What is postpartum?
The puerperium is the name given to the postpartum period, also known as quarantine or confinement, which lasts about 5 to 6 weeks. It begins right after the baby is born and ends when the woman begins to ovulate again.
A new mother undergoes hormonal, physical, and emotional changes. These changes are involuntary and cause serious imbalances in their moods, making them more sensitive and vulnerable.
Previously, I had the idea that mood disorders are part of the female trait, leaving the problem undiagnosed and without proper treatment. As a result, the disorder resolves on its own or progresses to a chronic condition.
The puerperium is directly affected by breastfeeding, and is divided into three stages:
From the first to the tenth day after birth. It starts right after the placenta is born. Within the first hour, the uterus continues to contract and vital signs stabilize. Also, in the first few hours, the new mother must get up and walk after birth. This prevents clot formation, benefits bowel flow, and contributes to your health.
The woman is under constant observation in the initial rehabilitation. This is when she has more intense sensations and a major hormonal change.
From the eleventh to the forty-second day after birth. The female body is still undergoing changes and care should be greater. Both the uterus and genital area are still changing to return to their normal state.
From the forty-third day after birth. Even after the mother starts breastfeeding, she has changed in her body. In the puerperal period, a woman does not ovulate. However, from the 40th day, she can reproduce again, and contraception is recommended if you want to avoid a new pregnancy.
What goes on in the female body
Decreased hormone levels are one of the major shift factors in the female body after the birth of a child. For this reason, a woman may feel more tired and depressed during this period.
Unlike during pregnancy, when the breasts are more elastic and do not cause any discomfort, in the puerperium, they are more full, hot, and more painful due to the production of milk. The appearance of milk appears between 24 to 72 hours after birth. Relief of symptoms occurs through breastfeeding.
The abdomen swells and gradually returns to its normal size, causing the skin to sag. The abdominal wall muscles may separate in women over the age of 35 who are giving birth to a baby weighing more than 4 kg or a twin, which is known as diastole.
Immediately after the placenta ablation, uterine contractions continue until the uterus remains solid and returns to its normal size, a process that takes an average of 10 days.
It is normal for a woman to experience cramping or abdominal pain while breastfeeding. This happens by suctioning the baby, which encourages the production of oxytocin, a hormone responsible for promoting contractions of the uterine muscles. The uterus shrinks by about 1 cm per day, and colic stops within 20 days.
Women who have given birth naturally with an episiotomy (a cut in the area of muscle between the vagina and the anus to help bring the baby out) feel pain and discomfort in the area where the incision was made. However, any woman who has had a baby will have changes in her vagina, as it tends to become flatter and swell in the first few days after delivery.
Similar to the menstrual cycle, lochia is a vaginal secretion made up of the secretions of the uterus, vagina, blood, and endometrium. Its duration is about 15 days, and it may extend up to 3 months after birth.
The discharge is more intense in the first two to four days, with a bloody color, and decreases, becoming pinker until it becomes white or yellow after 10 days.
It is the sudden urge to urinate, without the ability to fully control the urine, and it may pass through your panties. Loss of control is common in women who have given birth vaginally, but it may also appear in women who have had cesarean sections.
This condition lasts about 3 months and can be resolved with exercises that strengthen the muscles of the perineum (the area where the genitals and anus are located) or physical therapy.
Hemorrhoids are dilated veins in the anus that can be internal or external. It causes pain and in some cases bleeding. They appear during pregnancy or arise from the force exerted during childbirth.
50% of births in Brazil are cesarean sections – a cut in the woman’s abdomen and uterus to remove the baby, due to complications during pregnancy or with the newborn. The stitches are removed within 8 days and the uterine incision heals in about 6 weeks.
The return of menstruation depends on breastfeeding. When a woman stimulates milk production, the menstrual cycle returns around 6 months. If you do not breastfeed, menstruation returns within one to two months.
During childbirth, sex should be restricted, but not necessarily avoided. Sex life can be resumed from the first month after birth with the consent of the obstetrician. However, in this period, a woman is still unable to ovulate, causing a lack of sexual desire and exposure to infections.
