Postnatal

Postnatal (Latin for 'after birth', from post meaning "after" and natalis meaning "of birth") 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 prepregnancy conditions. 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.

In newborns

Main article: Infant

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 life, the most significant physiological transition until death.

The postpartum period in mothers

A woman in the Western world who is delivering in a hospital 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.^[1]

Physical

Further information: Sex after pregnancy

The mother is assessed for tears, and is sutured if necessary. Also, she may suffer from constipation or hemorrhoids, both of which would be managed. The bladder is also assessed for infection, retention and any problems in the muscles.

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%[1] to 38.4%[2], likely higher during pregnancy[3].

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.^[2]

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%.

Cultures

In East Asia

In some East Asian cultures, such as Chinese and Vietnamese, there is a traditional custom of postpartum confinement known in English as doing the month or sitting the month (Mandarin zuò yuèzi 坐月子). Confinement traditionally lasts 30 days.^[3] 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. ^{[4] [5] [6]}

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 systems, unimpeded establishment of breastfeeding, and the need for bonding time between parent and child.

In India

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 after visiting the mother in confinement. In the event of a stillbirth, the period of impurity for both parents was 24 hours.^[7]

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.^{[citation needed]}

See also

• Breastfeeding
• Childbirth
• Doula
• Episiotomy
• Infant
• Obstetric
• parental leave
• Pre- and perinatal psychology
• Puerperal fever
• Pelvic girdle pain
• Early postnatal hospital discharge
• Postpartum depression

References

1. ^ "With Women, Midwives Experiences: from Shiftwork to Continuity of Care, David Vernon, Australian College of Midwives, Canberra, 2007 ISBN 9780975167458, p17f
2. ^ Dobson, V.; B. Sales (2000). "The Science of Infanticide and Mental Illness". Psychology, Public Policy and Law 6 (4): 1098–1112. doi:10.1037/1076-8971.6.4.1098. 
3. ^ Effect of Alcohol consumption on Maternal lactation characteristics during ‘doing-the-month’ ritual
4. ^ Ayuvedic Postpartum Healing Tips
5. ^ Ayurvedic diet for de-stressing postpartum mothers
6. ^ Lactogenic Foods and Herbs
7. ^ GUIDE TO RITUAL IMPURITY - What to do at the junctions of birth and death

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