Post natal care is meant to accomplish a number of goals. Pairman, Pincombe and Thorogood (2006, 456) have identified the following as some of the objectives which ought to be accomplished by the care:
- Promotional of physical recovery from pregnancy, labour and birth effects
- Establishment of good infant-child feeding habits and consequently foster good maternal –child relationship
- The boost the mother’s confidence and ability to care for her baby in her own surrounding
Based on the above objectives the authors have identified the following as the desired outcomes of the care:
- The mother is comfortable, physiological stable and free of pain
- The mother is in control of the pace of the occurrence of events
- The mother is informed on the knowledge on her culture which relates to her situation (Pairman, Pincombe and Thorogood, 2006, 456)
Perineal care is part of the post natal care. In our case study it should be noted that Anna had under gone episiotomy and as such she will be in need of some special care. Though this procedure may decrease the amount of maternal pushing and thus reduces the stresses on the vaginal tissues it should be noted that episiotomy is prone to risky occurrences, “high incidence of extension or tears into the muscle of the rectum or even the rectum itself which is more difficult to repair and more painful for the mother” (APA, 2009. par. 1). Typically, episiotomy heals after 4 to six weeks. Back in the case study being dealt here then it means that Anna will take the whole post partum period to heal. Arguing from above section on ‘post partum period’ Anna should be encouraged to do breast feeding more often to induce prolactin which has been found to produce analgesia. This will help in the healing period as it will reduce the pain of the wound and possible from other sources such as hematomas.
Episiotomies form scars when they heal. Anna in this case study should be carefully to avoid opening the wound while it is healing. It will be vital that the perineum is kept clean. This will help Anna, in this case study; to heal quickly as the wound will not be contaminated. In ensuring the wound in not infected Anna should change pads frequently (Lochia factor) (APA, 2009. par. 1). Tampons should be avoided as they are likely to cause infection.
According to American Pregnancy Association (APA) (2009, par. 2), further precautions during the post partum period include: taking a bath once or twice a day with a sitz bath being used after a bowel movement. Cold sitz baths are appropriate as they help in reducing swelling and discomforts. A woman should soak for 20 minutes at a time for three to four days after which warm sitz should be introduced to improve the blood flow to the perineum. It is advised that one should stay well hydrated. This is because straining with bowel movement is likely to stretch the episiotomy scar causing pain. The perineum is also likely to pain due t o that. Constipation should be avoided for the same above reasons. APA (2009, par. 3) further advices on to use an inflatable cushion, “when sitting or lying down may help reduce pull on the episiotomy scar” (Par. 3).
Further measures which ought to be taken by women in similar situations as Anna include Kegel exercisers. In general Anna ought to be aware of the following potential side effects as given by APA (2009, par. 1), “infection, bruising, swelling, bleeding, extended healing time, abstinence from sex due to the painful scar, and likely future problems with incontinence” (par. 1). Being aware this places her at a better position to effectively take the necessary precautions as she endeavors to take care of herself.
Caring for pregnancy is a long process which starts when a women becomes pregnant. There is need to properly observe antenatal care so as to avoid developing complication as the pregnancy develops. Pregnant women should watch out for due trouble signs and take the necessary precautions. A pregnant women should watch for her body at all times including after giving birth. In case of complications such as the cases of episiotomy then a woman should even be caution to ensure that she does not hurt her wound and that it heals quickly. Husbands likewise midwives have got duties of encouraging and ensuring women through the post partum period especially for the cases of episiotomy.ing to stop urinating.