Postnatal Care at Rajul Nursing Home, Aligarh

What is Postnatal Care?

The postnatal period is a critical phase in the lives of mothers and newborn babies.
The guidelines address timing, number and place of postnatal contacts, and content
of postnatal care for all mothers and babies during the six weeks after birth.
A woman giving birth in a hospital may leave as soon as she is medically stable,
which can be as early as a few hours postpartum, though the average for a vaginal
birth is one to two days. The average caesarean section postnatal stay is three to
four days. During this time, the mother is monitored for bleeding, bowel and bladder
function, and baby care. The infant’s health is also monitored. Early postnatal
hospital discharge is typically defined as discharge of the mother and newborn from
the hospital within 48 hours of birth.
Vaccination Programme for Babies

Although the use of most vaccines during pregnancy is not usually recommended on
precautionary grounds, there is no convincing evidence that pregnancy should be an
absolute contraindication to the use of any vaccine, particularly inactivated vaccines.
The only exception is the vaccinia virus (smallpox vaccination), which has been
shown to cause fetal malformation. Although the use of most vaccines during
pregnancy is not usually recommended on precautionary grounds, there is no
convincing evidence that pregnancy should be an absolute contraindication to the
use of any vaccine, particularly inactivated vaccines. The only exception is the
vaccinia virus (smallpox vaccination), which has been shown to cause fetal
malformation.
Physiotherapist exercise

After your baby is born, it is important to follow a series of exercises to strengthen

the muscles which have been stretched by pregnancy and birth. This will help to
prevent backache, promote correct posture and help you regain your figure more
quickly. Your circulation and breathing will also benefit.
The physiotherapist or midwife will show you how to do your exercises and give you
a leaflet to take home with you. Pelvic floor and gentle deep tummy muscle
exercises are vital and you should try to do them every day to encourage the muscle
fibers to function normally again. This may take several months after birth
Infant caring in the acute phase

Within about 10 seconds the infant takes its first breath and the caregiver places the
baby on the mother’s chest. The infant’s condition is evaluated using the Apgar
scale. The Apgar score is determined by evaluating the newborn baby on five criteria
which are summarized using words chosen to form a backronym. Until recently
babies were routinely removed from their mothers following birth, however beginning
around 2000, some authorities began to suggest that early skin-to-skin contact
(placing the naked baby on the mother’s chest) is of benefit to both mother and
infant. As of 2014, early skin-to-skin contact, also called kangaroo care, is endorsed
by all major organizations that are responsible for the well-being of infants. Thus, to
help establish bonding and successful breastfeeding, the caregiver carries out
immediate mother and infant assessments as the infant lies on the mother’s chest
and removes the infant for further observations only after they have had their first
breastfeed.
Physical recovery in the subacute postpartum period

In the first few days following childbirth, the risk of DVT is relatively high as
hypercoagulability increases during pregnancy and is maximal in the postpartum
period, particularly for women with C-section with reduced mobility. Anti-coagulants
may be prescribed or physical methods such as compression are commonly
indicated to decrease the risk of DVT.
The increased vascularity and edema of the woman’s vagina gradually resolves in
about three weeks. The cervix gradually narrows and lengths over a few weeks.
Postpartum infections can lead to sepsis and if untreated, death. Postpartum urinary
incontinence is experienced by about 33% of all women; women who deliver
vaginally are about twice as likely to have urinary incontinence as women who give
birth via a cesarean. Urinary incontinence in this period increases the risk of long
term incontinence.
Adult diapers may be worn in the subacute postpartum period for lochia, as well as
urinary and fecal incontinence.
Discharge from the uterus, called lochia, will gradually decrease and turn from bright
red to brownish, to yellow and cease at around five or six weeks. Women are
advised in this period to wear adult diapers or nappies, disposable maternity briefs,
maternity pads or towels, or sanitary napkins. The use of tampons or menstrual cups
is contraindicated as they may introduce bacteria and increase the risk of infection.
An increase in lochia between 7–14 days postpartum may indicate delayed
postpartum hemorrhage
Infant caring in the sub acute period

At 2–4 days postpartum, a woman’s milk will generally come in. Historically, women
who were not breastfeeding were given drugs to suppress lactation, but this is no
longer medically indicated. In this period, difficulties with breastfeeding may arise.
Maternal sleep is often disturbed as night waking is normal in the newborn, and
newborns need to be fed every two hours, including during the night. The lactation
consultant and health visitor may be of assistance at this time.