Post natal care

Question 1

What is the puerperium?

Answer 1

The 6 week period after birth of recovery from pregnancy, labour, and birth.

This is when post-natal care occurs

Question 2

How quickly does the uterus regress during the post-natal period?

Answer 2

1cm/day for the first 4-5 days

then 5mm/day for the following 10days

it should not be palpable by 2 weeks postpartum

Question 3

What is normal post-natal bleeding and what isit called?

Answer 3

“lochia”

• a mix of erythrocytes, leucocytes, the decidua and fibrin
• First 4-5 days: red and looks like blood
• >5days: pink and serous

Question 4

What do we think if the ‘lochia’ does not become pink or serous >5 days

Answer 4

Could be an indication of infection or retained products

Question 5

When would you encourage pelvic floor exercises and skin-to-skin contact?

Answer 5

Immediately during the puerprium.

Pelvic exercises: aid continence

Skin-to-skin: important bonding for mum+baby and has multiple positive effects for the baby

Question 6

How long should a mother stay in hospital level care after birth?

Answer 6

1-3 days: normal vaginal birth

3-5 days: uncomplicated caesarean

Obviously longer stays are required if there are complications.

Question 7

How often should a midwife visit post-natally?

Answer 7

• within the first 24-48hours she has returned home
• Then 5-6x over the next 4/52

*** a 6-week check’ should be done by the GP (for a checkup and 6 week vaccinations

Question 8

What triggers milk production/release?

Answer 8

Initially the delivery of the placenta causes a huge drop in the progesterone levels (with remaining high prolactin) → copious milk production

Later as the baby sucks, this triggers the production of milk in the lactocyte within the mamillary alveoli.

This also stimulates oxytocin release → which squeezes myoepithelial cells in the alveoli

Question 9

What is baby initially drinknig from the breast?

Answer 9

Colostrum: Which is much high in WBC’s and antibodies (especially IgA) which lines babies stomach, protecting them from pathogens and development of food allergies.

Over 2/52 this gives way to mature milk production.

Question 10

What are some of the causes for women to stop breastfeeding?

Answer 10

1. Painful nipples
2. Engorgement
3. Under supply

Question 11

What are the ‘baby blues’

Answer 11

• Occur day 3-5 post birth
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