Why is the puerperium important?

• During pregnancy and labour, there is a schedule of systematic assessment to enable early detection of complications. The same applies to the period following birth, the puerperium
• However, there is a tendency for clinicians to be less vigilant following birth, even in women who had antenatal or intra-partum complications
• Consequently, exacerbations of antenatal or intra-partum complications may be detected late with consequences for maternal mortality and morbidity
• In addition, new and potentially serious complications may develop long after birth. Failure to identify and treat these complications impacts significantly on the health of new mothers, their babies and their families

Learning objectives

At the end of this module, you should

• Know the physiological changes associated with the normal puerperium
• Know the risk factors for primary and secondary post-partum haemorrhage
• Know the management of post-partum haemorrhage
• Know the causes and management of puerperal pyrexia
• Know about care of the perineum
• Know the benefits of breastfeeding and potential maternal problems
• Know the psychological and psychiatric problems associated with the puerperium