When a baby is born and given in your hands it’s the most magical feeling in the world and it’s something which can’t be explained in words. As the baby is born our care is naturally intensified towards the baby. But caring for the mother is equally important and should never be neglected. The care of the mother and the newborn starts immediately. WHO recommends that the mother shouldn’t be discharged before 24 hours after giving birth and most of the complications arise within 24 hours.
WHO has recommended guidelines on postnatal care that are -
1. Assessment of the mother – During the first 24 hours blood pressure, pulse, any bleeding, temperature and uterine contraction are to be monitored. Blood pressure is measured immediately, then if normal again at 6 hours.
After 24 hours of birth urination, healing, headache, fatigue, back pain and hygiene are assessed.
Breastfeeding is assessed everything the newborn is fed. The mother is asked about emotional well-being, support from family, and encouraged to talk.
After 10-14 days of birth, women are asked about postpartum depression.
2. Counselling - All women are given information about the process of recovery after birth and told about some common problems. They should be counselled about nutrition, hygiene, birth spacing, and family planning.
3. Iron and folic acid supplementation – iron and folic acid supplementation are given at least for 3 months after delivery. The chances of developing anaemia are more than 40%.
4. Antibiotics – only for a c-section delivery.
5. Psychosocial support – it is done to reduce the occurrence of postpartum depression.
Mothers are counselled for the following danger signs -
- Excessive bleeding
- Breathing difficulties
- Foul-smelling discharge
- Painful urination
- Severe abdominal or perineal pain
They are also counselled about danger signs in newborn
- Poor sucking
- Inactivity or lethargy
- Fast breathing, difficulty in breathing, chest retraction
- Fever or body too cold;
- Vomiting or abdominal distention
- Any umbilical infection (pus discharge at a base, surrounding redness or swelling, foul smell)
The birth of a baby may lead to many emotional changes. Many women go through a period of mild depression after the birth of a baby.
Women may experience “maternal blues” which is feeling low in the first week and may last up to two weeks, whereas postnatal depression is much more severe and may last longer.
In maternal blues, the mother may experience low energy, fatigue, sleep or appetite problems. Depression will continue longer and disturbs her routine. In depression, she might feel -
- persistent sad or anxious mood, irritation
- low interest from activities that used to be enjoyable
- difficulties in carrying out usual work, domestic or other activities
- negative or hopeless feelings about herself or newborn
- Symptoms like aches, pains, palpitations, and numbness with no physical cause.
In some cases, a woman may feel so depressed that she would want to end her life.
Supporting depressed women
Supporting mother at this stage is important, listening to her and seeking the help of family will help. Involvement in social activities and in mild depression regular physical exercise can also help. Mothers may not be able to take care of the newborn; they may feel inadequate as mothers and might feel that they are not taken seriously.
After the baby is born first few weeks are very demanding, physically and emotionally. Care about mother’s nutrition is equally important and more healthy food should be given like meat, fish, oils, nuts, seeds, cereals, beans, vegetables, cheese and milk.
Childbirth is an overwhelming experience but after efforts should be made to take care of the child and also the mother. Most of the times mothers are neglected as many are not aware of these conditions. Some women are very happy but some need extra care to get back to their normal routine.