THE HEALING PERIOD
Postpartum vaginal care is crucial in the first six weeks
By Deedee Santa Cruz-Espina
WOMEN DO IT SO WELL. THEY JUST BREEZE THROUGH A 12- TO 24-HOUR GRUELING LABOR. IT IS AMAZING HOW THEY SPRING BACK AFTER GIVING BIRTH. THEY WERE BUILT FOR THE JOB.
"Today I saw 15 women in the charity ward who were sprawled on the floor in one corner of this public hospital. There were no more beds. Those who gave birth earlier had the fortune of beds, but had to share," relates obstetrician-gynecologist Vaneza Valentina Penolio to illustrate a woman's amazing recovery after delivery. Their situation may have seemed pitiful, but they were stable and they were okay. "Sometimes you forget that they had just given birth. But they were there, lying on makeshift bed sheets, nursing their newborns."
The "healing" comes with the restoration of everything else, from the pregnant state to the nonpregnant state. "For the body to revert from the pregnant to the nonpregnant state takes about six weeks," adds Penolio, a consultant at the East Avenue Medical Center. "That's how quick a woman's body recovers from this 'life-on-the-edge' experience."
Called the puerperium period, this is the span of time within which women are to "heal" after childbirth. The skin, the uterus, the breast, the vulva, the episiotomy, and all the other body systems are supposed to go back to the "normal" state. However, this is the same span of time when a woman should take care of herself, lest the body faces risks of afterbirth complications.
"Hygiene is still most important," says Penolio. "When a woman delivers vaginally, it is important to keep her 'area' clean," because of the vaginal bleeding, more like how a woman keeps herself clean during menstruation."
This area-the vulva-is the one that really needs to be kept spotlessly sanitary and sterile. "The vulva is actually what you keep tidy," she says. Douching is not usually recommended, she adds, because in that case, one would be cleaning up the vagina. The vulva can be kept clean by washing it with mild soap and water. The trick is to wash the area from front to back and never from back to front, she firmly says. "Remember that the vulva is very close to the anus, that one wrong stroke of the hand when washing can bring contaminants up to that area."
The woman should also keep in mind that the bleeding, or the lochia, persists for six to eight weeks. At which time, Penolio advises, the woman should also observe the discharge. The lochia rubra, which persists for about 10 days, is the red discharge. The lochia alba which is the whitish discharge, comes after. This is when the woman, Penolio says, should observe good hygiene.
"Ecosystem"
Amazing though, she says, that only 0.05 percent get infection in this area. The infection usually occurs when its "ecosystem" is disturbed. "It's like it has its own ecosystem. There are microorganisms, not disease-causing though, that are naturally present there. If you tip the balance, as in any ecosystem, then you put the entire area in jeopardy," she explains. That's why consumers are easily convinced that feminine wash is better to use, which capitalizes on this pH thing. "Textbooks say a pH level of 4 is to be maintained to prevent infections in the vaginal area," she reveals. But still, washing with mild soap and water will suffice, she says.
Penolio explains that there are three most common infections that occur in this area. "All of them are itchy," she quips. Infection may be fungal or yeast, protozoan, or bacterial. Apart from the itchiness, the vaginal discharge sets the three kinds apart. While the normal white, curd-like, and odorless discharge in the dependent areas are signs that there is no infection, the "thin, grayish, and with odor" discharge are almost always signs of an infection. "Yeast or fungal infection is common among diabetics," she discloses. "However, among the three, bacterial vaginosis is the most common, perhaps occurring 50 percent in the cases," she adds.
And then there is episiotomy that requires pain management and prevention of infection. The good fortune of having absorbable sutures lessens the difficult process of dealing with the stitch. Pain resulting from the wound will be felt after delivery, on top of the other pains. Pain relievers are available and good hygiene still applies. "While still in the hospital though, an ice pack, or sitz bath, or perilight has pain-alleviating effects and done within the 24-hour period after delivery," Penolio says. After the patient is discharged, and goes back to the hospital for a follow-up check-up, the OB-gyne takes a peek at the wound and should tell if it is "ugly."
"The doctor should be able to say if there is in fact infection," she says. "If there is fever, swelling and redness in the area, and pain, then infection may have set in," Penolio says. The woman can actually feel the suture when she washes, and can tell if it is "ugly," she adds.
Then there is constipation to contend with. Normal bowel function is sometimes slowed down after giving birth because of hormones, medications, dehydration, episiotomy pain, and decreased activity. Women sometimes get the fear of moving their bowels thinking their sutures would give out. "There are stool softeners, medications that can ease constipation," Penolio advises. A good diet, she says, definitely helps. Generous water intake, eight to 10 glasses a day, and foods high in fiber content also help. It is not advised to use any suppositories or an enema, especially if the episiotomy went through the rectum, until the stitches have healed.
On top of all these, the new mother needs plenty of rest and TLC. When she is surrounded by tender, loving care, everything turns out right and easy, Penolio says. The responsibility of child care after giving birth can overwhelm a woman, but with the family around and a few trusted friends boosting her morale, she should be all right.
Times have changed, Penolio believes, as far as birthing is concerned. It used to be that womanhood was just about bearing children. Now times have expanded the definition of womanhood. She does multitasking, she is mother and career woman.
Penolio cites the woman's present societal status as a reason for her to recover quickly after delivery. "The woman wants to go back to her activities as quickly as possible. She has a routine to go back to, and if she does it sooner, the better for her. Gone are the days when women were 'bedridden' after childbirth, such a pathetic situation. Today, she is aided by a lot of things to make her recovery very fast."
|
