Postpartum Care Fundamentals Flashcards
6 Periods of Perinatal Continuum of Care
Preconception 1st Trimester 2nd Trimester 3rd Trimester Labour and Birth Postpartum/Newborn
Which periods are marked by the antepartum period?
1st, 2nd and 3rd Trimester
Which period is marked by the intrapartum period?
Labour and Birth
Which periods are nurses typically involved?
Labour and Birth and Postpartum/Newborn
aka. the 4th Trimester and beyond
Puerperium
Birth to the return of reproductive system to pre-pregnant state (birth to 6 weeks)
What are some factors that affect postpartum psychosocial adaptation?
(Physical) - pregnancy/birth experience - physical recovery - fatigue (Psychological) - role attainment - bonding and attachment behaviours - emotional responses (External) - socioeconomics - social support - family dynamics - cultural considerations (Others) - ability to meet needs - newborn/infant characteristics
What are some cultural considerations and influences to be mindful about?
- beliefs and values
- health, self care and newborn care practices
- interactions with HCP
- family dynamics
- newborn and infant feeding practices
Rubin’s Phases of Maternal Postpartum Adjustment
- Taking in (dependent)
- Taking hold (dependent-independent)
- Letting go (Interdependent)
Mercer’s (healthy) Stages of “Becoming a Mother”
- Commitment and attachment in pregnancy
- Acquaintance and attachment to newborn
- Moving toward a new normal
- Achievement of maternal identity, redefinition of self, integration of motherhood
What are some of the (common) father’s developmental tasks?
- New expectations and priorities
- Striking a balance between work, own needs, needs of partner and baby
- Redefinition of role
- Reaping rewards
What are some challenges that LGBTQ communities experience?
- Lack of family acceptance
- Public/provider ignorance and judgement
- Social invisibility
- Limited resources
Nurses’ teaching priorities should be catered towards..
Client learning priorities and readiness to learn
What are some learning needs described by Fahey & Shenassa (2013)?
- Physical recovery
- Meet own needs
- Parental role attainment
- Effective mobilization of support
- Self efficacy
- Positive coping strategies
- Realistic expectations
What is the Healthy Babies Health Children Screening Tool?
At birth screening tool to determine the child/family’s risk level and needs
Gravidity
Total number of pregnancies
Parity
Total number of pregnancies beyond 20 weeks (regardless of outcome)
In GTPAL, T refers to:
Term birth - birth of baby born after 37 weeks of gestation
In GTPAL, P refers to:
Pre-term birth - birth between 20w to 36w+6d
In GTPAL, A refers to:
Abortions or miscarriages
In GTPAL, L refers to:
Number of living children
The Ministry of Health and Long-Term Care requires what document to be completed?
Ontario Perinatal Record (OPR)
If need/eligibility is identified using the HBHC screening tool, who follows up?
Public Health nurse
Where do births take place?
- Hospital
- Birthing centres
- Home
What can a newly delivered woman expect with regards to menstrual activity?
First menstrual cycle will be heavier than normal and will return to pre-pregnant volume within 3 or 4 cycles
How long do episiotomies take to heal?
2 weeks
How long does it take hemorrhoids to decrease in size after childbirth?
6 weeks
What happens to the cervix postpartum?
The cervix never regains its pre-pregnancy form. Rugae (ridges lining the vagina) reappear within 3 weeks but never again as prominent as before.
Progesterone
Slows GI tract motility and digestion contributing to constipation and/or heartburn in pregnancy
Estrogen
Contributes to musculoskeletal joint and ligament relaxation in pregnancy
Prolactin
Responsible for initial lactation
