Abdominal Wall Relaxation

Exercise may be initiated any time after vaginal delivery and after abdominal discomfort has diminished after cesarean delivery.

There are no dietary restrictions/requirements for women who have delivered vaginally. Two hours postpartum, the mother should be permitted to eat and drink.

Continue iron supplementation for a minimum of 3 months postpartum. Immunizations

■ The nonisoimmunized D-negative woman whose baby is D-positive is given 300 ^g of anti-D immune globulin within 72 hours of delivery.

■ Woman not previously immunized against/immune to rubella should be vaccinated prior to discharge.

■ Unless contraindicated, woman may receive a diphtheria-tetanus toxoid booster prior to discharge.


The likelihood of significant hemorrhage is greatest immediately postpartum.

Inadequate postpartum uterine contraction is a major cause of postpartum bleeding.

1. Anticipated physiologic changes during the puerperium:

■ Lochia—the bloody discharge that follows delivery

■ Diuresis—the secretion and passage of large amounts of urine

■ Milk letdown—the influx of milk into the mammary ducts

2. She should go to hospital if she develops:

■ Excessive vaginal bleeding

■ Lower extremity pain and/or swelling

■ Shortness of breath

3. Family planning and contraception:

■ Do not wait until first menses to begin contraception; ovulation may come before first menses.

■ Contraception is essential after the first menses, unless a subsequent pregnancy is desired.

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