The postpartum (or postnatal) period starts after the placenta is delivered. This stage lasts for 6-8 weeks while the body is returning to its normal stage. The postpartum period is a critical phase because the most life-threatening conditions for mother and baby may occur during this period.
The common complications of this period are bleeding and infection related to the delivery. Optimal care is crucial in managing the baby and mother’s health.
Based on the nature of the complications, some reversals in the woman’s body take much longer than 8 weeks, and some may never entirely go back to the pre-pregnant state.
Oxytocin’s Role in Postpartum Stage
After delivery of the baby and placenta, the oxytocin hormone production increases. The uterine contractions continue for a few more hours. The milk release from the breasts also starts with an oxytocin surge in the first few hours of the postpartum stage.
Bonding between the mother and the baby begins right at the beginning of the postpartum stage. Oxytocin, being a “love hormone,” plays a vital role in the chemistry aspect of bonding. The bonding is enhanced with skin-to-skin contact, breastfeeding, eye contact, and newborn massage during the first postpartum hour.
Postpartum Stage has three (3) distinct but continuous phases.
1. Initial Phase: Acute Postpartum Period
The initial or acute period involves the first 6–12 hours postpartum. This initial period is a time of rapid change with the potential for immediate risks such as extreme postpartum bleeding, uterine inversion, amniotic fluid embolism, and eclampsia.
The uterus is still tender and enlarged. Pain from uterine contractions may require painkillers. Breasts are engorged with milk. And they become swollen, warm, and very sensitive to touch. Breastfeeding can be painful and difficult. Difficulty peeing due to swelling of the organs is expected at this period.
2. Second Phase: Subacute Postpartum Period
The second phase is the subacute postpartum period, which lasts 2–6 weeks. During this phase, the body is undergoing significant changes in physical recovery, vaginal bleeding, metabolism, and emotional status.
Vaginal bleeding subsidizes and turns to brownish-yellowish discharge in 2 weeks. Prolonged fresh bleeding should be evaluated for retained placenta parts. Anemia and fatigue due to blood loss during labour are common symptoms. Breastfeeding gets easier as the body regulates milk production.
The changes in this phase are slower than in the acute postpartum phase. The woman is generally capable of self-identifying her physical issues.
3. Third Phase: Delayed Postpartum Period
The third phase is the delayed postpartum period, which can last up to 6 months. Changes during this phase are incredibly gradual, and life-threatening risks are rare. This third phase is a period of muscle tone restoration and repair of connective tissue in the pelvic area.
Postpartum Stage Complications:
Many variables affect postpartum complications. The following factors are important for recovery:
- Baby’s size
- Route of delivery
- Severity of natural tears in the pelvic area
- Interventions during the labour
- Chronic diseases before pregnancy
The common complications are:
- Postpartum bleeding
- Endometrial infections
- Urinary tract infections and urinary incontinence
- Infections in the breast tissue (mastitis, breast abscess)
- Anemia and fatigue
- Pain during intercourse and other sexual complaints
- Transient depression
- Postpartum depression
Transient depression (baby blues) is prevalent during the first week after delivery. Baby blues differs from postpartum depression because baby blues typically lasts 2 to 3 days (up to 2 weeks) and is relatively mild. In contrast, postpartum depression lasts longer than 2 weeks. Postpartum depression can be disabling and interfering with activities of daily living.
Postpartum depression occurs in 10 to 15% of women after delivery.
Screening and continuously educating the new mothers for the first 6 months of delivery brings healthy outcomes for babies and their mothers.
Written by: Tina I Ureten MD, RDMS, RDCS
Read our blog on – Stages and Phases of Childbirth