Postnatal care

Postnatal care means, care of both mother and baby after delivery of the baby. After delivery the organs of reproduction return to their pre-pregnant stage within 6 weeks which is called puerperium. Lot of things may happen to mother and baby at this period.

Contents

Why the need of post-natal care ?

• Identification and management of any complication of mother and baby

• Helping the mother to recover the pre-pregnant state

• Ensure early initiation of breastfeeding and promote exclusive breastfeeding of the baby

• Advice to mother regarding family planning

• Advice to mother and other family members regarding how to take care of the baby

• Advice on immunization of the baby

When to take postnatal Visits ?

1^st visit – within 24 hours of delivery
2^nd visit – within 2 to 3 days of delivery
3^rd visit – within 6 to 7 days of delivery
4^th visit – at 6 week

Where and by whom to take the postnatal care ?

When a delivery is done at a hospital, usually the 1^st check up is done within one hour of delivery and the mother is advised to stay at hospital for at least 24 hour. 2nd checkup should be done before the discharge of the patient from hospital.

If the delivery is done at home, then the care can be given by a community health worker or by a skilled provider and if they find any complication, will refer the mother or baby to the nearby hospital.

Care during post natal period

Care for the mother:

Checking and assessment of the bleeding per vagina
Checking and recording the temperature of mother
If the mother suffers from anemia, need to take action regarding this
Provide supplementation of vitamins and minerals such as Iron, Calcium, Vit-A etc
Counseling on diet and family planning
If any complication found, such as bleeding, infections, post partum depression etc. refer to the nearby facility

Care for the baby:

Assessment of the baby for any danger sign
Measurement and recording of weight, checking of temperature
Ensure early initiation of breast feeding and promote exclusive breast feeding
Counseling about various care of the baby such as skin care, eye, cord care etc
Keep the baby warm and ensure first bathing after 24 hours of delivery
Advice regarding birth registration, routine immunization,
Counseling on the danger signs of the baby

What to do for vulnerable babies ?

Vulnerable baby means babies with low birth weight or small babies or babies of HIV infected mother. These babies must be identified early and managed properly, because they face various physical problems. So they need special attention.

Just after delivery –

Do the proper resuscitation if needed
Properly wrapping of the baby
Keep the baby warm
Make skin to skin contact with mother
Try to initiate breast feeding, if not possible provide expressed milk to the baby
Make sure the early identification of high risk and vulnerable babies and their proper management

What are the Danger signs ?

Many complications may occur to both baby and the mother during the post natal period. Early detection and management of emergencies of mother and baby can reduce the mortality. So the danger signs should be known to all.

Danger sign of mother:

Per vaginal bleeding more than normal
Increased temperature
Blurred vision
Severe pain at the abdomen
Discharge from the vagina, which is usually foul smelling
Engorgement of breasts

Danger sign of babies:

Reluctance to feeding
Fast breathing (60 or more breaths per minute )
Increased or decreased body temperature
Baby becomes lethargic
Convulsion with or without fever

So the postnatal care is very essential for both mother and the baby. Each and every mother should be aware of this care.

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