What to expect after you deliver your baby

Once the baby is born, your health care provider will perform certain assessments on both you and the baby. The postpartum assessment is a specific check-up that is done by the nurse, midwife, doctor or other healthcare provider. Immediately after the birth the woman should expect the healthcare provider to perform blood pressures and obtain heart rates and an assessment. This assessment is often done several times in the first few days after a woman has delivered. The basic details of the assessment are below, however, your healthcare provider may adapt these steps to meet your specific healthcare needs.

blue and silver stetoscope

Breasts:

  • Your healthcare provider will inspect your breast to assess for any issues or potential complications. They will often palpate palpate to assess for fullness, softness or engorgement, firmness and for any lumps.

Uterus (Fundus):

  • Another assessment your healthcare provider will do is to palpate your uterus. Your healthcare provider is checking for firmness or bogginess. If your fundus is boggy and soft your healthcare provider will rub and massage the fundus until it is firm. Your healthcare provider will also assess the location of the fundus in relation to the abdomen, and will monitor the location of the fundus in relation to the belly button to determine the amount of fundal height and involution.
  • If you have had a c-section your healthcare provider will inspect the incision site and monitor for infection and assess the progress of healing.

Bladder:

  • Part of the bladder assessment is checking to ensure that an appropriate amount of urine is being voided.
  • Sometimes there can be urinary issues with incontinence, urinary retention and urinary infection, especially if you had a Foley catheter or lacerations in the vagina and perineum.

Bowels:

  • Your healthcare provider may also check when you last moved your bowels or ask if you passed flatus or gas. During laboring and postpartum sometimes you may receive medications that slow down your bowels.
  • Your healthcare provider may assess for distention, abdominal pain and listen to your belly with a stethoscope.

Lochia:

  • Lochia refers to the vaginal bleeding after the birth and delivery of the placenta. This is checked for several days. Your healthcare provider is checking the amount, the color and if there is any foul odor. Too much bleeding can be serious and can lead to a hemorrhage. Foul smell is sometimes a sign of infection, which can be serious in the postpartum period.

Episiotomy:

  • This part of the assessment refers to the level of laceration at the perineum, both episiotomy and tears sustained.
  • Number of stitches, redness, edema, bruising, discharge, approximation of wound edges are all assessed.
  • Your healthcare provider will also check the perineum area to ensure proper healing and assess for any complications.

Homan’s Sign-for DVT:

  • Women who have just had a baby are at an increased risk for a blood clot, especially if she had a c-section. Your provider may or may not check the Homan’s Sign which is a test to assess for pain with dorsiflexion of your foot. This test is not always accurate, and may not always be done.

Emotional State:

  • Assessing for signs and symptoms of postpartum depression and infant-maternal bonding is also another key component of the postpartum assessment. It can be normal to have fluctuations in your emotions, especially in the first 2 weeks, this is often known as the postpartum blues.