The puerperium or postpartum

What is the puerperium?
The puerperium or postpartum is the period after delivery in which the body recover the situation prior to pregnancy; it includes the six weeks following the birth.

At this time it is very important to take care of yourself and follow a healthy diet; especially if you are breastfeeding your child needs a correct caloric intake and with all the necessary nutrients; remember that it is not the time to make strict diets.

During the puerperium ("the quarantine") will have blood losses (lochia), which are the different uterine secretions that must expel, can last about 30-40 days, during which they will change their appearance. If at any time you think they have a bad smell, please contact us.

If you have had a vaginal delivery, after a few hours and making sure you do not get dizzy, you can take a full shower. If you have practiced episiotomy you should wash it without fear with soap and water and then dry the wound well, no other measure is necessary. You can wash your hair as soon as you want.

If you have had a cesarean section, you should wait a little longer for a shower, until your doctor allows you to get up.

You should avoid bathing and intercourse until the quarantine is over.

What changes occur during the postpartum period?
If you are breastfeeding, it is most likely that you do not have the period until breastfeeding is over, and may take a couple of months to present after finishing breastfeeding; If you have opted for artificial feeding you can submit the rule 30 or 40 days after delivery.

The muscles of the pelvis and abdomen will gradually return to their normal tone, sometimes hampered by overdistention and muscle tears that may occur during pregnancy and childbirth. Therefore, you must perform abdominal and pelvic rehabilitation exercises to prevent prolapses and hernias; but it is not appropriate to start them too early and it is always better if you have a certain orientation, which can be provided in specialized centers.

It can also present difficulty in spontaneous urination in the first hours, due to the decrease in bladder tone in very prolonged or instrumented deliveries and epidural anesthesia. It is important in the first hours to be forced to frequent urination because a correct emptying of the bladder allows a better uterine involution. Later you may have some urinary incontinence, you should try to perform voiding rehabilitation exercises (Kegel exercises) to prevent prolonged incontinence and that may worsen over time.

Constipation is common after childbirth, due to enemas, lack of intake, decreased physical activity, the presence of hemorrhoids ...

Approximately in two weeks the tone and motility of your intestines will be normalized, try to follow a diet rich in fruits and fiber or you can even help with mild laxatives that are not absorbed at the intestinal level. For hemorrhoids there are different creams that will improve the discomfort. Ask your doctor.

Breastfeeding
The best option for breastfeeding your baby is the one you decide. Breastfeeding is not bad. Breastfeeding is a good option if you are convinced, you are excited and will be able to devote the necessary time.

If you have opted for artificial lactation or for any reason in your case is not indicated breastfeeding, you must tell your gynecologist to prescribe the appropriate medication to suppress the "rise of milk."

If you want to try breastfeeding it is good to put the newborn to the breast as soon as possible, suction is a stimulus for the rise of milk. It usually happens between the third and fourth day postpartum. Do not despair !. It is accompanied by an increase in the volume of the breasts, a certain fluid retention and a normal increase in temperature, which lasts no more than 24 hours.

The first secretion of the chest is colostrum (the first five days postpartum) with a high content of immunoglobulins ("defenses") that will protect the newborn from infections.

You should continue to avoid smoking, alcoholic beverages and any medication that has not been prescribed by your doctor; almost all go through breast milk.

On occasion during breastfeeding may present:

Cracks in the nipple: It is advisable to assess the correct position of the baby when breast, because if not little help preventive creams.
Engorgement (congestion) mammary: It occurs when the chest is not completely emptied. It can be relieved by applying local heat, analgesics and with a tight fastener.
Mastitis: This is an inflammation of the breast, which appears red, hot and painful, in this case notify your gynecologist, without interrupting breastfeeding.
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¿Si doy el pecho puedo quedarme de nuevo embarazada?
Durante la lactancia disminuye la fertilidad debido a la falta de la ovulación y muchas mujeres se encuentran amenorreicas (sin regla) pero no siempre está fuera de riesgo de volver a quedar embarazada, por tanto debe tomar medidas y consultar con su ginecólogo respecto a cuál es el método más adecuado en su caso.

¿Cuándo hay que llamar al médico durante el posparto?
Situaciones en que es aconsejable ponerse en contacto con su médico durante el puerperio.

Fiebre de más de 38ºC.
Hemorragia importante.
Loquios malolientes.
Enrojecimiento, dolor exagerado en mamas o episiotomía.
Dolor o inflamación de una de las piernas.
Problemas para respirar.
Molestias urinarias.
Depresión posparto
Entre un 30-80% de puérperas pueden presentar depresión posparto. No suele ser grave. Los signos y síntomas más frecuentes son: sentimiento de tristeza, llanto, cambios de humor, irritabilidad, confusión y olvidos, cefalea, indiferencia hacia el niño, trastornos del sueño, fatiga y ansiedad. Es una reacción general a una situación de estrés, relacionada también con la caída brusca de los niveles hormonales tras el parto que suele mejorar en pocos días. Es aconsejable que la mujer tenga el apoyo de la pareja, familiar y ayuda doméstica, que cuide su aspecto e intente salir de casa.

Es conveniente conocer este trastorno antes del parto y comentarlo con la pareja, para obtener la máxima ayuda en estos días tan importantes de su vida.