Postpartum Care

Subject: Midwifery III (Theory)

Overview

Following the delivery of the fetus and placenta, postnatal examination and care entail systemic assessment as well as appropriate guidance offered to mother and baby. The goals of a postnatal examination are to discover and repair any abnormal conditions in the mother and infant, to diagnose and treat life-threatening complications, to establish breastfeeding, and improve the mother's mental and physical health. It is an opportunity to diagnose and cure any gynecological – medical problem, whether pre-existing or arising after childbirth, as soon as possible. The National Essential Maternal and Neonatal Health Care Service Package for Nepal suggested three postnatal visits for all mothers, whether they were delivered at home or at a health institution. Emergency care, family planning counseling and assistance, community participation, and complication management are all components of postpartum care.

Postnatal examination

Following the delivery of the fetus and placenta, postnatal examination and care include systemic evaluation as well as appropriate guidance offered to mother and baby.

According to the National Safe Motherhood Program, moms should receive a postnatal checkup within three days of birth. The first 24 hours are the most critical for the postpartum mother and newborn baby, with many deaths occurring.

The woman should be closely monitored for the next 24 hours. Following that, the examination should be performed on the day of discharge before leaving the hospital. At the conclusion of the sixth week of puerperium, the third regular postnatal examination is performed. It is frequently done to discover any anomalies as well as to determine the mother and baby's status.

Objectives

To discover and treat any abnormalities in the mother and baby.
Detection and treatment of life-threatening problems in the mother and infant.
To start breastfeeding the baby and avoid breast complications.
For the early detection of minor and major Puerperium disorders.
To improve the mother's emotional and physical well-being.
Give the woman advice on immunizations for her infant and family planning.

Purposes

Aids in the prevention of infection and the promotion of comfort.
Educate the mother, family, and community.
Encourage and motivate the mother to embrace contraception.
To monitor the baby's development and resolve feeding and related issues.

Advantages

It is an opportunity to diagnose and cure any gynecological – medical problem, whether pre-existing or developing after childbirth, as soon as possible.
The baby's development can be assessed, and if any diseases are discovered, appropriate treatment can be begun.
This is the optimum time to instill motivation and acceptance of family planning options.

Time of Postnatal Visit

The Nepalese National Essential Maternal and Neonatal Health Care Service Package suggested three postnatal visits for all women, regardless of whether they were delivered at home or in a health institution.

First postnatal visit: within 72 hours or as soon as possible after delivey.

Second postpartum visit: within 4-7 days following delivey.

Third postpartum visit: within 6 weeks of delivery.

Note: incase of institution delivery good postpartum care examination or visit can be done as:

1st visit: 24 hours
2nd visit: 3 days
3rd visit: 7 days.

Danger Signs of the Postpartum Mother

A significant or sudden increase in vaginal bleeding.
Vaginal discharge has a foul odor.
Breast pain or warmth
Pain in the abdomen.
Tiredness that is excessive.
Hands and face edema
Extensive headache
Fits/seizure
Urinary frequency and/or burning
Calf discomfort/tenderness
Continuous leakage/passage of the stool
Newborn baby danger signs:
Sucking poorly
Rapid breathing
Intense chest indrawing
Grunting Movement only when triggered, no movement when stimulated, or lethargy
Everything is being vomited
Fever
Feeling unusually cold or hot,
Red eyes, bulging eyelids, and pus discharge
Swelling, redness, pus, or unpleasant odor around the cord or umbilicus, or spreading to the surrounding skin
Pigmentation in yellow.
A large abscess or a number of pustules on the skin.

Elements of Postpartum Care

Treatment in an emergency
Counseling and services for family planning.
Participation in the community
Complication management
Additional reproductive health services

Components of Postpartum Care

Complication detection and control should begin as soon as possible (e.g. heavy bleeding, sepsis.).
Preparedness for complications (supplies readiness, human resources, money, etc.).
Promoting health and illness prevention.
Education and counseling targeted on women.

Things to remember

Following the delivery of the fetus and placenta, postnatal examination and care include systemic evaluation as well as appropriate guidance offered to mother and baby.
The goals of a postnatal examination are to discover and rectify any abnormal conditions in the mother and infant, to diagnose and treat potentially life-threatening problems, to establish breastfeeding, and improve the mother's mental and physical health.
It is an opportunity to diagnose and cure any gynecological – medical problem, whether pre-existing or developing after childbirth, as soon as possible.
The Nepalese National Essential Maternal and Neonatal Health Care Service Package suggested three postnatal visits for all women, regardless of whether they were delivered at home or in a health institution.
Emergency treatment, family planning counseling and assistance, community participation, and complication management are all components of postpartum care.

Questions and Answers

What do you refer by Postnatal examination?

Postnatal examination and care involves systemic examination as well as appropriate advice given to mother and baby following the delivery of fetus along with placenta.

The National Safe Motherhood Program recommended that mothers should have a postnatal checkup within 3 days of delivery. The first 24 hours is the most crucial period for the postpartum mother and newborn baby, when large numbers of death occurs.

What are the objectives and the purpose of postnatal examination ?

OBJECTIVES:

To detect and correct any abnormal condition of mother and baby.
To detect and treat life threatening complications of mother and newborn.
To establish breastfeeding to the baby and prevent breast complication.
For early detection of minor and major disorder of Puerperium.
To improve mental and physical health of mother.
Provide advice to the mother on immunization to the baby and family planning to the mother.

PURPOSES:

Helps to prevent infection and promote comfort.
Provide education to mother, family and community.
Encourage and motivate the mother for contraceptive acceptance.
To note the progress of the baby and solve the feeding and its related problems.

List the Danger signs that are seen on postpartum mother and newborn baby ?

Danger signs of postpartum mother:

Heavy or sudden increase in vaginal bleeding.
Vaginal discharge with unpleasant odour.
Painful or warm breast
Abdominal pain.
Excessive tiredness.
Edema in hands and face.
Severe headache
Fits/seizure
Burning and/or frequency of urination.
Calf pain/ tenderness
Continuous leakage/stool pass.

Danger signs of newborn baby:

Not sucking well
Fast breathing
Severe chest indrawing
Grunting
Movement only when stimulated or no movement even when stimulated or lethargy.
Vomiting everything
Fever
Feeling abnormally cold or warm,
Eyes: red, swollen eyelids, pus discharge
Swelling, redness, pus or foul smell around cord or umbilicus or extending to the surrounding skin.
Yellow color pigmentation.
Large abscess or multiple pustules on the skin.

What are the Components of postpartum care ?

Components of postpartum care:

Early detection and management of complication (e.g. heavy bleeding, sepsis.)
Complication readiness (supplies readiness, human resources, money, etc.)
Promoting health and preventing diseases.
Woman centered education and counseling.