POSTPARTUM

POSTPARTUM CARE
Definition
Postpartum care encompasses
management of the mother, newborn,
and infant during the postpartal period.
This period usually is considered to be
the first few days after delivery, but
technically it includes the six-week
period after childbirth up to the
mother's postpartum checkup with her
health care provider.
Precautions
-During the postpartum period
the mother is at risk for such
problems as infection,
hemorrhage, pregnancy induced
hypertension, blood clot
formation, the opening up of
incisions, breast problems, and
postpartum depression.
 PHYSICAL CHANGES DURING POSTPARTUM

Uterus

 Involution- The reduction in the size of the uterus

after the delivery to the prepregnant
size.
 Fundus-The fundus steadily descends into pelvis;
fundal height decreases about one.
 Fingerbreath per day , by 10 days postpartum fundus
cannot be palpated abdominally.
Lochia –discharges from uterus that
consist of blood from vessels of placental
site and debris from deciduas.
Normally, has fleshy odor.

RUBRA – day 1 – 3 , bright red

SEROSA- day 3-10, brownish pink

ALBA- days 10-14, white

Afterbirth pains
-refers to the contraction of the uterus; more
common in breastfeeding mothers and clients
treated with oxitoxic drugs.

Cervix and vagina

Cervical involution- after 1 week ,muscle

begins to regenerate.
Vagina- Vaginal distension decreased;
lacerations or episiotomy suture gradually
heal.
Ovarian function and menstruation

 Menstrual flow resumes within 8 weeks in non-

breastfeeding mothers.
 Menstrual flow usually resumes within 3-4 months in
breastfeeding mothers. Women ovulate without
menstruating, so breastfeeding should not be
considered form of birth control

BREAST
 Decrease estrogen and progesterone levels after
delivery stimulates increased prolactin level , which
promotes breast milk production
 Breast become distended with milk on third day.

 Breastfeeding will relieve engorgement

URINARY TRACT
- client may have urinary retention due to loss of
elasticity and tone and loss of sensation from trauma,
drugs, anesthesia ,loss of privacy.
-Diuresis begins within 12 hours after delivery.
Gastrointestinal tract
 Constipation can occur because of decreased muscle
tone in intestines and perineal tenderness.
 Hemorrhoids are common but generally subsides.
 CARDIOVASCULAR SYSTEM
 The increase in blood volume is eliminated by diuresis.
 Hemoglobin and RBC decrease
 WBC usually increase during labor and early
postpartum period return to normal.
 Elevation in fibrinogen levels continues for 1 week
resulting in increased sedimentation rate and risk for
thrombophlebitis.
VITAL SIGNS
 Temperature may be elevated to 100.4 F (38 C) during
first 24 hours with pathology.
 Bradycardia common during 1st week and range
between 50-70
 Blood pressure remains unchanged.

PLAN
-Client will resume no pregnant physiological
function.
IMPLEMENTATION
 Check height, consistency, and location of fundus.
 Monitor Vital sings
 Check color, amount and odor of Lochia.
 Check breast for engorgement.
 Check perinium for swelling and discoloration.
 Check episiotomy for healing.
 Monitor bowel status
 Assess bonding with infant
 Assess emotional bonding
 Stress the important of check-up
 Encourage frequent rest period
 Provide nutritional counseling
 Encourage frequent voiding and frequent perineal care
after voiding.
 Encourage of wearing supportive bra.