[51] Post-Partum Perineal Care Flashcards
What is normal for the perineal area after childbirth?
It will normally feel sore, even if there were no stitches
How long can perineal discomfort last after childbirth?
Days or weeks
What trauma to the perineum is common after delivery?
Perineal tears and episiotomies
What is placed after repair of the perineum?
Dissolvable stitches
How long do dissolvable stitches used in perineum care take to dissolve completely?
About a month
What does post-natal perineum care consist of?
- Keeping perineum clean
- Doing pelvic floor exercises
- Measures to prevent strep A infection
- Easing discomfort
- Air filled valley cushions or rubber rings
- Taking warm bath
- Creams or local anaesthetic spray
What measures should be taken to keep the perineum clean?
- Plain warm water to clean perineum
- Wash perineum after using toilet
- Try and wear breathable materials
- Change sanitary pads frequently
What might the patient find helpful during passing urine, regarding the perineum?
Lean forwards over knees to direct urine away from stitches, or use a small jug to pour warm water over perineum during and after passing urine
Why is it important to do pelvic floor exercises?
Increase strength to reduce the risk of incontinence
Other than increasing strength, what is the additional benefit of doing pelvic floor exercises in the post-natal period?
Increases blood flow to damaged tissue which helps speed up healing process
What is group A strep?
A bacteria found on skin and in throat
When might group A strep be serious?
If it gets into the blood stream within 6 weeks of the birth of the baby
How can the mother reduce the risk of getting group A strep infection?
Wash hands before and after using toilet, changing sanitary pad, or wound dressing
When should the mother be advised to contact the midwife or GP urgently regarding group A strep?
If the patient or family member has sore throat, earache, impetigo, or they are concerned about how wound/stitches are healing
What might help with easing discomfort in the perineum after childbirth?
- Paracetamol and ibuprofen
- Cold therapy
What can paracetamol help with regarding the perineum?
Stinging pains
What can ibuprofen help with regarding the perineum?
Swelling
How is cold therapy for perineal discomfort carried out?
Ice/cool packs used in the first 2-3 days
What is the purpose of cold therapy for perineal discomfort?
Reduce swelling and ease discomfort
How long should cold therapy for perineal discomfort be used for?
Apply pack for up to 30 mins at a time, and allow at least an hours rest
What care should be taken when using hot/cold therapy for perineal discomfort?
The ice/cool pack should not come into direct contact with skin - wrap in flannel or tea towel
What is the purpose of air filled valley cushions or rubber rings?
Can relieve pressure on perineum when sitting
How long can air filled valley cushions/rubber rings be used for?
No more than 30 mins at a time
Why should you not use air filled valley cushions/rubber rings for more than 30 minutes at a time?
As they can restrict circulation
What happens to the rectum as the baby is born?
The rectum is pushed against the pelvis, leaving it feeling bruised
What should be patient be advised to do to minimise rectal discomfort?
Avoid constipation
How can constipation be avoided in the postpartum period?
- Fibre in diet
- Lots of water
- Gentle laxatives
When can the patient resume sex after childbirth?
There is no right time to resume sex, and it may be weeks or months until they feel ready
What can happen to the vagina when women breastfeed?
It can be drier
How can vaginal dryness caused by breast-feeding be managed?
Lubricant
What should the mother do if intercourse is painful after childbirth?
See GP or health visitor
