Postnatal Care: Why is it important?

The duration from after childbirth and within six weeks is called the postnatal period. Both mother and the baby require special care during this period. That's called postnatal care.

During the postnatal period, both the mother and newborn are very fragile. Therefore, any issues concerning health in the postnatal period may lead to long-term illness or even death.

The World Health Organization (WHO) provides a guideline on postnatal care. The guideline primarily focuses on postnatal care in resource-limited countries and places. The guideline helps health professionals provide postnatal care to both the mother and the child. It provides health professionals with

• Timing
• Number
• Place of postnatal contact
• Content of postnatal care.

WHO Recommendation for Postnatal Care

For mothers as well as newborns:

• Mothers as well as newborns should get 24 hours of postnatal care in the health facility.
• First postnatal care must be within 24 hours of birth, even if the delivery is at the house.
• Mothers and newborns must at least have additional three postnatal contacts
• On day number 3
• 7-14 days
• Six-weeks post-birth
• During the first week post-birth, home-postnatal care is essential.

For Newborn Baby:

• During every postnatal care contact, the newborn will be further evaluated if there are any signs present such as:
• Stop feeding well
• Convulsions over a certain period
• Fast breathing (if breath rate is greater than or equal to sixty per minute)
• Extreme chest in-drawing
• No movement
• Fever (if temperature greater than or equal to 37.5 degrees Celsius)
• Low body temperature that is, temperature less than 35.5 degrees Celsius
• Jaundice in the first 24 hours after delivery
• Yellow-palms and soles
• Babies need exclusive breastfeeding until six months; the mother needs special care, support and counselling at every postnatal care contact.
• The umbilical cord stump needs special care during life's first week
• For newborns in health facilities, it is recommended to have clean, dry cord care.
• For newborns at home, Daily application of chlorhexidine is recommended.
• It is best if bathing is delayed until 24 hours post-birth; otherwise, at least a 6-hour delay is a must.
• Baby should be clothed with one-to-two layers of clothing more than adults. Also, use hats to keep ambient temperature.
• The mother as well as the baby need to stay in the same room 24 hours a day and not be separated.
• Encourage playing and communication with the baby.
• Immunization should follow the WHO guidelines.
• If your baby has low birth weight and is preterm, special care (according to WHO guidelines) is recommended.

For mothers:

• Postnatal care for mothers during the first 24-hours post birth
• Regular evaluation and routine assessments are required for
• Bleeding from vagina
• Uterine contraction
• Heart rate or pulse
• Temperature
• Fundal height
• Shortly after birth mother's, a blood pressure measurement should be taken. If normal, then blood pressure should be measured again within 6 hours.
• Within 6 hours, a urine-void should be noted.
• Postnatal-care for mothers beyond 24-hours post birth
• At every postnatal-care contact following evaluation must be done, such as
• Micturition
• Urinary incontinence
• Uterine tenderness
• Bowel function
• Lochia
• Perineal wound healing
• Perineal pain
• Perineal hygiene
• Headache
• Fatigue
• Back pain
• Breast pain
• Progress of breastfeeding must also be assessed during every postnatal care contact.
• The emotional state as well as mood-changes must also be assessed during every postnatal-care contact.
• Resolution of mild as well as transitory postpartum depression or maternal blues must resolve within 10 – 14 days after delivery. If not, psychological well-being must be continued to be assessed.
• The mother must be provided information and counselling related to:
• Post-delivery's physiological recovery process
• Common health problems

Symptoms of PHH:

• Faintness
• Dizziness
• Palpitations/tachycardia
• Sudden blood loss or continuous increase in blood loss

Symptoms of pre-eclampsia/eclampsia:

• Headache
• Visual problems
• Nausea as well as vomiting
• Hypochondria or Epigastric pain
• Convulsions in the initial few days after delivery

Symptoms of infection:

• Fever as well as shivering
• Pain in the abdomen
• Offensive vaginal loss

Symptoms of thromboembolism:

• Unilateral pain in the calf region
• Calves become red or swell
• Chest pain
• Shortness-of-breath
• Nutrition
• Hygiene, especially hand washing
• Birth spacing
• Family planning
• Contraceptives options
• Malaria-endemic parts, babies and mothers must sleep under bed nets.
• Perform light exercises
• Take enough rest
• Supplementations of iron, as well as, folic folic-acid for three months are recommended.
• Prophylactic antibiotics are recommended use for the prevention of wound complications.

Newborns need an immediate assessment at birth. In addition, a complete clinical examination is required after an hour after delivery as well as before discharge.

Conclusion:

The postnatal period is a critical phase of maternal and infant death. During this period, both the mother and child need postnatal-care. WHO (World Health Organisation) provides guidelines for postnatal care. Follow the guideline and keep in contact with doctors during this period. As for the mother, many of the future emotional as well as physical issues arise during this period.

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