AFTER THE BIRTH

AFTER THE BIRTH

By :

Kiki Dwi Handayani

Politeknik Kesehatan Tanjung Karang 2011/2012

After The Birth

Natural process of childbirth is something that almost all women will pass through and post-spawned many new challenges faced by, among others, should take care of the baby, restoring physical and mental condition. At that time also undergone many changes, both physical form or any means of reproduction or emotional .

Disorder after childbirth

6-8 weeks after childbirth, women may experience symptoms of a mild and temporary because the body re-adjust to the circumstances before pregnancy.
24 hours of the first pulse and body temperature dropped slightly increased. From bloody vaginal discharge for 3-4 days, then the color becomes brownish until day 10-12 and ultimately became yellowish white.

After delivery, the uterus continues to contract and become smaller in size until it returns to its normal size. Irregular contractions are often painless and can be treated with analgesics (pain medication).
Pain lasts for 5-7 days and grew during breastfeeding due to contraction of the uterus is also stimulated by the hormone oxytocin is naturally released during breastfeeding.
After 5-7 days, the uterus back hard and not mushy, but it can still be felt by the doctor on examination of the abdomen. At week 2 after birth, the abdominal examination, the uterus can no longer be felt.

At the beginning of the formation of milk, the breasts will be filled by the breast milk so that it becomes hard and painful.
Mothers who are not breastfeeding will usually return to ovulate (release eggs) 4 weeks after delivery.
Mothers who breastfeed tended to ovulate more slowly, usually 10-12 weeks after delivery.

SEX AFTER CHILDBIRTH

Many couples want to know when they can have sex again after giving birth. Vagina of a woman who just gave birth too traumatized. In very baikpun, vagina still very sensitive. In addition, if you are breastfeeding, there may be vaginal atrophy - thinning and drying of vaginal tissue due to lack of estrogen in the body.

Sometimes wives are reluctant or afraid to have intercourse after childbirth. So what the problem is that the wife is afraid to have sex? And, when it would be fitting to have sex after childbirth?

In fact, six weeks postpartum mothers usually been able to have sexual intercourse again. Some doctors say, four weeks or when the fluid is removed from the hole intercourse after giving birth can be done has stopped the sexual relationship.

The main reason to avoid intercourse after childbirth is to provide opportunities for female genital tissues to heal, especially if you have an episiotomy or cutouts to widen the birth canal to help facilitate the baby out. Preventing the onset of infection is the next reason.

Keep in mind also that the period after birth for 6 weeks or 40 days, according to a count of laymen, is an important puerperium to continue to be monitored. Childbirth is a time of cleansing of the uterus, as well as during menstruation. Puerperal blood containing platelets, the cells degenerate, dead cells, and the rest of the endometrial cells.

Therefore, the re-examination after delivery is usually done after six weeks, and six weeks is the time when the uterus has returned to pre-pregnancy size. Shrinking of the uterus is the major physical changes after the last delivery. A few weeks and months following childbirth, a woman's desire for intercourse may be reduced or even nonexistent.

An Australian study found that six weeks is the average time for postpartum women to begin having sex. But the study also found that about half of those who have problems early on, continued to experience during the first year postpartum. Another study found that 20 percent of women giving birth for the first time takes 6 months to feel physically comfortable during intercourse, with an average time of about 3 months.

Although the relationship has to be done after the 6th week, sometimes certain mothers complain relationship still feels sore or painful though it has been several months of the birth process. Such disorders are called dyspareunia or pain when copulation. In such cases there are several possibilities that could be the cause, namely:

1.      The formation of new tissue after birth because of the wound healing process is still sensitive to clipping the birth canal so that the conditions for reproduction have not been back to normal.

2.      The presence of infection, can be caused by bacteria, viruses, or fungi.

3.      The presence of disease in the womb (tumors, etc.).

4.      Consumption of herbal medicine. These herbs contain substances that have properties that result astingents inhibit the production of lubricating fluid in the vagina when a woman is sexually aroused.

5.      Psychological factors that contribute to excessive anxiety, such as:

ü  Less mentally ready to have sex (false perceptions about sex, etc.).

ü  The existence of past trauma (physical, sexual)

ü   Personality type is less flexible.

ü  Communication husband and wife is not good, so usually the wife "lazy" to have sex. The lack of foreplay was so not happening lubrication during penile penetration. If the foreplay and lubrication is enough but still too painful, try to come to health clinics that serve female sex or just come to a female gynecologist.

