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10.10: Postpartum Care

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    After the baby is born, the umbilical cord is clamped and cut and the baby is assessed by a doctor, nurse practitioner, nurse midwife or nurse. The baby is given an APGAR score (defined below) at one and five minutes after birth. The Apgar score measures five things to check a baby's health. Each is scored on a scale of 0 to 2, with 2 being the best score. Watch one being done here: APGAR Testing.

    Example of APGAR Score Chart:

    SCORE 0 points 1 Point 2 points
    Appearance (Skin color) Cyanotic/Pale all over Peripheral cyanosis only Pink
    Pulse (Heart rate) 0 <100 100-140
    Grimace (Reflex irritability) No response to stimulation Grimace or weak cry when stimulated Cry when stimulated
    Activity (Tone) Floppy Some flexion Well flexed and resisiting extension
    Respiration Apneic Slow, irregular breathing Strong cry

    For the mother, if vaginal or perineum tearing occurs, or an episiotomy occurs the wound is closed with absorbable sutures. The mother is closely watched for blood loss, infection, or any other possible complications. Breastfeeding should be initiated as soon as possible after delivery, as the stimulation of oxytocin in the mother aids in hemostasis.

    Sidebar 10.3: I can feel that!

    I gave birth in 2002. The process itself did not go as planned. I had a vision of what I perceived as the right way to give birth (silly me!). No drugs or intervention, a natural childbirth. I woke up the morning after my due date and made coffee (admittedly not that natural). I waddled to the sofa and sat my giant behind down. All of a sudden, I felt this wetness between my legs. I got up and noticed a pool of yellow water on the (white) sofa. I screamed for my sister in the other room and she told me to call the hospital. They said the baby had pooped inside me, and I needed to come to the hospital as my labor was beginning. I asked if I could finish my coffee first. Once there I was told it was dangerous to let the labor produce naturally because the poop could hurt the baby.  They informed me they would need to induce me. They told me that it would be extra painful and so I needed an epidural. At the moment all I wanted was a healthy baby so I said ok. After the epidural, I couldn’t pee or feel anything below my waist. Labor progressed, and within about 10 hours I was able to start pushing. That lasted about 45 minutes until my daughter popped out. The OBGYN was minimally involved, and left and came back during the whole process. I was high on adrenaline at that point and was just so happy to have my baby. Then came time to stitch me up. The OBGYN was visibly impatient trying to force the placenta out. When they started stitching me up,  I screamed, “I can feel that”,  but the OBGYN seemed unphased. While my family and hospital staff looked on, the doctor ignored me and kept stitching until they were done and then left abruptly.

    This page titled 10.10: Postpartum Care is shared under a CC BY 4.0 license and was authored, remixed, and/or curated by Susan Rahman with Nathan Bowman, Dahmitra Jackson, Anna Lushtak, Remi Newman, & Prateek Sunder.