Exercises in the puerperium
You can advise the following simple exercises.
Breathing exercises( from the 2nd day of the postpartum period): put your hands under your head, breathing in - chest and belly;raise your head and exhale.
Put your hands on your chest, dilute them to the sides to shoulder level - inhale;bring your hands to your chest - exhale.
Exercises to improve blood circulation in the extremities( from the 2nd day).Starting position: the woman lies on the back with her arms stretched out along the trunk and her hands turned with her palms facing downwards;legs stretched, heels and socks together;head is straight. Dilute your fingers and simultaneously unbend( to yourself) until the stop of the foot;squeeze your fingers into a fist and simultaneously bend( from yourself) to the failure of the foot. The breathing is uniform.
Bend your legs in your lap, not taking your feet off the bed - inhale;unbend legs - exhale. From the 3rd-4th day, this exercise becomes somewhat more complicated: to bend the left leg in the knee and hip joints, the right leg is unbent;bend the right leg, simultaneously unbend the left leg. The breathing is uniform.
Exercise for the muscles of the trunk( from the 2nd day).The starting position is the same as in the previous exercises. Before the beginning of the exercise, take a breath. Get the right hand the opposite edge of the bed with a slight turn of the upper half of the body - exhale;return to the starting position - inhale;to reach with the left hand the opposite edge of the bed - exhalation;return to the starting position - inhale.
This exercise is further complicated and performed as follows. Starting position: the woman lies on her back, her hands are spread apart with her hands palm up. Before the beginning of the exercise, take a breath. Using the palm of the right hand to touch the palm of the left hand, turn the upper half of the trunk to the left - exhale;return to the starting position - inhale;with the palm of the left hand, touch the palm of the right hand, turn the upper half of the trunk to the right - exhale;return to the starting position - inhale.
Starting from the 4th-5th day of the postpartum period, the following are added to these exercises.
Exercise for the muscles of the abdominal wall. Raise, on the hands, the upper half of the trunk( to the "sitting" position).In the future, perform the exercise with the hands extended forward or laid behind the head.
Exercise for the muscles of the back. Bend your knees;Raise the pelvis, leaning on the feet and shoulders - inhaling;lower the pelvis - exhale.
Exercise for the muscles of the pelvic floor. Vigorously draw in the anus;relax it.
Each exercise is repeated 4-6 times. Before conducting the exercises, it is necessary to ventilate the room well. The general well-being of the parturient before the classes and at the end of them MUST be good. The lesson should leave a feeling of cheerfulness and not cause fatigue.
In all large maternity hospitals, physical exercises are conducted under the supervision of specially trained personnel for a special complex designed for the postpartum period. Exercises are prescribed only to those women whose labor and postpartum period have occurred without any
complications.
It is clear that it is not enough to engage in physical education only in the maternity hospital, this should be done and after discharge from the maternity hospital in the postpartum period, physical
is recommended for lightweight type. Exercises associated with significant stresses are prohibited. When practicing gymnastics, it is recommended to wear a bandage for the abdominal wall. Carrying out classes at home, it should be remembered that without observing general hygienic rules, physical exercises do not give the full effect. It is necessary to keep the body clean, and after physical exercises wipe it with water at room temperature,
After the birth, the dairy( breast) glands begin functioning. The necessary training for this is accomplished during the pregnancy. Developed by the mammary glands during pregnancy colostrum after childbirth gradually changes its properties and passes into milk, and this process ends in the re-birth between the 3rd and the 7th day, and in the primiparous, a little later. Proper feeding and vigorous suckling of a child speeds up this transition.
On the 3-4th day after childbirth, due to the onset of increased activity of the mammary glands, they are engorged. They suddenly increase;the skin tightens, becomes shiny;the glands become painful. At engorgement of mammary glands to the woman it is recommended to limit drink. It is important to know that the ability to produce milk is improved as breastfeeding. This is especially true of primiparas.
The good activity of the mammary glands depends on the proper application and lactation. It is necessary to strictly follow the feeding regimen. The child should be fed at a certain time at intervals of 3 to 3, 5 hours. At night between the feeds there should be a break of 6 hours. A night break is needed as a rest for the mother and child.
