Postpartum Period 2020

The Care of the
Mother and Child

During Postpartum
10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 1
Learning OUTCOME
At the end of the 4-hour virtual discussion the student will be able to:
1. Discuss related terminologies used during postpartum.

2. Explain the significant physiologic and psychological during postpartum
period.
3. Describe the different phases during puerperium:
• Taking In
• Letting Hold
• Letting Go
Learning OUTCOME
4. Utilize the nursing process in conducting postpartum assessment.
•Assessment
Breast
Uretus
Bladder
Bowel
Lochia
Episiotomy
Signs, vital
Homan’s sign
Emotional
Learning OUTCOME
• Diagnosis
• Planning/Goals
• Implementation
• Evaluation

Re l a t e d Te r m i n o l o g i e s
B a s i c
Postpartum B a b y C a r e
 6 weeks period after childbirth

I nv o l u ti o n
Barefers
s i c toBchanges
a b y ofCthe
are
reproductive organs which undergo
after birth to return to their pre-
pregnancy size and condition

S u b i n v o l u ti o n
Basic Baby Care

failure of the uterus to return to the
pre-pregnant state after 6 weeks

A ft e r p a i n s
Basic Baby Care

cramps or pains following
childbirth, caused by uterine
contractions

Fundus
Basic Baby Care

upper portion of the of the body of
the uterus

Lochia
 vaginal discharge after delivery

E p i s i o t o my
Basic Baby Care

 incision to enlarge the vaginal
opening

Po s t p a r t u m b l u e s
Basic Baby Care

 conflicting feelings of joy and
emotional letdown during the first
few weeks after birth

Po s t p a r t u m D e p r e s s i o n
Basic Baby Care

• persisent mood of unhappiness

Engrossment
Basic Baby Care

 intense interest of fathers to their
new child

Att a c h m e n t

B a s i c B a b y C a r e
an affectionate tie that occurs
over time as infant and caregivers
interact.

Bonding Colustrum
 refers to a strong  a yellowish fluid,

emotional tie that rich in protective
forms soon after birth antibodies that is
between parents and secreted by the
the newborn breasts.

Rooming In Galactagogue
 infant stays in the  Breast milk
room with the mother stimulators

Words o f W i s d o m
A woman in labor has pain,

Because her hour has come.
But after she has given birth,
She no longer remembers the
anguish,
For joy that her child has been
born into the
world.
10/12/2023 John 16:21

MILDRED G. GLINOGA UERMMMCI-CON 18
Introduction
Postpartum…
•It is s a period after delivery, usually

lasting 6 weeks
• considered as the fourth trimester of

pregnancy
•a time for maternal changes in the body

Retrogressive
It is returning of the body to its pre-
pregnancy state
Changes include:
- Shrinking & descent of uterus

- Sloughing of the uterine lining
- Development of lochia
- Contractions
- Recovery of vaginal and pelvic floor muscle

Progressive
• Is preparing the body for new

changes in relation to postpartum
Changes include:
- Production of breast
milk
- Beginning of a
parental role
Postpartum Changes:
Afterpains
- Caused by intermittent uterine contractions

- Self-limiting discomforts = 48 hours post
partum
- Occurs mostly in multiparas or in women
whose uterus was overly distended
- Breastfeeding can cause more afterpains
- Sucking causes posterior pituitary to release
oxytoxin
- Aspirin is contraindicated postpartum
Postpartum Changes:
BUBBLESHE

Breast
1st & 2nd day
Breast tissue should feel soft
on palpation
3 day:
rd
Should begin to feel firm and

warm
3rd or 4th day:
Appears large and reddened,
with shiny skin
Feels hard, tense, and painful
Breast
- Engorgement causes the breast
to feel warm or appear reddened
- Firm nodule is detected on
palpation
- Nodularity is bilateral and diffuse
- Location of the nodule
- Usually relieved by the infant’s
sucking
Breast
Firm nodule is detected on
palpation
Nodularity is bilateral and

diffuse
Location of the nodule
Usually relieved by the infant’s

sucking
Breast
Before lactation: Soft with a
yellowish fluid from the nipples
After lactation: Warm to touch and
firm
•Tenderness persist for 48 hours

