SECTION V: POSTNATAL CARE
The postnatal period is defined as the time from childbirth up to six (6) weeks after delivery. This period, particularly the first ten days, is the most vulnerable for the infant. It marks the beginning of parent-child relationships and it provides an opportunity for adjustment of the family to the infant.
It should be noted that CARPHA is in the process of developing clinical guidelines for neonatal care.
General Objectives of Postnatal Care
- To promote and maintain the health and welfare of the mother and child during the postnatal period
- To promote aspects of family life education.
- Every mother should stay at least 24-48 hours in hospital after delivery.
- Mothers who live in areas that are considered inaccessible, because of a hilly and rugged terrain, should remain in hospital for at least three (3) days after delivery.
- All mothers should be given a six (6) weeks appointment for a postnatal examination at the Health Centre in her district. A Day 6 appointment may be necessary for high risk mothers and neonates.
- All mothers leaving place of delivery should be given the particulars of the infant’s birth, for reference and for use at postnatal clinics in the community.
- All infants whether born in hospital or at home will receive at least one visit during the first two weeks of life (or an appointment to attend Clinic during that time).
- Every mother will be offered MMR vaccine, and have it administered if required.
- Every infant will be given an appointment to clinic within 4-6 weeks after birth.
- Every mother will be offered an appointment to Family Planning Clinic 6 weeks after delivery.
- Every mother will be given advice on appropriate infant feeding
- Every mother will be given advice concerning her nutrition
- Infants will commence vaccination
Preliminary Post-Natal Check (At Home)
- Ask mother about coping skills and general health including any fever after her discharge
- Check for engorged breasts
- Postnatal Care
- Encourage breastfeeding and address any problems that may compromise her determination to breastfeed
- Reinforce that it is possible for a mother to continue to breastfeed even if she has to go back to work
- Enquire about care of episiotomy or vaginal laceration
- Discuss diet, hygiene, breast care, cord care, etc
- Ask about general health indices – activity levels, irritability, feeding pattern, vomiting, urine and stools
- Check state of cord
- Look for jaundice
- Test reflexes
- Look for abnormalities
- Emphasise that should the mother or child develop any problem prior to the regular 6 week appointment, then an earlier visit to the clinic or a doctor is required and would be welcomed.