Postpartum Care and Newborn Adaptation
Core concepts
The postpartum period spans six weeks. Monitor uterine involution (fundus descends about 1 cm per day, palpable abdominally for ~10–14 days), lochia (rubra, serosa, alba), perineal healing, bladder function, and vital signs. Know normal blood loss (under 500 mL vaginal, under 1000 mL cesarean) and the signs of hemorrhage: boggy uterus, heavy bleeding, tachycardia, pallor.
Newborn adaptation
Understand the transition from fetal to neonatal circulation, the Apgar score (assigned at 1 and 5 minutes: appearance, pulse, grimace, activity, respiration), and initial newborn care: drying, warmth, skin-to-skin contact, delayed cord clamping, early breastfeeding within the first hour, eye prophylaxis per national policy, vitamin K administration, and weighing.
Breastfeeding and maternal wellbeing
Support correct latch and positioning, demand feeding, and recognition of engorgement, mastitis, and nipple trauma. Screen for postpartum depression and ask about mood, sleep, and support. Discuss immunization schedules and newborn danger signs (poor feeding, lethargy, jaundice, fever, fast breathing).
Traps
A uterus that remains high and soft suggests bladder distension or hemorrhage. Jaundice appearing within 24 hours of birth is always pathologic. Apgar scores do not determine resuscitation - resuscitate based on clinical status.
Rule of thumb
If the fundus is above the umbilicus or deviated, empty the bladder first, then massage and reassess bleeding.