7: Management of PP Concerns

Question 1

Management of hemorrhoids.

Answer 1

Tucks or witch hazel.
Ice packs.
Ointments (Prep H).
Anesthetic sprays.
Warm sitz baths.
Stool softeners or suppositories.
Prevention by increasing fluids, fiber, mobility.

Question 2

Management of perineal discomfort.

Answer 2

Decrease edema.
Ice packs initially (24 hours).
Topical anesthetics.
Warm sitz baths.
Kegel exercises.
Witch hazel compresses.
Analgesics.
Improve circulation.

Question 3

Management of breast engorgement.

Answer 3

Avoid supplementation or pumping if possible. Avoid expressing milk. Avoid standing in warm showers to increase letdown.
Lactating women: Early initiation of BF, frequent feeding, warmth / heat, mild analgesics.
Non-BF women:
Support (bra or breast binder), ice packs, analgesics.

Question 4

Management of constipation.

Answer 4

Encourage mobility.
Increase fluids.
Increase high-fiber foods.
Mild laxatives or stool softeners.
Fear can play a role of there is laceration or episiotomy.

Question 5

Management of diuresis / diaphoresis.

Answer 5

Keep bladder empty.
Reassurance.
Comfort measures.
Approximately 3,000 cc/day.
Frequent showers.
Wear natural fibers.
Dress in layers.
Drink to thirst.

Question 6

Management of afterbirth pains.

Answer 6

Empty bladder.
Prone position.
BF (BF may increase pain initially.).
Analgesics (NSAIDs).
Pain increased if multiparous or multiple gestation.