What is puerperium and what happens after delivery

The puerperium is the postpartum period that covers from the day of the baby's birth until the return of the woman's menstruation, after the pregnancy that can last 45 days, depending on how breastfeeding is done.

The puerperium is divided into three stages:

• Immediate puerperium: From the 1st to the 10th day of postpartum Late puerperium : From the 11th to the 42nd day of postpartum Remote puerperium : From the 43rd day of the postpartum

The puerperium is also known as the period of protection or quarantine, since it lasts about 40 days.

During the puerperium the woman goes through many hormonal, physical and emotional changes. During this period she must have a kind of 'menstruation', which is, in fact, an abundant bleeding that starts after delivery and lasts an average of 15 days and that gradually decreases. Initially the blood is a bright red in reasonable quantity and with the passing of the days, the quantity decreases and its color gets darker, reaching a brown or yellowish tone until it disappears completely.

Necessary care during the puerperium

In the immediate postpartum period it is important to get up and walk in the first hours after delivery to:

• Decrease the risk of thrombosis; Improve intestinal transit; Contribute to the well-being of women.

In addition, the woman should have an appointment with the obstetrician or gynecologist at 6 or 8 weeks after delivery to check that the uterus is healing properly and that there is no infection.

What happens during the puerperium

1. Breasts

Breasts that during pregnancy were more malleable and without any discomfort, usually get stiffer because they are full of milk. If the woman is unable to breastfeed, the doctor may indicate a medicine to dry the milk, and the baby will need to take infant formula, with the indication of the pediatrician.

• What to do: To relieve the discomfort of a full breast, you can put a warm compress on the breasts and breastfeed every 3 hours or whenever the baby wants. Check out a complete breastfeeding guide for beginners.

2. Belly

The abdomen still remains swollen due to the uterus not yet being in its normal size, which decreases every day, and is quite flaccid. Some women experience a withdrawal of the abdominal wall muscles, a condition called abdominal diastasis.

• What to do: Breastfeeding and using the abdominal belt help the uterus to return to its normal size, and doing the correct abdominal exercises helps to strengthen the abdomen, fighting belly flaccidity. Find out the best exercises to do after childbirth to get your belly up again in this video:

3. Vaginal bleeding

The secretions from the uterus gradually come out, which is why there is bleeding similar to menstruation, which is called fluid, which is more intense in the first days but which decreases every day, until it disappears completely.

• What to do: It is recommended to use an intimate absorbent of larger size and greater absorption capacity, and always observe the odor and the color of the blood, to quickly identify the signs of infection such as: bad smell and bright red color for more than 4 days. If these symptoms are present, you should go to the doctor as soon as possible.

4. Colic

When breastfeeding the baby it is normal for the woman to experience cramps or some abdominal discomfort due to the contractions that make the uterus return to its normal size. The uterus shrinks by about 1 cm a day, so this discomfort should not last more than 20 days.

• What to do: Placing a warm compress on the abdomen can bring more comfort while the woman breastfeeds. If it is very uncomfortable, the woman can take the baby out of the breast for a few minutes and then resume breastfeeding when the discomfort eases a little.

5. Discomfort in the intimate region

It appears in women who had a normal delivery with episiotomy, and it is necessary to close with stitches. But every woman who has given birth has changes in her vagina, which also becomes more dilated and swollen in the first few days after giving birth.

• What to do: Wash the area with soap and water up to 3 times a day, do not bathe before 1 month. Usually the area heals quickly and in 2 weeks the discomfort should disappear completely.

6. Urinary incontinence

It is normal in the postpartum period, especially if the woman had a normal delivery, but it can also happen in those who have cesarean sections. It is the sudden urge to urinate, being difficult to fully control the pee, with urine leaks still in the panties.

• What to do: Doing Kegel exercises is an excellent way to control your urine normally. See how these exercises are performed against urinary incontinence.

7. Scar of cesarean section

The scar of the cesarean section must be checked daily, the stitches are usually removed in 8 days and the woman can bathe normally.

• What to do: Using an abdominal brace can help reduce discomfort in the scar area, in addition, a healing ointment should be used 2 to 3 times a day to help make the scar as discreet as possible. In certain cases, an accumulation of liquid may appear just below the scar that is the seroma, which must be removed with a syringe or drain placed by the nurse. Know everything about seroma.

8. Menstruation

The return of menstruation depends on whether the woman breastfeeds or not. When exclusively breastfeeding, menstruation returns in approximately 6 months, but it is necessary to use contraceptive methods to avoid becoming pregnant during this period. If the woman does not breastfeed, menstruation returns in approximately 1 or 2 months.

• What to do: Check if the bleeding after childbirth is normal and start using contraception when the doctor or nurse tells you to. The day on which menstruation returns should be noted to indicate to the doctor at the next appointment. Know when to worry about Postpartum Bleeding.

9. Contraceptive methods

The use of contraceptive methods should be discussed with the doctor

• What to do: The woman can return to the birth control pill on the 15th day after the baby is born, or according to medical advice.

10. Sexual intercourse

It is only recommended to have sex again, 40 days after the baby is born, when the uterus is already healed, the woman is feeling better and there is no longer any risk of infections.

• What to do: Although there can be no penetration, it is possible to maintain the couple's intimacy during this period. Doing the same exercises that fight urinary incontinence also help to improve libido and improve intimate contact.