Complications during postpartum period

Research report complication During postpartum period

University of Gujrat Internship Agency

Complications during postpartum period

A Case Study of Tehsil Gujrat

INTERNSHIP REPORT
At
AZIZ BHATI HOSPITAL

GUJRAT

(15 JULY TO 31 AUGUST)

BY

Aroj Bashir
Muhammad Qasim

Page 1


Master in Population Sciences

2nd semester

Table of Content

Contents Page #
Introduction
1. Personal Biography
2. Session
3. Taught Courses
4. My career Interest
5. Motivation/ Reason for internship

Host Institute
1. Introduction
2. Ongoing Programs
3. Specialties
4. Working mechanism
5. Goals /Target
6. Salient Achievements
Focal Person
1. Name
2. Behavior toward Internee
3. Level of cooperation during work
4. Guidance to Complete Tasks
Project /Assignment
Research Project:
1. Name Of Project
2. Introduction
3. Literature
4. Objectives

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5. Method
6. General Findings
7. Statistical Tests
8. Discussions
9. Conclusion
10. References

Relationship of Internship with Taught Courses
Individual Benefits gained from internship
Lesson Learned from Internship
Conclusion of Internship

Page 3


Table of Contents

Page

Chapter: 1 Introduction

Personal biography………………………………………………………….. 07

Session……………………………………………………………………… 07

Taught courses……………………………………………………………… 07

My career interests…………………………………………………………… 08

Motivation/reason for internship……………………………………………. 08

Chapter: 2 Host Organizations/ Institute

Introduction…………………………………………………………………. 09

Ongoing programs…………………………………………………………… 09

Specialties……………………………………………………………………. 10

Working mechanism………………………………………………………… 11

Goals/target………………………………………………………………….. 11

Chapter: 3 Focal Person / Immediate Boss / Senior

Name………………………………………………………………………... 12

Behavior toward internee…………………………………………………… 12

Level of cooperation during work…………………………………………... 12

Guidance to complete tasks…………………………………………………. 12

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Chapter: 4 Project Assignment

Name of the project………………………………………………………… 13

Introduction………………………………………………………………... 13

Literature review…………………………………………………………… 17

Objectives………………………………………………………………….. 19

Method…………………………………………………………………….. 19

General findings…………………………………………………………… 20

Discussions…………………………………………………………….....29

Conclusion……………………………………………………………..…29

References………………………………………………………………...30

Relationship of Internship with Taught Courses………………………………31

Individual Benefits gained from internship……………………………………31

Lesson Learned from Internship………………………………………………31

Conclusion of Internship………………………………………………….…32

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Acknowledgement

My report is based on internship at “Aziz Bhatti Hospital Gujrat.”

I am very grate full to Sir Wajjid Tahir who gave me an opportunity to learn topic of “post-
partum complications among women” So, this topics teach me the complications during post-
partum period.

At Aziz bhatii hospital Gujrat all doctors were very cooperative me mostly I thanks full to Dr
Fouzia Arshad, gynecologist she guide me during my internship. She gave me full help related
to our field visit.

In the end I am really indebted to university of Gujrat which provided me the opportunity to
work in any organization in order to sharpen my skills and implement my knowledge in practical
field.

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CHAPTER#1

Introduction
Personal Biography

My name is Aroj Bashir student of” Population Sciences at University of Gujrat”.

Student Of MPS 2nd semester.

Session

Session (2010_2013)

Taught Courses

1. Introduction to population sciences
2. Gender and reproductive health
3. Information education and communication
4. Population and social Statistics (1)
5. Population and social Statistics (2)
6. Information technology
7. Introduction to social sciences
8. Planning and Management of Population Program
9. Introduction to Technique of Population Program
10. Population & Development

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My career Interests
Pakistan is a developing country and facing a lot of social, economic, demographic, heath and

Security problems. Social issues are the basis of all problems, so I decided to choose the social

sciences field. Being a social Scientist I want to do some thing for the betterment of our country.

