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Module 13: Postnatal care

In this module we will discuss aspects of postnatal care. Postnatal care occurs during the puerperium- the 6 week period after birth of recovery from pregnancy, labour, and birth. The three main changes that occur involve involution of the uterus, establishment of lactation, and the psychological adjustment to motherhood. 

In this module, we will discuss the importance of lactation and breastfeeding, the normal changes in the puerperium, postpartum mental health, and some key points in postpartum contraception. Case 11 in your coursebook will discuss pueperal sepsis. Your textbook includes an excellent chapter on the puerperium, and other readings are listed below. 

Objectives

Following this section you will be able to:

  • Understand the general principles of postnatal care 
  • Discuss the benefits of breast feeding for both the mother and the baby
  • Know how to contact your local DHB lactation consultant
  • Help advise mothers about some of their queries regarding breast feeding
  • Direct women to the MOH website and the Plunket website for further support
  • Understand the normal psychological responses to adjusting to motherhood 
  • Recognise which women are at high risk for postnatal depression and know how to screen for postnatal depression 
  • Be able to list suitable types of postpartum contraception 

Readings

Hoddinott P, Tappin D, Wright C. Breast feeding. BMJ. 2008 Apr 19;336(7649):881-7. doi:10.1136/bmj.39521.566296.BE
Full text

Castro T, et al. Breastfeeding indicators among a nationally representative multi-ethnic sample of New Zealand children. NZMJ.  2017: Vol 130, Iss 1466: 34-44. Full text

Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev. 2012(8):CD003517.
Full text

McFadden A, Gavine A, Renfrew MJ, Wade A, Buchanan P, Taylor JL, Veitch E, Rennie AM, Crowther SA, Neiman S, MacGillivray S. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database  Syst Rev. 2017(2):CD001141. doi: 10.1002/14651858.CD001141.pub5.
Full text

Farquhar C, Roberts A. Introduction to Obstetrics and Gynaecology, Fourth Edition. University of Auckland. Chapter 9: The puerperium, pp95-106

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