Exam 3 - Postpartum Care

Question 1

When is the postpartum period?

Answer 1

Generally occurs over 6-8 weeks

• Begins with birth of placenta and continues through involution of uterus and return of reproductive organs to a prepregnant state

Question 2

What is the pathophysiology of ovulation during the postpartum period for lactating women?

Answer 2

Release of GnRH, FSH, and LH are suppressed as a result of suckling infant –> ovulation suppressed –> lactional amenorrhea

Question 3

What happens to ovulation in non-lactating women in postpartum period?

Answer 3

Ovulation resumes within 6-12 weeks postpartum

Question 4

At what point in time is the early postpartum period considered?

Answer 4

First 72 hours after birth

Question 5

ACOG recommends screening all pregnant women how many times during perinatal period?

Answer 5

At least once

Question 6

What physiologic changes occur in the postpartum women as the uterus involates?

Answer 6

• CO and blood volume decreases
• Estrogen and progesterone levels drop

Question 7

What should the provider assess for in the infant-parent relationship?

Answer 7

• Gentle touch
• Face to face interaction
• Direct gaze and visual contact when interacting
• Expresses positive loving comments
• Responds to newborn cues

Question 8

Can the postpartum woman become pregnant before her initial period?

Answer 8

Yes - provide contraceptive education

Question 9

At what point in the late postpartum period should the patient come back for follow up?

Answer 9

Two week (if indicated)

Interim contact with patient between discharge and 6 week visit

• Telephone, office visits, home visits in some cases

Question 10

What questions should the provider ask/assess for during the 4-6 week postpartum visit?

Answer 10

• Adjustment: emotional, physical activity, finances, etc.
• Breasts
• Belly/abdomen
• Bladder
• Bleeding
• Bottom
• Bowel
• Birth control
• Baby blues
• Bonding
• Bodybuilding
• Lower extremity