This document outlines care for the immediate postnatal period and puerperium. It recommends monitoring the mother's pulse, blood pressure, uterine contractions, lochia, perineum or c-section wound, urine output, and providing immunizations in the first hour after delivery. It also recommends assessing the newborn's APGAR scores, facilitating skin-to-skin contact and breastfeeding within 1 hour, and checking head circumference, weight, and temperature. The puerperium period is defined as the 6 weeks following delivery when anatomical and physiological changes from pregnancy regress, with postnatal checks at 1-2 weeks and 6 weeks. Common problems like dyspareunia, constipation, hemorrhoids, and

2. PNC

3. Immediate PNC
Maternal:
• Pulse & BP every 15min for first hour then hourly
• Uterine contraction
• Lochia
• perineum ,episiotomy or CS wound
• Urine voiding
• Immunization ( anti-D (Rh) ,MMR (rubella)

4. Fetal
• APGAR score at 1 & 5 minutes
• Baby-mother bonding:
ØSkin-skin contact as soon as possible
ØBreast feeding within 1hour
• Head circumference-weight-temperature
• Examine the baby for any apparent anomaly

5. Puerperium care
• Definition:
It is 6wk following delivery during which
anatomical & physiological changes of
pregnancy regress
• Visits timing : 1-2 wk, 6wk

6. • Lactation (initiation- suppression)
• Contraception counselling
• Healing of wound (CS-episiotomy)
• Discuss common problems:
Ødyspareunia
Øconstipation
Øhemorrhoids
Øpelvic girdle pain

7. • Discuss and warn Serious problems:
ØVTE (leg swelling & pain-dyspnea,chest pain
tachypnea,tachycardia)
ØPuerperal sepsis (offensive vaginal discharge-fever-pelvic pain)
ØPPH
ØPost partum mental illness (depressed, feeling
down, hopeless, little interest)
ØFecal incontinence
ØUrinary problems( retention in urine, incontinence)
ØBreast abscess.
ØDomestic violence (maternal and child protection)