The word postpartum or postnatal refers to the period of time that starts after the delivery of a child. This time is where the mother’s body gradually returns to the original non-pregnant state. Medically, it is known as the puerperal period where it refers to the first six weeks after childbirth. It has been described by the World Health Organization (WHO) as an extremely critical period yet also the most neglected time in the lives of both mother and child as most maternal or newborn deaths happen in this phase. In the hospital, the mother may be discharged as soon as both her and the child are stable. This can range from as early as a few hours after delivery to four or more days depending on the situation. After delivery while both mother and child are in the hospital, the woman’s bowel and bladder function will be monitored along with any bleeding. Care will be provided for the baby. There are three stages in the postpartum period:
a) Initial or acute phase – six to twelve hours after the delivery of the child
b) Subacute phase – two to six weeks
c) Delayed phase – up to six months
Every woman after delivery of their new baby is asked to return for a visit with their obstetrician six weeks later. This visit is also known as the first postpartum visit. With your visit, you should also know what you should ask your doctor.
Postpartum Self-Care
While you may be focused on caring for your new baby, you should make sure that you also care for yourself. Your body will need time to recover from the pregnancy and delivery. Here are some tips that you can follow to help you heal and feel better faster!
- While it may be tempting to have your baby meet the rest of the family, take the first few days and limit the number of visitors so both you and the baby get adequate rest.
- Enlist help for cleaning and meal preparation.
- Follow your doctor’s instructions.
- If you have swelling in your legs, keep it elevated.
- A warm bath might help if you have vaginal discomfort.
- Start applying creams for your stretch marks.
- Eat a healthy diet.
- A supportive bra can help with sore breasts.
- For breast care, use nipple cream to help with sore nipples. If you are not breastfeeding, talk to your doctor about reducing milk production to avoid issues such as engorgement and mastitis.
- Lose your pregnancy weight gradually.
- Ask for help whenever you need.
- Schedule a visit with your doctor if you have any issues!
Postpartum Checklist
New mothers are often stressed and overwhelmed with so many new responsibilities after the delivery of their child that they can forget to care for themselves. Many mothers are so occupied with their new baby that they neglect their own care. One good example is the dismissal of symptoms of postpartum “blues” and regarding them as normal. Embarrassment is also an issue as many find it hard to talk about their sexual disinterest and contraceptive needs. To help you get started, here is a checklist that you can use to guide you during your postpartum visit to your doctor.
i. Breast Health
Breastfeeding has been touted by many to be the best nutrition you can provide for your baby as it contains nutrients and antibodies to nourish and protect your baby from illnesses during their early days of life. In the early postpartum period, as many as 64% of new mothers choose to provide breast milk and many experience engorgement of breasts, mastitis, poor let down, and many more issues. New mothers that are inexperienced can often think that the pain and breast lumps are normal during this time and do not seek treatment until there are serious complications. If mothers decide to stop breast feeding, this many also be an issue as it can lead to engorgement if stopped abruptly. A regular breast examination at your doctor’s visit can be helpful to rule out any issues. You can also discuss the difficulties you face such as difficulties feeding or wanting to discontinue lactation.
ii. Contraception
After delivery, the time it takes for your menstruation to resume can vary for each individual. Some begin as early as six weeks while some can take as long as a year (especially in women who breastfeed). Since there is no menstruation, many women make the mistake of assuming that ovulation does not happen and therefore they won’t be able to conceive. This is not true, and all women are encouraged to use a form of contraceptive as soon as they resume intercourse regardless if menstruation has started. Your contraceptive needs may also differ prior to your latest conception. Discuss with your doctor regarding the best method that will suit your new needs.
iii. Weight Loss
One of the biggest concerns in mothers are losing weight after the delivery of their child. The weight gained during pregnancy can take some time to accomplish and many new mothers are unsure of where and how to start. Most new mothers can safely begin their exercise routine once they are comfortable. Start slow, with walking and gradually increase your program. Through a healthy diet and a regular routine, the weight loss will average about one to two pounds every week. Breastfeeding may also contribute to weight loss as it burns more calories. It has been observed that mothers who do not lose the weight gained during pregnancy in the first six months, they are more likely to become obese or overweight in the future. Talk to your doctor before starting a new exercise routine.
iv. Intercourse
New mothers are unsure when they can resume intercourse. Most experts recommend waiting four to six weeks to allow the episiotomy incision or any vaginal tears to heal. This also depends on the mode of delivery. Some women may also experienced issues such as vaginal dryness due to low levels of estrogen and low libido due to hormonal changes, tiredness, stress, low confidence levels, and breastfeeding. If you are experiencing these issues, be sure to talk to your doctor about using appropriate creams and lubricants. Mothers with low libido should seek medical attention to ensure that there are no psychological or medical issues.
v. Emotions
As many as 85% of new mothers experience symptoms of postpartum depression or sadness. There are many support groups that are available to help new mothers cope. About 15% of new mothers have symptoms of postpartum depression that are persistent. They experience sadness, anxiety, despair, guilt, irritability, and poor focus. If you are experiencing these symptoms for more than two weeks, be sure to seek medical attention.
vi. Postpartum Examination
Your postpartum visit will usually include an examination of the breast and pelvis. After the puerperal period, the uterus should return to their normal size while vaginal tears and episiotomy incisions would have healed. This also applies for incisions for a caesarean section. A pap smear examination may also be performed. Other tests include a blood test to check your blood levels and thyroid function.
OFFICIAL REFERENCES
https://en.wikipedia.org/wiki/Postpartum_period
http://www.who.int/maternal_child_adolescent/publications/WHO-MCA-PNC-2014-Briefer_A4.pdf
https://www.urmc.rochester.edu/ob-gyn/obstetrics/after-delivery/breast-care.aspx
https://www.acog.org/Patients/FAQs/Postpartum-Depression
https://www.webmd.com/women/what-is-engorgement
https://www.webmd.com/parenting/baby/what-is-mastitis
https://www.webmd.com/parenting/baby/poor-let-down-while-breast-feeding
https://www.webmd.com/women/clinical-breast-examination#1
https://www.babycenter.com/0_birth-control-choices-after-you-have-a-baby_3755.bc
https://medlineplus.gov/ency/patientinstructions/000586.htm
https://www.babycentre.co.uk/a536362/sex-after-the-birth
https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml
https://www.storknet.com/a-postpartum-visit-checklist/
https://www.parents.com/pregnancy/my-body/postpartum/what-to-expect-at-your-6-week-postpartum-exam/
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