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MoonDragon's Pregnancy Information
Postpartum Care
4 TO 6 WEEKS POSTPARTUM VISIT

(Instruction For Midwives)


For "Informational Use Only".
For more detailed information, contact your health care provider
about options that may be available for your specific situation.




The timing of this visit depends on the mother's rate of recuperation. If her flow ceased at least a week prior to contacting the midwife, the midwife can assume her uterus is well involuted, her cervix firmed up, and that she is ready for her final checkup.

But if the mother had stitches, scheduling this checkup also depends on the condition of her perineum. If she is willing, ask her to wash her hands and gently insert her fingers to see if the area is sensitive to pressure; if so, she probably is not ready for sexual intercourse or barrier method contraceptive fittings. Nevertheless, wait no longer than six weeks to see her, for if adequate healing has not taken place by this time, the midwife must determine the reason. Perhaps the mother had deep second degree tears. These can take a while to heal, but if her lochia flow has stopped and she is feeling fine, the midwife should have no worries.

Sometimes emotional conditions precipitate scheduling this visit sooner than later. For example, if a woman calls at four weeks to report feeling severely depressed or emotionally incapacitated, she should be seen at once, even though her physical recovery may still be weeks away.

One important reason for this checkup is to give the mother the OK for sexual relations with her partner, along with suggestions on how to make the first occasion as pleasurable as possible. Recommend that she use plenty of lubrication, as breastfeeding will cause dryness and fragility of her tissues no matter how intense her desire. The midwife can also raise the issue of birth control for heterosexual women. Although rare, ovulation can occur as early as six weeks after a woman has given birth. It has been known that a few nursing mothers (giving no formula or anything else to the baby) have conceived in the first two months postpartum. It would be wise to recommend to the parents that if they are to resume sexual relations before considering future contraception, that using condoms is a choice available to them.

Things to check at the final exam include:

1. The Uterus.
    It should be out of range of palpation, except by bimanual exam. If it is enlarged, she is probably still bleeding, and her cervix will feel soft by bimanual exam. All of these are signs of poor recovery. Pale discharge, or lochia alba, is all that should be present at this time. Prescribe rest, long relaxed nursing sessions to allow oxytocin to do its work, optimal nutrition, supplements as indicated, and involuting tea or tincture of Black Haw and Shepherd's Purse.

2. The Cervix.
    It should feel firm, closed, and situated high in the vaginal vault as with initial pelvic assessment. However, some women do not regain their pre-pregnant cervical tone until they either stop or cut back significantly on breastfeeding, e.g., when solid foods are introduced to the baby.

3. Internal Muscle Tone.
    This should almost be back to normal by now if the woman has been doing vaginal exercises (kegels). If not, explain the importance of using the pelvic floor muscles for maintaining the uterus in its proper position, as well as revitalizing sexual desire and sensitivity. Check for tone high in the vaginal vault and just inside the vaginal opening. Often a woman has good tone in one area but little in the other.

4. Lacerations or Episiotomy, For Complete Healing.
    If the woman sustained labial skin splits, they may still be somewhat tender as newly formed skin takes time to toughen up. This may cause some discomfort with sex, but adequate lubrication and creative positioning can help.

    If the perineum feels rigid with scar tissue, encourage the woman to do perineal massage using Evening Primrose Oil to soften the area, and to prepare for intercourse. This practice can be emotionally and physically reassuring for any woman nervous about having sex again.

5. The Abdominal Muscle Tone.
    Have the woman lie down, then lift just her head and shoulders as you place fingertips along the juncture of abdominal muscles running from the umbilicus to the pubic bone. If there is any gaping, suggest simple abdominal exercises, starting with single leg lifts progressing slowly to full sit-ups (with knees bent). Most women have about half an inch separation in their abdominals, while others have very little. The mother may be referred to a postpartum exercise group or yoga class, if such are available, or suggest she meet informally with several other new mothers for exercise interspersed with baby massage and conversation.

6. The Breasts, For Tenderness or Lumps.
    It is said that the hormones of pregnancy tend to accelerate abnormal cell growth if any is pre-existing. Even if the mother has seen a health care practitioner since the birth she may not have had a thorough breast exam, so the midwife should do this herself. This is also a good time to review self-breast exam techniques with her.

