Post partum period is generally agreed as the period starting immediately after a mother has given birth to a baby. It is not clearly agreed on the length of this period. Many attempts have been made to divide this period into distinct sections. Many authors have come up with many phases in making a trial to demarcate the period (Rosdahi & Kowalski, 2007, 901; Blackburn, 2007, 320). Most of the authors have divided the period into three or four phases. As a response to this confusion Pairman, Pincombe and Thorogood (2006, p. 458) have compiled information from regional workshops which were held in New Zealand. These workshops identified four phases of postpartum period described as below. The phases are said to have different characteristics which make it possible for them to be distinguished from each other.
The authors argue that in the first and second phase physical recovery is the main concern for most women. This is equally accompanied by the concern for caring and being able to breast feed their babies. The authors advocate for women to be supported emotionally at this period of time. Such support may include simple acts like holding of their hands. They argue that the midwives should be attentive and, “aware of the normal physiology and being able to give practical help and advice” (Pairman, Pincombe and Thorogood, 2006, p. 458). This will be quite helpful especially for the case of Anna considering the fact that she has undergone episiotomy. The authors further argue that, “women need to be reassured regarding their physiological wellbeing” this is a fact which is very applicable for this case study. Anna will definitely need a lot of reassuring from a midwife concerning her well being factoring in her delivery procedure.
Pairman, Pincombe and Thorogood (2006, 458) associate these phases with high level of physical pain which is likely to cause emotional distress. They further implicate this distress with inability to cope with physical and emotional changes. Therefore, in this case study the husband (Ian) will have to be constantly attentive to his wife and provide the emotional support whenever it is possibly required. This in the actual sense will help Anna to feel more reassured and will help in the process of healing.
Pairman, Pincombe and Thorogood (2006, 458) advocates for women to engage more in breast feeding as this has the effect of boosting the levels of prolactin and oxytocin. Buckley (Pairman, Pincombe & Thorogood 2006, p. 458) on writing on the benefit of oxytocin on women claims, “oxytocin acts to keep the mother relaxed and calm, and there is an indication that it is involved in tolerance and adaptation, and feminine response such as tending and befriending” (p. 458). Therefore, it will equally be important for Anna to breast feed more often at this period as it will help her to balance her emotions.
Production of prolactin will be beneficial to Anna. The authors quote Riordan & Auerbach (1993) implicating milk production with the presence of prolactin. Insights by Buckley (2004) show that, “it reduces stress response, alters sleep patterns and stimulates natural hormonal analgesia” (Pairman, Pincombe & Thorogood, 2006, 458). This will be quite good as it will help Anna to heal quite quickly wihtb less pain-analgesia factor.
This the period characterized with the healing of a woman and the making of the progress in breastfeeding and gaining confidence in her efforts to care for herself and the baby. At this point the women will begin to take note of the changes that have occurred and their significance (Pillitteri, 2007, p. 200). In this case study the midwife and Ian will need to talk more to Anna as this, according to Pairman, Pincombe and Thorogood (2006, 458), will help her to make a difference on how she feels about herself and the baby. This period should be used by the midwife to enhance her self knowledge and learning.
This phase occurs in the sixth week of the post natal care. It involves the woman and her family accepting the transition to parenthood. The family at this phase accepts the changes in the family dynamics and takes the responsibility in taking care of the baby (Pairman, Pincombe and Thorogood, 2006, 458; Wickham, 2004, p. 154). At his phase the midwife is no longer required.
The Post partum period is mostly associated with transition challenges (Wickham, 2004, p. 154). In this case study it is even more challenging due to the fact that Anna has undergone episiotomy. The next section discusses the aims of prenatal care in the light of this case study.