The postpartum period is the period following the birth process. It begins with the end of the third stage of childbirth, which is the expulsion of the placenta. The postpartum period is from 6 to 8 weeks after birth, by which the organs in the body return to their previous state before pregnancy.
The first visit after the birth to the mother and child is very important to diagnose early cases of morbidity for the mother and the child, if any, health education on important topics such as nutrition, hygiene, family planning, breastfeeding, issues related to childbirth, talking about the danger signs if any.
First: Physiological changes during the postpartum period
During the postpartum period, many changes that affect women occur, including hormonal and psychological changes, and through this presentation, hormonal changes will be mentioned, which include a severe drop in pregnancy hormones that are abundantly present in the mother’s blood circulation during the first hours of her birth, namely the hormones progesterone and estrogen.
Second: Local changes
Uterus: After the end of its function, the uterus shrinks in a short period of six weeks. This process of uterine contraction on itself and a decrease in its size and weight about twenty times is called the involution of the uterus.
Postpartum pain: Pain in the lower abdomen that occurs after childbirth because of uterine contractions to prevent bleeding and until the uterus returns to its normal size. This pain increases when the newborn is breastfeeding because of the secretion of the hormone oxytocin. These pains are treated with painkillers prescribed by the doctor.
Lochia: The lochia is formed in the first 24 hours after birth. Lochia discharge continues for two to four weeks. The lochia is characterized by a special smell of red liquid blood known (as lochia rubra). After that, the amount of blood decreases and the amount of serum and mucus increases and its color tends to yellow known as (lochia serosa) and extends until the end of the first week, after which the amount of lochia decreases, and it turns white after two to three weeks.
It is noted that the continuation of the lochia and an increase in its quantity and the presence of blood masses or bad smells may indicate the storage of some parts of the placenta or puerperal infections or the presence of a bacterial infection that needs medical advice and treatment.
Vagina: The vagina in particular returns to its previous position and the wounds coalesce within 10 days unless any kind of infection occurs.
Bowel movements and urine: After childbirth, a woman may notice that the amount of urine has increased a lot. This is normal so that the body can get rid of the excess fluid that was necessary during pregnancy.
Breasts: As for the breasts, they secrete milk three days after birth, but before that, the breast secretes colostrum milk, which is rich in nutrients and antibodies needed for the newborn, despite the small amount of this quantity. The mother may feel pain in the breasts on the day when the milk flows, especially the mother who is breastfeeding for the first time.
It must be recalled the importance of starting breastfeeding immediately after birth, as mother's milk is the best natural food, and on the other hand, breastfeeding accelerates the return of the uterus and the rest of the mother's reproductive organs to their original nature.
Menstruation: The return of the beginning of the menstrual period again differs from one woman to another. It ranges from several weeks to one year until it begins if the mother is breastfeeding her child. It is not necessary to assume that she is pregnant again, but she must make sure of that.
Third: The psychological changes that affect the mother during the postpartum period
Some new mothers may suffer from a feeling of psychological pressure or anxiety after childbirth, and this is related to the sudden changes in their lives. The woman must talk to her husband and share those feelings with him, as he may have the same feelings as well. The presence of the child does not mean only responsibilities, but it also means a lot of happiness in life.
Mood: Childbirth is a quantity of pain that the mother can bear because she knows the joy that follows it that fills her home and her life in general. Childbirth contains very conflicting feelings for mothers, and despite the happiness it brings, it may affect the mother psychologically. Some women experience a wave of sadness, known as postpartum sadness, and suffer from crying (for no apparent reason), sadness, tiredness, and pain all over the body)
This is for several reasons:
· Rapid hormonal changes that affect the mother after childbirth.
· The mother's mixed feelings of joy, fear, and pain at the same time.
· The mother's entry into a new phase that she is afraid to face.
· The mother's fear of any responsibility that will fall on her from being a new mother who does not have any experience with what will be and what she will face.
· Feeling pain during childbirth, which leaves negative effects that the mother carries inside her.
The family conflict that occurs after the presence of a newborn, is due to the mixing of feelings of motherhood for women and feelings of paternity for men.
These symptoms disappear within 48 hours to 7 days. These feelings usually improve, and the affected woman usually only needs some psychological support and help with the burdens of the house and caring for the newborn.
At this stage, the mother needs the following procedures
· This situation requires psychological preparation to confront and overcome it.
· Complete reassurance, as these symptoms often end within several days after birth.
· Requesting family support from the husband and relatives.
· Seek advice from a specialist doctor, as the puerperal woman may need some sedatives in case of psychological stress.
Some of these women develop this condition into pathological depression. Symptoms begin between the second and eighth week after birth. In this case, the mother needs a necessary consultation with a doctor to receive the necessary treatment that helps speed up the recovery. If the mother does not receive appropriate treatment, she is at risk of developing the condition into depression accompanied by psychotic symptoms.