7. The Cervix, by Pap Smear.
    For reasons stated above, do a repeat Pap even if the mother was screened in early pregnancy.

8. The Hemoglobin or Hematocrit.
    This is especially crucial to check for anemia if the mother appears weak or exhausted, or if she has history of hemorrhage either with delivery or during the postpartum period.

9. The Diet.
    It is common for a new mother to forget her own needs once pregnancy is over and she becomes completely focused on the baby. Often, she finds she has no time to cook, and hardly any time to eat. This may prompt her partner to take over food preparation, though perhaps not methodically enough to meet the breastfeeding mother's nutritional requirements. If she complains of chronic fatigue, nervous irritability, or upper respiratory infection, prescribe more Protein, more calories, good sources of Vitamin Bs and Vitamin C, and Trace Mineral supplements. If her hematocrit is less than 37 or hemoglobin below 12 (non-pregnant standards), treat her for anemia with nutritional recommendations, herbal tinctures or teas, and supplements. If she is breastfeeding her baby, she should continue with her pregnancy diet plus 200 extra calories (preferably from a protein source).

    MoonDragon's Nutrition Information Index
    Nutrition guidelines and recommendations, diets, food analysis, supplements, recipes, and other helpful information for pregnant and lactating women.

10. Adjustment To Parenting.
    This is a broad category of evaluation, but a few well-chosen questions will reveal any disturbing trends. Ask the mother how well she has been sleeping, how she and her partner are getting along, and how she is coping with the frustrations of mothering. It is wise to have the mother's partner present as you discuss these important issues, unless there is a reason to believe that the mother needs privacy to express herself candidly.





NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER

  • You or your family member has questions about postpartum care.
  • You or a family member develops any unexpected and/or unusual symptoms or problems.


  • POSTPARTUM CARE INFORMATION

  • Postpartum Care: Index
  • Postpartum Care: Weight
  • Postpartum Care: Diet
  • Postpartum Care: Bowel Movements & Urination
  • Postpartum Care: Bathing
  • Postpartum Care: Breasts & Breastfeeding
  • Postpartum Care: Perineal Care
  • Postpartum Care: Vaginal Bleeding (Lochia) & Menstruation
  • Postpartum Care: Exercise & Back Care
  • Postpartum Care: Sexual Intercourse
  • Postpartum Care: Contraception


  • PostPartum Visit: Day One
  • PostPartum Visit: Day Three
  • PostPartum Visit: Day Seven
  • PostPartum Visit: 4 to 6 Week Visit

  • Baby Care & Concerns
  • Fatigue & Exhaustion
  • Postpartum Depression (The "Baby Blues")


  • MoonDragon's Pregnancy Information: Pregnancy Information & Survival Tips
    MoonDragon's Pregnancy Index
    MoonDragon's Womens Pregnancy Health Information Index
    MoonDragon's Pediatric Information Index
    MoonDragon's Parenting Information Index
    MoonDragon's Nutrition Information Index





    QUALITY SUPPLIES & PRODUCTS


    POSTPARTUM NUTRITIONAL SUPPLEMENTS & PRODUCTS

    Supplements and products for postpartum women (mothers of newborn babies) to help with depression, a mood disorder that is often triggered by a hormonal fluctuations, chemical imbalance or stressful situations. Supplement recommended are to help regain strength following childbirth and optimal health, assist in balancing hormones, and correct nutritional deficiencies. Consult with your midwife or health care provider if you are taking medications for depression. Some supplements are contraindicated with certain medications.

