What Is Puerperium?

The puerperium (the traditional "confinement" is only the first 30 days of the puerperium) refers to the period of adjustment and recovery of the maternal body, reproductive organs and psychological aspects after the fetus and placenta are delivered. . During this time, the mother should take rest as the main part, especially the bed rest within 15 days after giving birth, take care of her body, and promote the rapid recovery of the whole organs and systems, especially the reproductive organs.

Basic Information

Clinical manifestations during puerperium

1. Body temperature, pulse, breathing, blood pressure

Postpartum body temperature is mostly within the normal range. If prolonged labor causes excessive fatigue, body temperature may increase slightly within the first 24 hours after delivery, and generally does not exceed 38 ° C. People who are not breastfeeding can also have fever due to extreme filling of breast blood vessels and lymphatic vessels 3 to 4 days after delivery. The body temperature reaches 38.5 ° C, which usually lasts only a few hours and does not exceed 12 hours. The body temperature drops and is not ill. The postpartum pulse is slightly slower, 60 to 70 times per minute, which is related to the cessation of uteroplacental circulation and bedriddenness.

2. lochia

With the shedding of the uterine decidua (particularly the placenta at the placenta) after delivery, tissues containing blood and necrotic decidua are discharged through the vagina, which is called lochia. Lochia is divided into:

(1) Bloody lochie is bright red and contains a lot of blood. A large amount, sometimes with small blood clots, a small amount of fetal membrane and necrotic decidual tissue.

(2) Serum lochia is reddish, like the name of the slurry. Contains a small amount of blood, but has more necrotic decidual tissue, cervical mucus, vaginal drainage, and bacteria.

(3) White lochi is sticky and has a whiter color. Contains a large number of white blood cells, necrotic decidual tissue, epidermal cells and bacteria.

Normal lochia has a bloody smell, but no odor. It lasts for 4 to 6 weeks, and the total amount is 250 to 500 ml, which varies greatly from individual to individual. The bloody lochia lasted about 3 days, gradually turned into a serous lochia, and turned into a white lochia after about 2 weeks, which lasted about 3 weeks and was clean. These changes are the result of a gradual decrease in uterine bleeding. If the uterine insufficiency is incomplete or the placenta remains in the uterine cavity, a large number of placental membranes, or the amount of lochia increases during combined infection, the duration of bloody lochia will be prolonged and there will be an odor.

Puerperium health

The maternal systems of the puerperium change greatly, although they belong to the physiological category, but there are large wounds in the uterus, the mammary gland has a strong secretory function, and it is prone to infection and other pathological conditions. Need to pay attention to cleanliness and hygiene, strengthen nursing during puerperium, so that the body can recover as soon as possible.

1. maintain good habits

Establish a good rest environment and pay attention to hygiene. The indoor temperature is suitable, 18 20 , the air is fresh and well ventilated. Even in winter, it is necessary to open the window for a certain period of time to keep the air fresh, but pay attention to avoid direct blowing. After the delivery of vaginal lochia, pay attention to keeping the vulva clean, wash the vulva with warm water daily, and change underwear and sanitary pads frequently. Avoid the wound after urinating and defecation. Wipe clean with toilet paper from front to back, taking care not to reverse the direction, so as to prevent the bacteria around the anus from causing retrograde infection.

2. Pay attention to emotional changes

After experiencing the excitement and tension of pregnancy and childbirth, the mother's spirit is extremely relaxed; concerns about feeding her baby; discomfort during the puerperium can cause emotional instability, especially in the 3 to 5 days after delivery, which can manifest as mild depression, and should help the mother Reduce physical discomfort, and give spiritual care, encouragement, and comfort to restore self-confidence.

3. Diet

Due to the high physical exertion during childbirth, the various organs in the body must be restored, the digestive capacity of the mother is weakened, and milk is secreted for the growth of the newborn, so diet nutrition is very important. At 1 postpartum, the maternal can be fed liquid food or light semi-liquid food, and then can enter the ordinary diet. Food should be nutritious, with enough calories and moisture. If you are breastfeeding, you should feed more protein and eat more soup foods, and supplement vitamins and iron appropriately.

