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Training of Roma Health Mediators in Reproductive Health

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Tra<strong>in</strong>er document<br />

NORMAL CHANGES DURING THE POSTPARUM PERIOD<br />

Physical Changes<br />

A woman's body will never be exactly as it was before pregnancy. Some changes <strong>in</strong> the<br />

reproductive system are ever last<strong>in</strong>g changes. Body shape and weight come back to<br />

normal sooner if she breastfeeds her baby for a longer period <strong>of</strong> time.<br />

Body weight starts to be lost immediately after delivery; a woman loses about 5-7 kilos<br />

dur<strong>in</strong>g delivery and cont<strong>in</strong>ues to lose weight <strong>in</strong> the follow<strong>in</strong>g months, especially if she is<br />

breastfeed<strong>in</strong>g her baby.<br />

<strong>Reproductive</strong> organs:<br />

• Uterus shr<strong>in</strong>ks and sheds its l<strong>in</strong><strong>in</strong>gs<br />

Immediately after delivery, the uterus is still quite large and can be felt <strong>in</strong> the lower<br />

abdomen as a hard and round mass. It soon beg<strong>in</strong>s to get smaller <strong>in</strong> size due to<br />

contractions. These may be pa<strong>in</strong>ful (like periods) for the first couple <strong>of</strong> days.<br />

Breastfeed<strong>in</strong>g helps the uterus to contract properly: it reduces the amount <strong>of</strong> fluid that<br />

comes out after delivery and it helps the uterus to recover its shape and size.<br />

• Vag<strong>in</strong>al secretion decreases and changes.<br />

Fluids com<strong>in</strong>g out <strong>of</strong> the uterus and pass<strong>in</strong>g through vag<strong>in</strong>a are called lochia. This is<br />

bright red immediately after delivery because it conta<strong>in</strong>s mostly blood for the first few<br />

days. Gradually its color changes to dark brown and then to pale cream. The amount <strong>of</strong><br />

discharge becomes smaller over time and then completely stops, usually by the end <strong>of</strong> the<br />

fourth week.<br />

• Changes <strong>in</strong> the breast<br />

After childbirth, the breasts start produc<strong>in</strong>g milk. The milk secretion is established<br />

properly with<strong>in</strong> a couple <strong>of</strong> days, especially if the baby is put to the breast with<strong>in</strong> an hour<br />

<strong>of</strong> delivery and suckles regularly. The first milk, called colostrum, is thick and yellowish<br />

and is very good for the baby. Soon it becomes th<strong>in</strong> and white.<br />

• Return <strong>of</strong> menstruation<br />

The time it takes for menstrual periods to return follow<strong>in</strong>g childbirth may vary from one<br />

pregnancy and delivery to another. If a woman breastfeeds exclusively, without giv<strong>in</strong>g<br />

her baby any other milk, her periods may not return for six or more months after delivery.<br />

If she is not breastfeed<strong>in</strong>g, menstruation usually beg<strong>in</strong>s 4-6 weeks after delivery.<br />

Abdomen returns gradually to its normal size.<br />

Other changes that occurred dur<strong>in</strong>g pregnancy (respiratory, blood, renal systems)<br />

disappear several days after childbirth.<br />

The sk<strong>in</strong> darkness (on face, breast, abdomen) lasts for a few weeks or months.<br />

Emotional Changes<br />

As childbirth is a deeply emotional experience, it <strong>of</strong>ten affects the mood and behavior <strong>of</strong><br />

the woman. She may feel happy and relaxed one m<strong>in</strong>ute and anxious, depressed, or<br />

tearful the next. She needs support, understand<strong>in</strong>g and reassurance from her husband,<br />

other family members and friends.<br />

126<br />

RFHI/JSI <strong>Roma</strong>nia <strong>Tra<strong>in</strong><strong>in</strong>g</strong> <strong>of</strong> RHMs <strong>in</strong> <strong>Reproductive</strong> <strong>Health</strong> Session 7: Postpartum Care

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