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Updated on February 7, 2011

The period of pregnancy is a period of conception which last for about 9 months before delivery. The state after a pregnant women has given birth is termed puperium which is defined as the period of recovery from child birth. This extends for 6 weeks after delivery.

The management or the care given during this period include the following:
After delivery, the woman should be properly observed for signs of excessive bleeding which may indicate the retention of part of placental, excessive lochia rubra which indicate engagement in too many activities. Vital signs which include temperature, pulse, respiration and blood pressure should be observed and any abnormality appropriately treated. The woman should also be observed for signs of early infection which could be detected through raised body temperature.

The woman who has just delivered should be advised on the importance of adequate rest. This will help to enhance the fast return of the uterus to its normal place. Adequate rest will enable the woman to gain her strength and prevent unnecessary fatigue. She should avoid any activity that will require more strength as this brings about fatigue and tiredness.

Early Ambulation
The woman should be helped to understand the need for early ambulation that is moving from one place to another, 6 - 8 hours immediately after delivery. Thereafter, she could gradually increase the time of ambulation but she should avoid any activities that can lead to fatigue.

Physical care
There is need for maintenance of good personal hygiene after delivery. She must be encouraged on daily bath, care of the vulva, proper disposal of used pads etc. A newly delivered woman is encouraged to avoid urinating immediately after delivery and hourly for the next 12 hours. This aids good contraction of the uterus to the former level. Aseptic technique must be maintained to prevent infection of both mother and the baby.

Care of Cord
The care of baby's cord must not be neglected. The cleaning is done immediately after bath and after each feed. Care must be taken not to infect this cord, wash your hand before cleaning the stump and the base of the cord, use clean cotton wool and methylated spirit and expose. Do not tuck it in the pampers or Napkins and do not pour powder on it.

After delivery, the woman should be asked to do some investigation such as the P.C.V. (packed cell volume) and hemoglobin estimation which should be done 24 hours after delivery. If it is found to be very low that is below 20% the woman may be transfused but if found to be above 20% she should be given haematinics such as vitamin C, ferrous sulphate of aid absorption and boost up the hemoglobin estimation.

It is not advisable for a woman who has just delivered to take unprescribed drugs that could affect the baby during lactation. This mother is placed on routine drugs such as vitamin C, vitamin B complex, ferrous sulphate and in case of any minor disorder such as after pain and abdominal pain, she can be given paracetamol tablet. In case of infection she could be placed on antibiotics that will not affect lactation. The baby should be immunized.

After delivery, the mother is advised to start breastfeeding the baby thus her diet must be nourishing. She should take, most especially, food rich in protein, vitamins and minerals. The food must be in balanced proportion and most times liquid food such as pap, tea in order to aid the secretion of breast milk that will be given to the baby.

Moreover, the elimination pattern must be observed by the midwife and the woman thus advised on the importance of taking more roughages e.g. vegetables and fruits which will enhance easy defication and this prevent constipation which may lead to anal prolapsed (Haemomhold).

Feeding of Baby
Exclusive breast feeding must be encouraged, that is baby should be fed with only breast milk. This will aid returning of the uterus to the normal place. Breast feeding ties the mother to the baby. It is cheaper. Breast milk is available in correct preparation, guarantees less risk of infection and ensures normal growth.

The woman will be helped to engage in some beneficial exercises such as pelvic exercise which will help to strengthen the pelvic floor muscles.

Advice on Discharge
When client is discharged an appointment is given for her to come for post natal examination within 6 weeks, where the mother should be examined thoroughly especially the uterus and total physical examination must be conducted from head to toe.

Mother should be encouraged to complete immunization for her child. She should avoid using any unprescribed drugs for the baby. Any unusual sign noted in the baby should be reported promptly at the hospital for proper care.

In conclusion, the woman should be on the importance of family planning in order to enhance her health and promote the care of the baby.


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