•Breast nipples are normally erect
and not inverted
•Return to normal size: 1-2 weeks
Nursing Care: Breast
 Inspect breast for localized tenderness

 Check for every 8 hours :
Consistency, size, shape, and symmetry of the
breasts
 Wear comfortable bra to support engorged breasts
 Inspect nipples for redness, cracking, inverted or flat,
or presence of caked milk

Promote Breast Hygiene
Wash nipples with plain water
To avoid drying effects which can cause
cracking
Teach a woman to wash her breasts daily with clean

water and dry them with soft towel
 Insert clean gauze pad if colostrum discharge is heavy

 Check every 8 hours for the following:
Beginning of lactation
Presence of infection
Presence of breast mass
 Assess the mother’s knowledge of regular breast
examination
 Application of warm compress or standing under a
warm shower to relieve discomfort
 Good supporting bra
A woman who is not breastfeeding may experience more
discomfort
 Accumulation of milk inhibits further milk formation
 Engorgement subsides in about 2 days
 Apply cold compresses, 3-4 times a day during the
period of engorgement
 May also take oral analgesic
 Wear a snug-fitting bra or commercial breast binder
 Avoid nipple stimulation
Postpartum Changes: Uterus
•Involution
•Sub-involution
•Reduction in size and weight after birth
•Pre-pregnant size: 5-6 week after
delivery
•Uterine lining is shed when the
placenta detaches
•A basal layer remains for future
pregnancies
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•Placental site is healed by 6-7 weeks
•Descends at a predictable rate

•Location: Midline or below the
level of the umbilicus
•Shape: A firm mass
•Frequency: Begins to descend about 1
cm (1 finger’s width) each day
•10 days post-partum: no longer
palpable
Cervix
•Soft and malleable
•Both internal and external os are open
•Internal os closes as before
•End of 7th day, external os has
narrowed its size, remained slightly
open

•Appears slitlike or stellate

(star shaped), previously it is
round
•Cervix is firm and nongravid
again
 Assess for the position of the

abdomen every 30 minutes for 4
hours
Every 8 hours for 3 days
 Assess for firmness of the abdomen
 Position the mother in supine with
her knees flexed to relieve tension
on the abdomen
 Allow the mother to void or empty

bladder before the procedure
 Demonstrate to the mother how she
should give intermittent massage

Provide pain relievers

Anti-inflammatory or Analgesics
Avoid heat to the abdomen – can
cause relaxation of the uterus;
bleeding

Postpartum Changes: Bladder
2,000 – 3,000 ml excess fluids accumulates in the body

Extensive diuresis begins almost immediately after birth
From 1,500 ml to 3, 000 ml/day during the 2nd-5th day after
birth
Increase in urine production causes the bladder to fill rapidly
Fetal head exerts a pressure on the bladder and urethra
Transient loss of tone with edema surrounding the urethra
Decreases the ability to sense she has to void
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Usage of anesthesia affects sensation in the bladder
Postpartum Changes: Bladder
 Assess woman’s abdomen

frequently
 On palpation, it is felt hard or firm
just above symphysis pubis
 On percussion, sounds resonant
 Assess for soft or uncontracted upon
palpation
 Assess for the location of the uterus
Promote Urinary Elimination
Encourage woman to void at the end of the first hour after birth to prevent
bladder distention
If woman still has not been able to void by 4-8 hours after birth,
catheterization is necessary
Kegel exercise to prevent urinary incontinence and promote perineal
muscles

Bowel
• Majority of women do not have regular bowel movement for 2-3 days after
delivery
• 1st or 2nd postdelivery period: Oral laxative or stool softeners may be

administered
• 3rd morning: laxative suppository may be inserted and with hot drink
• Enema is necessary if laxative is unsuccessful

Bowel
•Reestablishment of regular bowel habits is encourage
•Exercise, roughage in diet and adequate fluid intake are
helpful
•Prevent irritation of hemorrhoid by producing soft stools
•Sim’s position aids in good venous return to the rectal area
and reduces discomfort
•Enema or laxative suppository is contraindicated for a woman
with a 3 or 4 degree laceration
rd th
•Oral stool softeners and laxatives may be administered

