Midwifery Care during Postnatal Period (Class 3)
Page 1: Introduction
Title: Midwifery Care during Postpartum Period
Affiliation: Princess Nourah bint Abdulrahman University
Author: Dr. Safaa G. Salem, Ph.D., RN
Page 2: Learning Objectives
At the end of this lecture, students will be able to:
Determine the goals of postpartum care.
Identify components of immediate postpartum care.
Understand components of subsequent daily care.
Page 3: Management of Postpartum Period
Importance:
Postpartum period is a critical time requiring physical, psychological care, and emotional support.
Duration of postpartum care is six weeks after childbirth.
Midwifery care helps restore physical and emotional health and supports care for the newborn.
Page 4: Goals of Postpartum Care l
Promote normal uterine involution.
Prevent or minimize postpartum complications.
Promote healing of genital and perineal tissues.
Assist in restoring normal body functions.
Increase understanding of physiological and psychological changes.
Facilitate mother’s self-care and newborn care.
Integrate newborn into the family.
Help parents adjust to new roles.
Provide effective discharge planning.
Page 5: Immediate Care During Postnatal Period
Timeframe: First hour after delivery.
Midwifery Assessment includes:
General physical examination.
Palpation of the fundus (should be firm, round, small, central).
Inspection of perineum for bleeding.
Recording vital signs every 15 minutes (temperature, blood pressure, pulse, respiration).
Page 6: Midwifery Diagnosis Based on Assessment
Potential for:
Postpartum bleeding.
Deep vein thrombosis.
Infection.
Page 7: Midwifery Planning and Implementation
Assessing the uterus:
Immediately after delivery, the uterus should be firm and contracted.
If soft, massage fundus to contract.
Fundus location should be midline, at the level of the umbilicus post-delivery.
Page 8: Lochia and Perineal Care
Assess lochia for color, amount, odor, consistency, and clots.
Aseptic technique for perineal care to prevent infection.
Administer oxytocin as ordered to control bleeding and promote involution.
Encourage voiding to aid uterine involution and prevent atony.
Page 9: Hygiene and Early Breastfeeding
General hygiene includes warm showers after stabilization.
Encourage early breastfeeding to stimulate uterine involution and bonding.
Address dehydration promptly, offer fluids, and encourage early ambulation.
Page 10: Evaluation of Immediate Care
Assess uterine tone and vital signs.
Ensure cleanliness, comfort, and hydration maintained.
Page 11: Subsequent Daily Care
Midwifery Assessment includes:
Vital signs.
Uterus involution and lochia assessment.
Breast consistency and lactation status.
Perineum assessment (REEDA: Redness, Oedema, Ecchymosis, Discharges, Approximation).
Assess legs for pain or redness.
Monitor appetite, energy, elimination, and emotional state.
Page 12: Further Midwifery Diagnosis
Pain from episiotomy or lacerations.
Skin integrity alteration due to injuries.
Urinary elimination changes like retention.
Bowel elimination disturbances (constipation).
Risk of infection and knowledge deficits in self-care.
Page 13: Additional Diagnoses
Disturbance in self-concept related to body changes.
Potential altered parenting due to support interruptions.
Impaired breastfeeding related to positioning issues.
Page 14: Daily Care Implementation
Vital signs checked every 4 hours if stable.
Observe for symptoms of infection (temperature 38C+).
Regular palpation of the uterus for tone and position.
Page 15: Rest and Positioning
Encourage sufficient rest and appropriate positioning for recovery and drainage.
Avoid supine position, prone or knee-chest positions may be indicated.
Page 16: Preventing Infection and Promoting Functions
Use aseptic techniques to avoid postpartum infections.
Encourage bladder and bowel functions, intervene if needed with catheters or glycerine.
Page 17: Nutrition and Fluid Intake
High protein and caloric diet required (3000-3500 cal/day) for recovery.
Adequate fluids and roughage are important to prevent constipation.
Page 18: Postpartum Exercises
Encourage Kegel’s exercises to strengthen pelvic floor muscles.
Page 19: Ongoing Evaluation and Care
Provide analgesics for afterpains.
Monitor lab reports for hemoglobin and white blood cell counts.
Address the psychological effects of hormonal changes on day 4-5.
Page 20: Family Planning and Postpartum Follow-up
Discuss resumption of relations and menstrual expectations.
Emphasize importance of postpartum check-ups.
Update care plans based on client responses.
Page 21: Breast and Perineal Care
Early initiation of breastfeeding; check breast condition regularly.
Teach self-care for perineum hygiene and care.
Page 22: Newborn Care
Assess newborn condition, cleanliness, feeding, and physical needs.
Ensure attachment and bonding through skin-to-skin contact.
Page 23: Preparing for Discharge
Discuss newborn care topics with mother.
Prepare discharge health care plan.
Page 24: Evaluation of Maternal Care
Ensure mother can self-care, interacts with newborn, and maintains adequate nutrition.
Page 25: Handling Postpartum Report
Report any abnormal signs or complications.
Discuss contraceptive methods and follow-up plans.
Page 26: References
Marshall, J. E., & Raynor, M. D. (2020). Myles Textbook for Midwives, 17th edition.
Klossner, J. N. (2020). Introductory Maternity Nursing, 15th Edition.
Page 27: Conclusion
Expression of gratitude: شكراً لكم (Thank you).