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Postpartum period - Juno

Postpartum period: content of the article

Duration of the postpartum period

In obstetrics, it is customary to single out the early and late postpartum periods. The early one lasts from 2 hours to a day. Its duration depends on the condition of the woman. Usually the duration of the early period is 6-8 weeks. Normally, the puerperal is transferred to the postpartum department 2 hours after the birth and 6-24 hours after the caesarean section. The time spent in the delivery room or intensive care unit is the duration of the early postpartum period.

The late period begins from the moment the puerperal is transferred to the postpartum ward. The duration is determined by how quickly the reproductive organs recover, in particular, the uterus shrinks to normal size.

Physiology of the postpartum period: what changes occur in the body

During pregnancy, a woman's body is seriously rebuilt, changing its usual state. After childbirth, all organs and systems undergo tangible physiological changes:

• Placental circulation stops, the number of heartbeats decreases. Normally, the indicators of the cardiovascular system should be restored by 10-14 days after childbirth.
• Bladder restores tone after 3-4 weeks, blood flow in the kidneys is restored within 6 postpartum weeks.
• Gastrointestinal motility returns to normal levels within a month on average.

The nervous, cardiovascular, endocrine, and immune systems are also rebuilt. The most pronounced reverse restorative changes occur in the genital organs, especially in the uterus.

What happens to the uterus

The most intense involution (contraction) is observed within 8-12 days after delivery. The pace depends on the number of pregnancies and childbirth, the degree of stretching, breastfeeding. The uterus contracts faster in primiparous women, in those who breastfeed their babies. In multiparous, as well as in those who carried a large child, the uterus contracts longer.

After a caesarean section, the uterus contracts longer, and more careful care is also required.

Start of breastfeeding

Lactation is initiated and maintained by hormones such as prolactin and oxytocin. Early attachment to the breast (within an hour after childbirth) has a good effect on lactation and uterine contraction. In order to have enough milk, you need to regularly feed the baby on demand.

In the first 2-3 days after childbirth, colostrum is released from the breast. It differs from milk in having less fat and carbohydrates, but with a higher content of proteins and salts. The product has a high energy value, it also contains a lot of immunoglobulins that protect the body of a newborn.

From 3-4 days, milk begins to be produced, and its amount increases every day. This is the optimal food for babies, containing the necessary amount of nutrients.

Mammary glands

Under the influence of hormones, the milk ducts are formed and the blood rushes intensely to the glands. The breast becomes heavy, sensitive and "poured" with the arrival of milk. Discomfort may appear - pain, tingling, swelling. When breastfeeding improves, the discomfort will pass.

If there is a lot of milk, and the breast "swells" too much, you can express until relieved. Be sure to wear comfortable underwear, apply the baby more often. Remember that active lactation helps the female body recover faster.

Vagina and perineum

During natural childbirth, the area between the vagina and the anus is stretched. At breaks or cuts, stitches are applied. During the healing period, swelling and pain are possible. The muscles of the perineum are restored within 10-12 days, the anterior abdominal wall - by the 6th week.

About 2-3 weeks after childbirth, the walls of the vagina are edematous, then their normal state is restored. The lumen of the vagina often does not recover, especially after repeated births - it becomes a little wider.

Ovaries in the postpartum period

Follicle maturation begins in the ovaries. Lactating women, against the background of prolactin production, do not have menstruation for several months, and sometimes until the end of lactation. In non-breastfeeding women, menstruation begins after 6-9weeks after childbirth.

The first menstruation after childbirth often occurs without ovulation. In the future (from 2-3 cycles), the ability for a new pregnancy is restored.