    POSTPARTUM SUPPLEMENT PRODUCTS

  • Black Haw Herbal Products
  • Evening Primrose Herbal Oil Products
  • Multimineral Supplement Products
  • Multivitamin Supplement Products

  • Protein Supplement Products
  • Shepherd's Purse Herbal Products
  • Vitamin B-Complex Products
  • Vitamin C Supplement Products






  • MoonDragon's Womens Health Index

    | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z |






    Health & Wellness Index





    AROMATHERAPY: ESSENTIAL OILS DESCRIPTIONS & USES


    Allspice Leaf Oil
    Angelica Oil
    Anise Oil
    Baobab Oil
    Basil Oil
    Bay Laurel Oil
    Bay Oil
    Benzoin Oil
    Bergamot Oil
    Black Pepper Oil
    Chamomile (German) Oil
    Cajuput Oil
    Calamus Oil
    Camphor (White) Oil
    Caraway Oil
    Cardamom Oil
    Carrot Seed Oil
    Catnip Oil
    Cedarwood Oil
    Chamomile Oil
    Cinnamon Oil
    Citronella Oil
    Clary-Sage Oil
    Clove Oil
    Coriander Oil
    Cypress Oil
    Dill Oil
    Eucalyptus Oil
    Fennel Oil
    Fir Needle Oil
    Frankincense Oil
    Geranium Oil
    German Chamomile Oil
    Ginger Oil
    Grapefruit Oil
    Helichrysum Oil
    Hyssop Oil
    Iris-Root Oil
    Jasmine Oil
    Juniper Oil
    Labdanum Oil
    Lavender Oil
    Lemon-Balm Oil
    Lemongrass Oil
    Lemon Oil
    Lime Oil
    Longleaf-Pine Oil
    Mandarin Oil
    Marjoram Oil
    Mimosa Oil
    Myrrh Oil
    Myrtle Oil
    Neroli Oil
    Niaouli Oil
    Nutmeg Oil
    Orange Oil
    Oregano Oil
    Palmarosa Oil
    Patchouli Oil
    Peppermint Oil
    Peru-Balsam Oil
    Petitgrain Oil
    Pine-Long Leaf Oil
    Pine-Needle Oil
    Pine-Swiss Oil
    Rosemary Oil
    Rose Oil
    Rosewood Oil
    Sage Oil
    Sandalwood Oil
    Savory Oil
    Spearmint Oil
    Spikenard Oil
    Swiss-Pine Oil
    Tangerine Oil
    Tea-Tree Oil
    Thyme Oil
    Vanilla Oil
    Verbena Oil
    Vetiver Oil
    Violet Oil
    White-Camphor Oil
    Yarrow Oil
    Ylang-Ylang Oil
    Aromatherapy
    Healing Baths For Colds
    Aromatherapy
    Herbal Cleansers
    Using Essential Oils


    AROMATHERAPY: HERBAL & CARRIER OILS DESCRIPTIONS & USES


    Almond, Sweet Oil
    Apricot Kernel Oil
    Argan Oil
    Arnica Oil
    Avocado Oil
    Baobab Oil
    Black Cumin Oil
    Black Currant Oil
    Black Seed Oil
    Borage Seed Oil
    Calendula Oil
    Camelina Oil
    Castor Oil
    Coconut Oil
    Comfrey Oil
    Evening Primrose Oil
    Flaxseed Oil
    Grapeseed Oil
    Hazelnut Oil
    Hemp Seed Oil
    Jojoba Oil
    Kukui Nut Oil
    Macadamia Nut Oil
    Meadowfoam Seed Oil
    Mullein Oil
    Neem Oil
    Olive Oil
    Palm Oil
    Plantain Oil
    Plum Kernel Oil
    Poke Root Oil
    Pomegranate Seed Oil
    Pumpkin Seed Oil
    Rosehip Seed Oil
    Safflower Oil
    Sea Buckthorn Oil
    Sesame Seed Oil
    Shea Nut Oil
    Soybean Oil
    St. Johns Wort Oil
    Sunflower Oil
    Tamanu Oil
    Vitamin E Oil
    Wheat Germ Oil





    HELPFUL RELATED MOONDRAGON NUTRITION BASICS LINKS

  • MoonDragon's Nutrition Basics Index
  • MoonDragon's Nutrition Basics: Amino Acids Index
  • MoonDragon's Nutrition Basics: Antioxidants Index
  • MoonDragon's Nutrition Basics: Enzymes Information
  • MoonDragon's Nutrition Basics: Herbs Index
  • MoonDragon's Nutrition Basics: Homeopathics Index
  • MoonDragon's Nutrition Basics: Hydrosols Index
  • MoonDragon's Nutrition Basics: Minerals Index
  • MoonDragon's Nutrition Basics: Mineral Introduction
  • MoonDragon's Nutrition Basics: Dietary & Cosmetic Supplements Index
  • MoonDragon's Nutrition Basics: Dietary Supplements Introduction
  • MoonDragon's Nutrition Basics: Specialty Supplements
  • MoonDragon's Nutrition Basics: Vitamins Index
  • MoonDragon's Nutrition Basics: Vitamins Introduction