Lochia
•Changes during early postpartum period
•Composed of endometrial tissue, blood, and lymph
•Has a characteristic fleshy or menstrual odor
•Upright position – pooled lochia in the vagina is discharge
•When ambulation, amount of lochia is heavier
•Increase amount when breastfeeding - sucking causes uterine contraction

Lochia
•Few small clots may be seen but not large clots
•Absence of lochia is not normal
•Associated with blood clots retained within the uterus or with infection
•Women who had a caesarean birth have less discharge of lochia during the
first 24 hours
•Because the uterine cavity was sponged at delivery

Lochia
1.Lochia rubra – red; composed mostly of blood; last for 3 days after birth
2.Lochia serosa – pinkish to brownish; composed mostly of blood ad mucus

content; lasts for 4-7 days
3.Lochia alba – mostly mucus and is clear and colorless (white); lasts for 7-
14 day after birth

Lochia
Estimating the volume of lochia
•Scant: Less than a 2” stain or 5cm
•Light: Less than a 4” stain or 10cm
•Moderate: Less than a 6” stain or 15cm
•Large or heavy: larger than 6” stain or one pad saturated within 2 hours
•Excessive: Saturation of a perineal pad within 15mins

Lochia
Excessive discharge of lochia
• Apply a clean pad and check every 15mins
• Pads should be counted and weighed
• Assess underpads on the bed to determine of bleeding has overflowed
• One gram of weight = about 1 ml of blood

Care: Lochia
•Assessment of fundus: firmness, location and position
•If uterus stops descending, notify the birth attendant or physician
•Assess women at risk for postpartum hemorrhage or infection
•Poorly contracted uterus should be massage until firm to prevent

hemorrhage
•It is essential not to push down on an uncontracted fundus to avoid

inversion
Care: Lochia
•Provide perineal care
Avoid lochia to become dry and harden on the vulva and perineum
because it can cultivate bacterial growth
Wash every after voiding or defecating

Care: Lochia
NOTIFY PHYSICIAN!!
Foul-smelling lochia, with or without fever
Lochia rubra that persists beyond the 3rd day
Unusually heavy flow of lochia
Lochia that returns to a bright red color after it has progressed to serosa or
alba
MEDICATIONS:
Oxytoxin
Methylergonovine Malleate (Methergin)
Postpartum Changes: Episiotomy


Midline episiotomy
• the incision of the vaginal opening is directly in the midline, straight down
toward the anus
• less painful and is less likely to result in long-term tenderness or problems
with pain during intercourse
• less blood loss
• easy repair and improved healing
• type of incision to extend (continue tearing) and involve the anal sphincter
or the lining of the rectum
Mediolateral Episiotomy
• begins at the vaginal opening in the midline

• incision directed toward the right buttocks at a 45-degree angle
• less likely to extend into or involve the anal sphincter and the
rectum
• increased blood loss, increased pain, difficult repair, and an
increased risk of long-term discomfort, especially during intercourse
Perineum
•Is often edematous, tender, and bruised
•Ecchymosis from ruptured capillaries may show on the surface
•Labia majora and labia minora remains atrophic and softened
after birth
•Never returning to the pre-pregnant state
•Women with haemorrhoids may temporarily worsen during the
pressure of birth
Postpartum Changes: Vital Signs
•Changes in the postpartum period reflect the internal

adjustments
•Vital Signs
Temperature
Blood Pressure
Pulse

Temperature
•Always take orally or tympanically
•Rectal is contraindicated
•1st 24 hours: Slight increase in temperature
•Will return to normal if with adequate hydration
•Temperature of 38 degrees Celsius (100.4 degrees F) is
considered febrile
•3rd or 4th postpartum day: temp increases for a period of
hours d/t increased vascular activity in lactation

!!!!!
Infection is a major cause of postpartal
mortality and morbidity.
Nurses play a major role in assessing
postpartum temperature for possible
infection

 Pulse rate is slightly slower than normal

 During pregnancy: distended uterus obstructed the amount of
venous blood return
 After birth: Increase blood volume return, stroke volume
increases
 Increase stroke volume reduces the PR between 60-70bpm
 Diuresis diminishes the BV & BP decrease
 End of 1st week: PR is normal

