Training of Roma Health Mediators in Reproductive Health

Trainer document
NORMAL CHANGES DURING THE POSTPARUM PERIOD
Physical Changes
A woman's body will never be exactly as it was before pregnancy. Some changes in the
reproductive system are ever lasting changes. Body shape and weight come back to
normal sooner if she breastfeeds her baby for a longer period of time.
Body weight starts to be lost immediately after delivery; a woman loses about 5-7 kilos
during delivery and continues to lose weight in the following months, especially if she is
breastfeeding her baby.
Reproductive organs:
• Uterus shrinks and sheds its linings
Immediately after delivery, the uterus is still quite large and can be felt in the lower
abdomen as a hard and round mass. It soon begins to get smaller in size due to
contractions. These may be painful (like periods) for the first couple of days.
Breastfeeding helps the uterus to contract properly: it reduces the amount of fluid that
comes out after delivery and it helps the uterus to recover its shape and size.
• Vaginal secretion decreases and changes.
Fluids coming out of the uterus and passing through vagina are called lochia. This is
bright red immediately after delivery because it contains mostly blood for the first few
days. Gradually its color changes to dark brown and then to pale cream. The amount of
discharge becomes smaller over time and then completely stops, usually by the end of the
fourth week.
• Changes in the breast
After childbirth, the breasts start producing milk. The milk secretion is established
properly within a couple of days, especially if the baby is put to the breast within an hour
of delivery and suckles regularly. The first milk, called colostrum, is thick and yellowish
and is very good for the baby. Soon it becomes thin and white.
• Return of menstruation
The time it takes for menstrual periods to return following childbirth may vary from one
pregnancy and delivery to another. If a woman breastfeeds exclusively, without giving
her baby any other milk, her periods may not return for six or more months after delivery.
If she is not breastfeeding, menstruation usually begins 4-6 weeks after delivery.
Abdomen returns gradually to its normal size.
Other changes that occurred during pregnancy (respiratory, blood, renal systems)
disappear several days after childbirth.
The skin darkness (on face, breast, abdomen) lasts for a few weeks or months.
Emotional Changes
As childbirth is a deeply emotional experience, it often affects the mood and behavior of
the woman. She may feel happy and relaxed one minute and anxious, depressed, or
tearful the next. She needs support, understanding and reassurance from her husband,
other family members and friends.
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RFHI/JSI Romania Training of RHMs in Reproductive Health Session 7: Postpartum Care