Postnatal care and care

The postpartum stage is a time of adaptation. The mother needs to be ready for certain changes and even discomfort. A new mother may be concerned about:

• Abdominal cramps. The uterus contracts, which causes pain. More often, pain is disturbed when feeding - try to choose a more comfortable position.
• Discomfort when urinating. This condition usually lasts for the first few days after childbirth. Warm water will help alleviate the condition - you need to water the vaginal area with it while visiting the toilet.
• Swelling of the legs. The phenomenon can last as long as the normal functioning of the kidneys is restored. It is advisable to raise your legs more often.
• Constipation. Some women are simply afraid to push, in addition, the abdominal muscles weaken, the hormonal background changes, which causes a delay in defecation. You need to eat more vegetables, fruits, drink plenty of water.
• Severe sweating is especially pronounced at night and is associated with a changing hormonal background. Ventilate the room and wear cotton underwear.

Other possible problems include hemorrhoids, decreased libido, stretch marks, and hair loss. It is logical that the newly-made mother is very tired. Childbirth and the postpartum period is a serious physical and emotional stress. It is important to adhere to hygiene recommendations.

Postpartum hygiene

To avoid problems with health and well-being, follow the rules of intimate and personal hygiene:

• Wash your face several times a day, preferably in the morning, evening and after going to the toilet.
• Before hygiene procedures, be sure to wash your hands with soap and water, wash from front to back. Wash your anus last.
• Avoid spraying water directly into the vagina, use only hands - no sponges or other objects.
• Dry skin and mucous membranes with a disposable towel (or individual).
• Use baby or hypoallergenic intimate soap as a cleanser.
• Change maternity pads every 2-4 hours regardless of fullness.
• Refrain from bathing for 6 weeks postpartum. There is a risk of infection because the cervix is ​​ajar.
• Stitches after caesarean section can be washed, but should not be rubbed with a washcloth. It is necessary to treat them with brilliant green or antiseptics until a crust appears.

Do not wear tight underwear, as it puts pressure on the crotch. Try to wear only cotton things, change bed linen every 5 days, underwear - daily. Sexual rest is about 1.5-2 months. You can return to intimate life, provided that there is a desire, at the same time the discharge has ended and nothing causes concern.

Discharge and bleeding in the postpartum period

The endometrium (the tissue that lines the uterus) and blood are shed after childbirth. Such secretions are called lochia. In the first 2-3 days they have a bright red color, as they have a blood character. By day 4-5, they become bloody-serous, with a brown or yellow tint. After about a week, mucus appears in the discharge, and the color changes to a more transparent, white one. With a physiological course, lochia has a specific rotten smell.

Retention of lochia in the uterine cavity is a pathological condition called a lochiometer. It is dangerous for the development of infection and inflammation. Therefore, if the discharge stops abruptly, this should alert. No less dangerous and abrupt bleeding, or simply an increased amount of discharge. In case of any concerns, you should immediately contact the doctor.

When do you need to visit the doctor for the first time and what will he do?

If the postpartum period proceeds normally, an examination by a gynecologist should be completed approximately 2 months after childbirth. The management of women after the maternity hospital is carried out by a women's consultation.

If you had a caesarean section, then you should go to the doctor 1-2 weeks after the operation to check the condition of the suture. When you go to the doctor, prepare a list of questions, take a referral for tests and other examinations.

Postnatal care

At the first visit, the doctor will ask how the birth proceeded, how long it lasted, and also conduct an examination on the armchair. The examination usually includes:

• Assessment of the condition of the external genital organs. The doctor will see if there are any fistulas, if the walls of the vagina have recovered.
• Examination of the cervix. The doctor checks for tears or broken sutures, assesses the need for a colposcopy.
• Smears and cytology. They allow to detect inflammatory processes and infections.
• Palpation of the ovaries and uterus. The doctor evaluates the size, elasticity. A flabby, enlarged uterus can be a sign of endometritis.

If necessary, the doctor additionally prescribes an ultrasound examination, which determines whether there are any remains of the placenta or blood clots in the uterus.

When is a doctor needed immediately?