Blood Pressure
• A decrease can indicate bleeding
• An elevation above 140 mmHG or 90 mmHg: postpartal PIH
• Oxytoxics can increase BP
• Hypostatic Hypotension or dizziness – d/t lack of adequate BV to
maintain supply in the brain

Postpartum Changes: Homan’s Sign
•Discomfort behind the knee on forced dorsiflexion of the foot
•Dorsiflexion of foot causes calf muscles to compress tibial

veins
•Thus, producing pain if thrombosis is present

Postpartum Changes: Homan’s Sign
Assess for edema at the ankle and over the tibia on the lower leg
Inspect for swollen reddened vein that feels hard or solid to touch
Assist patient to perform dorsiflexion movement of the feet
Check for adequate peripheral circulation once every 8 hours
Allow the woman to dangle legs first before she gets up
Provide exercises to promote circulation on lower extremities
If thrombus is suspected
Elevate the affected limb on pillows
Do not massage the area
Notify physician
EmotionalStatus
• Dependent behaviors for 24-48 hours
• Depressive reactions may begin by end of 2 nd postdelivery day
• It can persist for 1-3 days
• Mother-child relationship
Positive Maternal Lag

Postpartum Changes: Emotional Status
• Mother is adapting to a new role.
• Is attending to the infant’s needs
• Typical issues:
Breast soreness
Body Image
Housework demands
Partner’s expectations
Children Management
Coping with emotional tension and sibling jealousy
Fatigue
Abandonment
•Mother versus newborn
•Welcoming statements: “How does this situation makes you
feel?”
Disappointment
•Expectations on the infant’s features

•Encourage mothers to verbalize their emotions or feelings
•Observe mothers for attitudes of self-isolation, crying, loss of

appetite

EmotionalStatus
Postpartal blues
•50% of women experience some feelings
of overwhelming sadness (St.John &
Rouse, 2018)
•Decrease in estrogen and progesterone
that occurs with delivery of the placenta
•Tearfulness, feelings of inadequacy, mood
lability, anorexia, and sleep disturbance

EmotionalStatus
•Anticipatory guidance and individualized support from health

care personnel
•30% of women experience a more serious level of sadness

after birth – Postpartum Depression

Rubin’s Psychological Changes
1. Taking-In Phase
• Is a time of reflection
• Span of 2-3 days
• Passive mothers
• Conversation focuses on her birth experiences
• Interested in her baby
• Minimal interest on learning about and caring for the
baby
• Primary focus: recovery from birth, food and fluids
supplement and deep restorative sleep
F I R S T A I D
G U I D E | 2 0 2 0
2. Taking-Hold Phase
•Begins with initiation of actions
•Interested in caring for the infant
•Becomes critical of her performance
•Assume responsibility for self-care needs
•Ideal for health teaching

F I R S T A I D
G U I D E | 2 0 2 0
3. Letting-Go Phase
•Mothers give up the ideal birth experiences
•Reconcile birth experience with reality
•Accommodation of infant to the family
F I R S T A I D
G U I D E | 2 0 2 0
Rooming In
•Infant stays in the room with the

mother rather than in a central
nursery
2 types:
•Complete
•Partial

The more time a woman has to spend
with her baby, the sooner she may feel
competent in child care, and the more
likely she may be to form a sound
mother-child relationship (Crenshaw,
2004).
Checkpoint!
Nurse Cheska enter the room to check on Myra, 25