The milk compartment - lactation - is maintained by the irritation produced by the sucking movements of the baby, and emptying the breast, for which only one breast should be given in one feeding, and the next one - the other. With a good allocation of milk from the breast, a healthy strong baby empties it in 15-20 minutes. If after breastfeeding, milk remains in the mammary gland, then it should be decanted by the doctor( preferably with the help of a breast pump).The separation of milk is undoubtedly affected by the nervous system. In this regard, first of all, it is necessary that during the feeding a quiet and quiet environment was created, so that the effect on the nervous system of all unnecessary and irritating moments is eliminated. Further, it is necessary that the established mode of feeding is strictly observed, so that all the preparatory measures for it( airing the room, washing hands, washing the nipple before feeding) are performed at a strictly defined time and in strict sequence. All this will promote proper lactation in the first time, until the function of the breast is established.
Every healthy woman should feed the baby herself. With the mother's milk, the child receives all the substances necessary for its growth and development, as well as substances that ensure its resistance to infection and protect against some infectious diseases.
Most breastfeeding women do not have menstruation before the end of feeding. Maturation of eggs in the ovaries does not occur. The uterus is at rest, under the influence of feeding it becomes less than usual. With this state of the reproductive organs, a new pregnancy does not occur. All this has a certain biological significance. Pregnancies, which follow one after another, place very high demands on the woman's body, so there must be a break between pregnancies. Since the maturation of the egg in the ovary still occurs earlier than menstruation, during the period of feeding a woman can become pregnant before the resumption of menstruation. A nursing mother can apply to a women's consultation, where she will receive advice on how to prevent pregnancy.
At the beginning of the postpartum period, when the woman has not yet fully recovered and when the extensive wound surface in the uterus has not yet healed, there are known prerequisites for the occurrence of postpartum wound infection. After-
, the birth-related infection is a serious complication of the postpartum period. It is caused by pyogenic microbes - staphylococci and streptococci, which lead to inflammation and suppuration of wounds. All these microbes are found on the human body: on the skin, in the cavity of the pharynx, nose, vagina, intestines.
Postpartum infection can develop as a result of infection with both its own microbes and microbes imported from outside. The most important is the penetration of microbes into the wound surface of the uterus. The signs of a beginning postpartum infection include, first of all, fever, sometimes with chills. The temperature is not always very high;it can also be moderately elevated-37-37.9 °.Allocations in the parturient are blood-purulent or purulent. Sometimes women complain of pain in the lower abdomen, in the groin, lower back, and also in pain in the legs.
Manifestations of postpartum infection can be very diverse - from the mild form of the disease in the form of minor inflammation of the uterus to severe forms. It is important to remember that under unfavorable conditions that contribute to reducing the body's resistance and exacerbating the inflammatory process, light forms can turn into heavy ones.
Severe forms of postpartum diseases in our country are extremely rare. This is due to the achievements of Soviet health in the prevention of postpartum diseases, as well as in their treatment. It should be emphasized that treatment is the more successful the earlier it was started.
The work of the maternity hospital is organized in such a way as to prevent the occurrence of postpartum diseases and to create after delivery the proper care for the mother and newborn. In addition, in the maternity hospital the woman receives the necessary information about the postnatal period and the necessary skills for caring for the child.
The complications of the postpartum period include inflammation of the breast - mastitis( mastitis).Inflammation of the breast is most often caused by staphylococci, less often streptococci. In most cases, the inflammation of the breast is preceded by the cracking of the nipples, which are the gateway for the introduction of infection into the gland tissue. Cracks in the nipples usually occur during the first weeks of feeding, when the skin of the nipples has not yet acquired sufficient resilience. It is clear that when they appear, you need to see a doctor. Infection can penetrate the mammary gland and directly through the dairy ducts that open on the nipple.
An important factor contributing to the occurrence of mastitis is the microbial contamination of the skin of the puerpera and, above all, of the nipples.
