1. Reproductive Health Nursing NUR 324
Postpartum Care
Lecture 4

2. Postpartum Care *Essential concepts,,,
-Postpartum care refers to the medical and nursing care given to woman during the puerperium ,which is 6-weeks period after delivery, beginning with termination of labor and ending with the return of the productive organs to the non-pregnant state.
-This period constitutes a physical and psychological adjustment to the process of childbearing and is sometimes referred to as the fourth trimester of pregnancy.

3. Cont.
-During this stage period ,the uterus undergoes involution – the progressive changes in the uterus after delivery ,leading to its return to near prepregnant size and condition.
*Goals of postpartum care..
1-promote normal uterine involution .
2-prevent or minimize postpartum complications.
3-promote comfort and healing of pelvis, perianal, perineal tissue.
4-assist in restoration of normal body functions.

4. Cont.
5-increase understanding of physiologic and psychological changes.
6-facilitate newborn care and self care by the new mother.
7-promote the newborns successful integration into the family unit.
8-support parenting skills and parent-newborn attachment.
9-provide effective discharge planning including appropriate referral for home care follow up.

5. Factors affecting the postpartum care
1-the nature of labor and delivery and birth outcome.
2-preparation of labor ,delivery and parenting.
3-the family's individual and collective experiences with childbearing.
4-sensitivity and effectiveness of nursing and other professional care.
5-risk factors for postpartum complications (ex: DM, Cardiac problem,….)

6. Postpartum biophysical changes
A-Reproductive system:
1-the uterus.
-lochia: Discharge from the uterus during the first 3 weeks after delivery.
2- cervix, become thicker and firmer.
3-the vagina , become smooth and swollen.
4-the perineum-edematous and bruised after delivery.
5-the abdomen-remains soft and flabby. Striae remains.
6-breast-primary engorgement

7. B-Endocrine system changes.
Cont.
B-Endocrine system changes.
-estrogen and progesterone levels decrease rapidly after delivery.
-ovulation and menstruation
C-Cardiovascular system changes
-transient bradycardia (50-70)-persist for 6-8 days.
-blood volume decreases.
-Hematocrite rises
-leukocytosis (WBC: thousand)
-blood pressure remain stable.

8. D-Immune system changes.
-maternal body temperature increase
E-Respiratory system changes
Return to non pregnant status within 6 weeks.
F-Renal and urinary system changes.
- Bladder distention can lead to urinary retention (increase bladder capacity).

9. Cont. G-Gastrointestinal system changes. -Hunger, thirst, constipation
-Weight return to non pregnant weight within 6-8 weeks
H- Musculoskeletal system changes.
-early ambulation is encouraged.
I- Integumentary system changes.
-melanin decrease gradually.

10. Postpartum psychological adaptation
-the post partum period represents a time of emotional stress for the new mother made even more difficult by the physiological changes that occur.
-factors affecting:
Response and support of family and friends.
Experience.
Cultural influences.

11. -postpartum depression.
Psychological adaptation during Postpartum period occurring in three stages:
*”Taking-in” period
*Taking-hold” period
*Letting go” period
-postpartum depression.