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9.1 Physiological, psychosocial and spiritual changes of postpartum…

- - - - Autolysis or self-digestion
        
        Causing the secretion of proteolytic enzymes
        
        Out to digest proteins in the cytoplasm Of muscle cells To change to
        Protein compound
        
        Postpartum period, the levels of estrogen and progesterone will decrease
        
        From then, the protein compound is absorbed into the bloodstream and
        Eliminated through urine in the form of waste substances containing nitrogen.
      - Ischemia or localized anemia
        
        Therefore pressing the blood vessels in the uterus causing
        The amount of blood fed to the uterus decreases
        
        Therefore resulting in a smaller uterus At the same time, thrombi thrombosis occurs
        and closes the torn blood vessels tightly closed to control blood loss.
        
        In the postpartum period, the uterine muscles contract, the corset is very intense
    - - Lochia
        
        Lochia serosa
        
        in the period 4 - 9 days after birth With a color slightly pink or brown, beginning to become more liquid
        
        Lochia alba
        
        In the range of 10 days The color is yellow to creamy
        
        Lochia rubra
        
        The first 2-3 days after birth Has a deep red color, resembling a small blood clot
      - The lining of the womb will be completely repaired.
        Around the end of the 3rd week after birth
    - - Immediately after birth, the cervix is very soft and not in shape
      - Area of the vulva and uterus in the lower part Will be thinner, swollen, with marks
        Repeatedly and has a small tear mark which is prone to infection easily
      - About 18 hours after birth, the cervix becomes shorter
        and stiff and returns to its original shape 2-3 days after birth
    - - vaginal orifice
        
        Initially, the vulva will swell repeatedly
        
        After birth there will be a permanent tear of the hymen. Polyp is a small light next
        act bearings
        
        Repaired and maintained clean, will return as
        Before birth within 2 weeks
      - pelvic floor
        
        The tight muscles will return to normal.
        Those who had had perineal incision and who received perineal repair. The wound will heal within 5 - 7 days
      - Vagina
        
        The decrease in estrogen in the postpartum period causes the vaginal mucosa to become thinner and
        Extendable and without creases
        
        Until the 3rd week, there will be an embossing. But it's not clear
        Like when having not yet been born
        
        Until the onset of menstruation, it becomes thicker.
    - - Postpartum mothers will have perineal pain. And the wound will heal
        normally within 5-7 days
    - - Breast changes occur during the pregnancy period. To prepare the mammary glands to be ready for
        Produce milk for babies after birth
      - Types of milk
        
        Colostrum
        
        Production begins in the early stages of pregnancy and
        Continued for 2 - 3 days after birth
        
        There are proteins that are immune to the newborn and contain
        lactoferin
        
        Transitional milk
        
        Is water produced continuously from milk
        Yellow until about 2 weeks after birth
        
        True milk
        
        Beginning about 2 weeks after birth
        The appearance is thick white
        
        It contains the most abundant amount of water, protein, fat, carbohydrates, minerals and
        vitamins which are of many kinds
  - - - After birth, the level of hormones from the placenta in the plasma decreases rapidly within 24 hours
      - After birth, hormones will not be detected
        
        Human
        chorionic gonadotropin (HCG)
        
        Human placental lactogen (HPL) , Human chorionic
        somatomammotropin (HCS)
    - - Follicle stimulating hormone (FSH)
      - Luteinizing hormone ( LH)
      - Will be lower in 10 - 12
        days after birth
    - - Growth hormone
        
        The first phase after birth, GH levels are low,
        combined with HCS, Cortisol and Placental enzyme insulinase rapidly reduced.
        
        fasting plasma glucose
        
        Postpartum hypothyroidism
        
        Plasma renin and
        angiotensin II
  - - - coagulation factors
        
        The concentration of the composition of blood clotting is 1,2,7,8,9,10 after birth, and these values are reduced within 2-3 days
      - white blood cell
        
        May have values up to 30,000 / mm 3
        
        Making the diagnosis of an infection like
        Acute can go wrong
      - Hematocrit
        
        The level of hematocrit increases on the 3rd - 7th day after birth
        
        Those without complications The hematocrit level is in
        Normal level is equal to the period before pregnancy about 4 - 5 weeks after birth
    - - Stroke
        volume
      - Slow Heart rate
      - Immediately after birth, the amount of blood in the circulatory system will increase suddenly
    - - Immediately after birth, the amount of blood that is released from the heart in 1 minute is still high
      - After 2 - 3 minutes, the amount of blood that is released from the heart in 1 minute will decrease
      - After 2 - 3 minutes, the amount of blood that is released from the heart in 1 minute will decrease
    - - There is little change in blood pressure
    - - Most will find during the pregnancy period
  - - - The bladder will swell
      - The capacity of the bladder will increase. But pressure sensitivity is reduced. For this reason, after giving birth, mothers often have
        difficulty urinating
      - ขณะทารกผ่านช่องคลอดออกมาจะทำให้เกิดการบาดเจ็บของท่อปัสสาวะ
    - - After
        birth, when hormone levels and reduced kidney function is reduced
      - The
        renal function will gradually return to normal within 4-6 weeks after birth.
  - - - Abnormal symptoms will heal in the postpartum period
- - - - Takes 1-2 days for mother after
        birth
      - Focus on your self-reliance on others More interested in their own needs and comfort rather than thinking about their
        children
      - The mother is sluggish and does not move. Accept the physical and
        mental needs. Follow the instructions
      - Talk a lot but don't dare to do it by yourself. Hesitate in making a decision
      - Mothers have food needs.
        And a very restful sleep Mothers are worried about getting breast milk.
    - - This period lasts about 10
        days, starting from the 3rd day after birth
      - Mothers have behaviors that are independent and independent of themselves
      - Interested in self-care, children and family.
        Mother is interested in the functions of various organs of the body
      - Mothers often have mood swings easily. Needing someone to visit after giving birth
    - - It is the period that mothers return home, and mothers
        in this phase are most ready and enthusiastic in learning new things.
      - Maternity adjustment
        
        Realizing and accepting the fact that you are separated from children physically
        
        Abandoning the original independent role
  - - - There was an immediate decrease in estrogen and progesterone during the first 72 hours after birth
      - Disappointed about your body during the postpartum period
        
        Abdomen hanging loose
        
        Feeling bored and
        think that they are in bad shape
      - With physical stress, fatigue, perineal pain Pain from congested breast Hemorrhoids
      - Having mental stress during the role of motherhood But at the same time have to maintain the role
        Being a good wife
      - There are conflicts between people
      - Feeling neglected, not paying attention due to the postpartum period
    - - Easy cry
      - With a sad, lonely mood
      - Confused not being able to catch the end
      - Feeling sober and sober
      - His face
        was unwell.
      - Exhaustion, insomnia
      - Don't want to receive food
      - Easy to forget. No concentration
    - - Providing mental support and support to mothers
      - Describe the emotional state that
        Change of mother to husband and relatives to understand
      - provide psychological support for mothers
        
        Helps to
        relieve tension
        
        Able to adapt to physical changes
        
        Mind properly
  - - - Raising a baby
      - Explain the change
        Physical and mental
      - Providing counseling about the role of motherhood
  - - - Childcare activities
        
        Lactation
        
        Excretion
        
        Cleanliness
        
        Carrying and holding
        a baby to give warmth
      - Understand the needs of children from the behavior that they express
      - Respond to the needs of the child appropriately according to the child's condition
    - - Butte's response
      - Mothers' self-esteem will help develop the ability to take care of children
      - Hearsay from close people