Through my demographic field I can point out the social, heath, and demographic and

development problems of the Pakistani peoples, that can help the policy makers to make their

policies according to problems of the people and the country.I am student of population Science

and interested in research work and I want to enhance my research Work by learning quality

research tools so in this regard my internship remain very

Helpful for me and I conduct research on the topic “complication during postpartum period

Tehsil Gujrat” and during this work, I learned a lot about the research work tools.

Reason for Internship:
My internship is the part of my course of second semester. This is my learning process. Through

the internship. I gain more knowledge about our study. I will be able to know the real meaning of

our study and gain the confidence. Through internship I gain experience about the research work

and practical work in the field. I seen the problems and issues of the people in the field.

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CHAPTER#2

Host Organization
Introduction:
Name: Aziz Bhati Shaheed Hospital (DHQ) Gujrat
History:

The DHQ Hospital Gujrat was established in 1963 and renamed as Aziz Bhati Shaheed Hospital
in 1966 after war against India. It is sited on the north of Gujrat city. The hospital has been
attached with the Nawaz Sharif Medical College as the teaching hospital. It is not only catering
to the health care needs of local people, but also of the people of neighbouring districts and
towns such as Bhimber, Mandi Bahauddin and Lalamusa. Initially it was started with one
hundred beds and some departments. With the passage of time the number of beds and facilities
was increased and now 452 beds hospital. The pediatrics Department has the capacity of 30 beds.
Almost fifty six doctors and ninety nurses are working there. The hospital currently has 5 major
departments . The major departments are;

 General surgery
 General medicine
 Gynecology
 ENT department
 Eyes department

And with some other departments

 Orthopedics
 Pediatrics
 Physiotherapy
 Radiology
 Urology/Dialysis Unit
 Tele-Medicine
 Cardiology
 Dentistry

Ongoing programs:
The basic purpose of organization is accrue &treatment of the patient and provides them best
medication facility. In addition to treatment of the patient the hospital’s ongoing programs are

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Vaccination of child, Hepatitis B,C treatment, vast management(preset), Dialysis(artificial
kidney facility and the training of dispensers and receives the emergency. This hospital is also providing
routine care services to the prisoners of District Jail, Gujrat.

Specialties:
There are sixteen specialties of the hospitable

 General OPD
 General medicine
 Surgery
 Pediatrics
 Eye
 ENT
 Orthopedics
 Psychiatry
 Dental
 Skin
 OB/GYN
 Emergency/Casualty
 Home Cases
 Tibb/Unani Shifa Khana OPD cases
 Cardiology
 Other

Page 10


Working Mechanism:
Medical Superintendent is the head of organization. All the management of the hospital is
operates by the medical superintendent. He makes policies and arrangements for the hospital.
The hospital has a deputy medical superintendent, that makes check and balance of doctors,
nurses, paramedics, clerks and other staff of the hospital.

Medical superintendent (MS) ↓

↓ Nursing Superintendent

Deputy Medical superintendent ↓
. DNS (1)

↓ ↓

Paramedics Head Nurses(13)

↓ ↓

Dispenser (13) → Lab/Tech (4) → Lab/Att (3) Staff Nurses (78) ↓

X-ray/Tech (3) → OTA (4) → Driver (6) MD/Wife-2 LHV’s-2

Goals/targets:
Our goal and targets are continuous improvement in…

 Visibility
 Competitiveness
 Accessibility
 Communication
 Education
 Total Health Management

 Promote the highest level of rehabilitation and independence through restorative nursing
care using a team approach and collaborating with therapy disciplines as appropriat
 Provide quality care by teaching and monitoring client’s response.
 Provide high quality health care services in a cost-effective manner
 To provide the best health care services to the people of Gujrat and adjoining areas

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CHAPTER#3

Focal person/immediate boss/senior

Name:
Dr Fouzia Arshad

Behavior towards Me:
She is very nice, humble, and kind. Her behavior towards me is very nice. she taught me all the
work very efficiently and greatly. she helped me in every matter related to my work. she guided
me at every step.