In the early postpartum period, postpartum discharges containing various microbes, including pathogens, can become a dangerous source of contamination. Infection of the nipple's skin can occur due to the transfer of microbes by hands, contact with contaminated linen, and also with microbial air pollution( air infection).Hence it becomes clear how important impeccable cleanliness in everything is for the mother and how it is necessary to regularly ventilate the room in which she is.
One of the important measures to prevent mastitis is the proper care of the mammary glands. First of all, it is necessary to monitor their impeccable cleanliness. The breastfeeding mother should wash the mammary glands daily with warm water and soap. Before each feeding, you should thoroughly wash your hands, then wash the teat with a hygroscopic, preferably sterile, cotton wool moistened with a weak solution of boric acid or other disinfectant prescribed by the doctor. After feeding, it is recommended to gently remove the nipple from the child's mouth, dry it with cotton. Some advise to wash the nipple with a disinfectant solution and at the end of feeding, as the mouth of the child can become the source of infection of the nipple. This is possible in the event that in the nasal cavity of the child the pathogenic staphylococci, capable of causing inflammation of the mammary gland, will settle. In no case should you touch the nipple with your hands. Air baths for mammary glands are very useful;they should be taken in a well-ventilated room, lying on your back, twice a day for 10-15 minutes.
A breastfeeding woman should not be wrapped up in mammary glands.
The wrapping does not protect against mastitis, but rather contributes to its occurrence. This is because regardless of the application of the baby to the breast, there may be a discharge of milk that moistens the nipple and breast skin, and when wrapped, the mammary gland and nipple are exposed to moist heat. As a result, the resistance of the skin decreases, and it loosens and h t about is very important, conditions are created resembling those in which microbes are cultivated artificially. A nursing woman should wear a comfortable bra, well supporting, but not squeezing the mammary glands. Both tight tightening and sagging of the mammary glands adversely affect the release of milk and lead to stagnant phenomena in individual lobules of the gland.
Proper application of the baby to the breast plays a significant role in preventing nipple cracks. Breastfeeding mother must learn and follow all the rules of feeding. Of great importance is also the nutrition of the pregnant woman and the puerperium. Lack of vitamin A can promote the formation of nipple cracks. Rude and inept expression of milk or massage of the mammary glands can injure them and contribute to the occurrence of mastitis.
It is necessary to resort to the decantation of milk, after consultation with a doctor, and only when it is really necessary. Most often in the postpartum period, the need for expression arises if the child is weak, premature and sucks badly.
During the entire postpartum period, a woman needs a certain regimen. First of all, you should take care of enough rest. At home, looking after the child, the mother is often forced to get up to him at night, her sleep is interrupted and she does not sleep enough. It is very important to establish such a regime that a woman can rest in the afternoon. The baby girl must sleep at least 8 hours a day. Systematic lack of sleep causes irritability and fatigue, and also adversely affects the separation of milk. The need for rest does not mean that a woman should not do anything in the postpartum period, that it is good for her to lie down a lot. On the contrary, her health requires an active lifestyle. The baby girl must get up in a timely manner, move enough, do physical exercises in the morning, go out in the fresh air, and gradually become involved in homework. Then her strength will quickly recover.
However, it must be remembered that if early movements are of benefit to the puerperium, then early heavy physical labor in the postpartum period is harmful.
We have already said that the uterus after delivery is very mobile, easily displaced, ligaments, and the muscles of the pelvic floor are relaxed and stretched. Therefore, work associated with significant stress, with lifting of gravity, can lead to the omission of the uterus.
In domestic work, in the care of a child, especially at the first time, the family member should help the puerpera.
While the birth wounds have not healed, the strictest observance of the rules for protecting them against the ingress of microbes is required. In the maternity hospital, the toilet of the external genitalia is performed in the same way as the wound dressing in surgical practice: through sterile instruments, using sterile cotton wool. For irrigation, a slightly disinfectant solution of potassium permanganate is used. After undermining, a cloth, treated with a disinfectant solution, an underlay diaper, disinfected by sterilization with hot steam in an autoclave or ironed with a hot iron, is put under the panty liner.