Diseases that occur after childbirth

1.      INFECTION post-partum
Post-partum infections are infections that occur in new mothers.
If the body temperature at 2 times the examination is performed 24 hours after childbirth with an interval of 6 hours to reach 38? Celsius and found no other cause (eg bronchitis), it is said that there have been post-partum infection.
Infections that are directly related to the delivery process is an infection of the uterus, the area around the uterus or vagina. Kidney infections can also occur immediately after delivery.
Other causes of fever are likely to occur 4 days or more after childbirth is a blood clot in the leg or breast infection.

2.      Infection of the uterus
Post-partum infection usually begins in the womb.
Infection of the sac of amniotic fluid during labor and fever can cause endometriosis (uterine lining infection), miometritis (infection of the uterine muscle) or parametritis (infection of the area around the uterus).
In the following circumstances, women are more susceptible to infection (so the bacteria that normally live in the vagina after childbirth can cause infection):
• Anemia
• Pre-eclampsia
• Examination of the vagina repeatedly
• The delay delivery for more than 6 hours after rupture of membranes
• Delivery of the old
• Operation fault
• Retained the placenta in the uterus after childbirth
• severe bleeding after childbirth.

Symptoms include:
- Chills
- Headache
- Feel unwell
- Face pale
- Rapid heartbeat
- Increased number of white blood cells
- Her uterus soft, swollen and tender
- The liquid that comes out of the womb stink.
If the infection attacks the tissue surrounding the uterus, the more severe pain and fever.

Complications:
• Peritonitis (inflammation of the lining of the abdominal cavity)
• pelvika Thrombophlebitis (blood clots in the pelvic veins), with the risk of pulmonary embolism
• Toxic Shock due to high levels of toxins produced by bacteria in the blood. Toxic shock can cause severe kidney damage and even death.

Diagnosis based on results of examination of the lungs and the uterus and culture results of urine samples and fluid from the uterus.
The infection resolved with intravenous antibiotics pemberikan until the patient free of fever for 48 hours.

3.       Kidney Infection
Kidney infection (pyelonephritis) caused by bacteria from the bladder can occur after childbirth.
Sometimes an infection caused by the use of catheters.
Infection may begin to arise during pregnancy where the bacteria can be found in the urine, but without causing symptoms.
If symptoms occur, then there will be a high fever, pain in lower back or side, feeling unwell, sometimes constipation and pain when urinating.
Antibiotics intravenously (through a vein / infusion) was given to the patient free of fever for 48 hours. Treatment continued with antibiotic tablets for 2 weeks after discharge from the hospital.
It is advisable to drink plenty of water for the kidneys to function properly.
6-8 weeks after delivery the urine examination to ensure that no remaining bacteria.

4.      Other post-partum infection
Fever that occurs 4-10 days after delivery may indicate a saphenous thrombophlebitis (blood clots in the legs), which dioati with warm compresses and legs removed. May need to be given anticoagulants.
After delivery, dormant tuberculosis can become active and treated with antibiotics.
A fever that starts more than 10 days after delivery is usually caused by mastitis (breast infection) or cystitis (bladder infection).
Both of these infections are treatable with antibiotics.
In case of mastitis, mothers should continue breastfeeding their babies to reduce the risk of breast abscess. Breast abscesses are rare, usually treated with antibiotics and nanahnya issued.

5.      BLEEDING post-partum
Post-partum hemorrhage is the loss of more than 0.5 liters of blood that occurs during or after delivery phase III, when the placenta (placenta) are born.

Post-partum hemorrhage is the leading cause of maternal death due to birth number 3.
The cause could be:
• Bleeding from the placenta attached. This could happen if the uterus does not contract properly because:
- The uterus is too stretched.
- Abnormal or prolonged labor
- The use of anesthesia during childbirth pengendur muscle.
• A torn in spontaneous labor
• The placenta is left inside the womb
• Levels of fibrinogen (blood clotting factors) is low.

To help prevent uterine contractions and bleeding, the placenta immediately after birth, was given an injection of oxytocin.
If within 30 minutes after birth the placenta does not escape by itself, then the placenta removed manually (using the hands of doctors).
If there is severe bleeding, to help the uterus contract, the mother's abdomen massaged and continues to be given oxytocin intravenously. If bleeding continues, may need to be given a blood transfusion.
To help the uterus contract, prostaglandins may also be injected into the muscles of the uterus. If uterine contractions are not too successfully stimulated, could be closing the arteries leading to the uterus.