years old, a primapara, who gave birth to a healthy baby
boy. She was in labor for almost 7 hours via normal
spontaneous vaginal delivery. When Nurse Cheska
asks Myra about her condition, she started to talk about
her pain in giving birth and expresses fatigue as of the
moment.
Using Rubin’s Psychological Changes, in which
phase do you classify Myra?
Progressive Changes: Lactation
- Period from onset of contractions to full dilatation
and effacement of the cervix
•Increased estrogen level produced by the placenta
•-Stimulates
Averages the growth of
: nullipara : 12milk glands
to 18 hrs
•Colostrum –multipara
a thin, watery
: 8 to 9prelactation secretion
•Excretes this fluid the first 2 postpartum days
- Divided into three Phases : (LAT)
•3 day:
rd
breasts
- Latent – full, tense or tender
- Active
- Transitional
•Breast milk forms in response to the decrease in
-estrogen and: nullipara
Averages progesterone
: 12 tolevels
18 hrsthat follows
delivery of the placenta
multipara : 8 to 9
•Delivery of placenta stimulates prolactin and milk
- Divided into three Phases : (LAT)
production
- Latent
- Active
- Transitional
Breast milk production
•Formation of milk causes milk ducts become distended
•Distention is not limitied to the milk ducts but occurs in the
- surrounding
Averagestissue as well : 12 to 18 hrs
: nullipara
•Blood and lymph enter the
multipara : area
8 to to
9 contribute fluid to the
formation of milk.
-•Primary engorgement
Divided into threeends as the
Phases infant begins effective
: (LAT)
sucking and empties the breasts of milk
- Latent
•Pumping actions release oxytoxin, contract milk ducts, and
- Active
push milk forward to cause a let-down reflex
- Transitional
Return of menstrual flow
• The production of placental estrogen and progesterone stops
- when the placenta
Averages is delivered
: nullipara : 12 to 18 hrs
• Thus, increasing the production
multipara : 8 to of
9 FSH and slight delay on
return of ovulation
-• Initiates
Dividedreturn
intoofthree
normalPhases
menstruation
: (LAT)
• Menstrual
- Latentcycle resumes by 6-8 weeks, if not breastfeeding
• If breastfeeding, menstrual cycle may not return for 3-4 months
- Active
(lactational amenorrhea)
- Transitional
The goals of postpartum care are to
maintain an environment that is
conducive to the mother’s physical
recovery from childbirth and fosters
family-child relationships and the learning
of child care activities.
Preventive & Promotive
Management
•Encourage mothers to verbalize
their emotions or feelings
•Observe mothers for attitudes of

self-isolation, crying, loss of
appetite

Massaging the Uterine Fundus
1. Identify the need for fundal massage.
2. Place the woman in supine position with the knees flexed. Lower
the perineal pad to observe lochia as the fundus is palpated.
3. Place the outer edge of nondominant hand just above the

symphysis pubis, and press downward slightly to anchor the lower
uterus.
4. Locate and massgae the uterine fundus with the flat portion of the
10/12/2023
fingers of the dominant hand in a firm, circular motion.
5. When the uterus is firm, gently push downward on the fundus,

toward the vaginal outlet, to expel blood and clots that have
accumulated inside the uterus.
6. If a full bladder contributes to uterine relaxation, have the mother

void. Catheterize her if she can’t void.
7. Document the consistency and location of the fundus before and

after massage.
8. Give any ordered medications, such as oxytocin, to maintain

uterine contraction. Have the mother nurse her infant if she is
breastfeeding to stimulate the secretion of natural oxytocin.
9. Report a fundus that does not stay firm.

Assessment of the Perineum
Purpose: To observe perineal trauma, hemorrhoids, and status
of healing
1.Provide privacy; explain the procedure.

2.Apply gloves.
3.Turn the woman on sides and flex upper leg, lower perineal
pad, and lift up upper buttocks
4.Observe for edema, bruising, and hematoma.
5.Examine episiotomy or laceration for REEDA
Assessment of the Perineum
6. Observe hemorrhoids for extent of edema (can interfere with
bowel movements).
7. Apply clean peripads, taking care to only touch edges.
8. Reposition woman in a comfortable position.
9. Dispose of soiled contents in appropriate waste container.
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10. Document care provided.
Sitz Bath
Purpose: To aid healing of perineum through application of
moist heat or cold
1.Wash hands, explain procedure, and provide privacy.

