Postnatal care MANIK

 Introduction about postnatal care
 Define postnatal care
 Aims & objectives postnatal care
 Important conditions we should enquire in postnatal care
 Schedule of postnatal care
 Postnatal exercise
 Advice given to the mother during discharge postnatal care
 Advice regarding family planning and sterilization during puerperium

1. Subheading goes here Postnatal Care Presented By: Diploma in midwifery 3 rd Year (First Batch) Class Roll Number: 15 Rajshahi Nursing College Rajshahi .

2. LESSON PLAN Title of the Course : Diploma in Midwifery Name of the subject : Transition to practice Subject Code : Name of the Topic : Postnatal Care Venue : Class room, Academic building, Rajshahi Nursing College, Rajshahi Date :  Name of the Teacher : Laila Arjuman  Duration : One hour  Levels of Students : Diploma in Midwifery

3. Number of Students : 23 (3 rd year students) Method of Teaching : Lecture method and demonstration Teaching Aids : Marker Pen white board and duster, Multimedia and Microphone Assessment Method : Asking question Room Layout : Line Arrangement of the chair  Evaluation : Students able to understanding  Roll Call : Pen, roll call khata , microphone

4. LESSON AIM General Objective: After completion of this session the students will be able to acquir knowledge, develop attitude & skill on postnatal care Specific objective: Al the end of the session the students will be able to knowledge about the  Introduction about postnatal care  Define postnatal care  Aims & objectives postnatal care

5. Specific objective( Cont …) Important conditions we should enquire in postnatal care Schedule of postnatal care Postnatal exercise Advice given to the mother during discharge postnatal care Advice regarding family planning and sterilization during puerperium

6. LESSION OBJECTIVE Introduction about postnatal care Define postnatal care Aims & objectives of postnatal care Important conditions we should enquire in postnatal care Schedule of postnatal care Postnatal exercise  Advice given to the mother during discharge postnatal care  Advice regarding family planning and sterilization during puerperium

7. Introduction Postnatal care includes systematic examination of mother and baby and appropriate advice given to the mother during postpartum period. Over 5,36000 women die annually from complications during pregnancy, child birth or the postpartum period. Nearly all of this death occur in developing countries where fertility rates are higher and and a womens life time risk of dying during pregnancy or child bith . Almost all 95% of this maternal death occurred in Africa and Asia. The durden of maternal complications and deaths is also highst in the first few days of delivery.

8. Definition Care of mother and newborn from 1 hour after delivery up to 6 weeks post delivery Aims and Objectives To access the health status of the mother and institute effective therapy to rectify the defect if any. Medical disorders like DM, HTN should be reassessed .  To detect and treat at the earliest any gynaecological condition arising out of obstetric legacy  To note the progress of the baby including the immunization schedule for the infant  To import family planning guidance

9. Important conditions we should enquire in postnatal care A. Enquiry to the mother : Any excessive PN bleeding Puerperal pyrexia Puerperal sepsis Involution of the uterus Breast complications: Breast engorgement Mastitis Cracked nipple Breast abscess

10. Important conditions we should enquire in postnatal care B. Enquiry to the baby: Exclusive breast feeding Keeping the baby warm Dry and wrap Delayed bathing for 72 hour  Immunization  Importance of neonatal care

11. Danger signs of the baby Reluctant to faced High pitched cry Fever Granting in drawing of chest  Convulsions  Yellow coloration eyes & body  Discharge / bleeding from umbilicus

12. Schedule of postnatal visit  First : within 24 hours  Second : within 2-3 days  Third : within 4-7 days  Fourth : Within 42-45 days

13. Postpartum/Postnatal Exercise Postnatal exercise should begin as soon as possible & continue throughout the puerperium . It is particularly important for multipara women, whose muscles are more flaccid than those of primipara . It increases  Muscle tone  Venous return from the legs & lower abdomen  Drainage of the Lochia  Voiding of urine

14. Postpartum/Postnatal Exercise Postpartum exercise begins with five repetitions two or three times daily & gradually increases to ten repetitions. After 2-3 weeks more strenuous exercise such as sit ups & side leg raises may be added as tolerate.

15. 1 st day 1. Prone position : Lying on abdomen with 2 pillows under lower abdomen & arms at sides . Rest at least 20 minute 2. Abdominal breathing: Lying supine with no pillow & legs straight. Inhale deeply through the nose. Keeping rids as stationary as possible & allowing the abdomen to expand up. Exhale slowly but forcefully while contracting the abdominal muscles. Repeat with 6 repetitions.

16. 1 st day 3. Pelvic rocking (knee to Abdomen): Lying supine position with no pillow & arms at side. Bend right knee& thigh until foot touches buttolk . Straighten right leg & lower it slowly. Alternate with right & 5-6 times.

17. 2 nd day 1. Chin to chest : Lying supine with no pillow & legs straight. Raised head & attempt to touch chin to chest. Slow lower head, Repeat with 10 repetitions . 2. Arm raised: Lying supine with arm extended at 90 angle from body, slow raised arm keeping elbow stiff. Touch hands together & gradually return arms to original position . Repeat 5-10 repetitions.

18. 2 nd day 3. Leg raising: Lying supine with no pillow & legs straight. Raised the right leg as high as possible , keeping the toe pointed in lie with leg. Do not bend the knee. Lower the leg slowly to the bed. Alternate with right & left 5-10 times . 4. Buttock lift: Lie on back with arms at sides , knees, & feet flat. Slowly raised buttock & arch back. Return slowly to starting position. Repeat with 5- 10 repetitions.

19. After 2 nd day Leg exercise: Sitting on a chair or lying on a bed touching the heel of the foot on floor bed rotate the heel clock & anti-clock wise alternatively. Repeat 5-10 repetitions. Both legs . Perineal exercise: Sitting on a chair or lying position squeeze the perineal muscles & relax them repeat 5- 10 repetitions .

20. Advice given to the mother during discharge Advice after normal delivery : Diet: High nutritious diet containing vitamins, mineral including iron folic acid vitamin-c calcium etc. Should not bear heavy weight for at 3 months  Contraception- Progesterone only pill / minipill for first 6 month Barrier method for next 2 years.  Coitus Abstinence in 1 st 1.5 months. With caution next 1.5 months .

21. Advice after normal delivery (Cont..)  Birth Spacing For at least 2 years  Breastfeeding Exclusive breastfeeding for 1 st 6 months. Extra notorious food in addition to breastfeeding . ( weaning ) from month till 2 years .  Immunization Immunization of the baby properly as early as possible .    Sunlight exposure of the body By covering the mouth & genetalia .  If any symptoms of jaundice appear, please contact with a pediatrician

22. Advice after cesearian section delivery ( All above Advices in addition to the followings) Should not bear heavy weights for at least 6 months. Should wear abdominal binders for at least 2-3 months.  Coitus Abstinence in 1 st 3 months. With caution in next 3 months. Advices regarding family planning & sterilization during purperium . Sometimes vasectomy is done during cesearian sectionin if family is complete or in case of multigravida after proper consent .  If family is not complete or in case of NVD. Patient is advised & encouraged for permanent sterilization ( tubectomy /vasectomy ) after second baby.

23. SUMMERISATION

24. HAVE ANY QUESTIONS ?

25. Thanks to All For Listening