The Postnatal or postpartum period starts following childbirth and lasts for six weeks during which all the organs revert back to the pre-pregnant state. The postnatal period is a critical, yet often neglected period in a new parent’s life.
Many women experience problems after delivery of the baby like painful perineum, back pain, incontinence, etc which needs to be managed effectively.
Postpartum Problems and their management
Some of the postpartum problems and their management are listed below-
After pain
After pain is the infrequent and spasmodic pain felt in the lower abdomen after delivery for 2 to 4 days. The presence of blood clots or bits of the afterbirths leads to vigorous uterine contractions in an attempt to expel them out.
Management
- It is usually managed by massaging the uterus to expel the clot.
- Administration of analgesics (ibuprofen) and antispasmodics to relieve pain.
Painful perineum
If you have given birth to your baby by normal vaginal delivery then you will get pain on the perineum due to episiotomy or perineal tear. The perineum should be inspected to check for any infection.
Management
- Analgesics are given to relieve the pain.
- For the first 24 hours, you can use a cold pack to get relief from pain.
- Sitz bath (sit in warm water by immersing the perineal area) can also give pain relief. It should be done 24 hrs after delivery.
- When the pain is less, pelvic floor exercises should be encouraged with the aim of increasing the local circulation and easing the weight off the painful area.
Incontinence
Urinary incontinence is the leaking of urine that you can’t control. The most common type of postnatal incontinence is stress incontinence. It was discovered in a study that 38% suffered from urinary incontinence 2 months after giving birth.
Management
- Pelvic floor exercises will help to rehabilitate the pelvic floor and regain muscle strength.
- If the problem persists, you can consult physiotherapy.
Back pain
You may experience back pain in the postpartum period due to stretching of the muscles and ligaments during pregnancy and childbirth.
Management
- Back pain can be relieved by warmth and pelvic tilting exercises.
- If you have persistent and severe back pain then you need to consult a physiotherapist for physiotherapy sessions.
Diastasis recti
It is a condition in which abdominal muscles separate. Rectus muscles are more than two fingers apart. You may develop the condition because of increased tension on the abdominal wall during pregnancy and childbirth.
Management
Actually, there is no cure for diastasis recti but the gap between the abdominal muscles can be reduced by doing postnatal exercises like pelvic tilting and transversus exercises.
Symphysis pubis dysfunction
Symphysis pubis dysfunction refers to symptoms you feel when the joint (pubic symphysis) between your left and right pelvic bones allows for more movement than usual. This condition may be present in late pregnancy, occur during labour or after delivery.
Management
- Complete bed rest with some support around the level of the pubis is needed in case of severe pain indicating complete separation of the pubic joint.
- Press knees together when moving in bed.
- Transversus and pelvic tilting exercises plus circulatory exercises can be performed while resting.
- Ice can be used to relieve the local pain.
- Mobilization of the woman should progress gently and only when the acute pain has subsided.
Coccydynia
It is the condition of acute pain in the coccyx or tailbone after delivery.
Management
Pillows may be placed to give some relief in the sitting position and alternative positioning for feeding is encouraged. If your coccyx bone has been displaced then manipulation can be done to correct it.
A physiotherapist can administer therapeutic ultrasound or pulsed electromagnetic energy with beneficial effects.
Anaemia
The majority of the women in the rural areas remain in an anaemic state following delivery due to blood loss during childbirth and inadequate diet.
Management
Anaemia should be corrected by supplementary iron therapy. Ferrous sulphate 200 mg is given daily for a minimum of four to six weeks.
Eating a healthy and nutritious diet after the birth of the baby help to improve the blood level.
Conclusion
In the about post, we have discussed the different problems experienced by a woman during the postpartum period and their management. Postpartum problems may include after pain, painful perineum, incontinence, back pain, anaemia, symphysis pubis dysfunction, diastasis recti. These problems can be managed by medications and exercises.