Level of Cooperation During work:
Level of cooperation is very nice. e cooperates with me maximum and gives me maximum of
her time. she cooperated to me in every matter related to my survey on “postpartum
complication. she told me about the diseases and socially and medically reasons behind the
complications. she helped me in every stage where I needed their help.

Guidance to Complete Tasks:
She very truly wants me to learn every aspect of my internship. She also gives short lectures me
to complete my work. she encouraged me to complete my task. She also appreciates my survey
work. She guided me at every step during internship.

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CHAPTER#4

Project /assignment

Name of project

Complications during postpartum period

Introduction

The postpartum period is the time immediately after a woman delivers her baby. It is the time
when the mother's body is changing back to the non-pregnant state. It lasts approximately 6
weeks or until the reproductive organs return to normal size. During the postpartum period, a
woman can expect a variety of symptoms ranging from physical discomfort to emotional upsets.
“Postpartum hemorrhage is traditionally defined as blood loss greater than 500 mL during a va-
ginal delivery or greater than 1,000 mL with a cesarean delivery. However, significant blood loss
can be well tolerated by most young healthy females, and an uncomplicated delivery often re-
sults in blood loss of more than 500 mL without any compromise of the mother's condition.”

Feeling overwhelmed with the responsibility of caring for an infant is a normal postpartum
symptom. Other emotions may include sadness, feeling helpless, and a "let down" feeling. “Dis-
comfort in the perineum (area between the rectum and vagina) is expected and may cause diffi-
culty with sitting or walking. It is common for the breasts to be swollen and painful.”The new
mother may feel tired, experience hot flashes and sweating, and may be constipated.. All these
symptoms are normal, a temporary reaction to childbirth.

“Treatment for complications varies depending on the source of the problem. Infection usually
responds to antibiotic treatment.” Other special medications and procedures are available for
treating postpartum problems.

A new mother who experiences one or more of these symptoms should contact her provider im-
mediately.

There are some things which avoid postpartum complications and health problems. “Before baby
is born, eat a healthy diet that's high in leafy green vegetables, red meat, or legumes to avoid
iron-deficiency anemia.”

“During the immediate postpartum period, high levels of oxytocin in blood are helping uterus
return to its prep regnant size. “Stress creates adrenaline, which can make it more difficult for the
hormones to do their job.” Stay in bed and partner or a friend or relative (or paid help, if neces-
sary) care for mother.Eat nutritious foods and drink plenty of water. Don't lift anything heavier
than baby, and just try to rest and relax as much as can. Limit visitors.

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Postpartum infections are caused by bacteria entering the the urinary tract, or the site of an inci-
sion or tear. But there are also other kinds of infections that can occur during postpartum, such as
breast infections . Since infections can be serious, it's important to be on the lookout for fever
and other signs of infection during postpartum.

“The more objects enter vagina during labor or after birth, the more risk there is that infection-
causing bacteria could be pushed upward toward uterus. Limit internal exams during labor .

It's normal to lose some blood after giving birth. When the placenta separates from the uterine
wall, the resulting wound bleeds until the blood vessels close off with help from your contracting
uterus. And since body's blood volume increases by about 50 percent during pregnancy, some
blood loss won't affect health.

But sometimes, women bleed too much after giving birth, which is called a postpartum hemorr-
hage. This happens in up to 5 percent of all births, and is most likely to happen while the pla-
centa is separating or soon afterward Postpartum hemorrhage can be divided into 2 types: early
postpartum hemorrhage, which occurs within 24 hours of delivery, and late postpartum hemorr-
hage, which occurs 24 hours to 6 weeks after delivery. Most cases of postpartum hemorrhage,
greater than 99%, are early postpartum hemorrhage. most women are still under the care of their
delivering provider during this time. With many women delivering outside of hospitals and early
postpartum hospital discharge being a growing trend, postpartum hemorrhage that presents to the
emergency department may be either early or late..

