Postpartum Adaptations of Family and Mother Flashcards
What promotes contraction and involution of the uterus and helps decrease the risk of PHH?
Breastfeeding promotes contraction and involution of the uterus and thus can help decrease the risk of PPH.
When does ovulation and menstration resume/occur in lactating women?
Depends on breastfeeding pattern (i.e., frequency & duration)
Mean time is about 6 months
First postpartum period,
frequently heavier than
pre-pregnant periods
What are signs in the mother can suggest potentially serious complications and should be reported to the health care provider or clinic (these may be noticed by the partner or other family members)?
*Unable or unwilling to discuss labour and birth experience
*Refers to self as ugly and useless
*Excessively preoccupied with self (body image)
*Markedly depressed
*Lacks a support system
*Partner or other family members react negatively to baby
*Refuses to interact with or care for baby (e.g., does not name baby, does not want to hold or feed baby, is upset by vomiting and wet or dirty diapers) (cultural appropriateness of actions must be considered)
*Expresses disappointment over baby’s sex
*Sees baby as messy or unattractive
*Baby reminds mother of family member or friend they do not like
*Has difficulty sleeping
*Experiences loss of appetite
On palpation how should the breast feel on days 1-2, days 2-3, and days 3-5?
On palpation:
Days 1-2: soft
Days 2-3: slightly firm (associated with filling)
Days 3-5: full, soften with breastfeeding
what are some complications involving the urinary system post delivery?
1.) decreased sensation to void
2.) Incomplete emptying of bladder
3.) Bladder distention & urinary retention
4.) Increased risk of UTI
What are the 3 components of Rubins Three Phases?
1.) Taking-In
-First 24-48 hours
-Dependent behaviour
2.) Taking-Hold
-Start 2nd to 3rd day; lasting 10 days to several weeks
-Becomes preoccupied with the present
3.) Letting-Go
-Re-establishes relationships with other people and moves forward accepting the parenting role
How long is uninterrupted skin-to-skin contact recommended for after delivery?
The Baby-Friendly Initiative (BFI) recommends placing the newborn in uninterrupted skin-to-skin contact for at least 1 to 2 hours after birth (BCC, 2021). At this time, the newborn is in an alert state and ready to nurse.
What are normal findings and deviations of temperature for the mother?
Normal
*Within normal range (36.2° C – 38° C)
*Some, slight fever up to 38° C in first 24 hours
Deviations
After 24 hours, above 38° C is abnormal
What are some urinary system complications after delivery?
glycosuria disappears
BUN ↑
pregnancy induced proteinuria resolves
ketonuria may occur
What are some criteria for the discharge of the mother?
Perineum is healing with appropriate care provided.
There are no intrapartum or postpartum complications that require ongoing treatment or observation.
The mother is mobile with adequate pain control.
Bladder and bowel functions are adequate (although patient will probably not have had a bowel movement).
The mother has received Rh immune globulin, if appropriate.
The mother has demonstrated ability to feed the infant—i.e., the infant has demonstrated adequate latch.
Contraception advice has been provided.
The care provider for ongoing care has been identified and notified of discharge.
The community liaison nurse is aware of discharge and has access to the patient’s contact information for postdischarge follow-up (if appropriate).
Appointments are made for follow-up and the mother understands the necessity for and timing of newborn health checks.
If the home environment is not adequate, community resources are in place to support the new mother and newborn.
The mother is aware of community resources and how and when to access these resources.
The mother has received rubella immunization if not immune.
When is suppression of lactation necessary? What is typically done to suppress lactation?
Suppression of lactation is necessary when the person has decided not to breastfeed or in the case of newborn death. Wearing a well-fitted support bra continuously for at least the first 72 hours after giving birth aids in this process
How long is it normal for a BM to not occur post-delivery?
It is normal not to have a bowel movement for 2 to 3 days after birth, so many new mothers may be home before having a bowel movement
-Occasionally, stool softeners or laxatives may be necessary during the early postpartum period, especially if the patient has extensive perineal repairs.
What is Lochia Alba? when does it typically occur and last for?
Creamy white or yellowish white
Days 10-14; can last 4-8 wks.
No clots
Leukocytes, decidua, epithelial cells, mucus, serum and bacteria
What are some potential complications of vaginal discharge?
Potential complications: Large amount of lochia: uterine atony, vaginal or cervical laceration
Foul odour: infection
What does a normal uterus feel like post-delivery? What are some deviations?
Normal: Firm, midline; first 24 hours at level of umbilicus involutes ≈1–2 cm/day
Deviations: Soft, boggy, higher than expected level: uterine atony
Lateral deviation: distended bladder
When do the postpartum blues typically peak and subside
During this period, new mothers are emotionally labile and often cry easily for no apparent reason. This lability seems to peak around the fifth day and subside by the tenth day.
