Puerperium - Care after Delivery

Child birth is an important event in the life of a woman.  After the birth of a baby the woman is a mother and the change that brings in her life is for ever at fundamental level.  But medically speaking the changes that occur in a woman during pregnancy will return to almost prepregnancy level within 6-12 weeks.  This period is called puerperium.  For practical purposes this is limited to 6weeks period.  

A woman needs medical and family care during this period for restoration of physical and psychological normalcy.  For the woman who has become a first time mother needs good guidance and care to take care of her and the newborn.  The physical and physiological changes that occurred in the body of the woman will gradually return to pre-pregnancy state.  Immediately after childbirth, woman will have bleeding which may continue for 2-3 weeks.  Initially bleeding may be dark and thick, within a week it will be thin and pinkish and by third week it could be pale brownish yellow discharge.  Bleeding subsides usually by third week.  Occasionally it may continue off and on for another month.  Any time if the bleeding is felt to be excessive, woman should consult obstetrician.  Uterus which had accommodated the baby and placenta till delivery will gradually return to its original size of about fist.  By 6^th week it comes to its almost original non gravid size. 

All the changes that have occurred in heart, lungs, kidneys gastrointestinal and hormonal systems will come to non pregnant state. 

Changes in breast persist and help in milk secretion.  Milk secretion continues as long as the mother feeds the baby. 

The physical stress of labor and delivery may make woman worn out and new mother may take rest for few hours.  After the resting period she will start taking care of the newborn – start suckling the baby.  With the encouragement and help from family members and medical personnel she may as well feed the baby within an hour of delivery.

Various religions and ethnicities have different taboos that interfere with the recovery of woman after child birth.  When the delivery is a normal one, the woman should take bath regularly and keep herself clean.  Normal diet with increased proteins and fruits and lots of water is must.  Though heavy work is not allowed for 6weeks, woman should move about and take care of the newborn. Routine activities can be resumed after 6weeks of delivery.  Appropriate postnatal exercises can be taken up for restoration of body tone. Sexual activity can be resumed when woman feels comfortable and the perineal wounds if any healed well and there is no pain in the genital area or lower part of abdomen.  If sexual activity is resumed contraceptive practice also initiated.  A healthy woman can ovulate any time from 5^th week of delivery.

Puerperal care involves

-         care of perineal/ vaginal wounds

-         attention to any excessive or offensive vaginal bleeding

-         appropriate adequate nutrition

-         psychological support in emotionally stressed woman

-         watch out for any infection –genital, urinary or breast infection or infection of veins in legs

-         encouragement and guidance for breast feeding

-         Education about newborn care and immunisation and contraceptive practices.

The birth of a child turns a woman into a mother and her care makes a boy or girl a healthy citizen. 

“The hand that rocks the cradle rules the world”.