Post Delivery

Post DeliveryPrinciples Includes
  • Restoring health status of mother
  • To prevent infection
  • To take care of breast
  • To motivate mother for contraception
Rest & Ambulance

Rest

  • Early ambulation is encouraged
  • Provides sense of well-being
  • Facilitates uterine drainage & fasten involution of uterus
  • Decreases puerperal venous thrombosis & pulmonary embolism
  • Bladder complications & constipation are reduced
Diet

Diet

  • In lactating woman, diet with high calories, protein, fat vitamins, minerals & plenty of fluids should be encouraged.
Care of Bladder

Care of Bladder

  • Causes in patients failing to pass urine
  • Unaccustomed position
  • Reflex pain from perineal stitches
  • If patient still fails to pass urine, catheterization is required
Care of Bowel

Care of Bowel

  • Diet containing sufficient fibers & fluid should be taken to avoid constipation. Mild laxatives such as isabgol husk.
  • Personal cleanliness especially after micturition & defecation
Care of Vulva & Episiotomy Wound

Care of Vulva & Episiotomy Wound

  • Dressing with antiseptic cream twice a day & after micturition & defecation
Care of Breast

Care of Breast

  • Nipples & breasts should be washed with sterile water before each feeding
  • Nipples soreness should be avoided by spout feedings & by keeping nipples clean & dry.
  • A clean supporting brassiere should be worn
Postnatal Exercises
Objectives
  • To improve muscle tone, which are stretched during pregnancy & labour (especially abdominal & perineal muscles) to prevent genital prolapse & stress incontinence of urine.
  • To educate about course of posture to prevent backache
  • To decrease risk of venous thromboembolism
  • Exercises can be started as early as 7 days after delivery & continued up to 3 months
Exercises

Postnatal Exercises

  • Breathing exercise & leg movements lying in the bed
Pelvic floor muscles

Pelvic floor muscles

  • Contract pelvic muscles in a manner to withhold an act of defecation & urination should be done several times a day.
Abdominal muscles

Abdominal muscles

  • Lie on back with knees bent & feet flat on bed. Abdominal muscles are contracted & relaxed alternatively; should be done several times a day.
Back muscles

Back muscles

  • Lie on face with arms by side. The head & shoulders are slowly moved up & down; should be repeated 3-4 times a day & then increased gradually.
Breast Feeding

Breast Feeding

  • All the babies regardless of type of delivery should be given early & exclusive breastfeeding up to 6 months of age.
Advantages
  • Ideal composition for easy digestion
  • Protection against infections (e.g. gastrointestinal infections) & deficiency states (e.g. vit D, vit C)
  • Breast milk is readily available sterile & given to baby directly at body temperature
  • No danger of allergy
  • Establishes mother-child relationship
First Feed
  • Normal delivery after 1/2-1 hr
  • Cesarean delivery after 4-6 hrs
Time Schedule
  • The baby should be fed every 2-3 hours. Regularity becomes established at 3-4 hrs pattern by the end of first week. The baby should be fed more on demand as well.
  • Duration of Feed – Initial feeding should last 5-10 minutes at each breast. Thereafter, baby is fed from one breast completely so that baby can get both foremilk & hindmilk. The next feed should be started with second breast.
Techniques
Feeding in Sitting Position
  • The mother holds baby in an inclined upright position on her lap
  • The neck is kept slightly extended with baby’s ears, shoulder & hip in one line
  • The Infant’s mouth is widely open & chin touches the breast
  • The mother should guide nipple & areola into baby’s mouth
Burping
  • The baby should be held upright against chest and his back is gently patted until he belches out air
  • Burping enables the baby to take more feed
  • The mother requires an additional 600 Kcal/day during breastfeeding