Postnatal
Encyclopedia
Postnatal is the period beginning immediately after the birth
of a child and extending for about six weeks. Another term would be postpartum period, as it refers to the mother (whereas postnatal refers to the infant). Less frequently used is puerperium.
Biologically, it is the time after birth, a time in which the mother's body, including hormone
levels and uterus
size, returns to a non-pregnant state. Lochia
is post-partum vaginal discharge, containing blood, mucus, and placental tissue.
In scientific literature the term is commonly abbreviated to PX. So that 'day P5' should be read as 'the fifth day after birth'. This is not to be confused with medical nomenclature which uses G P to stand for number of pregnancy and outcome of pregnancy.
, the most significant physiological transition until death
.
may leave the hospital as soon as she is medically stable and chooses to leave, which can be as early as a few hours postpartum, though the average for spontaneous vaginal delivery
(SVD) is 1–2 days, and the average caesarean section
postnatal stay is 3–4 days.
During this time the mother is monitored for bleeding
, bowel and bladder
function, and baby care. The infant
's health is also monitored.
s, and is sutured if necessary. Also, she may suffer from constipation
or hemorrhoid
s, both of which would be managed. The bladder is also assessed for infection
, retention
and any problems in the muscle
s.
The major focus of postpartum care is ensuring that the mother is healthy and capable of taking care of her newborn, equipped with all the information she needs about breastfeeding
, reproductive health
and contraception
, and the imminent life adjustment.
Some medical conditions may occur in the postpartum period, such as Sheehan syndrome and peripartum cardiomyopathy
.
In some cases, this adjustment is not made easily, and women may suffer from postpartum depression
, posttraumatic stress disorder or even puerperal psychosis.
Postpartum urinary incontinence
is experienced by 23.4%http://members.multimania.co.uk/shiryu01/Pdf/Hvidman%202003.pdf to 38.4%http://www.ncbi.nlm.nih.gov/pubmed/12028976, likely higher during pregnancyhttp://journals.lww.com/greenjournal/Abstract/1999/11000/Antenatal_Prediction_of_Postpartum_Urinary_and.9.aspx.
Over 1 in 100 women develop posttraumatic stress disorder following childbirth, many more suffer from one or more of the symptoms. PTSD may occur after severe complications during delivery, but personality characteristics and previous psychiatric illness has also been associated with the development of posttraumatic stress symptoms.
Postpartum psychosis (also known as puerperal psychosis), is a more severe form of mental illness than postpartum depression, with an indicence of approximately 0.2%.
known in English as doing the month or sitting the month (Mandarin
zuò yuèzi 坐月子). Confinement traditionally lasts 30 days. Similarly, women in Japan frequently practice ansei, or peace and quiet, for a period of time after giving birth for the purpose of recuperating. This tradition combines prescribed foods with a number of restrictions on activities considered to be harmful. It is widely believed in many East Asian societies that this custom helps heal injuries to the perineum
, promote the contraction of the uterus
, and promote lactation
.
, unimpeded establishment of breastfeeding
, and the need for bonding time between parent and child.
In Hindu culture, the puerperium was traditionally considered a period of relative impurity (asaucham) due to the processes of childbirth, and a period of confinement of 10 days (known as purudu) was recommended for the mother. During this period, she was exempted from usual household chores and religious rites. The father was purified by a ritual bath before visiting the mother in confinement. In the event of a stillbirth, the period of impurity for both parents was 24 hours.
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
of a child and extending for about six weeks. Another term would be postpartum period, as it refers to the mother (whereas postnatal refers to the infant). Less frequently used is puerperium.
Biologically, it is the time after birth, a time in which the mother's body, including hormone
Hormone
A hormone is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from one...
levels and uterus
Uterus
The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals including humans. One end, the cervix, opens into the vagina, while the other is connected to one or both fallopian tubes, depending on the species...
size, returns to a non-pregnant state. Lochia
Lochia
In the field of obstetrics, lochia is post-partum vaginal discharge, containing blood, mucus, and placental tissue. Lochia discharge typically continues for 4 to 6 weeks after childbirth.It progresses through three stages....
is post-partum vaginal discharge, containing blood, mucus, and placental tissue.
