Postpartum Adaption and Nursing Assessment - KNOW!

- During the puerperium, or postpartum period, the woman readjusts, physically and

psychologically, from pregnancy and birth. The period begins immediately after birth and

continues for approx. 6 weeks, or until the body has returned to a near pre-pregnant

state.

- It is divided into three phases:

o Immediate Postpartum: the 24-hour

period immediately following delivery.

Most important a lot of complications

can happen. Watch for hemorrhage and

uterine atony.

o Early Postpartum or puerperium: up to

7 days.

o Remote postpartum or puerperium: up

to 6 weeks.

Postpartum Physical Adaptations

Reproductive System

Involution of the Uterus

- The term involution is used to describe the rapid reduction in size and the return of the

uterus to a non-pregnant state. AT: Uterus should be midline and firm and go to the back of

the pubic bone. Use of Pitocin to keep the uterus contracting (close vessels back up from the

detachment of the placenta). If the uterus is boggy – MASSAGE IT for a couple of mins!

Can lead to hemorrhage. The uterus can feel boggy due a to a full bladder because it pushes

on the uterus and relaxes it. Figure out why it’s boggy? Is it that the bladder is full? Bedpan or

catheterize. Other reasons can be clots that have been pooling inside while woman is lying

down.

o First 6-12 hrs. midline and firm at the umbilicus

o Every 24 hrs. it shrinks a little and it should be 1 cm below. Ex. Delivered at 6 am by 10

am it’s going to be by the umbilicus. At 6 am the next day it should be 1 cm below.

o By the 10th day you cant feel it because its behind the bone

- Following separation of the placenta, the decidua of the uterus is irregular, jagged, and varied

in thickness.