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Postpartum

Reproduction: Postpartum

QuestionAnswer
Postpartum Period of time immediately after delivery through 6 weeks
Puerperium Period after delivery of placenta, lasting 6 weeks
Involution Shrinking of an organ when inactive (uterus, cervix)
Breast Changes -Estrogen and progesterone levels plummet -Prolactin levels increase causing milk production -Colostrum is secreted for 3-4 days -Milk typically comes on day 5-6 -No nipple stimulation -Wear tight bra -Milk production typically stops after 5-7 days
Uterine changes -Rapid shrinking/involution -Breastfeeding moms will experience more rapid shrinking -Fundal height decreases approx. 1 cm each day and should be midline -By 3 days should be 2-3 fingerbreadths below umbilicus -By 10 days usually can't be palpated
Fundal Assessment -Assess every 15 minutes during the 1st hour post birth -Fundus needs to remain firm to prevent bleeding -Feels like size and consistency of grapefruit -Located midline and below umbilicus -If not firm (boggy) gently massage until firm
Postpartum Hemorrhage -Can occur fit the bladder is full which interferes with uterine contractions -S/S include hypovolemic shock, restlessness, light-headedness, dizziness, pale skin, increased pulse rate, hypotension, rapid and shallow respirations, thready pulse, clammy
Bladder Changes -Excessive output the first 12 hrs post delivery -Encourage regular emptying to prevent retention -Note whether urinary retention occurs can be common d/t trauma, meds, anesthesia
Bowel Changes -Hemorrhoids and constipation common -Administer stool softeners as ordered
Lochia -Uterine lining and blood that is shed for up to 6 wks after birth -Shed in 3 stages: Rubra (bloody) 3-4 days after birth Serosa (brownish pink) 3-10 days postpartum Alba (milky white) 10-14 days postpartum but can last 3-6 wks
Amounts of Lochia -Scant: 1-2 inch stain on pad (10 ml loss) -Light or small: approx. 4 inch stain (10-25 ml loss) -Moderate: 4-6 inch stain (25-50 ml loss) -Large or heavy: pad is saturated within 1 hr of changing -Excessive: saturated pad in 15 mins -1g=1mL
Created by: NikkiLeigh83
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