Over 536,000 women die annually from complications during pregnancy, childbirth, or the postpartum period, nearly all occurring in developing countries with higher fertility rates. Postnatal care involves examining both the mother and baby after birth and providing advice on health, breastfeeding, immunizations, family planning, and signs of complications. The mother is assessed for issues like bleeding, breast health, bladder function, bowel movements, and emotional state while the baby is examined and the mother educated on newborn care.

1. 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

2. POSTNATAL CARE

3. DEFINITION
According to World health organization postnatal care is defined
as a care given to the mother and her newborn baby immediately
after the birth of the placenta and for the first six weeks of life.

4. To assess the health status of the mother. Medical disorders
like diabetes, hypertension should be reassessed.
To detect and treat at the earliest any gynecological
condition arising out of obstetric legacy.
To note the progress of the baby including the
immunization schedule for the infant.
To impart family planning guidance.
AIMS AND OBJECTIVES

5. PROCEDURE
Examination of
the mother
Advice
given to
the mother
Examination
of the baby
and advice

6. EXAMINATION OF MOTHER
Routine examination
Pelvic examination
Laboratory investigations depending on clinical needs

7. BUBBLE- is a acronym used to denote the components of the
postpartum maternal nursing assessment.
POST NATAL ASSESSMENT

8. BREAST UTERUS BLADDER
BUBBLE HE
HOMAN’S SIGN
EMOTIONAL STATUS
BOWEL LOCHIA EPISIOTOMY

9. BREAST EVALUATION
Size Shape Firmness Redness Symmetry

10. POSTNATAL CARE

11. UTERUS

12. UTERUS
Size, Weight , location and firmness
Immediately after delivery , the uterus begins the process of involution or
reduction in size.
At the end of 6th week weighs 50-100g.
A bulky uterus may indicate the presence of blood clots or retained
placental beats.
Normally uterus should be contracted ,hard and not painful if touched.
The height of uterus should be measured.
After the 1st postpartum day ,the fundus involute 1-2 cm. Per day.

13. BLADDER
In the immediate postpartum period, the bladder is congested , edematous
and hypotonic from the effect of labour .
After delivery , the client should urinate within 4 hours , at least 300 ml ,
with completely emptying the bladder .
Ask mother when last voided

14. BUBBLEHE Assessment
• Breasts — Soft, filling, firm, Nipples
• Uterus — consistency, position, height
• Bladder — voiding pattern
• Bowels — bowel sounds, hemorrhoids,
• Lochia — type, amt, clots, odor
• Episiotomy— laceration, bruising, swelling
• Homan sign — present or not
• Emotional status — bonding, blues

15. BOWELS
The patient
should be
encouraged
to drink
should be 6
to 8 glasses
of water
daily.
Eat a high
fiber diet
(whole
grains ,
legumes ,
vegetable
and fruits ).
Sitz bath.
Enema may
be given.
Stool
softener.

16. .
POSTNATAL CARE
Color
• Depending upon the
variation of the color of
the discharge it is
names as:
• Lochia Rubra
• Lochia serosa
• Lochia Alba (10-15
days ) pale white

17. POSTNATAL CARE

18. Sitz bath
with warm
water may
be given.
The
perineum
should be
cleaned
after each
voiding.
Change
pad
frequently.
Perform
perineal
exercises
such as
kegel
exercise.
Care of the
vulval
hematoma
includes
applying ice
packs .
EPISIOTOMY

19. REEDA

20. REEDA

21. HOMAN’S SIGN
Should be perform leg
exercise, to teach the
client to flex and
extends the both leg
and feet alternatively.
Keeping the leg
uncrossed while
seated.
Padding pressure
points during
lithotomy position .

22. EMOTIONAL STATUS
The immediate postpartum period is an emotional roller coaster.
Mother is exhausted and need sleep and rest to restore their bodies to
health.
In this “taking in phase” mother wish to meet their own rest and nutritional
needs before focusing their energy on newborns.

23. 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

24. EXAMINATION OF THE BABY
Head to toe
examination
Newborn
reflexes

25. ENQUIRY ABOUT BABY
Exclusive
breastfeeding
Keep baby
warm
Dry and wrap Immunization

26. COMMON BREASTFEEDING POSITIONS

27. POSTNATAL DIET

28. CARE IN POSTPARTUM BLUES

29. POST NATAL EXERCISES
A series of physical
exercises that are
performed by the postnatal
mother to bring about
optimal functioning of all
systems and prevent
complications

30. • It increases
• Muscle tone
• Venous return from the
legs & lower abdomen
• Drainage of the Lochia
• Voiding of urine
BENEFITS OF EXERCISES

31. TYPES OF EXERCISES
Abdominal
exercises
Circulatory
exercises
Pelvic floor
exercise

32. ABDOMINAL EXERCISES

33. HEAD LIFTING

34. HEAD & SHOULDER RAISE

35. LEG EXERISES - LEG RAISE

36. PELVIC FITTING

37. KNEE & LEG ROLLING

38. HIP HITCHING

39. CIRCULATORY EXERCISES

40. FLOOR & LEG RAISE

41. PELVIC FLOOR EXERCISE
Sit, stand or half lie with legs slightly apart close and draw up
around the anal passage as through preventing a bowel action

42. ADVICES AT TIME OF DISCHARGE

43. Measures to improve her general health
Perineal care
Breast care
Care of breast durig breast engorgement
Postnatal exercises
Gradual return to day to day activities
Return for 6th week post partum check up
SELF

44. Breastfeeding
If being bottle feed; Care and preparation of bottles and nipples or container
Hold the baby during feeding
Baby bathing and dressing including care of genital area
Cord care
Prevention and treatment of diaper rash
Checking babies temperature
Recognizing baby’s needs
Check up and immunization for the baby
BABY