Postpartum period
The process of reverse development of the uterus begins with a reduction in its muscular elements. The supply of the uterus with blood decreases;in connection with this, the supply of nutrients to its tissues also decreases. All this leads to the reverse development of the organ, which most intensively occurs in the first 10 days of the postpartum period. -
The repeated development of the uterus is greatly facilitated by regular breastfeeding. Irritation of the nipples during feeding causes uterine contractions. Often in the first days of the postpartum period, a nursing woman feels these cuts, sometimes even in the form of painful fights. The cervix closes only at the third week.
Simultaneously with the reverse development of the uterus, the healing of its wound surface takes place, the two processes being closely related to one another. When a wound is healed, a wound detachable is formed on its surface. Postpartum discharge( lochia) is the same wound separable. As the postpartum wound heals, their appearance changes. In the first days after delivery, bright bloody, sometimes small clots( the departure of larger clots indicates an abnormal state).Starting from the 3rd day of the postpartum period, the discharge becomes brownish-red, brown, then yellowish-white.
By the 10th day after childbirth, the admixture of blood in the discharge from the uterus disappears. Postpartum discharge becomes meager, gradually assuming the nature of the usual secretions of the genital tract.
Everything said refers to the normal, uncomplicated course of the postpartum period. Deviations from this( sudden delay in discharge, excessively abundant discharge, unusual appearance and character) should cause caution in women;in such cases it is necessary to seek advice from a doctor.
During births on the cervix, vaginal walls and perineal abrasions or tears occur, usually minor. They heal fairly quickly, for several days. If there are tears on the perineum, they must necessarily be protected. Unshielded crotch gaps may further lead to the omission and prolapse of the genitals.
During labor, the vagina, ligaments supporting the uterus, and the muscles of the pelvic floor undergo great stretching. In the first days after childbirth, they are poorly cut, and therefore the organs of the small pelvis with straining have a tendency to descent. Elasticity of ligaments and muscles of the pelvic floor is gradually restored. Gradually, but the vagina narrows more slowly. All this makes it clear why the women in the first days after childbirth should avoid physical stress, and at home, after discharge, do not engage in heavy physical work.
It should be mentioned that in a woman who gives birth to a woman, the genitals do not return completely to the condition that was before pregnancy. At the end of pregnancy, the abdominal wall undergoes considerable stretching. In this case, there is a divergence of the rectus abdominis muscles, which in the delivery is even greater.
After the delivery, the abdominal wall is stretched and relaxed. This circumstance, as well as the lack of habit of urinating in a recumbent position, often in the first days of the postpartum period lead to difficulty urinating. Relaxation of the abdominal wall and forced stay in bed does not contribute to the emptying of the intestine. All this leads to the fact that the stool is usually delayed in the first days after childbirth, especially if it is inclined to constipation, and the first emptying of the rectum after delivery is usually achieved with the help of a laxative or enema.
Active movements of the puerperas should begin as early as possible. They contribute to the reverse development of the genital organs of new and most favorably affect the general condition of the woman, on breathing, blood circulation, intestinal activity, etc. Of course, early active movements after birth are only permissible if pregnancy and childbirth were normal and inthe postpartum period there are no complications.
A healthy baby girl can turn to the side by the end of the first day after the delivery. A small sutured crotch rupture is not an obstacle to the nome, but if there are sutures on the perineum, you should turn without raising your legs. With large ruptures of the perineum, the puerpera should lie on her back for at least 3 days. A healthy woman can gently begin to get out of bed and walk on the 2nd - 3rd day after birth. But sitting in bed is not recommended before 3 days - by this time, surface cracks and abrasions of the external genitalia are healing. If there are wired crotch gaps, you can sit and stand up only after the stitches are removed( stitches are usually removed on the 6th day, and sometimes later).
The parental woman should remember that she can turn, sit and get up, only after having received the doctor's permission.
A powerful means for raising the general condition( tone) of the body, strengthening the muscles of the abdominal wall and pelvic floor is therapeutic gymnastics. Simple and easy exercises can begin from the 2nd day of the postpartum period. They are performed in bed and seem to serve as morning exercises.