“Sometimes, a mother will hemorrhage days or even weeks after birth. This rare but serious con-
dition is called a late or delayed postpartum hemorrhage and is usually caused by retained mem-
branes or tissue in the uterus.” If experience unexpected heavy bleeding days or weeks postpar-
tum, lie down, stay warm, nurse baby if possible,

About 1 out of every 8 women has postpartum depression after delivery. It is the most common
complication among women who have just had a baby. Changes in the woman's hormones after
delivery probably cause postpartum depression. Women
who have been depressed before are at increased risk for postpartum depression. Postpartum de-
pression can begin at any time within the first 3 months after delivery. It can
seriously threaten both the woman and her baby. Since the mother is seriously ill, she may
not be able to care for her baby as she would if she were well. The disease may make it hard
for the mother to breastfeed or bond with her baby. For these reasons, postpartum depression
is a threat to newborns.

Postpartum depression can be treated in several ways. Support groups may help. Some women
go to therapy or counseling with a mental health professional. This professional may talk with
the woman about the risks and benefits of antidepressant medications.

“After the baby is born, many new mothers have the "postpartum blues" or the "baby blues." The
word "blues" is not really correct since women with this condition are happy most of the time.
But compared to how she usually feels, the new mother. Postpartum depression is not the same
Page 14


as the "postpartum blues," a condition that is more
common and less serious. Postpartum blues usually ends by the tenth day after the baby is
born. The postpartum blues peak three to five days after delivery.” They usually end by the tenth
day after the baby's birth. Although the postpartum blues are not pleasant, the woman can func-
tion normally. The feeling of the "blues" usually lessens and goes away over time.

Feeling overwhelmed with the responsibility of caring for an infant is a normal postpartum
symptom. Other emotions may include sadness, feeling helpless, and a "let down" feeling.There
are symptoms that are not normal and may be considered postpartum complications. Contact
healthcare provider immediately if one of more of these symptoms develop:

 Chills
 Nausea Or Vomiting
 Moderate To Strong Abdominal Or Back Pain That Is More Than Just An Ache
 Increased Pain, Swelling, Redness, Or Drainage From The Episiotomy Or C-Section Inci-
sion
 Bleeding Through More Than One Pad Per Hour
 Blood Clots The Size Of A Plum
 A Foul Smelling Vaginal Discharge
 Chest Pains
 Increasing Tenderness In The Lower Abdomen

 Red, Warm To The Touch, Painful Breasts
 A Severe Headache In The Forehead And Behind The Eyes, Accompanied By Extreme
Pain While Sitting Or Standing

 Feeling Depressed Or Blue For More Than 3 Days
 Severe Weakness
 Extreme Paleness Or
 A Rapid, Racing Pulse
 Postpartum Hemorrhage
 Shock
 Infection In Blood Septicemia
 Anemia
 Genital Infection

Treatment for complications varies depending on the source of the problem. Infection usually
responds to antibiotic treatment. Other special medications and procedures are available for
treating postpartum problems.

