Monitoring After Delivery

Most women with a normal delivery stay in the hospital or a birthing center for 1 or 2 days. First-time mothers are recommended to stay 2 days rather than 1. Patients recovering from a caesarian section stay 3 to 4 days. More than 80% of patients in one study had at least one symptom of the following: headaches, urinary tract infections, problem with incontinence of feces or urine (from pelvic floor descend), painful perineum or breast feeding problems (Ref. 18, p. 694).

About 3% in that study needed to go back into the hospital because of abnormal bleeding, more serious infections or symptoms of blood clots. All of this can be managed clinically, but the physician and the patient have to be certain that any problems are communicated. If in doubt, go to the hospital to be checked out!

A missed blood clot could develop into a serious condition where the patient runs out of clotting factors or the clot gets dislodged and leads to severe breathing problems due to pulmonary emboli and possible shock as a result of this.

As Dr. Ignaz Semmelweiss described in 1861 in his book (Ref. 21), there is the constant danger of infections from non sterile techniques during child birth.

In addition, there is always a possibility of infections from intravaginal, cervical and perineal lacerations due to childbirth where the bacteria naturally present in the area can enter into the tissues or blood stream. Luckily we do have powerful antibiotics available in our time that help the physician to combat infections where needed.

Apart from the mother, the baby has to be monitored. Alarm signs to watch for are fever, lethargy in the child, change in feeding habits, vomiting, diarrea, newborn jaundice. Regular visits with the treating physician are important to weigh the baby, monotor for a normal growth rate and to give the child vaccinations on a regular basis.

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Disclaimer

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References

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4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 245.

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14. LM Apantaku Am Fam Physician Aug 2000; 62(3): 596-602.

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17. St. Paul's Hosp. Contin. Educ. Conf. Nov. 2001,Vancouver/BC

18. Gabbe: Obstetrics - Normal and Problem Pregnancies, 3rd ed., 1996 Churchill Livingstone, Inc.

19. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 251.

20. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 250.

21. Ignaz P Semmelweiss: "Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers" ("Etiology, the Understanding and Prophylaxis of Childbed Fever"). Vienna (Austria), 1861.

22. Rosen: Emergency Medicine: Concepts and Clinical Practice, 4th ed., 1998 Mosby-Year Book, Inc.

23. Mandell: Principles and Practice of Infectious Diseases, 5th ed., 2000 Churchill Livingstone, Inc.

24. Horner NK et al. J Am Diet Assoc Nov-2000; 100(11): 1368-1380.

Last Modified: March 27, 2005