CN109- Care of Mother and Child at Risk or with Problem

RLE- Hospital ( OB-NSD)

3rd Trimester S.Y. 2019-2020

JOURNAL READING NO. 2

Topic: Perineal Care for Episiotomy Pain and Wound Healing

Name of Student: Sunga Jean Aubrey S.A Student No: 181-1197

Date and time submitted: March 12,2020 BSN II-A Grp:3_____

A. Title of the article

Effect of Self Perineal Care Instructions on Episiotomy Pain and Wound Healing
of Postpartum Women
B. Summary
Postpartum period is the period during which the woman adjusts,
physically and psychologically post pregnancy and birth. It is the period
after the end of labor during which the attendance of a midwife upon the
woman and baby is required, being not less than 10 days and for a longer
period if the midwife considers it necessary. An arbitrary time frame
divides the period into the immediate postpartum , early postpartum and late
postpartum. The main goals in postpartum care are to assist and support the
woman's recovery to the prepregnant state and educate the mother about
her own self-care. This is a surgical incision through the perineal tissue that
is designed to enlarge the vulval outlet during delivery and to minimize the
risk of severe spontaneous, maternal trauma and to expedite the birth when
there is evidence of fetal compromise. The perineal pain resulting from
episiotomy is a stressful factor in mothers, which interferes with their
ability of nursing and doing their duties as a mother and may interfere with
urination and defecation. The perineum is assessed for the type and amount
of vaginal discharge, unusual swelling, discoloration, healing of the tissues
and discomfort. If an episiotomy was performed, the state of healing is
assessed by observing for redness, edema, ecchymosis, discharge and
approximation of the wound. Foul odor accompanied by drainage indicates
infection, further examination of the incision and area of warmth and
tenderness should be performed he normal episiotomy site should not have
redness, discharge or edema. The majority of healing takes place within the
first 2 weeks, but it may take 4 to 6 months for the episiotomy to heal
completely.
All women should be asked about discomfort in the perineal area,
regardless of whether the birth resulted in actual perineal trauma. Advices
from the midwife may be welcomed and clear information and reassurance
are helpful where women have poor understanding of what happened and are
 anxious about urinary, bowel or sexual function in the future. For the
majority of women, the perineal wound gradually becomes less painful and
healing should occur by 7-10 days after the birth common causes of
discomfort is episiotomy.
C. Reflection
Postpartum perineal care is cleaning and caring for your perineum
after having a baby. The perineum is the area between the vagina and the
anus. In the first few weeks after childbirth, they will probably have
soreness or pain in their perineum. They will also have discharge coming out
of their vagina. Good thing is that there are medical professionals such as
nurses that are willing to conduct health education to the mother either
primigravida or multigravida so that they will know and determine what are
the proper way on rendering wound and perineal care.
As a student nurse, it is my duty understand that some of the
patients are not yet informed about the do’s and don’ts. We should inform
them the proper way of cleaning the perineum such as; rinse the perineum
with water after you use the toilet and before putting on a new peri-pad.
We, health care providers will show them how to use a peri-bottle (hand-held
squirt bottle) to rinse their perineum. Squirting warm tap water on their
perineum will keep it clean and may provide comfort for pain. Remind them to
do the handwashing before doing so.
Lastly, for a person who has an indwelling catheter, proper perineal
care reduces the risk for infection. Perineal care also protects the skin
around the genitals and anus from breaking down. For bedridden loved ones,
the risk of bed sores is high. Proper perineal care helps to keep that at bay.
We will serve as the guiding book of our patients. Whatever we will
say to them, it is hundred percent sure that they will do that and follow that
because they trust us more. We should know what are the guidelines and we
should be aware of it because at the end of the day, we are the one who will
give them the legitimate facts about what they shall do. Whatever happens
to them , we are accountable for that.

D. Reference
Mohamed, A. and N.El Nagger. “Effect of Self Perineal Care Instructions on Episiotomy Pain
and Wound Healing of Postpartum Women”. January 2016
https://www.researchgate.net/publication/308414766_Effect_of_Self_Perineal_Care_Instru
ctions_on_Episiotomy_Pain_and_Wound_Healing_of_Postpartum_Women