Page 15


Literature review:
 Nupur Chaudhury ( 2003) argued that women who suffered from postpartum depres-
sion after the birth of her fourth child, and that she attempted suicide twice for this
very disorder One in ten women experience postpartum depression , a condition that
often goes undiagnosed, and occurs in women after childbirth. A reason for the lack
of diagnosis of postpartum depression is a milder, more common form of depression
after childbirth, often known as the "baby blues". The baby blues occur in mothers
three to five days after childbirth .
 MLA,( 2002) The writer reveals that postpartum depression is on the rise in the
United States, due to increasing stress, and contends that more responsibility needs
to be taken to ensure that women are prepared to handle the challenges that will
come their way. The writer also hopes that more states will pass laws that mandate
education and screening with women after delivery. Postpartum depression is a
significantly under diagnosed pregnancy complication, which can have serious
consequences. Sadness following the birth of a baby is believed to be as high as 85
percent in new mothers and normally lasts under two weeks. Postpartum depression
may last as long as 18 months. The condition is thought to be caused by hormonal
changes and the condition can worsen if the woman is suffering additional stresses.
Many women experience some mood changes after childbirth.
 Stanley Poulos (2008) Women are more likely than men to suffer from depression,
especially during their reproductive years. Rates of depression are higher where
stressful circumstances exist such as poverty, lack of education, sexual inequality,
poor social support and in pregnancy. Single and adolescent pregnant women are
especially at risk
 Abbas Mohila (2007,) ) conducted a study in Bangladesh and said A large
proportion of these deaths are preventable by appropriate measures through the
periods of antenatal, delivery and postnatal care . Complications of pregnancy and
childbirth are still the leading causes of death and disability among women of
reproductive age in developing countries common were weakness, anemia, and
lower abdominal pain the main direct 1causes of severe maternal morbidity in West
Africa were hemorrhage, obstructed labor, eclampsia, and sepsis .
 Vallely, Ahmed(2005) Information on the extent of postpartum maternal morbidity in
developing countries is extremely limited. In many settings, data from hospital-based
studies is hard to interpret because of the small proportion of women that have
access to medical care. However, in those areas with good uptake of health care, the
measurement of the type and incidence of complications severe enough to require
hospitalization may provide useful baseline information on the acute and severe
morbidity that women experience in the early weeks following childbirth. An analysis
Page 16


of health services data from Lusaka, Zambia, is presented. the maternal referrals in
the first 24 hours after delivery were for retained placenta and just over one-third
were for pregnancy- related hypertension or eclampsia Three referrals were for
postpartum hemorrhage. There were no maternal deaths in this group.
 Shane.(2001) There are an estimated 14 million cases of pregnancy-related
hemorrhage every year; at least 128,000 of these women bleed to death.6 Most of
these deaths occur within comprehensive emergency obstetric services. These
services often are available only at a referral hospital and may require that the
woman be transported a long distance, again increasing her risk of death. Women
who survive PPH often suffer from severe anemia if the condition is not managed
appropriately.4 Lifesaving blood transfusions are associated with risks of transfusion
reactions and transmission of infections. Surgery, such as hysterectomy, carries its
own risks from infection, anesthesia, and other complications, as well as high
financial costs.

Page 17


0bjectives:

 To study the postpartum complication among women
 To study in which age women have most postpartum complication
 To study education status of gujrat district

Method:

This research based on both primary and secondary data. Primary data is collected from the
women patient of aziz bhati hospital which is facing postpartum complication through face to
face interview and secondary data from the register of aziz bhati hospital gujrat. In the study
researcher selected the respondent by non probability sampling because list of patient of
the postpartum complication are difficult to find so this sampling technique was thought
to be the best to select the respondents.

Page 18


General Findings

Table No. 1 Age of Respondents

Categories Frequency percent
15-19 10 10.0
20-24 27 27.0
25-29 24 24.0
30-34 19 19.0
35-39 20 20.0
Total 100 100.0

The table shows that majority of women (27%) are in age group of

20-24 years. It indicates that the women in age group of 20-24 years are

facing more complications.

Page 19


Table No. 2 Area of Respondents

urban 43 43.0
rural 57 57.0
Total 100 100.0

This table shows that majority of women belonged to rural area.

And 43% women belonged to urban area.

Table No. 3 Husband Occupation

govt. job 13 13.0
private. sector 23 23.0
own. business 36 36.0
agriculture 28 28.0
Total 100 100.0

This table shows that majority of men (36%) have their own business,

Page 20

Research report Diseases Among Elder people

Table No. 4 Husband Education

Categoreis
Frequency Percent

18 18.0
primary
middle 18 18.0
metric 29 29.0
intermediate 15 15.0
graduation 14 14.0
master 6 6.0
Total 100 100.0

This table shows that majority of men (29%) have done

matriculation and (18%) have done middle.

