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20.1 Physiologic Changes During the Postpartum Period

The postpartum period is a time of many changes. The nurse assesses for normal and abnormal changes during the postpartum period. During the immediate postpartum period, the nurse performs routine postpartum assessments using the BUBBLEHE acronym. Breast-feeding is initiated, and bonding is encouraged through skin-to-skin contact. During the 6 weeks postpartum, persons bond with their infant, take on their new role as the caregiver, and experience changes that restore their body to the prepregnant state. Postpartum healing and transitioning to being the primary caregiver of a newborn are influenced by resolution of physiologic changes, support systems, and culture and traditions. During this period, postpartum depression may occur. The nurse assists the postpartum person in promoting healing and making these transitions.

20.2 Psychosocial Adaptation to Parenthood

Psychologic adjustments occur in both parents during the postpartum period. The postpartum person goes through phases of focusing on themselves to focusing on their newborn. Siblings also make adjustments to the new person in their family. Parental adjustment and attachment can be positively or negatively affected by newborn health, maternal mental health, and family support. Psychosocial concerns such as substance use, poverty, and discrimination can lead to maladaptation to the parenting role. The nurse can use assessments to determine risk factors of maladaptation and maladjustment. The nurse can also assist the parents in finding resources to aid in their situations and plan for alternative support.

20.3 Nursing Care During the Postpartum Period

Nursing care during the postpartum period includes caring for the postpartum person and educating the person, partner, and family. The nurse assesses the person’s physical, mental, and emotional health. Interventions and education differ depending on route of birth, infant feeding choice, and complications of birth. Interventions and education are provided to ensure the postpartum person’s comfort. The nurse provides individualized care with special care for populations at higher risk for complications. Consulting with social services can provide needed resources for the postpartum person. The nurse ensures the person feels confident to care for themselves and their newborn prior to discharge. Discharge instructions include breast care, peri-care, medications, warning signs, newborn care, activity restrictions, and sexual health. The nurse encourages the person to contact their health-care provider with any concerns.

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