• All women and their families/partners should be
Postpartum Care encouraged to tell their health care professionals
about any changes
Puerperium - in mood,
A Latin term for the period of involution when - emotional state
the mother’s body returns to its pre-pregnant - and behavior that are outside of the woman’s
state
normal pattern
Postpartum period
• Is the period beginning immediately after the
birth of a child and extending about six weeks Postpartum Maternal Physical Assessment Summary
(BUBBLE HE)
• The World Health Organization (WHO)
describes the postnatal care as the most critical • B-U-B-B-L-E H-E
and yet the most neglected phase in the lives of • B- Breasts
mothers and babies; most deaths occur during
the post natal period • U- Uterine fundus
• It is the time after birth, a time in which the • B- Bladder function
mother’s body, including hormone levels and • B- Bowel function
uterus size, returns to a non-pregnant state
• L- Lochia
Assessment of the mother
• E- Episiotomy
First 24 hours after birth
• H- Homan’s sign
All postpartum women should have regular
assessment of • E- Emotions
vaginal bleeding
uterine contraction
B- Breast
fundal height
temperature and heart rate(pulse) routinely
Assessments of Breast
during the first 24 hours starting from the first • Inspect for redness and engorgement
hour after birth.
• Palpate breast to determine if they warm
Blood pressure should be measured shortly after
birth. If normal, the second blood pressure and tender
measurement should be taken within six hours.
• Pain on palpation
Beyond 24 hours after birth
Breast Infection
• At each subsequent postnatal contact, enquiries
should continue to be made about general well
being and assessments made regarding the
following: micturition and urinary incontinence,
bowel function, healing of any perineal wound,
headache, fatigue, back pain, perineal pain and
perineal hygiene, breast pain, uterine tenderness
and lochia.
• Breastfeeding progress should be assessed at
each post natal contact
• At each postnatal contact, women should be
asked about their:
- emotional well being
- what family and social support they have
- their usual coping strategies for dealing with
day-to-day matters
What to assess/what to expect
Height
-where is the top of the fundus in relationship to
the umbilicus
(below, at the level of the umbilicus, above)
- the fundus is measured above or below the
Umbilicus.
What to expect/what to assess
o Firmness
Let down reflex Palpate the fundus, how does it feel?
The passing of milk down the ducts -The fundus should be firm and hard
o Centeredness
Where is the fundus located?
U- Uterine Fundus - The fundus should be located midline to the
Assessment of the Uterine fundus umbilicus
• It should be firm, if not, massage prior to o Afterpains
palpation and assess for any blood discharge
- cramping caused by the involution of the
during massage
uterus
• Assess its location and the degree of uterine
contraction - breastfeeding also increases afterpains
• Note any tenderness or presence of pain
What to teach
o Encourage patients to empty bladder every two
hours
o Encourage patients to breastfeed
o Encourage patients to massage own uterus
B- Bladder function E- Episiotomy
Stress Urinary Incontinence
B- Bowel Function E- Emotions
L- Lochia Associated Risk Factors of Postpartum
Blues
• Hormonal changes
• Physical changes
• stress