Page 21


Table No. 5 Delivery Condition

Categories Frequency Percent
Normal 43 43.0
C-section 57 57.0
Total 100 100.0

This table shows that majority of women had C-section delivery

which is 57% and normal deliveries were 43%.

Table No. 6 Respondents Blood pressure

Normal 33 33.0
High 29 29.0
Low 37 37.0
Total 100 100.0

This table shows that majority of women had low blood pressure

(37 %.) and the patients of hypertension were 29%.

Page 22


Table No. 7 Chill Fever Vomiting

yes 25 25.0
no 4 4.0
Total 29 29.0
System 71 71.0
Total 100 100.0

This table shows that 25% women had chill fever and vomiting

during postpartum period.

Table No. 8 Abdominal or Back Pain

Frequenc
Categories y Percent
yes 37 37.0
no 18 18.0
Total 55 55.0
System 45 45.0
Total 100 100.0

This table shows that 37% women had abdominal and back pain


Page 23


Table No. 9 More bleeding and Blood Clots

Frequency Percent
Categories
yes 41 41.0
no 8 8.0
Total 50 50.0
System 50 50.0

Total 100 100.0

This table shows that 41% women had more bleeding and blood

clots as compare to others, during postpartum period.

Table No. 10 Headache

yes 40 40.0
no 23 23.0
12 1 1.0
21 1 1.0
Total 65 65.0
System 35 35.0
Total 100 100.0
This table shows that 40% women had headache during postpartum

period.

Page 24


Table No. 11 Feeling Depressed

yes 45 45.0
no 40 40.0
11 2 2.0
Total 87 87.0
System 13 13.0
Total 100 100.0

This table shows that 45% women felt depressed during

postpartum period.

Table No.12 Weakness. Paleness .Rapid Pulse

yes 50 50.0
no 25 25.0
Total 75 75.0
System 25 25.0
Total 100 100.0

This table shows that 50% women had weakness, paleness and

rapid pulse during postpartum period.

Page 25


Table No.13 Postpartum Hemorrhage

yes 37 37.0
System 63 63.0
Total 100 100.0

This table shows that 37% women had postpartum hemorrhage


Table No.14 Shock

yes 14 14.0
System 86 86.0
Total 100 100.0

This table shows that 14% women had shock during postpartum

period.

Page 26


Table No.15 Infection in blood and septicemia

yes 10 10.0
System 90 90.0
Total 100 100.0

This table shows that 10% women had infection in blood and

septicemia during postpartum period.

Table No.16 Anemia

yes 21 21.0
System 79 79.0
Total 100 100.0

This table shows that 21% women were anemic during postpartum

period.

Page 27


Table No.17 genital infection

yes 11 11.0
System 89 89.0
Total 100 100.0
This table shows that 11% women had genital infection during

postpartum period.

Discussion

The women living in Gujrat who came for medical checkup or treatment at Aziz Bhatti
Shaheed (DHQ) Hospital, Gujrat were facing various complications during postpartum
period i.e. abdominal pain, bleeding, feeling depressed, postpartum hemorrhage, shock
conditions, septicemia, anemia, and genital infections. The women from rural areas
were at high risk of complications and had more visits to DHQ, Hospital for medical
checkup and treatment purposes than urban women. The majority of women reported
low blood pressure. Many women were facing nutritional deficiencies and relevant
diseases. It seems that the other socio-economic factor have strong influence on
women health in Gujrat. Mostly women belonged to rural area and their husband have
own business and agriculture. the education level is also t high so they do not
awareness about health.
Conclusion:
There are many villages attached to gujrat. Most patient of aziz Bhatti Shaheed hospital
belong to rural areas. During the pregnancy and after pregnancy women go through
many complications. There are many genetic changes occur in their body due to which
they often get depression. so no one behave rude with her and particularly take care of
their nutrition as to maintain their and also child health.

