Normal Postpartum

Written by : Dr.M.D.Mazumdar, MD

The puerperium or the postpartum period is the period of time following the delivery of the child during which the body tissues, especially the reproductive system reverts back to the pre-pregnant state, both anatomically and physiologically.

The process of reversion of the genital organs is called 'involution'.

The puerperium or the postpartum period lasts for 6 weeks. It is divided into three phases:

  • Immediate Postpartum: the 24-hour period immediately following delivery.
  • Early Postpartum or puerperium: upto 7 days.
  • Remote postpartum or puerperium: upto 6 weeks.

  • Immediately after Delivery
  • Immediately after delivery, the body goes into a few hours of stress before it begins to settle down to a normal state again. During these hours, the pulse rate remains high, usually due to the stress of giving birth but also due to a loss of blood during the childbirth. The body temperature may decrease and there may be retention of urine. Read More ...

  • Care in the Postpartum Period
  • Caring for the postpartum woman starts Just after the delivery, the woman is exhausted from the process of childbirth. She should be allowed to rest for a few hours to recuperate and then encouraged to sit up and walk if she has had a normal vaginal childbirth. This helps drainage of lochia and encourages uterine involution. The perineum and the vulva should be checked and the breasts examined to initiate breastfeeding. Read More ...

  • Breastfeeding
  • Breastfeeding should be initiated within 1 hour of birth - this helps in psychological support of the baby, easy latching of the baby to the breast and in creating the mother-baby bond. The milk secreted in the first few days is thin and whitish and is known as colostrum. It is rich in immunoglobulins which pass from the mother to the child and increases the baby's resistance to various diseases. Read More ...

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  • Involution
  • Involution is the process by which the reproductive organs revert back to the normal pre-pregnant state in about 6 weeks. The uterus not only returns to its pre-pregnant size, but it also returns to its normal position in the pelvic cavity and regains its muscular tone. The vagina, uterine ligaments and muscles of the pelvic floor all revert back to the pre-pregnant state. Read More ...

  • Lochia
  • Lochia is the vaginal discharge which occurs in the 4-6 weeks after childbirth. In the first week, it is red in color with large amounts of blood and blood clots and is known as the lochia rubra. The color changes to a lighter pinkish to brownish as the amount of blood decreases - at this stage it is known as lochia serosa. In the later weeks, it is yellowish to whitish, and is then known as the lochia alba. Read More ...

  • Birth Control in the postpartum period
  • Sex is not advisable for at least 6 weeks after delivery, i.e. in the postpartum period, as the tissues are fragile at this time and need time to recover. But, if necessary, birth control in the form of barrier contraceptives like condoms should be used.

    Condoms have the advantage of being readily available, of not containing any hormones and being cheap. They have no effect on breastfeeding and have no risks to the mother or child. But they can irritate the vaginal tissues. Other birth control measures which can be used are the hormonal pills, the intra-uterine contraceptive device, the rhythm method etc. Read More ...

  • Return of the Period after Childbirth
  • The return of the period after childbirth vary from woman to woman. In women who are breastfeeding exclusively and where the baby gets its entire nutritional needs from the mother's breast, the menstrual period may return only 6 months after the childbirth. But if a woman is bottle-feeding, or combining breast and bottle, the periods may return as early as 1 month after birth. in most cases, it returns after about 3 months. Read More ...

  • Postpartum exercise
  • Regular postpartum exercises help the body to regain its pre-pregnancy shape and size. Decrease in weight increases energy levels, stimulates appetite and helps a new mother cope with the demands of looking after a newborn. The exercises also help to tone up the pelvic and abdominal walls and to correct postural defects. Read More ...

  • Postpartum Posture
  • The postpartum posture is very important. The postpartum period is the time when the woman has not totally recovered from the stress and strain placed on her body by pregnancy and labour. Yet, this is the time when she has to look after her baby - feed, bathe, lift and take care of everything else as well. Wrong posture can cause back pain, knee pain and pain at various parts of the body. The correct postures as shown here, can help decrease many of the aches and pains which occur during the postpartum period. Read More ...

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