In obstetrics, there is a certain set of symptoms that indicate postpartum complications. Urgently call an ambulance or urgently consult a doctor if:

• Increased body temperature. This happens during the development of lactation, but it is important to exclude inflammation in the uterus or the suture area.
• Bleeding. You can do a test: if the pad gets completely wet in 30-60 minutes, this is a sign of uterine bleeding.
• Change in the nature of the discharge (unpleasant smell, pus).
• Unusual pain in the lower abdomen or in the area of ​​the postoperative suture.
• Swelling of the suture after caesarean section or its weeping.
• Sharply painful lumps in the chest with temperature.
• Pain in the legs, swelling, hot to the touch (risk of thrombophlebitis).

If something is bothering you, don't wait. Delay is very dangerous - call the doctor immediately at the slightest suspicion of a pathology. You do not have the right to be denied either in the maternity hospital or in the antenatal clinic.

In obstetrics, it is customary to single out the early and late postpartum periods. The early one lasts from 2 hours to a day. Its duration depends on the condition of the woman. Usually the duration of the early period is 6-8 weeks. Normally, the puerperal is transferred to the postpartum department 2 hours after the birth and 6-24 hours after the caesarean section. The time spent in the delivery room or intensive care unit is the duration of the early postpartum period.

The late period begins from the moment the mother is transferred to the postpartum ward. The duration is determined by how quickly the reproductive organs recover, in particular, the uterus shrinks to normal size.

Postpartum depression and its prevention

The physiology of childbirth is such that they greatly affect the psychological state of a woman. Every third woman in labor experiences bouts of sadness and sadness. Euphoria, typical for 1–2 days after childbirth, is later replaced by uncertainty, confusion, and emotional discomfort. Especially at risk are impulsive, suspicious, anxious women. Unfavorable ground can also be created by problems with the health of the child or the mother herself.

Sometimes the blues can turn into a severe chronic form of depression. In this case, a woman is not happy about her maternity leave with a child, obsessive frightening thoughts arise or, conversely, complete apathy. It is already difficult to cope with such a state.

To prevent the development of postpartum depression, try to adhere to the following recommendations:

• Get ready for the fact that there will be less time for yourself, so that later you will not get annoyed with your child.
• Define priorities. Do not try to maintain impeccable cleanliness. Maternity leave is time for you and your baby, but cleaning can wait.
• Try to find time to be alone with yourself. Let your husband or mother let you go for a couple of hours a week to go shopping, to a friend, to a salon.
• Distribute responsibilities - let your spouse help you. This is a kind of test of the strength of a relationship.
• Eat well, but don't overeat. Give preference to cereals, vegetables, fruits, lean meats.
• Sleep with your baby. Recovery is the most important thing for you.
• Read books or find a hobby you love. A hobby will bring you back to a resourceful state.

Do not hesitate to ask loved ones for help, and if this does not help, be sure to find a psychologist or psychotherapist. Remember that a healthy and happy mother is a priority for a child.

Observation in the postpartum period. Complications and diseases of the postpartum period

Postpartum period — the period of time during which the female body returns to normal after childbirth. It begins immediately after the birth of the child and ends after 6-8 weeks. Usually this period is normal, but sometimes there are complications that require medical attention.

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Postnatal care

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Postnatal care

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Postnatal care

What changes occur in the postpartum period?

Immediately after giving birth, a woman's uterus begins to contract. The walls of the uterus are compacted, the vessels of the placental site (i.e., the place of attachment of the placenta) are compressed. In the future, the uterus continues to shrink and acquires its original size.

During the postpartum period, regeneration of the uterine mucosa occurs, accompanied by secretions (lochia). Depending on the period of the postpartum period, lochia has a different color and character - from bloody at the beginning to serous at the end.

The cervix is ​​finally formed 2-3 weeks after birth.

The vagina shrinks and shortens within three weeks. The perineum is restored in 10-12 days.

Features of the lactation period

Due to changes in the level of hormones in the postpartum period, a woman develops lactation. As a rule, 3-4 days after birth, the mother has milk.

Women's breasts increase in volume, become hard and painful. Body temperature may rise. With proper observance of the feeding regimen, these unpleasant features gradually disappear.

