Puerperium

Puerperium
Other names	Postpartum period
Specialty	Obstetrics
Complications	Postpartum hemorrhage, infection, depression
Duration	6 weeks

The puerperium, also known as the postpartum period, is the time following childbirth during which the mother's body, including hormone levels and uterus size, returns to a non-pregnant state. This period typically lasts six weeks and involves significant physiological and psychological changes.

Physiological Changes

During the puerperium, the body undergoes several changes:

Uterine Involution

The uterus undergoes a process called involution, where it returns to its pre-pregnancy size. This process is facilitated by the hormone oxytocin, which is released during breastfeeding.

Lochia

Lochia is the vaginal discharge that occurs after childbirth, consisting of blood, mucus, and uterine tissue. It typically lasts for about four to six weeks and progresses through three stages: lochia rubra, lochia serosa, and lochia alba.

Hormonal Adjustments

Hormone levels, including estrogen and progesterone, decrease significantly after delivery. The hormone prolactin increases to stimulate milk production for breastfeeding.

Cardiovascular Changes

Blood volume and cardiac output, which increased during pregnancy, gradually return to normal levels. This process can take several weeks.

Psychological Changes

The puerperium is also a time of psychological adjustment. Many women experience mood swings, commonly known as the "baby blues," due to hormonal changes and the stress of caring for a newborn. In some cases, more severe conditions such as postpartum depression may occur.

Complications

Several complications can arise during the puerperium:

Postpartum Hemorrhage

This is excessive bleeding following childbirth and is a leading cause of maternal mortality. It requires prompt medical attention.

Infection

Infections such as endometritis can occur if bacteria enter the uterus. Symptoms include fever, abdominal pain, and foul-smelling lochia.

Thromboembolic Disorders

The risk of deep vein thrombosis and pulmonary embolism is increased during the postpartum period due to changes in blood coagulation.

Management

Proper management of the puerperium involves:

Monitoring

Regular monitoring of vital signs, uterine size, and lochia is essential to detect any abnormalities early.

Breastfeeding Support

Encouraging and supporting breastfeeding can help with uterine involution and provide nutrition to the newborn.

Emotional Support

Providing emotional support and counseling can help new mothers cope with the psychological changes and challenges of the postpartum period.

Also see

• Childbirth
• Breastfeeding
• Postpartum depression
• Obstetrics