Buy the Book

Print This Topic Email This Topic

Pronunciations diphtheria immune globulin oxytocin pertussis uterus

Immediately after delivery of a baby, the mother is monitored. If a general anesthetic was used during delivery, she is monitored for 2 to 3 hours after delivery, usually in a well-equipped recovery room with access to oxygen, intravenous fluids, and resuscitation equipment.

Staff members check the mother's pulse rate and temperature. Normally, within the first 24 hours, the mother's pulse rate (which increased during pregnancy) begins to decline toward normal and her temperature may increase slightly, usually returning to normal by the second day. After the first 24 hours, recovery is rapid.

Hospital staff members make every effort to minimize the new mother's pain and the risk of bleeding and infection.

Bleeding: Minimizing bleeding is the first priority. After delivery of the placenta (afterbirth), a nurse may periodically massage the mother's abdomen to help the uterus contract and remain contracted, thus preventing excessive bleeding. If needed, oxytocin Some Trade Names
PITOCIN
is given to stimulate contraction of the uterus. The drug is injected into a muscle or given intravenously as a continuous infusion until the uterus is contracted.

Urination and Defecation: Urine production often increases greatly, but temporarily, after delivery. Because bladder sensation may be decreased after delivery, hospital staff members encourage a new mother to try to urinate regularly, at least every 4 hours. Doing so avoids overfilling the bladder and helps prevent bladder infections. Staff members may gently press on the mother's abdomen to check the bladder and determine whether it is being emptied. Occasionally, if the new mother cannot urinate on her own, a catheter must be inserted into the bladder to empty the urine. Hospital staff members try to avoid using a catheter, which increases the risk of bladder and kidney infections.

The new mother is also encouraged to defecate before leaving the hospital. But because hospital stays are so short, this expectation may not be practical. Doctors may recommend that if she has not defecated within 3 days, she take laxatives to avoid constipation, which can cause or worsen hemorrhoids. If the rectum or muscles around the anus were torn during delivery, doctors may prescribe stool softeners.

Did You Know... When breasts are engorged, expressing milk between feedings temporarily relieves the pressure but overall tends to make engorgement worse.

Diet and Exercise: A new mother can have a regular diet as soon as she wants it, sometimes shortly after delivery. She should get up and walk as soon as possible.

A new mother can start exercises to strengthen abdominal muscles, often after 1 day if delivery was vaginal and later if it was cesarean. Sit-ups with bent knees, done in bed, are effective. However, most women are too tired to start exercising so soon after delivery. Cesarean delivery is a major surgery and women should not begin exercising until they have had time to fully recover and allow healing, which typically takes about 6 weeks. Women can resume their prior exercise after approval from their physician at their postpartum visit.

Vaccines and Immune Globulin: Before the mother leaves the hospital, she is given the German measles (rubella) vaccine if she has never had rubella or never been given this vaccine. If a woman has never received the tetanus, diphtheria, and pertussis (Tdap) vaccine and her last tetanus booster was at least 2 years ago, it is recommended that she be given a Tdap vaccine before she is discharged.

If a new mother has Rh-negative blood and the baby has Rh-positive blood, she is usually given Rh₀(D) immune globulin within 3 days of delivery. This drug masks any of the baby's red blood cells that may have passed to the mother so that they do not trigger the production of antibodies by the mother. Such antibodies may endanger subsequent pregnancies (see Pregnancy Complications: Rh Incompatibility).

Before Discharge: Before a new mother leaves the hospital, she is examined. If mother and baby are healthy, they commonly leave the hospital within 24 to 48 hours after vaginal delivery and within 96 hours after a cesarean section. Sometimes, discharge is even earlier than 24 hours if no general anesthetic was used and no problems occurred.

The mother is given information about changes to expect in her body and what measures to take as her body recovers from having a baby. Regular follow-up visits are scheduled.

Last full review/revision November 2008 by Julie S. Moldenhauer, MD