This document summarizes key aspects of postpartum uterine involution and nursing assessments. It describes the natural reduction in size of the uterine cells and healing process in the first weeks following delivery. Factors that can enhance or retard involution are listed. Common signs like lochia, cervical changes, abdominal changes and vital signs in the postpartum period are outlined. The document also briefly discusses postpartum blues, nursing assessments, various family planning methods and contraceptive options as well as rubella vaccination.

1. Puerperium Uterine Involution autolysis – reduction in the size of uterine cells exfoliation – healing without leaving a fibrous scar

2. Enhancing Involution vs Retarding Involution Uncomplicated L&D Expulsion of placenta Breastfeeding Ambulation Prolonged labor Anesthesia Retained fragments Full bladder Overdistention

3. Fundal Position 6-12 hours after delivery firm, midline Descends 1cm daily Boggy

4. LOCHIA Rubra Serosa Alba

5. Lochia

6. Cervical changes External os permanently changed

7. Abdomen Abdominal wall loose and flabby Diastasis recti no muscular support

8. Vital signs BP should be stable Bradycardia Temperature up to 100.4 OK in the first 24 hours

9. Afterpains More common in multiparas 2-3 days postpartum Breastfeeding mother – medicate 1 hr prior to feeding

10. Postpartum Blues Transient depression Occurs during the first 1-2 weeks Signs/symptoms mood swings/anger/weepy anorexia difficulty sleeping

11. Postpartum Nursing Assessments Vital signs Breasts Abdomen and fundus Lochia Perineum Extermities Elimination Rest/nutrition Psychological

12. Family Planning Fertility Awareness Method calander method/rhythm basal body temperature cervical mucus

13. Situational Contraceptives Abstinence Coitus interruptus Douching

14. Barrier methods

16. Diaphragm

17. Cervical cap

18. Intrauterine Device

20. Hormonal Contraceptives

21. Sterilization

22. Tubal Ligation

23. Birth Control Video START HERE

24. Rubella Vaccine Live vaccine Given to prevent rubella in the childbearing population Given if titer is less than 1:10 Consent needed