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Most mothers go through a moment of grief after giving birth, which is about grief known as the baby blues, it affects 15 out of every 100 women. This stage lasts about two weeks and goes away on its own. A new mom goes through mood swings, bouts of crying, worrying and sleepless nights.
The most common difficulties encountered by a woman transitioning into the role of mother are bathing, being careful of the umbilical stump, breastfeeding, identifying crying, type of delivery, and physical weakness.
In addition, during quarantine, the mother undergoes hormonal changes, as mentioned earlier, which makes her more sensitive and emotional.
The arrival of a baby is a cause for celebration, but with that comes responsibilities and changes in routine. Breastfeeding at any time of the day, sleepless nights, and being apprehensive about other babies are recurring concerns. However, some women may experience more severe symptoms and develop postpartum depression.
The mother may feel insecure about the care needed for the baby and herself at this early stage. Specialists do not know the exact cause that causes the disease, but they believe that it is a combination of hormonal, environmental, psychological, and genetic factors.
Without proper treatment, depression can last for months or even years. Severe disruption can lead to postpartum psychosis. Therefore, the partner and the family must be attentive and ready to help her.
In general, puerperal psychosis or puerperal psychosis affects women about 2 to 3 weeks after the birth of the baby. He has all the symptoms of postpartum depression and can develop from this disease. What distinguishes them is that women appear in psychosis, confusion, delusions, and visions. The number of suicides of women with psychotic disorders is high, as is the risk of infanticide.
The disease is not limited to females: one in ten fathers suffers from postpartum depression. The challenges of a new lifestyle and seeing a family grow to contribute to stress and anxiety.
Questions such as how to be a good father, how to raise a child, and reciprocate affection lead men to lose disposition, appetite, pleasure, and joy in the new “job”. The chances of contracting the disease increase in the first year of the child and when the parents for the first time.
How do you avoid postpartum stress?
To avoid stress or relieve symptoms, here are some guidelines for new moms:
Young women or women over the age of 35, frequent miscarriages, and those with chronic diseases are more likely to have risky pregnancies and prefer the onset of stress.
Eating a balanced diet, drinking plenty of water, engaging in regular and moderate physical activity, not smoking, not drinking alcohol, and not taking drugs all contribute to a more stable emotional state
Having emotional bonds with family and friends is very important, even if the pregnancy was unplanned or unwanted. Receiving support and help at this time makes the stress go away.
Bonding with the baby should be done while the baby is on his tummy. Talk to him, pamper him, knead his limbs. If you have other children, try to bring them together during pregnancy, as jealousy can become an issue in the future.
Do not panic
First-time moms are concerned about new responsibilities. The key is to follow your instincts and seek information, whether from other mothers, family members, books, or specialist websites, about the care needed after a baby is born and changes in the body.
Keep your accounts updated
Having debts greatly increases stress. Therefore, getting organized and leaving accounts on time is essential. And saving up and keeping a spare in case of emergency will spare you any potential inconvenience.
After the birth of the baby, the woman must monitor her health with the obstetrician. If the delivery was normal, the first visit should take place between 4 to 6 weeks after delivery. In the case of cesarean delivery, the consultation should take place between 8-10 weeks after discharge from the hospital.
The doctor will analyze the mother’s physical condition, breastfeeding, and vaginal bleeding, examine the healing and remove the stitches, and can clarify any doubts about the condition of the puerperium.
Postpartum depression treatment
Treatment depends on the degree of severity of the patient. Techniques such as psychiatric medications, psychotherapy, hormonal therapies, and electroconvulsive therapy may be used.
Postpartum depression treatment
Use of medications such as antidepressants, antipsychotics, and mood stabilizers.
In this therapy, the psychiatrist will accompany the patient and her family to find emotional balance in this new reality.
One approach that can be used is cognitive-behavioral therapy, which analyzes and modifies the distorted thoughts and emotions that a person has about himself that are the cause of his ineffective behavioral reactions, and restructures these perceptions.
Psychotherapy can also help to stop or reduce the dose of pharmaceutical therapy, thereby reducing the risk of relapse or symptoms of postpartum depression. However, in severe or recurrent cases, discontinuation of drug therapy is not recommended.
Medications based on estrogen (a hormone responsible for controlling ovulation and the development of female characteristics) may be prescribed sublingually and transdermally (applied to the skin). The treatment balances the amount of the hormone, which reduces mood swings and thus helps with women’s psychological disorders.