4. Urination and defecation

Be alert to postpartum urinary retention, and urine volume will increase significantly within 5 days after giving birth. Women should be encouraged to urinate as soon as possible. The woman should be allowed to urinate 4 hours after giving birth. If urination is difficult, you should relieve the fear of pain caused by urination, encourage the mother to sit up and urinate, wash the vulva with hot water, and rinse the urethra with warm water to induce urination. Place a hot water bottle in the middle of the lower abdomen and massage the bladder to stimulate the bladder muscles to contract. Pay attention to constipation: eat more vegetables and get out of bed early. If constipation occurs, laxatives, caesars, or suds should be taken orally.

5. Observe uterine regeneration and lochia

The height of the uterine floor should be measured at the same time every day to understand the process of uterine restoration. Before the measurement, the woman should be instructed to urinate and massage the uterus to contract it, and then measure the distance from the upper edge of the pubic bone to the bottom of the palace.

6. Breast Care

Breastfeeding is recommended and breastfeeding must be properly guided. Start breastfeeding within half an hour after giving birth, and discontinue breastfeeding. It is recommended to breastfeed as needed. Breastfeeding should be performed every 1 to 3 hours within 24 hours after birth. Within 2 to 7 days after birth, it is the mother's lactation process, and the frequency of breastfeeding should be more frequent. The mother should breastfeed 8 to 12 times a day and night after milking. The initial breastfeeding time is only 3 to 5 minutes, and then gradually extended to 15 to 20 minutes. After the newborn has emptied one breast, suck the other breast. Wash your breasts and nipples with warm soapy water and warm boiling water before first breastfeeding, and scrub your breasts and nipples with warm boiling water before each breastfeeding.

7. Postpartum exercise

Proper postpartum activities and physical exercise are conducive to promoting uterine contraction and recovery, helping abdominal muscles and pelvic floor muscles to restore tension, maintaining a healthy shape, and good physical and mental health. Proper rest after birth, it is best to lie sideways in bed, turn over more, and lie supine as little as possible. You can sit up for 12 to 24 hours after giving birth and get down to the ground for simple activities. After 24 hours of production, you can exercise without lying on the bed. Someone should help at first, and then do it yourself. According to your own physical conditions, you can do: prone exercises, supine leg curls, sit-ups, supine leg lifts, anal and perineal, buttock muscle contraction exercises. It's simple and easy, decide the exercise time and frequency according to your ability. Be careful not to be overworked, it is advisable to start for 15 minutes, 1 to 2 times a day.

8. Health Checkup

At the end of the puerperium, that is, 6-8 weeks after delivery, you should go to the hospital for a comprehensive postpartum examination to understand the recovery of the whole body and pelvic organs and breastfeeding, in order to detect abnormalities and early treatment in time to prevent delay in treatment and residual diseases. If there is special discomfort, it should be checked in advance.

9. Postpartum medication

Most medicines taken by the mother can enter the milk through the blood circulation, affecting the baby. Therefore, when taking maternal medication, the harm to the baby should be considered. Some drugs cannot be used during lactation. For example, erythromycin can cause liver damage and jaundice in infants; chloramphenicol can cause gray infant syndrome; streptomycin and kanamycin can cause hearing impairment; tetracycline can cause yellowing of infant teeth; sulfa drugs can Causes liver and kidney function damage; chlorpromazine and diazepam can also cause infant jaundice; metronidazole causes anorexia and vomiting in infants; reserpine causes nasal congestion and lethargy in infants.

10. Postpartum body

For new mothers who are concerned about postpartum beauty, the uterus, cervix, vagina, etc. will return to pre-pregnancy levels during the puerperium, and the pelvic enlargement and pubic symphysis due to pregnancy will also recover within 2 months after delivery. If the pre-pregnancy level is not recovered within two months, the post-natal body shape is formed and fixed. Because the pelvis is left and right, the postpartum body is mainly the pelvic recovery. If active and scientific postpartum body exercises are performed within two months after delivery, then the wide pelvis and separated pubic symphysis can be retracted back, and like the uterus, it will return to the level before pregnancy. The specific method is to lie on the hard bed on the side. If you are lying on the left side, please lower the palm of your left hand under the sacrum, and then lift your head and feet. The whole body weight is pressed to the hand through the fulcrum of the sacrum. Simple movements can effectively reduce the left and right width of the pelvis, that is, the width of the pubic symphysis, which can be restored to the pre-pregnant state by 2-3 times a day for 3 minutes each time. In addition, the swing can also restore the pelvic height to the pre-pregnancy level, and the abdomen can restore the pelvic anteroposterior diameter and perimeter to the pre-pregnancy level.