Page 28


Reference:
Francis 2007 Tips for a Healthy Postpartum Period retrieved from
http://www.netplaces.com/postpartum-care/postpartum-complications-and-health-
concerns/tips-for-a-healthy-postpartum-period.htm

Yaa A B Yiadom2010 Postpartum Hemorrhage in Emergency Medicine retrieved from
http://emedicine.medscape.com/article/796785-overview

Dimes 2006Postpartum depression retrieved from
http://www.marchofdimes.com/postpartum_depression.html

Hawkins Drive 2002 Postpartum complications retrieved from
http://www.uihealthcare.com/topics/pregnancyandchildbirth/preg4879.html

Nupur Chaudhury ( 2003) Postpartum Depression retrieved from
http://serendip.brynmawr.edu/bb/neuro/neuro03/web2/nchaudhury.html

MLA,( 2002) Postpartum Depression retrieved from
http://www.academon.com/Research-Paper-Postpartum-Depression/118600

Stanley Poulos (2008) Postpartum Depression retrieved from http://www.xanax-
effects.com/

Mirza Abbas Mohila Degree College, Shahjahanpur, 2007 Journal of Applied Sciences
Research, 3(11): 1320-1326,2007, INSInet Publication retrieved from
http://www.aensionline.com/jasr/jasr/2007/1320-1326.pdf

Vallely, Ahmed(2005) Centre for International Child Health, Institute of Child Health, University
College London, London, UK retrieved from http://www.biomedcentral.com/1471-2393/5/1

Shane.(2001) preventing postpartum hemorrhage volume 13 Seattle, Washington 98109-1699 U.S.A.
Retrieved from http://www.reproline.jhu.edu/english/2mnh/2articles/otlkpph.pdf

Page 29


Relationship of internship with taught courses:

The courses which I taught during session have a strong relation with my internship. I taught
reproductive health in course as my internship topic is “complication during during postpartum
so it helps me a lot to understand my topic. we were taught skills of research work and in
internship I implemented those learned research tools practically to conduct a research project.
So taught courses remain helpful throughout my project work and I was guided at every step of
research by my studied courses.

Individual’s benefits gained from internship

I have learnt from this internship about research programs and counseling of patients. I have
learnt that how to communicate and counsel the patient. I got awareness about complications
after pregnancy and their management. I understood how we can educate and aware the
women about their health problems so that these complications can be reduced.

Lesson learned from internship

I have done my internship in Aziz Bhatti Shaheed Hospital Gujrat, I have seen that doctors and
staff do not perform their duties honestly due to which patient gets into trouble. No one attends
patient carefully or attentively, if all the doctors and staff perform its duty honestly then many
problems can be solved out. Patient can get better treatment and better compliance. I have
learnt from this internship that we should perform our duties honestly, carefully and attentively,
we should not be harsh or rude to patients, as some one’s life is dependant on us, so we should
not keep ignorant attitude as if we are in life saving profession. As QURAN says

“If anyone saved a life of a man it would be as if he had saved the life of whole mankind”

May ALLAH guide us on right path.

Page 30


Conclusion of internship

The conclusion of this internship is that small or little mistakes can bring about big mishaps or
upsets. Little ignorance can cause serious complications. Our home environment, education of
the women and economic condition effects women health. I have observed during this
internship that the women who belongs to rural areas shows more postpartum complications as
compare to those who lives in urban areas. The reason is lack of awareness regarding their
health problems. Education is also a key point concerning the health problems because an
educated woman can take good care of not only her as well as her family’s health, but illiterate
woman fails to do so due to lack of awareness. Another reason is depression which badly
effects women health. Women whom delivery is carried out by mid-wives are at more risk to
have genital infections.

Page 31

Complications during postpartum period

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