Puerperium

Dr. rer. nat. Daniela Oesterle is a molecular biologist, human geneticist and trained medical editor. As a freelance journalist, she writes texts on health topics for experts and laypeople and edits specialist scientific articles by doctors in German and English. She is responsible for the publication of certified advanced training courses for medical professionals for a renowned publishing house.

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The puerperium is a precious time in which mother and baby can get to know each other. The maternal body can also regenerate itself after the hardships of childbirth. Weekly flow and postpartum labor are typical signs of this. However, about every seventh woman who has recently given birth experiences a low mood in the actually happy time. Read more about the puerperal blues and why the puerperium is important.

What does puerperium mean?

The puerperium begins after the child is born and ends six to eight weeks later. It is a very valuable time to build a good mother-child relationship and to give the infant confidence and security. Even if they are now physically separated, mother and child still form a unit. And that is important for the newborn. Because man is born as a nestling and needs the protection of the mother.

In the puerperium, the woman and child can build an intensive relationship that works even without language. Thanks to her intuition and increased sensitivity, the mother usually succeeds in recognizing the needs of her child. Close physical contact, for example when breastfeeding, promotes trust and gives the child a feeling of security.

Care of the woman who has recently given birth

After a hospital birth, the mother and baby are placed on the maternity ward. There the woman who has recently given birth can take it easy and, thanks to helpful advice from the sisters, prepare for the time at home. In the case of outpatient births, the mothers often go home after about four hours. Then - and also after home births - the young mother should get support. Because recovery in the first few days after the birth is very important.

The body needs rest

In the puerperium, physical changes in the mother that arose from pregnancy and childbirth regress. Among other things, the uterus, pelvic floor, abdominal wall, urinary bladder and intestine regenerate:

• Uterus: The regression from around 1000 grams to 500 grams occurs within a week. After approximately six weeks, the uterus finally weighs 60 to 100 grams.
• Cervix: About one to two weeks after the birth, the inner cervix is ​​closed again.
• Vagina: After almost six weeks, water retention and blood vessels in the vagina decrease. The labia recede a little.
• The increased blood volume is normalized again through the loss of blood at birth (about 500 milliliters) and then continuously in the following four weeks.
• Dilated urinary tract recedes in the puerperium. Urination can be difficult due to edema in the ureter area. In this case, speak to your doctor.
• Abdominal wall, pelvic floor: The muscles that have become slack during pregnancy should be strengthened through gymnastics during the puerperium.
• Intestinal tract: An intestinal sluggishness during pregnancy quickly normalizes in the puerperium.
• Endocrine system: after the birth, the hormonal balance changes. Milk production starts and the woman becomes fertile again. Hot flashes are possible due to hormones.
• "Postpartum blues": Fears, depressive moods, despair and feelings of failure often occur in the postpartum period, but usually subside after a few days.

Occasionally, however, the woman who has recently given birth suffers from severe depression (postpartum depression) with listlessness, brooding and even suicidal thoughts, sleep disorders or obsessive-compulsive thoughts. In this case, don't be afraid to talk to your doctor about your problems. He will be able to help you.

Weekly flow - how long?

During the puerperium, the puerperium contractions start. They decrease the blood supply to the uterine muscles and help stop bleeding from the uterine wound. They also produce wound secretions, the so-called lochia (weekly flow). After about six weeks the wound will heal and there will be no more weekly flow. The weekly flow after caesarean section is less in terms of quantity, but it takes a little longer.

During the puerperium phase, the weekly flow changes:

• 1st week: purely bloody weekly flow (Lochia rubra)
• 2nd week: brownish weekly flow (Lochia fusca)
• 3rd week: yellowish weekly flow (Lochia flava)
• 4th week: white weekly river (Lochia alba)

Occasionally, blood clots or remains of the skin can lead to a jam. Then the weekly flow does not flow away, forehead headaches and suddenly occurring high fever can occur. Then see a doctor - he will help you quickly.

Hygiene and gymnastics

You can shorten the time it takes for your body to recuperate and regress. Physiotherapy exercises already in the maternity hospital strengthen the entire musculature, correct the posture and promote the regeneration of the uterus, intestinal activity and the muscles of the urinary bladder. In addition, dangerous thromboses are avoided by postpartum exercise.

Hygiene is very important for a woman who has recently given birth. Even if the weekly flow is not highly infectious, it still contains bacteria and germs. Therefore, wash your hands particularly thoroughly if they have come into contact with weekly flow, especially before breastfeeding.

Even if you should wait for full baths until the lochia has dried up, there are exceptions: after a perineal cut, Sitz baths with chamomile extract at a temperature of 37 degrees Celsius help. Do not bathe for more than five to ten minutes, however. Chamomile or witch hazel ointments can also be used externally to heal wounds.

Rest for the mother in childbed

The woman who has recently given birth needs a lot of rest in the puerperium. Therefore, as a new mother, try to win over your life partner, family, friends and acquaintances. They can help you with shopping, cooking and washing as well as with organizational duties. But rest and a break for you and your child are also precious. Too many visitors and the hustle and bustle costs you and your child energy. Strike a balance between visiting and family support.

Puerperium: time for the young family

The puerperium is an important phase for both mother and child. A vacation or a break during this phase can also bring a lot of positive things to your life partner. It helps him come to terms with the exciting days surrounding the birth and the birth itself. Close contact with the baby also creates trust and security between father and child. The puerperium is the best way to build a loving family relationship. Use the time when everyday life allows.

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