Care after Spontaneous Vaginal Delivery
After uncomplicated vaginal delivery in a health facility, the mother and the baby should receive proper care to avoid possible post-delivery complications that might develop, such as excessive bleeding, perinatal tears, and birth asphyxia for the baby. Assessment of postpartum mothers should be done for possible conditions such as uterine contractions, the fundal height, heart rate, and blood pressure to ascertain that there is no possibility of any complications that may cause danger to the maternal and newborn health. Confirmation that the mother takes a lot of fluids is critical to ensure the baby gets sufficient breast milk.
In the postpartum management, the mother should be provided with necessary education the signs and symptoms of potential life threatening conditions after delivery. Both the mother and the baby are at risk of complications during the postpartum period and should all be cared for in equal measure. The baby should be cared for to avoid the risk of complications such as infection development or risk for asphyxia. The nurse should ensure the baby is breastfed appropriately after birth for the baby’s protection against infections. To avoid any chance of asphyxia development, the nurse should teach the mother the most appropriate positions to let the baby lie. The baby should be placed in a position where breathing is not compromised since the breathing system is still not properly developed at birth. The nurse care provider should inform the mother on signs such as persistent blood from the vaginal parts. Excess blood loss after delivery is a sign of the potential development of postpartum hemorrhage. The mother should be informed o report to the healthcare provider when she has a feeling of faintness or tachycardia a few hours after the conduction of the delivery. After delivery, the nurse providing care should assess such conditions to make the necessary interventions in case such signs show up after the delivery has been conducted. The bleeding might be from the internal ear that might be unnoticed during the delivery process. Before handing over to the next nurse on the care, the records of blood pressure and the amount of blood loss should be correctly documented and handed over such that the next care provider is certain of the mother and the baby safety. Assessment of the mother should also be done to rule out possible infections, preeclampsia, and thromboembolism. Within the first two hours after delivery, signs such as abdominal pain, fever, and shivering are signs of a possible infection. The assessment should be done to rule out postpartum sepsis that usually6 occurs especially after an offensive blood loss. Signs such as chest pain and shortness of breath create an alarm of possible thromboembolism development. Possible thromboembolism development may also manifest in unilateral calf pain, swelling, or redness within the affected areas. As nurses taking over from the previous care, confirmation of the records to ensure the maternal and the baby’s health is within the normal is critical.
Management of a Rhesus negative mother with a Rhesus positive baby
In the situation, Susan is rhesus negative, and the baby is rhesus positive; therefore, the initiation of Rhogham to protect both the baby and the baby is critical. Rhogham is an immune globulin used to prevent sensitization in a situation where the mother is rhesus negative, and the baby is rhesus positive. The Rhogham dosage is only prescribed for the mother and not the infant—a dose of 250 international units per kilogram of the individual administered intravenously for three to five minutes. The initial dose is given twice a day on each dose or administered separately depending on the mothers underlying conditions. A maintenance dose of 125 international units per kilogram of the individual is again administered intravenously for three to five minutes. The drug s associated with severe complications such as disseminated intravascular dissemination, renal failure, and severe anemia. The drug also a possible risk of developing intravascular hemolysis. The condition resulting from Rhogam complications is a major cause of death in most patients with immune thrombocytopenic purpura. The patient should be closely monitored before administration of the drug to prevent the occurrence of such complications.
References
Henderson, J., Alderdice, F., & Redshaw, M. (2019). Factors associated with maternal postpartum fatigue: an observationalstudy. BMJ open, 9(7), e025927.
Feldman-Winter, L., Goldsmith, J. P., & Task Force on Sudden Infant Death Syndrome. (2016). Safe sleep and skin-to-skin care in the neonatal period for healthy term newborns. Pediatrics, 138(3).
Durmaz, A., & Komurcu, N. (2018). Relationship between maternal characteristics and postpartum hemorrhage: a meta-analysis study.
Almalik, M. M. (2017). Understanding maternal postpartum needs: a descriptive survey of current maternal health services. Journal of clinical nursing, 26(23-24), 4654-4663.