In scientific literature the term is commonly abbreviated to PX. So that 'day P5' should be read as 'the fifth day after birth'. This is not to be confused with medical nomenclature which uses G P to stand for number of pregnancy and outcome of pregnancy.
In newborns
Upon its entry to the air-breathing world, without the nutrition and oxygenation from the umbilical cord, the newborn must begin to adjust to life outside the uterus. Also starts his/her adaptation to extrauterine lifeAdaptation to extrauterine life
At the end of pregnancy, the fetus must take the journey of childbirth to leave the reproductive female mother.Upon its entry to the air-breathing world, the newborn must begin to adjust to life outside the uterus.-Breathing and circulation:...
, the most significant physiological transition until death
Death
Death is the permanent termination of the biological functions that sustain a living organism. Phenomena which commonly bring about death include old age, predation, malnutrition, disease, and accidents or trauma resulting in terminal injury....
.
The postpartum period in mothers
A woman in the Western world who is delivering in a hospitalHospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
may leave the hospital as soon as she is medically stable and chooses to leave, which can be as early as a few hours postpartum, though the average for spontaneous vaginal delivery
Spontaneous vaginal delivery
A vaginal delivery is the birth of offspring in mammals through the vagina. It is the natural method of birth for all mammals except monotremes, which lay eggs into the external environment...
(SVD) is 1–2 days, and the average caesarean section
Caesarean section
A Caesarean section, is a surgical procedure in which one or more incisions are made through a mother's abdomen and uterus to deliver one or more babies, or, rarely, to remove a dead fetus...
postnatal stay is 3–4 days.
During this time the mother is monitored for bleeding
Bleeding
Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...
, bowel and bladder
Urinary bladder
The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...
function, and baby care. The infant
Infant
A newborn or baby is the very young offspring of a human or other mammal. A newborn is an infant who is within hours, days, or up to a few weeks from birth. In medical contexts, newborn or neonate refers to an infant in the first 28 days after birth...
's health is also monitored.
Physical
The mother is assessed for tearTear
Tear may refer to:*Tears, a type of eye secretion*Tearing, the ripping apart of something by force*Robert Tear, a Welsh singer-Elements in fiction:*Tear, a character Tear Grants in video game Tales of the Abyss...
s, and is sutured if necessary. Also, she may suffer from constipation
Constipation
Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation...
or hemorrhoid
Hemorrhoid
Hemorrhoids or haemorrhoids , are vascular structures in the anal canal which help with stool control. They become pathological or piles when swollen or inflamed. In their physiological state they act as a cushion composed of arterio-venous channels and connective tissue that aid the passage of...
s, both of which would be managed. The bladder is also assessed for infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
, retention
Retention
Retention may refer to:* Retention, in learning, the ability to retain facts and figures in memory ** Selective retention* Cultural retention* Customer retention...
and any problems in the muscle
Muscle
Muscle is a contractile tissue of animals and is derived from the mesodermal layer of embryonic germ cells. Muscle cells contain contractile filaments that move past each other and change the size of the cell. They are classified as skeletal, cardiac, or smooth muscles. Their function is to...
s.
The major focus of postpartum care is ensuring that the mother is healthy and capable of taking care of her newborn, equipped with all the information she needs about breastfeeding
Breastfeeding
Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breasts rather than from a baby bottle or other container. Babies have a sucking reflex that enables them to suck and swallow milk. It is recommended that mothers breastfeed for six months or...
, reproductive health
Reproductive health
Within the framework of the World Health Organization's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene, addresses the reproductive processes, functions and system...
and contraception
Contraception
Contraception is the prevention of the fusion of gametes during or after sexual activity. The term contraception is a contraction of contra, which means against, and the word conception, meaning fertilization...
