Postpartum

Question 1

Lochia

Answer 1

• first three days vagina discharge is bright red in color and moderate to heavy in volume
• next seven days discharge becomes less in amount and is darker in color
• day 10 bleeding is significantly less and contains more mucous
• as days progress discharge becomes less in amount and becomes brownish in color
• ~4 weeks site where placenta was attached is healed and discharge has usually stopped

Question 2

Changes in weight and fluid volume

Answer 2

• Weight gained during pregnancy will not disappear immediately after birth
• Mothers initially may have increased swelling after birth due to IV fluids and medications like Pitocin or from epidural
• ~ 1/6 of mom’s total body weight will be lost in first 3-5 days with remaining weight gradually disappearing over several weeks/months
• Normal diuresis occurs over several days after birth
• Mom’s circulating blood volume will decrease by 50% within few weeks
• Moms may be unable to urinate immediately after birth due to trauma/swelling of urethra but will normally be able to urinate within 6-8 hrs after birth
• If mom is unable to urinate, having her sit on commode with 2-3 drops of peppermint oil placed in 2-3 ounces of hot water in urine collection container may aid in voiding. Do not put peppermint directly on skin

Question 3

Tremors

Answer 3

• Leg and lower body tremors are often noted immediately after birth due to significant exertion needed to give birth
• Placing warm blankets on mom may feel good, however tremors will disappear shortly after birth without intervention
• Food and fluids will aid in raising mom’s blood sugar, decrease tremors and help her energy level

Question 4

Postpartum mood disorders

Answer 4

• ~1/7 women are diagnosed
• Many women experience symptoms but are not diagnosed or treated
• Symptoms generally occur several weeks to months after birth unless mom has previous history of depression before
• Symptoms last longer than two weeks
• Mom often feels she is a “bad mom”
• Thyroid functions may also be abnormal
• Sleep deprivation is significant contributing factor
• Traumatic births put mothers at higher risk for depression
• Stress triggers inflammatory response which triggers depression

Question 5

Placenta Encapsulation

Answer 5

• Process in which placenta is dried, pulverized, and placed in capsules
• Placenta is unique to each woman, no prescription medication, over-the-counter medication can match a woman’s own placental hormones

Question 6

Placenta Encapsulation - Benefits

Answer 6

• Decrease in baby blues and postpartum mood disorders
• Increased energy and milk supply
• Decrease in lochia and therefore anemia
• Decrease in insomnia and sleep disorders

Question 7

Placenta Encapsulation - Preparation methods

Answer 7

• Must be done under sterile conditions
• Mom must be tested prior to birth for communicable diseases
• Oriental method includes herbs mixed in after dehydration, then encapsulated, and has an indefinite shelf life
• Other methods steam placenta, dehydrate it, pulverize it and encapsulate with, shelf life is 1-3 years

Question 8

Placenta Encapsulation - Dosage

Answer 8

• Dosage is individualized depending on each mother’s need

- Initial recommendation is two capsules three times daily

Question 9

Edinburgh Postpartum Depression

Answer 9

• Recommendation is that baby’s provide does it every visit for first year