  • NUTRITION BASICS ARTICLES

  • MoonDragon's Nutrition Basics: 4 Basic Nutrients
  • MoonDragon's Nutrition Basics: Avoid Foods That Contain Additives & Artificial Ingredients
  • MoonDragon's Nutrition Basics: Is Aspartame A Safe Sugar Substitute?
  • MoonDragon's Nutrition Basics: Guidelines For Selecting & Preparing Foods
  • MoonDragon's Nutrition Basics: Foods That Destroy
  • MoonDragon's Nutrition Basics: Foods That Heal
  • MoonDragon's Nutrition Basics: The Micronutrients: Vitamins & Minerals
  • MoonDragon's Nutrition Basics: Avoid Overcooking Your Foods
  • MoonDragon's Nutrition Basics: Phytochemicals
  • MoonDragon's Nutrition Basics: Increase Your Consumption of Raw Produce
  • MoonDragon's Nutrition Basics: Limit Your Use of Salt
  • MoonDragon's Nutrition Basics: Use Proper Cooking Utensils
  • MoonDragon's Nutrition Basics: Choosing The Best Water & Types of Water





  • RELATED MOONDRAGON HEALTH LINKS & INFORMATION

  • MoonDragon's Nutrition Information Index
  • MoonDragon's Nutritional Therapy Index
  • MoonDragon's Nutritional Analysis Index
  • MoonDragon's Nutritional Diet Index
  • MoonDragon's Nutritional Recipe Index
  • MoonDragon's Nutrition Therapy: Preparing Produce for Juicing
  • MoonDragon's Nutrition Information: Food Additives Index
  • MoonDragon's Nutrition Information: Food Safety Links
  • MoonDragon's Aromatherapy Index
  • MoonDragon's Aromatherapy Articles
  • MoonDragon's Aromatherapy For Back Pain
  • MoonDragon's Aromatherapy For Labor & Birth
  • MoonDragon's Aromatherapy Blending Chart
  • MoonDragon's Aromatherapy Essential Oil Details
  • MoonDragon's Aromatherapy Links
  • MoonDragon's Aromatherapy For Miscarriage
  • MoonDragon's Aromatherapy For Post Partum
  • MoonDragon's Aromatherapy For Childbearing
  • MoonDragon's Aromatherapy For Problems in Pregnancy & Birthing
  • MoonDragon's Aromatherapy Chart of Essential Oils #1
  • MoonDragon's Aromatherapy Chart of Essential Oils #2
  • MoonDragon's Aromatherapy Tips
  • MoonDragon's Aromatherapy Uses
  • MoonDragon's Alternative Health Index
  • MoonDragon's Alternative Health Information Overview
  • MoonDragon's Alternative Health Therapy Index
  • MoonDragon's Alternative Health: Touch & Movement Therapies Index
  • MoonDragon's Alternative Health Therapy: Touch & Movement: Aromatherapy
  • MoonDragon's Alternative Therapy: Touch & Movement - Massage Therapy
  • MoonDragon's Alternative Health: Therapeutic Massage
  • MoonDragon's Holistic Health Links Page 1
  • MoonDragon's Holistic Health Links Page 2
  • MoonDragon's Health & Wellness: Nutrition Basics Index
  • MoonDragon's Health & Wellness: Therapy Index
  • MoonDragon's Health & Wellness: Massage Therapy
  • MoonDragon's Health & Wellness: Hydrotherapy
  • MoonDragon's Health & Wellness: Pain Control Therapy
  • MoonDragon's Health & Wellness: Relaxation Therapy
  • MoonDragon's Health & Wellness: Steam Inhalation Therapy
  • MoonDragon's Health & Wellness: Therapy - Herbal Oils Index







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