Pregnancy: Everything You Need to Know About Puerperium

The puerperium is the period from the end of childbirth until the physiological state prior to pregnancy is restored. It usually lasts about 40 days, which is why this period is also commonly called quarantine. This stage is characterized by the beginning of breastfeeding, the reappearance of ovulation and, with it, menstruation.

In addition to being a time of joy and excitement, this “fourth trimester” can present considerable challenges, especially for the mother.

During this time, it will be very common to experience

• Lack of sleep
• Feeling tired
• Pain
• Breastfeeding difficulties
• Stress
• Lack of sexual desire
• Urinary incontinence

It is important to receive the necessary information about the puerperium from the time of pregnancy so that you can arrive at the moment of delivery with the necessary knowledge to begin this new and wonderful stage. The objective of this period is to achieve your physical, psychological, emotional and social well-being, as well as that of your baby and your partner.

Hospital Discharge and Recommendations

The time of discharge from the hospital will be determined by your clinical progress and that of your baby.

• In general, in the case of an uncomplicated vaginal birth, discharge can be made after 24 to 48 hours.
• However, if your delivery was instrumental or by cesarean section, discharge may take up to 48-72 hours after delivery.
• Before discharge, your immunity to certain germs, such as rubella, will be assessed. If during pregnancy you have been shown to have no immunity to this germ, administration of a dose of triple viral vaccine in the immediate postpartum period will be recommended. The second dose will need to be repeated in 2 to 3 months, which will be done at your primary care referral center. Similarly, if you are RhD negative and your baby is found to be RhD positive, administration of anti-D immunoglobulin will be recommended to avoid any problems in future pregnancies you may have.
• Finally, upon discharge, you will be advised to contact your primary care center to request follow-up visits with the midwife.

It is recommended that you have an initial visit one week after delivery and then the quarantine visit (40 days). These two visits are important for follow-up, resolving doubts and monitoring the puerperium. We recommend that you participate in breastfeeding and postpartum education activities that take place at the primary care centers or, if you prefer, at the hospital itself.

What Do You Need to Know About the Puerperium When You Are at Home?

During the puerperium, which is about 40 days or 6 weeks, vaginal bleeding will gradually decrease.

It is important to know that during this period, you can only use pads and never use tampons or menstrual cups or have penetrative sex. At this stage baths cannot be done (bathtub, pool, beach) advising daily showers without problems.

Home care of C-section wounds, episiotomy wounds or perineal tears is not very difficult because the most important thing is to wash them with water and neutral soap at least once a day and then dry them well.

However, you should be aware of a series of warning signs that may prompt you to consult your doctor or medical attention center. These signs are summarized below:

• Abdominal or perineal pain that does not relieve with the usual painkillers.
• Discomfort during urination (tingling, inability to urinate)
• Pain and swelling of the legs
• Inability to empty one of the breasts associated with an increase in local temperature and the appearance of redness on the skin
• A state of mind that affects the relationship with the newborn or with other people and affects quality of life
• Infection of the cesarean section or perineum, with the appearance of suppuration and redness
• Headaches, especially if accompanied by visual disturbances, nausea or vomiting.

Remember! This article was written to inform and educate patients and families. It is not a substitute for consultation with your health care team. If in doubt, consult your specialist. Do you know anyone who had Puerperium before? How did she deal with it? Let us know in the comments below.