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Maternal Needs During the Postpartum Period, A. Immediate Care (First Hour…
Maternal Needs During the Postpartum Period
1. Physical Needs
A. Hygiene
Maintain cleanliness to prevent infections.
B. Nutrition
Consume a well-balanced diet with nutrient-rich foods.
Avoid high-fat, high-salt, and high-sugar foods, as well as caffeine.
Drink at least 2,500 ml of fluids per day unless contraindicated.
Avoid alcohol, tobacco, and harmful drugs.
Breastfeeding mothers should have a diet rich in iron and calcium.
Physical Activity
Encourage early ambulation.
D. Breastfeeding
Ensure the correct positioning of the newborn's mouth.
Demonstrate proper latch and sucking sounds.
Show different breastfeeding positions (cradle hold, football hold, side-lying).
Teach how to break suction safely.
E. Urinary Elimination
Monitor for bladder distension.
Encourage frequent urination.
Use techniques to promote voiding (pouring warm water on the vulva, running water sounds).
If the mother cannot void within 8 hours, catheterization may be necessary.
F. Prevention of Constipation
Encourage fiber-rich foods, fluids, and physical movement.
Bowel movements return within 2–3 days postpartum.
2. Psychological Needs
Evaluate the mother’s emotional readiness to care for herself and her newborn.
Provide emotional support and feedback.
Explain to the husband the importance of his emotional and physical support.
3. Emotional Needs
Acknowledge the mother’s efforts during labor.
Encourage and support her in infant care.
Limit visitors if they cause exhaustion.
Ensure physical comfort, rest, sleep, and proper hygiene.
4. Social Needs
Fathers should be involved in newborn care.
Postpartum support groups can help parents adjust to their new roles.
5. Financial Needs
Nurses should be aware of the family's financial situation and available community resources.
Refer families to appropriate support agencies if needed.
6. Educational Needs
Educate mothers about postpartum changes, hygiene, contraception, and warning signs of complications.
Components of Postpartum Care
B. Subsequent Daily Routine Care
Provide rest and sleep to maintain physical and mental health
.
Encourage proper positioning to promote lochia drainage and uterine involution.
Observe perineal healing for signs of infection (REEDA: Redness, Edema, Ecchymosis, Discharge, Approximation).
Sexual relations should be avoided for at least 40 days postpartum (minimum 3 weeks).
Palpate the uterus to assess involution.
Monitor lochia (amount, color, odor, and consistency).
Postpartum Complications and Risk Factors
1. Risk Factors for Postpartum Hemorrhage (PPH)
Precipitous labor.
Placenta previa or abruptio placentae.
Uterine atony.
Retained placental parts.
Multiple pregnancies.
Operative procedures (C-section, forceps, vacuum extraction).
2. Risk Factors for Postpartum Infection
Prolonged labor (>24 hours).
Use of a urinary catheter.
Anemia (Hb <10.5 mg/dL).
Multiple vaginal exams.
Premature rupture of membranes (>24 hours).
3. Postpartum Danger Signs
Fever > 38°C
Foul-smelling lochia.
Visual disturbances.
Pain and swelling in the calf (DVT risk).
Difficulty breathing.
Newborn Care
1. Bathing
Not required daily, as it may irritate the skin.
Performed in a warm room at 38°C.
2. Umbilical Cord Care
Falls off within 7–10 days (up to 14 days for preterm babies).
Cleaned with 70% alcohol at each diaper change.
3. Feeding
Breastfeeding should start within 30 minutes after birth.
Newborns should sleep on their right side after feeding.
4. Immunization Schedule
BCG: At birth.
Pentavalent (DPT, Hep B, Hib1): 2, 4, 6, and 18 months.
OPV: 2, 4, 6, 9, 12, and 18 months.
MMR: 12 and 18 months
TT: 7 and 10 years.
Meningococcal: 4, 6, 12, and 15 years.
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5. Male Circumcision
Reduces urinary tract infections and penile cancer risk.
Lochia Monitoring:
:
Scanty: 2–3 pads per day.
Light: About 4 pads per day (10–25 ml loss).
Moderate: 4–6 pads per day (25–50 ml loss).
Heavy: A pad is saturated within 1 hour.
Total volume: 240–270 ml, decreasing daily.
Postpartum Follow-Up Visits:
1st visit: 3–4 weeks postpartum.
2nd visit: 40 days postpartum.
3rd visit: 3 months postpartum.
4th visit: 6 months postpartum.
A. Immediate Care (First Hour After Birth)
This period is the most critical and is considered the 4th stage of labor.
Postpartum hemorrhage (PPH), shock, or collapse may occur.
- Vital signs should be checked:
Every 15 minutes in the first hour.
Every 30 minutes in the second hour.
Every 4–6 hours until 24 hours postpartum.
Twice daily after the first 24 hours.
Assess for:
Consciousness level.
Vital signs.
Bleeding signs and palpate the uterine fundus.
Perineal inspection for bleeding and lochia assessment.
Fundal Checks:
Every 15 minutes in the first hour.
The fundus should be firm, midline, and well-contracted.
- If the uterus is soft:
1- Perform gentle massage
2- Encourage breastfeeding.
3- Initiate skin-to-skin contact.
4- Empty the bladder.
5- Notify the physician if necessary.
6- Administer oxytocin if ordered.