6.      INVERSIO uteri

Inversio uteri is a condition where the body of the uterus turned, protruding through the cervix (cervical) into or out of the vagina.
Inversio uteri usually occurs when an attendant medical personnel who are less experienced too many pressing the top of the uterus or the umbilical cord too hard pull of the placenta that has not been released.
This situation could be causing the occurrence of shock, infection and death.

To restore the uterus to its original state, a doctor may push it into the vaginal canal, inserting a tube into the vagina and closes the vaginal opening. Then the tube is inserted through a salt solution into the vagina and uterus to develop reverse the uterus.
Rarely requires surgery.

Care after  the birth

1. Breast Massage  

 To help launch ation and stimulate the emergence of the hormone prolactin (a hormone which affects milk production). But it would be more successful programs exclusive ation as early as possible if your baby is introduced and taught menghisab nipple. (Do not introduced with the first milk bottle)

2. Spices bath or Lap
Useful herb bath to warm the body and lift used oil massage, because the artificial spice contains substances that can warm the body and lift the oil. Among others, Ginger, Powder, Lemon, Cinnamon and others. For those not healthy enough should not bathe in the lap alone. As for patients who were born in OPERATION CAESAR, bathing is allowed after the plaster in the open or at least 2 weeks after surgery.

3. Use Tapel / Slimming

Tapel and slimming used to help warm up the outside of the abdomen before the tide octopus and bengkung. So if the stomach was warm expenditure dirty blood will be helpful even without the massage, because of heating from the outside. But for skin allergies is not recommended to use this.

4. Use of Octopus and Bengkung

To assist in the downsizing of the abdomen and uterus, hold your stomach muscles, avoid stretching the hips due to stretching during pregnancy, so after using the octopus and Stagen can lean back. Many people have myths using bengkung and octopus are not any good, but it's wrong. Hundreds and even thousands of women complaining and regretting he did not use due bengkung after giving birth, so that although the weight back to normal, but the stomach, hips remain elastic even organs, too intimate to be stretched. And usually when it's over a year gave birth to the muscles of the body parts that have to be strong is not as soft as after childbirth, making it difficult to shape into lean back like a man who just gave birth. YOU ARE NOT LATE, preferably after giving birth and octopus bengkung use at least 2 months, because at that time your muscles are still easy to set up.

5. Hundred femininity and Totok Legit (For the period Childbed nearing completion)

To help avoid unpleasant smells, into healing, kill bacteria, avoid vaginal discharge, enhance immunity, prevent moisture, caused by prolonged use of pads, post-partum bleeding.
Totok useful to restore the function of the muscles of your sex organs to relax, so avoid the whiteness and the womanhood you back like a girl.
Note: For full-blooded Hundred and stitching the vagina can be done during normal vaginal birth for nifasnya is dry and has begun to diminish. For a caesarean section should be full-blooded done after 4 or 5 weeks after surgery, where patients can tengkurep.

6. Infant Massage (For Parents who recommended)

Baby massage should be done after the baby's navel crowbar, you get a 1-week.
Today, experts have been able to prove scientifically what has long been known to man, ie touch and infant massage has many benefits.
Among the benefits of infant massage are as follows:
1. Increasing weight
2. Increasing growth
3. Fostering parental bonding and child
4. Increasing milk production
 
7. Rump care, Groin and Axilla

Everyone surely knows, that the buttocks, armpits and selangakangan a sensitive area which is often the scourge of every woman giving birth out in addition to the color becomes dark, dull, sometimes people forget that if this area is very much needed attention but was not sensitive care what else should one use products that are not clear.
 masks buttocks groin and armpits of the original materials of interest, ranging from rose, jasmine, pangrripani and grains that can provide nutrients and soften the sensitive part has become more refined, soft and bright.
Stages of treatment can be combain with all body massage, body scrub (including the pubic area, buttocks, and armpits), after which this area in the mask, let stand 15 to 20 minutes, then removed and rinsed.

Conclusion

And the conclusion is that after the birth of the baby and the mother should take care of the body and their health, and the mother must take care of yourself, because it's important for babies, because babies need to suck more milk from mothers and babies usually cry like a bitch. and the mother will continue to produce enough milk for babies up to 9 or 10 months. thus, the mother must eat good food and milk.