In some maternity hospitals, puerperas who are allowed to walk give the opportunity to wash themselves. For this there are hygiene rooms equipped with special devices with a rising shower. The external genitalia should be washed with a shower without the help of hands. After showering, with cleanly washed hands a piece of sterile gauze or cotton wool, the woman gently wipes her hips and crotch with blotting movements.
After discharge home during the entire postpartum period, a woman should also wash the external genitalia twice a day. To wash it should be warm boiled water with children's or boron-timolovym soap, watering from a teapot or a small jug;To wash off genitals it is necessary from the front back( from a pubis to an anus).Before washing, you should clean your hands thoroughly.
Douching of the vagina during normal postpartum period is superfluous and can cause harm, since they contribute to the introduction of microbes into the upper genital tract and injure the walls of the vagina and cervix.
In the first weeks after childbirth, a woman has secretions from the genitals. Therefore, on the bed on top of the sheet should put a clean oilcloth and ironed bedding, which must be changed daily. Bed linen should be changed every 5 days.
In the postpartum period, when a woman begins to lead an active lifestyle, it is advisable to use hygiene dressings. They must be either sterilized or
carefully ironed with a hot iron.
It is possible to wash the entire body with warm water 1.5-2 weeks after delivery, that is, a few days after discharge from the maternity hospital. In the future, the woman should approximately every 5 days to wash the whole body with warm water and soap and then change the laundry. The first time after childbirth, you should wash at home in the shower or standing in the pelvis. When visiting the bath, you also need to wash standing, preferably under the shower;can not be sweated.
It is not recommended to take a bath during the entire postpartum period, because contaminated water can penetrate the vagina.
In the normal course of the postpartum period, sexual activity can be resolved not earlier than 6 weeks after the delivery of
, since before this period the genitals are easily vulnerable and can be infected. In addition, early sexual intercourse can cause a mother to have severe uterine bleeding.
The living conditions, the surrounding environment are of great importance for the health of the mother and child. The room in which the mother and child are living should be kept in perfect cleanliness and often ventilated. Mother and child should spend as much time as possible in the fresh air.
In conclusion, we must emphasize with all perseverance that in the postpartum period, especially at the beginning of it, the puerperas need a careful and attentive attitude towards themselves. At this time, the resistance of the body is lowered, and breastfeeding, the expenditure of energy associated with caring for the child, make him demand higher. Therefore, it is important that the rules for the care of the parturient woman are carefully followed and the regime necessary for it is respected. Let us recall once again what this basically amounts to.
First of all for the woman in need of peace and cleanliness, and the puerpera needs not only physical, but also peace of mind.
Peace does not exclude peace, but rather requires some physical activity. Under this condition, the processes of reverse development in the body will proceed better and faster, emptying the bladder and intestine will be normal.
For the correct course of the postpartum period, early standing and gymnastics are of great importance. However, it should be recalled that after suturing the perineum rupture, as well as with increasing temperature in the postpartum period, early erection is not allowed, and gymnastics are limited to breathing exercises.
Proper, regular breastfeeding is important not only for the baby, but for the mother. Breastfeeding promotes the processes of reverse development in the mother's body.
Young and inexperienced mothers need to know that copious drinking and overfeeding does not increase the amount of milk, but is an unnecessary burden for the organism of a nursing woman.
At the end of the postpartum period, a woman begins to lead a normal lifestyle. However, after the end of the postpartum
period, the breastfeeding mother must adhere to a certain regimen, eat regularly, observe hygienic rules, in particular for the care of the mammary glands. On this depends largely the separation of milk.
Note that without the appointment of a doctor, you should not take medicine, since many of them through milk are passed on to the child and can cause harm to him. Nicotine is the strongest poison for a child, so a lactating woman should not smoke. You can not allow anyone to smoke in the room where the child is.
It is important for a child's health that his mother is healthy. After normal delivery, a woman usually does not need any treatment, but in order for the postpartum period to proceed correctly, it is necessary to observe the doctor. This obliges a woman to visit the women's consultation systematically. It is also absolutely necessary to regularly bring the child to the children's polyclinic, where they will follow his development and help the mother in caring for him.
At the first signs of any complications, both the mother and the child should consult a doctor.