CHAPTER 34

POSTNATAL COUNSELING AND PSYCHOLOGICAL SUPPORT

POSTNATAL COUNSELLING

Postnatal care includes assessment and counseling provided to the mother before discharge after giving birth in a health facility, as well as later contacts during home visits by community health workers or postnatal visits to a health facility.

Breast milk expression: (by pressing thumb and other fingers in towards the body.)

PSYCHOLOGICAL SUPPORT

Behavioural adjustment of Puerperium

NORMAL POSTNATAL BABY BLUES AND RECOGNITION OF POSTNATAL DEPRESSION

Postnatal Blues

Postnatal blues are one of the commonest psychological complication faced by a postnatal mother of all ethnicity and races.

Recognition of Postnatal Depression

Postnatal depression is an intense and continuous sadness with mood swings. It is more severe and persistent than baby blues.

Definition

It refers to the period starting from the decision to conceive up to the first few months after having a baby in which parental roles are developed and adjustment to parenthood occurs.

TRANSITION TO PARENTHOOD

Assessment of Attachment Behavior

• When the newborn is brought to the parents, do the parents reach out for the newborn?
• Parents talking about the child, e.g., with whom the newborn resembles, etc?
• When the parents are holding the newborn, do they are comfortable in changing the position of the infant, any body part they are touching or examining carefully?

• When the infant is awake, what kind of interaction parents are having with the child like talking to the newborn, not maintaining eye contact, or avoiding the child.
• Are parents comfortable in caring for the child? Do they share any concerns about childcare?
• What kind of affection parents are showing to the child like smiling, kissing or rocking?
• What kind of comforting techniques parents are using?

CARE FOR WOMAN UP TO 6 WEEKS AFTER CHILDBIRTH

1. Care of the Mother at 7th Postnatal Day

• Diet and Rest

• Contraception

2. Care at 6th Week of Delivery

CULTURAL COMPETENCE �(TABOOS RELATED TO POSTNATAL DIET AND PRACTICES)

RDA for lactating mother (0-6 months)

POSTPARTUM FAMILY PLANNING

The postnatal woman should be educated on both birth spacing or limiting, as required. Educate her and her husband that if after childbirth she is not exclusively breastfeeding and has unprotected sex, she can become pregnant as early as six weeks after childbirth.

Methods of contraception (Postpartum)

FOLLOW-UP OF POSTNATAL MOTHERS

Records and Reports in Postnatal Period

Records are the permanently written documents that contain important information related to clients’ health status. Records are an integral part of care in the postnatal period.

Mothers Record

Newborn record