Electroconvulsive therapy (ECT)
Women with certain types of depression, suicidal thoughts, or psychotic breaks may need to be hospitalized. ECT is used when a patient does not respond to medication or exceed medication side effects.
The treatment has nothing to do with the electric shocks used in the past for torture purposes. Self-limiting shots are made in the brain, making the carriersNeurotransmitter (responsible for spreading nerve impulses in the brain and maintaining well-being) is constant.
The patient is subjected to anesthesia, muscle relaxants, and oxygen, in addition to being examined with blood pressure, heart, and brain monitors.
Medicines commonly used in the treatment are:
fluoxetine hydrochloride (Prozac);
nortriptyline hydrochloride (Pamelor);
sertraline hydrochloride (Zoloft, Toast);
Never self-medicate or stop using a medication without consulting your doctor first. Only he will be able to determine the most appropriate medication, dosage, and duration of treatment for your particular case. The information on this site is intended to inform you only and is in no way intended to replace the advice of a specialist or to serve as a recommendation for any kind of treatment. Always follow the directions on the insert, and if symptoms persist, seek medical or pharmaceutical advice.
In the postpartum stage, a woman should take some measures to help her recover. are they:
Get good nutrition. Eat vegetables, greens, and fruits, as well as foods that contain iron and calcium, such as red meat, milk, and dairy products. Another tip is to drink plenty of water, as it contributes to bowel function and milk production.
Do not lift weight or engage in intense physical activity for 45 days. In the case of cesarean delivery, the duration should be up to 3 months;
do not drive in the first month, as it can be difficult to heal the perineum if the birth was natural, and the abdominal seam if it was a cesarean section;
Maintain good personal hygiene. If there is a perineal incision or a cesarean section, the area should be kept clean by washing with soap while showering and drying well.
Waxing, climbing stairs, and using tampons are not forbidden during this period.
Discomfort is caused by the appearance of puerperal mastitis, inflammation of the mammary glands during the puerperal stage, due to the sucking of the child when gnawing, and moisture on the breasts from the outside, which facilitates the appearance of cracks in the nipples.
In puerperal mastitis, a woman experiences pain, swelling, and a high temperature of the inflamed breast. A doctor should be called and indicated the best treatment, and antibiotics, in case of infection, may be prescribed, or healing ointments. During the recovery period, direct breastfeeding should be avoided.
In 10% of cases, puerperal mastitis develops into a breast abscess, which is a collection of pus in the breast. In these cases, breastfeeding should be discontinued.
Such problems can be avoided by following some recommendations:
The baby needs to feed properly at the time of feeding and to drain the breast milk;
wear comfortable and supportive bras, and avoid using half a cup with an iron;
Lots of rest
Get good nutrition.
Postpartum hemorrhage recurs and manifests through natural delivery and cesarean section. They occur during the first hours after birth and are usually external, due to a rupture of the birth canal or uterus, inclusion of fragments of the placenta, impaired uterine contraction, or changes in blood coagulation.
In certain cases, internal bleeding may occur due to the rupture of a blood vessel caused by the force exerted by the baby’s head when crossing the birth canal. The blood is concentrated under the superficial tissues, causing pain in the area and bruising.
Unusually, hemorrhage also arises in the advanced puerperium, resulting from remnants of the placenta not removed from the uterus, due to failure of detection at the end of delivery.
The bleeding usually goes away on its own within a few days, but a woman can undergo medical treatment as symptoms develop.
It is the second most common complication of the postpartum period. However, the incidence has been greatly reduced due to the procedures used in childbirth to prevent the entry of pathogenic germs into the body, which are predominantly sterilization techniques.
Infection arises in circumstances such as sinus rupture, severe labor, or during a cesarean section. Fever above 38°C, chills, and sweating are indicators of infection.
The problem appears in the first hours of birth, so the patient is treated while she is still in the hospital. However, if a woman identifies symptoms at home, she should contact her doctor immediately.
The puerperium is a stage that all women who have given birth undergo. It is not only a female trait, the symptoms must be evaluated and treated.
So, new mom, stay tuned and share this info with family and friends!