In the first three days, colostrum is secreted from the mammary glands of a woman. Unlike milk, it contains a large amount of immunoglobulins and protein. There is not much colostrum, but it is 10 times more nutritious than milk, so even a small amount is enough to feed the baby. Then milk appears in the breast. But in order to always have enough of it, you need to follow a simple rule - regularly apply the baby to the breast and do not supplement the baby.

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Gynecological consultation in MedicCity

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Medical City Gynecological Consultation

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Medical Ultrasound

Postpartum Care

After labor is completed, each woman's cervix, vagina, and perineum are assessed. If breaks are found, they are immediately sewn up.

In the first few days, the mother is in the maternity hospital under medical supervision. This is extremely necessary, since the vast majority of postpartum complications, such as bleeding associated with poor uterine contractility, incomplete discharge of placental tissue, occur on the first day after childbirth.

At the maternity hospital, a doctor and a midwife take care of the mother and baby every day. They try to prevent the occurrence of purulent-inflammatory diseases in the newborn and the woman in labor.

The general well-being of the woman in labor, the condition of the uterus, external genitalia, mammary glands, as well as the nature of the discharge are necessarily assessed. Body temperature is checked twice a day, blood pressure and pulse are measured daily.

In the case of a normal postpartum period, the newborn is vaccinated with BCG, and the mother and baby are discharged home for 3-4 days. Further observation is carried out by a gynecologist of the antenatal clinic.

For some reason, some mothers think that after the birth of a baby, only the baby needs regular medical care. But this is a misconception!

To avoid numerous health problems, mom also needs to see a gynecologist!

What problems can occur in the postpartum period?

Constipation and urinary retention

Problems with urination may occur in the first days after childbirth. This is especially true for childbirth that is long in time or carried out by caesarean section. In such cases, urine is released using a catheter.

With a tendency to constipation, exercise and simple morning exercises help to restore bowel function. In the absence of a chair within 4 days, you can use a laxative candle.

Quite often, after childbirth, a woman develops hemorrhoids, the treatment of which should be entrusted to a professional proctologist.

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Proctologist's consultation

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Proctologist's consultation

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Proctologist's consultation

Vaginal discharge

The appearance of blood from the vagina in the first days after childbirth is a common phenomenon. In the first 2-3 days, the discharge is quite plentiful, then they become smaller and turn brown.

Cracked nipples

Cracked nipples are also quite common. To avoid cracks, try not to breastfeed your baby for more than 7 minutes in the first days. Before each application of the child to the breast and after feeding, wash the mammary glands with warm water and soap, dry them with a towel. Be sure to wash your hands before feeding. You can use a special cream for cracked nipples.

Drawing pains in the lower abdomen

Contractions of the uterus are accompanied by pain sensations that are a bit like contractions. The pain may be exacerbated by breastfeeding. Performing postpartum exercises helps strengthen the muscles of the small pelvis and achieve faster rehabilitation.

Pain in the perineum occurs in women who have received tears in this area during childbirth. Healing occurs within 7-10 days. For severe pain, the doctor may prescribe pain medication to the patient.

The baby does not suck out all the milk

If the baby does not suck out all the milk, it is necessary to express the rest of the milk to avoid stagnant fluid in the breast. Thanks to this simple technique, you can increase lactation and prevent lactostasis.

The postpartum period is characterized by exacerbation of chronic diseases, metabolic disorders, endocrinological problems, and the menstrual cycle may also change.

Postpartum conditions

Be sure to see your doctor if you have:

• painful lumps in the chest and high body temperature are symptoms of lactostasis or mastitis;
• pain at the site of the perineal incision and a foul-smelling discharge are signs of infection or suture separation;
• severe (with scarlet clots) bleeding from the vagina is one of the symptoms of uterine bleeding;
• foul-smelling vaginal discharge, together with high fever and chills, may indicate an inflammatory process in the uterus;
• the appearance of hot, red, painful, swollen areas on the legs - symptoms of incipient thrombophlebitis.

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