2.Assess woman’s condition; analyze appropriateness of
procedure.
3.Assemble equipment; a sitz bath, clean towel, and clean
perineal pad.
4.Place sitz bath on toilet seat; turn flow of water.
5.Help woman remove pad and sit in flow of water for 20
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minutes. MILDRED G. GLINOGA UERMMMCI-CON 88
Sitz Bath
6. When completed, assist woman to pat perineum dry (front to

back); apply clean perineal pad.
7. Assist woman in returning to room.
8. Wash hands.
9. Document in medical record that sitz bath was taken,

condition of woman, and condition of perineum.
Sitz Bath

Teaching the new mother how to BREASTFEEDING
breastfeed:
1.Wash hands before feeding; wash

nipples with warm water, and no soap
2.Position self (sitting or side-lying)
3.Sit comfortably in chair or raised bed
with back and arm support; hold
infant with cradle or football hold,
supported by pillows
4.Side-lying with pillow beneath head,
arm above head, support infant in
side-lying position.
5.Turn body
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of infant to face mother’s
breasts
BREASTFEEDING
6. Stroke infant’s cheek with nipple.
7. Infant’s mouth should cover
entire aorta.
8. Avoid strict limits for nursing;
nurse at least 10 minutes before
changing to other breast, or
longer if infants is nursing
vigorously.
9. Use a safety pin on the bra as a
reminder about which breast to
start with at the next feeding.
10. Lift infant or breast slightly if
breast tissue blocks nose.
BREASTFEEDING
11. Break suction by placing finger

in corner of infant’s mouth or
indenting breast tissue
12. Nurse infant after birth and

every 2-3 hours thereafter.
13. Burp infant halfway through the

following feeding.

Postpartum Complications
Shock and Hemorrhage
 A condition in which the cardiovascular system fails to provide
essential oxygen and nutrients to the cells
S Causes: S
h  Cardiogenic shock – pulmonary embolism, anemia, ho
o hypertension, or cardiac disorders ck
c  Anaphylactic shock – allergic responses to drugs administered
 Septic shock – puerperal infection
k  Hypovolemic shock – postpartum hemorrhage or blood clotting
disorders
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Shock
Occurs when the blood volume is depleted and cannot fill the
circulatory system
S Medical Management: S
h  Giving IV fluids to maintain the circulating volume and to ho
o replace fluids ck
c  Giving blood transfusion to replace lost erythrocytes (Cultural
consideration is noted)
k  Giving oxygen to increase the saturation of remaining blood
cells; pulse oximeter
 Placing an indwelling (Foley) catheter
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Hypovolemic Shock
 Blood loss greater than 500 ml after vaginal birth or 1000 ml
after caesarean birth
S  Average woman has 1-2 liters of added blood volume from S
h pregnancy ho
 Most cases of hemorrhage occur immediately after birth, but
o some are delayed up to several weeks, as follows: ck
c
k  Early postpartum hemorrhage – within 24 hours of birth
 Late postpartum hemorrhage – after 24 hours until 6 weeks
after birth
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Hemorrhage
Medical Management
 WOF early signs of hypovolemic shock (tachycardia, pallor, cold
clammy skin, decreased urine output).
 Routine frequent assessment of lochia
 Assess for hematoma: Amount and character of lochia are
normal and the uterus is firm but signs of hypovolemia is still
evident
 WOF: vaginal or cervical laceration: Excessive bright red
bleeding despite firm fundus
 WOF: occurrence of petechiae: bleeding from puncture sites,
oliguria = blood clot problems
 Perineal pads should be counted and weighed
 Monitor intake and output F I R S T
G U I D E |
A I D
2 0 2 0
Uterine Atony Lacerations Hematoma
Characteristics Soft, high uterine fundus Continuous flow of brighter If visible, blue or purplish
Heavy lochia with large clots than normal blood mass on vulva
Bladder distention Firm fundus Severe and poorly relieved
Possible sign of hypovolemic Onset of hypovolemic shock pain
shock Large amount of blood lost
Lochia that is normal in
amount and color
Contributing factors Bladder distention Rapid labor Prolonged or rapid labor

Abnormal or prolonged labor Use of instruments Large infant
Overdistended uterus Use of forceps or vacuum
Multiparity extractor
Use of oxytoxiin during labor
Medications that relax uterus
Operative birth
Low placental implantation

