Postpartum care

• refers to the medical and nursing care given to a women during post partum
• 6 weeks period after delivery
• beginning w termination of labor and ending w termination of labor ending with the return of the
reproductive organs to the non pregnant state
• this period constitutes a physical and psychological adjustment to the process of child bearing

goals of post party care

• promote a normal uterine involutionary and return to the non pregnant state
• prevent or minimized postpartum complication
• promote comfort and healing of pelvic perineal tissues
• assist in restoration of normal body functions
• increase understanding of physiologic and psychological changes
• facilitate newborn care and self care by a new mother
• promote the newborn’s successful integration into the family unit
• support parenting skills and parent-newborn attachment
• provide effective discharge planning, including appropriate referral for home care follow up

Factors affecting the postpartum experience

• the nature of labor and delivery and the birth outcome
• preparation of labor, delivery, and parenting
• abruptness of the transition to parenthood
• the family’s individual and collective experience s with the child bearing and child rearing
• family members’ role expectation
• sensitivity and effectiveness of nursing and other professional care

Risk factors for postpartum complication

1. preeclampsia
2. diabetes
3. cardiac problems
4. uterine over distension
1. multiple birth and hydramnios
5. abruptio (premature separation of placenta) placenta and placenta previa (
6. precipitous or prolong labor, difficult delivery, or extended time spent in stirrups

PSYCHOLOGICAL ADAPTION
TAKING IN PERIOD
• occurring in 1-2 days after delivery
• mothers typically is passive and dependent
• energies are focused on bodily concerns
• she may review her labor and delivery experience frequently
• she sleep frequently
• increase in appetite
TAKING HOLD
• 2-4 days after delivery
• concerned with her ability to parent successfully and accepts increasing responsibility
• mother focuses on regaining control over her bodily functions , bowel and bladder functions, strength
and endurance
• mother strives to master newborn skills
LETTING GO
• generally occurs after the new mother returns home
• involves a time of family reorganization
• mother assumes responsibility for newborn care
• postpartum depression most commonly occurs during this period
POSTPARTUM DEPRESSION
• Any mothers experience a “let down” feeling after giving birth related tot he magnitude of birth
experience or doubts ability to cope the effective with the demands of childbearing
• Depression is mild to transient beginning 2-3 days after delivery and resolving within 1-2 weeks
• Mild depression leads to postpartum psychosis
POSTPARTUM DANGER SIGNS
• Increased bleeding cloths, or passage of tissue
• Bright red vaginal bleeding anytime after birth
• Pain greater than expected
• Fever
• Enlarging hematoma
• Feeling of full bladder accompanied by inability to void
• Feelings of restlessness accompanied by pallor, cool, clammy skin, rapid heart rate, dizziness, and
visual disturbance
• Pain redness, and warmth accompanied by a firm area in craft
• Difficulty of breathing, rapid hear rate, chest pain, cough, feeling apprehension, pale, cold, or blue skin
color
ASSESSMENT
Breast
Uterus
Bladder (voiding freely 6hrs after delivery)
Bowel (check after 24hrs)
Lochia (6 weeks, 0-3 days rubra, 4-10 days serosa, 11 days - 6 weeks alba)
Episholopy (sutures from episiotomy)
Systems/skin (extreme diaphoresis to remove extra blood volume)
Homan’s sign
Emotional status