, and the imminent life adjustment.
Some medical conditions may occur in the postpartum period, such as Sheehan syndrome and peripartum cardiomyopathy
Peripartum cardiomyopathy
Peripartum cardiomyopathy is a form of dilated cardiomyopathy that is defined as deterioration in cardiac function presenting typically between the last month of pregnancy and up to five months postpartum...
.
In some cases, this adjustment is not made easily, and women may suffer from postpartum depression
Postpartum depression
Postpartum depression , also called postnatal depression, is a form of clinical depression which can affect women, and less frequently men, typically after childbirth. Studies report prevalence rates among women from 5% to 25%, but methodological differences among the studies make the actual...
, posttraumatic stress disorder or even puerperal psychosis.
Postpartum urinary incontinence
Urinary incontinence
Urinary incontinence is any involuntary leakage of urine. It is a common and distressing problem, which may have a profound impact on quality of life. Urinary incontinence almost always results from an underlying treatable medical condition but is under-reported to medical practitioners...
is experienced by 23.4%http://members.multimania.co.uk/shiryu01/Pdf/Hvidman%202003.pdf to 38.4%http://www.ncbi.nlm.nih.gov/pubmed/12028976, likely higher during pregnancyhttp://journals.lww.com/greenjournal/Abstract/1999/11000/Antenatal_Prediction_of_Postpartum_Urinary_and.9.aspx.
Psychological
Early detection and adequate treatment is required. Approximately 25% - 85% of postpartum women will experience the "blues" for a few days. Between 7% - 17% may experience clinical depression, with a higher risk among those women with a history of clinical depression. Rarely, in 1 in 1,000 cases, women experience a psychotic episode, again with a higher risk among those women with pre-existing mental illness. Despite the wide spread myth of hormonal involvement, repeated studies have not linked hormonal changes with postpartum psychological symptoms. Rather, these are symptoms of a pre-existing mental illness, exacerbated by fatigue, changes in schedule and other common parenting stressors.Over 1 in 100 women develop posttraumatic stress disorder following childbirth, many more suffer from one or more of the symptoms. PTSD may occur after severe complications during delivery, but personality characteristics and previous psychiatric illness has also been associated with the development of posttraumatic stress symptoms.
Postpartum psychosis (also known as puerperal psychosis), is a more severe form of mental illness than postpartum depression, with an indicence of approximately 0.2%.
In East Asia
In some East Asian cultures, such as Chinese and Vietnamese, there is a traditional custom of postpartum confinementConfinement
Confinement may refer to either* Civil confinement for psychiatric patients* Color confinement, the physical principle explaining the non-observation of color charged particles like free quarks* Solitary confinement, a strict form of imprisonment...
known in English as doing the month or sitting the month (Mandarin
Standard Mandarin
Standard Chinese or Modern Standard Chinese, also known as Mandarin or Putonghua, is the official language of the People's Republic of China and Republic of China , and is one of the four official languages of Singapore....
zuò yuèzi 坐月子). Confinement traditionally lasts 30 days. Similarly, women in Japan frequently practice ansei, or peace and quiet, for a period of time after giving birth for the purpose of recuperating. This tradition combines prescribed foods with a number of restrictions on activities considered to be harmful. It is widely believed in many East Asian societies that this custom helps heal injuries to the perineum
Perineum
In human anatomy, the perineum is a region of the body including the perineal body and surrounding structures...
, promote the contraction of the uterus
Uterus
The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals including humans. One end, the cervix, opens into the vagina, while the other is connected to one or both fallopian tubes, depending on the species...
, and promote lactation
Lactation
Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process occurs in all female mammals, however it predates mammals. In humans the process of feeding milk is called breastfeeding or nursing...
.
In Greece
Traditionally, Greek mothers would spend 40 days confined at home with their infant after giving birth. At the end of the 40 days (the sarántisma, or "fortying"), the child was symbolically taken to church for the first time, where the mother asked for a special blessing on the conclusion of her puerperium. There are a number of modern theories seeking to justify this traditional practice, including weakness of infant immune systemsNeonatal sepsis
In common clinical usage, neonatal sepsis specifically refers to the presence of a bacterial blood stream infection in the setting of fever...
