RECOVERY OF MOM’S BODY TO PRE-PREGNANCY STATE
Postpartum is a state of maternal-fetal recovery from the labor to birth
Involution is the process of the uterus returning to non pregnant state after birth
Subinvolution is when the uterus return to nonpregnant state
Fundus should not be palpable at 2 weeks
At 6 weeks, the uterus should be in a non pregnant state
● Cervical changes occur
● Vaginal dryness due to estrogen
12-18 hrs after birth deprivation
● Fundus should not be palpable
● Episiotomies heal
2-3 weeks
● Uterus should be in a nonpregnant
state
6 weeks ● Placental site healing including
transition through 3 lochia stages
● Hemorrhoids decrease
Kegel exercises strengthens the pelvic floor, prevent prolapse, and uterine inversion
Rapid fluid loss and decrease hormone are at risk for women in postpartum
BREASTFEEDING
Colostrum is a yellow precursor to milk that is best for newborn. It contains antibodies and
nutrients good for babies.
Milk develops 72-96 hrs after birth
, Non breastfeeding mothers with engorged breast— one week of no feeding to stop
lactogenesis
Mastitis– massage breast, apply warm, moist compress, and warm shower, encourage
breastfeeding to keep the milk flowing from the milk ducts.
Normal blood loss
Normal vaginal birth has 300 to 500 mL of blood loss
Normal C section delivery has 500 to 1000 mL of blood loss
Hemorrhage
Vaginal birth more than 500 mL of blood loss
C section delivery more than 1000 mL of blood loss
Vital signs: ↓BP, ↑HR
Can manifest to bradycardia, hypertension, low grade fever, chills, ↑WBC count is normal
Labs: ↓Hgb, ↓Hct
Postpartum hemorrhage intervention
Algorithm:
● Call for help
● Massage fundus until firm when uterus is soft and boggy
● Administer O2
● Insert Foley cath
● Weigh pad for saturation of blood loss
● Administer fluids
● Administer Pitocin
● Monitor BP
Uterotonics:
● Methergine–administered via IM
● Cytotec– administered per rectal/vaginal
● Oxytocin–administered via IV
● Hemabate–administered per rectal
Goals: prevent infection, promote comfort and pain management
Postpartum is a state of maternal-fetal recovery from the labor to birth
Involution is the process of the uterus returning to non pregnant state after birth
Subinvolution is when the uterus return to nonpregnant state
Fundus should not be palpable at 2 weeks
At 6 weeks, the uterus should be in a non pregnant state
● Cervical changes occur
● Vaginal dryness due to estrogen
12-18 hrs after birth deprivation
● Fundus should not be palpable
● Episiotomies heal
2-3 weeks
● Uterus should be in a nonpregnant
state
6 weeks ● Placental site healing including
transition through 3 lochia stages
● Hemorrhoids decrease
Kegel exercises strengthens the pelvic floor, prevent prolapse, and uterine inversion
Rapid fluid loss and decrease hormone are at risk for women in postpartum
BREASTFEEDING
Colostrum is a yellow precursor to milk that is best for newborn. It contains antibodies and
nutrients good for babies.
Milk develops 72-96 hrs after birth
, Non breastfeeding mothers with engorged breast— one week of no feeding to stop
lactogenesis
Mastitis– massage breast, apply warm, moist compress, and warm shower, encourage
breastfeeding to keep the milk flowing from the milk ducts.
Normal blood loss
Normal vaginal birth has 300 to 500 mL of blood loss
Normal C section delivery has 500 to 1000 mL of blood loss
Hemorrhage
Vaginal birth more than 500 mL of blood loss
C section delivery more than 1000 mL of blood loss
Vital signs: ↓BP, ↑HR
Can manifest to bradycardia, hypertension, low grade fever, chills, ↑WBC count is normal
Labs: ↓Hgb, ↓Hct
Postpartum hemorrhage intervention
Algorithm:
● Call for help
● Massage fundus until firm when uterus is soft and boggy
● Administer O2
● Insert Foley cath
● Weigh pad for saturation of blood loss
● Administer fluids
● Administer Pitocin
● Monitor BP
Uterotonics:
● Methergine–administered via IM
● Cytotec– administered per rectal/vaginal
● Oxytocin–administered via IV
● Hemabate–administered per rectal
Goals: prevent infection, promote comfort and pain management
