 Introduction about postnatal care  Define postnatal care  Aims & objectives postnatal care  Important conditions we should enquire in postnatal care  Schedule of postnatal care  Postnatal exercise  Advice given to the mother during discharge postnatal care  Advice regarding family planning and sterilization during puerperium

1. Subheading goes here

2. • Title of the Course : Diploma in Midwifery
• Name of the subject : Transition to practice
• Subject Code :
• Name of the Topic : Postnatal Care
• Venue : Class room, Academic
building, Rajshahi Nursing College, Rajshahi
• Date :
 Name of the Teacher : Laila Arjuman
 Duration : One hour
 Levels of Students : Diploma in
Midwifery

3. • Number of Students : 23 (3rd year students)
• Method of Teaching : Lecture method and
demonstration
• Teaching Aids : Marker Pen white board
and duster, Multimedia and Microphone
• Assessment Method : Asking question
• Room Layout : Line Arrangement of
the chair
 Evaluation : Students able to
understanding
 Roll Call : Pen, roll call khata,
microphone

4. General Objective: After completion of this
session the students will be able to acquir
knowledge, develop attitude & skill on postnatal
care
Specific objective: Al the end of the session
the students will be able to knowledge about the
 Introduction about postnatal care
 Define postnatal care
 Aims & objectives postnatal care

5. Specific objective(Cont…)
• Important conditions we should enquire in
postnatal care
• Schedule of postnatal care
• Postnatal exercise
• Advice given to the mother during
discharge postnatal care
• Advice regarding family planning and
sterilization during puerperium

6. LESSION OBJECTIVE
• Introduction about postnatal care
• Define postnatal care
• Aims & objectives of postnatal care
• Important conditions we should enquire in
postnatal care
• Schedule of postnatal care
• Postnatal exercise
Advice given to the mother during discharge
postnatal care
 Advice regarding family planning and
sterilization during puerperium

7. Postnatal care includes systematic examination of
mother and baby and appropriate advice given to the
mother during postpartum period. Over 5,36000
women die annually from complications during
pregnancy, child birth or the postpartum period.
Nearly all of this death occur in developing countries
where fertility rates are higher and and a womens life
time risk of dying during pregnancy or child bith.
Almost all 95% of this maternal death occurred
in Africa and Asia. The durden of maternal
complications and deaths is also highst in the
first few days of delivery.

9. A. Enquiry to the mother:
• Any excessive PN bleeding
• Puerperal pyrexia
• Puerperal sepsis
• Involution of the uterus
• Breast complications:
Breast engorgement
Mastitis
Cracked nipple
Breast abscess

10. Important conditions we should
enquire in postnatal care
B. Enquiry to the baby:
• Exclusive breast feeding
• Keeping the baby warm
• Dry and wrap
• Delayed bathing for 72 hour
 Immunization
 Importance of neonatal care

11. • Reluctant to faced
• High pitched cry
• Fever
• Granting in drawing of chest
Convulsions
 Yellow coloration eyes & body
 Discharge / bleeding from umbilicus

12. Schedule of postnatal visit
 First : within 24 hours
 Second : within 2-3 days
 Third : within 4-7 days
 Fourth : Within 42-45 days

13. Postpartum/Postnatal Exercise
Postnatal exercise should begin as soon as possible
& continue throughout the puerperium.
It is particularly important for multipara women,
whose muscles are more flaccid than those of
primipara.
It increases
Muscle tone
Venous return from the legs & lower
abdomen
Drainage of the Lochia

14. Postpartum/Postnatal Exercise
Postpartum exercise begins with
five repetitions two or three times
daily & gradually increases to ten
repetitions. After 2-3 weeks more
strenuous exercise such as sit ups
& side leg raises may be added
as tolerate.

15. 1. Prone position: Lying on abdomen with 2
pillows under lower abdomen & arms at sides .
Rest at least 20 minute
2. Abdominal breathing: Lying supine with no
pillow & legs straight. Inhale deeply through
the nose. Keeping rids as stationary as
possible & allowing the abdomen to
expand up. Exhale slowly but forcefully
while contracting the abdominal muscles.
Repeat with 6 repetitions.

16. 3. Pelvic rocking (knee to Abdomen):
Lying supine position with no pillow &
arms at side. Bend right knee& thigh
until foot touches buttolk. Straighten
right leg & lower it slowly. Alternate with
right & 5-6 times.

17. 1. Chin to chest: Lying supine with no
pillow & legs straight. Raised head &
attempt to touch chin to chest. Slow lower
head, Repeat with 10 repetitions.
2. Arm raised: Lying supine with arm
extended at 90 angle from body, slow
raised arm keeping elbow stiff.
Touch hands together &
gradually return arms to original
position. Repeat 5-10 repetitions.

18. 3. Leg raising: Lying supine with no pillow
& legs straight. Raised the right leg as high
as possible , keeping the toe pointed in lie
with leg. Do not bend the knee. Lower the
leg slowly to the bed. Alternate with right &
left 5-10 times.
4. Buttock lift: Lie on back with arms at
sides, knees, & feet flat. Slowly
raised buttock & arch back. Return
slowly to starting position. Repeat
with 5- 10 repetitions.

19. Leg exercise: Sitting on a chair or lying on
a bed touching the heel of the foot on floor
bed rotate the heel clock & anti-clock wise
alternatively. Repeat 5-10 repetitions. Both
legs.
Perineal exercise: Sitting on a chair or
lying position squeeze the perineal
muscles & relax them repeat 5- 10
repetitions.

20.  Advice after normal delivery:
• Diet: High nutritious diet containing vitamins, mineral
including iron folic acid vitamin-c calcium etc.
• Should not bear heavy weight for at 3 months
Contraception-
Progesterone only pill /minipill for first 6 month
Barrier method for next 2 years.
 Coitus
Abstinence in 1st 1.5 months.
With caution next 1.5 months.

21. Advice after normal delivery (Cont..)
 Birth Spacing
• For at least 2 years
 Breastfeeding
• Exclusive breastfeeding for 1st 6 months.
• Extra notorious food in addition to
breastfeeding.(weaning ) from month till 2 years.
 Immunization
– Immunization of the baby properly as early as
possible.
 Sunlight exposure of the body
– By covering the mouth & genetalia.
If any symptoms of jaundice appear, please contact
with a pediatrician

22. Advice after cesearian section delivery
(All above Advices in addition to the followings)
• Should not bear heavy weights for at least 6 months.
• Should wear abdominal binders for at least 2-3 months.
 Coitus
–Abstinence in 1st 3 months.
–With caution in next 3 months.
• Advices regarding family planning & sterilization during
purperium.
• Sometimes vasectomy is done during cesearian sectionin if
family is complete or in case of multigravida after proper
consent.
 If family is not complete or in case of NVD. Patient is
advised & encouraged for permanent sterilization
( tubectomy/vasectomy ) after second baby.