Vulvar Hematoma
Categories of Lacerations
1. 1 degreest
• Involves the fourchette,

perineal skin vaginal mucus
membrane

2. 2 Degree
nd
• Includes the muscle of

perineal body

3. 3 Degreerd
•Extends to the anal sphincter

4. 4 Degreeth
•Extends to the mucosa or

lumen of the rectum

Discharge Planning

Discharge Planning
W • Avoid heavy work for at least 3 weeks after birth W

o o
r r
k
• Avoid lifting or straining body for 3 weeks k

Discharge Planning
• Should plan at least one rest period each day and

R try to get a good night’s sleep R
e e
s s
t • Rest during the day when the newborn is sleeping t
• Allow family members to help in taking care of the

other children
Discharge Planning
E • Should limit her number of stairs she climbs to one E

x flight/day for the first week at home x
e e
r • Beginning 2 week, if her lochial discharge is
nd r
c c
i
normal, she may start to increase this activity i
s s
e • Should do muscle-strengthening exercises e
Discharge Planning
• May use the bath tub or showers for daily washing
H • Should continue to apply any cream or ointment as H

y y
ordered for the perineal area and cleanse her perineum
g g
from front to back
i i
e e
n • Any perineal stitches will be absorbed within 10 days n
e e
• Should not use vaginal douches until she returns for her
postpartal check-up
Discharge Planning
C •Is safe as soon as the woman’s lochia has turned to alba C

o o
i •Episiotomy is healed (1st week of birth) i
t t
u •Use of contraceptive foam or lubricating jelly will aid comfort u
s s

C Discharge Planning C
o o
n n
t •Should begin contraception measure with the initiation of t
r coitus r
a a
c c
•Use of IUD – fitted immediately after birth or at her first
e e
p postpartal check-up
p
t t
i •Use of contraceptives – 2-3 weeks after birth i
o o
n 10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 111
n
Discharge Planning
•Notify physician if there is an increase lochial discharge or lochia

F serosa or alba becomes lochia rubra
F
o o
l •Delayed postpartal hemorrhage can occur in women who become l
l extremely fatigued l
o o
w •Getting adequate rest w
- -
u •4-6 weeks after birth, should return for postpartal examination u
p p
•Checking of complete involution and reproductive life planning is
indicated
Discussion Board
Group Discussion: Each member should:
1. Research for postpartum complications.

Differentiate each other.
2. Identify phases of milk production and types
of milk produce during breastfeeding.
3. Each group should post your answer in the
discussion board.
( Break Room will be assigned in Canvas )
END

Postpartum Period 2020

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Postpartum Period 2020

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The Care of the

Mother and Child

1. Discuss related terminologies used during postpartum.

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 4

 6 weeks period after childbirth

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 5

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 6

Basic Baby Care

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 7

Basic Baby Care

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 8

Basic Baby Care

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 9

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 10

Basic Baby Care

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 11

Basic Baby Care

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 12

Basic Baby Care

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 13

Basic Baby Care

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 14

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 15

 refers to a strong  a yellowish fluid,

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 16

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 17

A woman in labor has pain,

10/12/2023 John 16:21

•It is s a period after delivery, usually

• considered as the fourth trimester of

•a time for maternal changes in the body

- Shrinking & descent of uterus

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 20

• Is preparing the body for new

- Caused by intermittent uterine contractions

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 23

Should begin to feel firm and

Nodularity is bilateral and

Location of the nodule

Usually relieved by the infant’s

•Tenderness persist for 48 hours

 Inspect breast for localized tenderness

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 28

Teach a woman to wash her breasts daily with clean

 Insert clean gauze pad if colostrum discharge is heavy

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 29

•Descends at a predictable rate

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 34

•Appears slitlike or stellate

 Assess for the position of the

 Allow the mother to void or empty

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 37

Provide pain relievers

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 38

2,000 – 3,000 ml excess fluids accumulates in the body

 Assess woman’s abdomen

10/12/2023 MILDRED G. GLINOGA UERMMMCI-CON 41

• 1st or 2nd postdelivery period: Oral laxative or stool softeners may be

• Enema is necessary if laxative is unsuccessful

•Oral stool softeners and laxatives may be administered

•Composed of endometrial tissue, blood, and lymph

•Has a characteristic fleshy or menstrual odor

•Upright position – pooled lochia in the vagina is discharge