What is postnatal care? Why is it so important? I would like to share some experience and knowledge here in this post, every women will be benefited as the new journey become a mother shall begin.
In Chinese tradition, confinement is one of the most important period for women after labor. Some elderly people said if we does not follow the “do and don’t” set by them since generations ago, we will have all sort of sickness when we get old. How true is that? Well, nobody will dare to challenge it after all believing it does not cause you any harm, isn’t it? Therefore, it is a period when you will be treated like a queen, only eat, sleep and breastfeed.
Generally, a confinement period is 28days from the 1st day of postpartum but some people will consider longer which is 40days depends on her health condition and recovery rate. Every women after postpartum has a great deal of new things to cope with besides physical recovery. Therefore, the confinement period is the time we need to really look into very carefully on things we do, food we eat, watch out for sign of infection such as fever and other health condition for both mom and the infant. Postnatal care is given to ensure both mother and child, physical health are well taken care of.
We used to hear about the tradition, carry on generation to generation, that we shall not do lots’ of things during confinement period. We are not allowed to take bath, wash our hair, lift weight, climb up and down the staircase, no exposure to wind ( afraid of catching cold), no crying, no reading newspaper or watching TV for too long etc. Believe it or not, are these trues or myth? Depends very much on you. We are living in 21st century with advancement of technology in medicine and better living environment, some of these beliefs can be explained scientifically and logically.
Postnatal care is generally looking at mommy and baby health condition after childbirth and ensure no significant sickness occurs during confinement period. In Malaysia, we are able to get postnatal care at home for free by the local government Health Dept. Some of us will have to attend a scheduled followup at local hospital after childbirth.
Woman has gone through 10 months pregnancy and finally the baby is born. From the day of childbirth until 28th or 40th day, it is called confinement period. This is the time when women will take a good rest, eat healthy food to gain back your energy which has been lost during the delivery. Depends on your interest, some women may opt for confinement at the Confinement center, home confinement with engagement of experience confinement lady or home confinement assisted by your mother or mother-in-law.
Beside physical health recovery and due to changes in hormone, mental health also need to look into very carefully. Some new mom might get postnatal depression if not handle properly. Postnatal depression can be due to child care stress, low financial support, difficult infant temperament and other recent life event. Family support is very important. Without the support from our loves one, we will not be able to cope with all the changes- body, emotion and childcare. Let’s mom take a good rest and eat well, positively facing this new life challenges.
Generally, our uterus will slowly shrink back to its normal size after one month. Some of you may experience pain under abdomen but it will go away after few days. It is due to the contraction of the uterus, the pain is greater if you have delivered more than two times. Doctor usually wants us to start walking within 24 hours because walking can help to reduce the risk of blood clots in the blood vessel ( for Caesarian mom) and promote menstruation. Menstruation starts after the childbirth and can last about four to six weeks time.
About the episiotomy wound care / surgical wound care, make sure no big movement and lifting heavyweight. Recovery is much faster for episiotomy wound. Personal hygiene is very important as the wound may get infected if you does not handle it properly because heavy menstruation which last about 4-6 weeks is likely to cause infection to the wound. I was a Ceacerian mom, so I know how it feels like on the first two days, the pain from the surgical wound is just so excruciating so I have to take pain killer. Be aware. If you accidentally break the wound and get infection, you need to take antibiotics which is not really a good idea if you breastfeed. For Ceaserian, the wound is located at the lower belly so just wipe with clean wet cloth and let it stay dry. Oh, it is better to wear high waisted underwear in this case.
Personal hygiene is also important as we need to stay clean to avoid bacteria infection especially we have episiotomy wound/surgical wound. It is quite normal for us if we just wipe clean instead of going to bathe or shower. For Chinese, we don’t use tap water directly but we used boiled water instead for washing. It is believed the boiled water does not have “wind” which will not let us catch cold.
Food for women during confinement are usually targeting on milk production, energy booster and promote menstruation. For Chinese, we used to cook every meal with ginger, white wine and Chinese herb such as “motherwort”, without salt. Less salt intake will lead to better water discharge and help with metabolism. Nowadays, people can buy mixtures of herbs for postnatal care and just boil them into soup. These are heaty food which can make your body warm. We are only allowed to drink water which we infused with few types of herb/ingredients called “gou qi” ( Lycium Chinese), red dates and dried longan. We need at least 2L of water to keep our body hydrated and milk production. And again it is believed that this kind of water will prevent us from getting water retention in our body.
Every infant need to be fed every 1-2hourly. For breastfeeding mom, you can pump out the milk and let your caretaker to feed the baby if you need more rest. Sometimes, direct latching is better as it will stimulate the milk production. Some of us may experience low milk production, breast engorgement, blocked duct and mastitis. Sometimes breast engorgement is due to blocked duct and the breast will be swollen red and painful. The best way to avoid engorgement is to make sure the milk is emptied each time of breastfeeding or pumped out. Sometimes mastitis may happen if the nipples are infected due to the baby suckling is too intense or the wrong latching method. Always keep your nipples clean at all time.
Baby shall be monitored for Jaundice. Doctor will advise whether there is a need to stay in the hospital due to Jaundice.
Enough resting can promote milk production. Woman after postpartum is encouraged to rest as much as possible and eat enough food to make sure your fast recovery. If the pain is slightly getting better, can try to walk around.
Malaysia Healthy Ministry is offering postnatal care at home for free. I will share some services they provide to us.
If you deliver in Malaysian government hospital, you can seek for postnatal care from your nearby health clinic. Notify them 24hours earlier before discharge so that they can arrange a nurse to home visit based on schedule.
Examination of the mother will consist of:
- Physical observation of the mother
- Checking on body temperature, blood pressure, pulse rate and respiratory rate of the mother.
- The fundal height of the uterus is measured during each visit to detect involution of the uterus
- Breast examination to detect any abnormalities such as swollen, cracked nipples, inverted nipples or less flow of milk
- Observe mother while breastfeeding the baby and provide breastfeeding education/counselling
- Inspection of the genital/surgical wound
- Inspection of lochia to detect any abnormality, whether it is excessive bleeding, color and odors abnormalities.
- Detect any signs of chest pain, difficulty breathing, swelling and redness in the leg or calf.
- A check of the urination and pass stools.
Examination of the baby includes:
- Body weight
- Body temperature
- Urination and defecation
Health education will be given such as:
- Care of newborns
- Detection of jaundice in infants
- Nutrition during postnatal care
- Episiotomy wound care / surgical wound care
- The importance of taking medication regularly
- The aim of early exercise and early ambulation during the postnatal period is to allow blood flow, restore muscle tone and blood supply to the reproductive organs
- Examples of early exercise and ambulation include:
- Light postnatal exercise
- Pelvic floor exercise
- Family Planning
- The importance of follow-up visits to the clinic
( References are based on ”http://www.myhealth.gov.my/en/postnatal-care-home/”)
Postnatal care is important to detect any abnormalities during confinement period. The nurse will inform the family if there is necessity to revisit to the nearest clinic or hospital if they found the situation before it gets worse. I think it is important to let all the Malaysian women know about these services and it benefits us.
Confinement period is the best time to take a good rest after 10 months pregnancy and postnatal care is crucial to ensure both mother and child are healthy. It is believed that if we have enough rest and eat good, we shall regain our energy and faster recovery.