginal discharge is reddish brown in color and contains trophoblastic tissue remnants and blood. Later it becomes yellowish and towards the end of postnatal period lochia again becomes red.

Frequent Problems of Post Natal Period-

Some of the problems commonly encountered by pregnant women are listed under-

Bowel problems-Expectant women usually experience constipation. You can take stool softeners and fiber-rich diet to deal with constipation.

Micturition- Around 50 per cent of pregnant ladies experience incontinence of urine, an annoying condition. Practicing of pelvic floor exercises can be quite helpful in improving the menace.

Haemorrhoids-It is seen as a common post birth problem. You should take fresh vegetables and fiber rich fruits as these help in easy evacuation of bowels. Haemorrhoids usually disappear in 3-4 weeks post delivery.

Painful perimeum- If the perineum is sutured during delivery, it can become painful at times. Get it checked from your gynaecologist for any underlying infection.

Mastitis-Some women can have problem in milk expression from the breast. This can cause mastitis-a very painful condition. Use breast pump or cold compresses to get prompt relief.

Backache– Lower backache can be noted by women after the birth of the baby. Take mild analgesics and local application of hot oil can provide relief.

Psychological problems:

Post partum depression is seen in approximately 10 per cent of females. This depressive state is transient and usually passes off by the end of puerperium.

According to psychologists the probable causes of this post delivery depression are the doubts pertaining to her efficiency about taking good care of the new-born.

Some Fatal Complications-

Post Partum Haemorrhage- if excessive abnormal bleeding occurs after 24 hours of childbirth with first 6 weeks of delivery. It is termed as post partum haemorrhage.

It can be due to retained placental pieces, poor epithelialisation of placental site, etc.

Postnatal anaemia- This is very common so get your haemoglobin level checked regularly.

Puerperal pyrexia: It is also called post natal fever. It is medically defined as presence of body temperature 38°C or above in the first 14 days post delivery.

Deep Vein Thrombosis-

In this condition common clinical features seen are low-grade, feeling of uneasiness and elevated pulse rate.

If you experience any of the above symptoms, immediately seek the help of your gynaecologist.

Pulmonary embolism-This is another complication of delivery.

Important Do’s

Here are some vital post natal care do’s that should be borne in mind-

• The expectant mothers should be educated about the process of child birth and the significance of antenatal care and post natal care.
• Appropriate knowledge should be imparted to them regarding how to take proper care of their health as well as that of the babies.
• An important part of post natal care is advising the women about the symptoms and signs of some life-threatening situations.
• Toilet hygiene should be maintained.
• Well-balanced diet should be given to the mother.
• Regular check-ups should be done, both for the mother and the baby.
• New-born should be timely vaccinated.
• Encourage ambulation-The mothers should be encouraged to walk as walking improves blood circulation and helps in speedy repair of perennial area.
• Encourage breast feeding
• Educate the mothers about the importance of contraception
• Light Exercises – to get back in shape and feel confident.

Important Don’ts-

• Avoid excessive straining as the perennial region is tender
• Avoid too much sitting
• Avoid constipation so eat a lot of green leafy vegetables and fiber-rich fruits
• Do not lift heavy weights

Breast Feeding-

The care givers should encourage breast feeding because it has immense advantages such as-

• It lowers the threat of autoimmune disorders in the future life of the baby.
  

  Breastfeeding a baby has dual benefits

• It enhances the immunity of the baby.
• It significantly lowers infant mortality.
• It strengthens the baby-mother love and relationship.
• It lowers the vulnerability of gastrointestinal ailments.
• Breast feeding provides relief in discomfort caused due to breast engorgement.

 

The mother should be well informed and educated about the direness of contraception. The available contraception alternatives should be told to her and depending upon her feasibility she should be encouraged to adopt one.

In the initial 21 days contraception is not needed. The commonly available methods of contraception are barrier method, intrauterine devices, the lactation-amenorrhoea method, progesterone-only pill, the etonogestrel implant, injectable progesterone contraceptives and sterilization. Combination pills are not advised as it adversely affects the lactation.

As a mother now, you need to keep your health in check and should ensure that you do not miss any of your postnatal appointments – do not neglect yourself at all.