This is the period of time that begins immediately after childbirth and ends with the return of all the anatomical and physiological changes induced by pregnancy under pre-gravidic conditions. Let’s discover together all the changes that take place at this stage and what they involve
The term “puerperium“Derives from the Latin puer (child) and parus (which is being brought to light). Traditionally it is defined as that period of time, following the birth, during which the return to pre-gravidal state of all anatomical and physiological changes induced by pregnancy. There Duration of the puerperium It is between four and six weeks. Let’s see together the sensitive changes that occur in this period and the possible complications that can be verified and to pay attention to.
What is and how long does the puerperium last?
What is the puerperium? As mentioned, it is the period of time that begins immediately after childbirth and ends with the return of all the anatomical and physiological changes induced by pregnancy under pre-gravidic conditions. Conventionally the Duration of the puerperium it is about 40 days. In this period of time the woman sees her life revolutionized, nothing is more as before: sleep, affections, the social and family role.
In other words, in the days of the puerperium Everything is put back into the gamein a moment of life when the woman must devote himself to another individual, full of needs to be identified and satisfied.
What happens in the days of puerperium?
Immediately after the expulsion of the placenta (in technical jargon, “secondform”), the first two hours are defined post partum And drastic changes occur that mark the passage of the body from pregnant with the puerperal one. In the puerperium, the woman receives from the staff who assist her a constant clinical evaluation, to monitor vaginal bleeding, uterine contractions, blood pressure, temperature, heart rate, etc., and comes supported for breastfeedingif you want to. It takes time to adapt to the new role of mother and at the same time it is appropriate that the processes to which the body goes through during the puerperium is appropriate to be informed.
But exactly, What happens during the puerperium? THE’uterus It contracts to reduce its size and to return to pre-gravidic ones, even if, usually after each birth, it remains slightly larger than the gestation just passed.
At the beginning of the puerperium, the elimination from the uterus of deciduous tissues determines a vaginal loss of variable quantity. These losses are called “loci” or “loving“, And contain erythrocytes (blood cells), epithelial cells and bacteria. In the first days there is sufficient blood to determine a red (Rubra location). After three to four days the loci gradually take on a light color (serous location), finally, towards the tenth day, the loci take on a white or white-yellowish color (Alba location).
The average duration of the locations oscillates between 24 and 36 days. The return of the uterus to the preverted dimensions is favored by breastfeeding and even the locations can increase in correspondence with the feedin response to the production of oxytocin, hormone responsible for the contraction of the uterus and the mammary glands, stimulated by the Singing to the breast of the newborn. These contractions can be warned by the mother and take the name of “uterine bites”.
The first days after childbirth the woman may warn discomfort at the perineal leveldue to the presence of suture points in case of lacerations or episiotomy. Cold compresses applied to the perineum contribute to reducing edema and pain.
Intimate hygiene is important: It is recommended to cleanse the genitals daily, from the vulva to the anus. Within a couple of weeks, any suture will become almost completely asymptomatic and will be controlled by the midwife or by the reference gynecologist on the occasion of the check to be carried out at four to six weeks from childbirth, as recommended by all scientific societies.
What to do and What Not do after childbirth? Here are some tips:
- Women with an unknown course can resume most of the activities (guide, carry out home activities …). Even in the event of a cesarean cut, it is possible to shower early, already 24 hours after the intervention.
- Women can get out of bed immediately after childbirth since this significantly reduces the complications of the puerperium. In fact, early walking decreases the difficulties in urinating, post -birth constipation and episodes of deep venous venous thrombosis. In the case of cesarean cut, mobilization is recommended not before the six hours after the intervention, always and only if the conditions of the mother allow it. Women who give birth to vaginally usually have one faster recovery compared to those subjected to cesarean cut.
- In the care and assistance to the newborn it is important that the newly receives large help from the partner And from the family and friendly networkespecially as regards home affairs, such as meals and cleaning the house.
When do you contact the doctor during the puerperium?
During the puerperio some complications can occur, many of which are manifested by fever, or one temperature above 38 ° Cmeasured on an inguinal or tympanic level, and not axillary, as the temperature could be altered due to the thermal changes that occur at the breast level.
When to worry during the puerperium? Fever is an alarm bell that always needs attention, as it can represent a signal of puerperal infection. Very high fever can be attributable to abdominal wound infections in case of cesarean delivery.
An alarm signal is certainly the presence of redness and escape of secretions from the wound, especially if in the presence of persistent fever. Generally it occurs four to five days from the intervention and requires a Evaluation of the doctorwhich will prescribe antimicrobial therapy.
In the case of vaginal birth, a complication is represented by Genital trait infections. Episiotomy infections are not common, since the procedure is performed much less frequently than in the past today. Fever, local pain, purulent secretions and edema are typical symptoms ofinfection of the suture of perineal lacerations. Sometimes the infection can cause the spontaneous reopening of a previously sutured wound. In the presence of foul -smelling fever and losses, a medical supervision is recommended to evaluate the presence of any perineal complications.
Another signal of alarm in the puerperium is the presence of acute pain to one or, rarely, to both breasts. Fever, chills, general malaise, tachycardia, redness and breast pain are typical symptoms of the mastitiswhich occurs in women who breastfeed, not to be confused with the breast traffic jam. The mastitis stands out from theswallow For the specific symptomatology described, due to the infectious process of responsible germ (the aurean staphylococcus is the most frequently insulated microorganism, in 40% of cases of puerperal mastitis).
It is important promptly treat the mastitisaddressing the midwife and the reference gynecologist, so as to start an appropriate antibiotic therapy and prevent an abscess from developing, as happens in 10% of cases. The swallowing is more often bilateral, it involves the feeling of heavy and painful breasts, but you do not see redness and there is no fever.