, unimpeded establishment of breastfeeding
Breastfeeding
Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breasts rather than from a baby bottle or other container. Babies have a sucking reflex that enables them to suck and swallow milk. It is recommended that mothers breastfeed for six months or...
, and the need for bonding time between parent and child.
In India
Most traditional Indians follow the 40 day confinement and recuperation period also known as the 'Jaappa'(in Hindi). A special diet to facilitate milk production and increase hemoglobin levels is followed. Sex is not allowed during this time.In Hindu culture, the puerperium was traditionally considered a period of relative impurity (asaucham) due to the processes of childbirth, and a period of confinement of 10 days (known as purudu) was recommended for the mother. During this period, she was exempted from usual household chores and religious rites. The father was purified by a ritual bath before visiting the mother in confinement. In the event of a stillbirth, the period of impurity for both parents was 24 hours.
In Pakistan
Mothers are traditionally required to spend a period of 40 days in confinement after her child birth. During the period, she usually stays away from household activities and is supposed to have a rehabilitation period through rest and some energy diet.See also
- BreastfeedingBreastfeedingBreastfeeding is the feeding of an infant or young child with breast milk directly from female human breasts rather than from a baby bottle or other container. Babies have a sucking reflex that enables them to suck and swallow milk. It is recommended that mothers breastfeed for six months or...
- ChildbirthChildbirthChildbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
- DoulaDoulaA Doula is someone who provides non-medical support to women and their families during labour and childbirth, and also the postpartum period. The term can also be used to describe other supportive roles for other life events such as abortion, death and more....
- EpisiotomyEpisiotomyAn episiotomy , also known as perineotomy, is a surgically planned incision on the perineum and the posterior vaginal wall during second stage of labor. The incision, which can be midline or at an angle from the posterior end of the vulva, is performed under local anaesthetic , and is sutured...
- InfantInfantA newborn or baby is the very young offspring of a human or other mammal. A newborn is an infant who is within hours, days, or up to a few weeks from birth. In medical contexts, newborn or neonate refers to an infant in the first 28 days after birth...
- Obstetric
- parental leaveParental leaveParental leave is an employee benefit that provides paid or unpaid time off work to care for a child or make arrangements for the child's welfare. Often, the term parental leave includes maternity, paternity, and adoption leave...
- Pre- and perinatal psychologyPre- and perinatal psychologyPrenatal and perinatal psychology is an interdisciplinary study of the foundations of health in body, mind, emotions and in enduring response patterns to life...
- Puerperal feverPuerperal feverPuerperal fever or childbed fever, is a bacterial infection contracted by women during childbirth or miscarriage. It can develop into puerperal sepsis, which is a serious form of septicaemia. If untreated, it is often fatal....
- Pelvic girdle painPelvic girdle painPregnancy related Pelvic Girdle Pain causes pain, instability and limitation of mobility and functioning in any of the three pelvic joints...
- Early postnatal hospital dischargeEarly postnatal hospital dischargeA definition that has been used for early discharge from hospital after childbirth is discharge of mother and baby within 48 hours of the birth....
- Postpartum depressionPostpartum depressionPostpartum depression , also called postnatal depression, is a form of clinical depression which can affect women, and less frequently men, typically after childbirth. Studies report prevalence rates among women from 5% to 25%, but methodological differences among the studies make the actual...
External links
- New born Care
- eMedicine: Normal and Abnormal Puerperium
- Patient UK: Postnatal Care (Puerperium)
- Postpartum Social Awareness
- Discovery Health's Postpartum Planning Tool guides you through the mysteries of motherhood and babyhood from birth to 12 weeks.
- Pregnancy & Childbirth
- NHS Choices Birth to Five Planner: Postnatal post-traumatic stress disorder