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Postpartum Nursing Care Plan for Mothers

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The first hours after birth are a delicate time for the newborn and mothers. Even more so for first time moms. As such, nurses who assist on this very special moment usually follow a protocol known as the postpartum nursing care plan, postpartum nursing diagnosis or also labor care plan.

Our focus will be on this period, commonly referred to as the third and fourth stages of labor. It is focused on providing immediate care for the newborn in the adjustment to extrauterine life, assisting with the delivery of the placenta, monitoring and assisting the mother with the physiological adjustments of labor and birth, and facilitating the attachment between the mother and baby.

Characteristics of the Third Stage of Labor

The third stage of labor begins with the birth of the infant and ends with the delivery of the placenta. Usually takes 5–10 minutes, and may take up to 30 minutes. These are the main characteristics:

  • Uterus becomes globelike.
  • Uterus rises upward.
  • Umbilical cord descends further.
  • Gush of blood as placenta detaches.
  • Some discomfort or cramping as the placenta is expelled.

Nursing Care of the Mother During the Third Stage of Labor

After the birth of the infant, the nurse checks if the placenta has separated from the wall of the uterus. She may after examination ask the woman to push again, to facilitate in the delivery of the placenta.

Characteristics of the Fourth Stage of Labor

These are the main characteristics of the fourth stage of labor:

  • It is a time of physiological adaptation that begins following delivery of the placenta that lasts 1 to 2 hours.
  • The uterus should be firmly contracted.
  • Lochia rubra, bright red blood flow with occasional small clots.
  • Vital signs return to prelabor values.
  • It is common to experience perineal discomfort usually related to trauma from the episiotomy or tearing, or hemorrhoids.

Nursing Care of the Mother During the Fourth Stage of Labor

While the physician examines the mother’s perineum, cervix, and vagina for evidence of tears, the nurse assesses the uterus for firmness, height, and position. To perform fundal palpation, the left hand is placed directly above the symphysis pubis and gentle downward pressure is exerted. The right hand is cupped around the uterine fundus. On palpation, the uterus is expected to feel firm and be positioned in the midline, at or just below the umbilicus.

8 Steps Concise Postpartum Nursing Care Plan

  1. Goal

    To assist new mothers and their partners during their initial transition to parenting

  2. Breasts and Legs Care

    Assess every four hours in the first twenty-four hours
    Then assess every 8 hours thereafter until discharge

  3. Perineal Care

    Pouring a stream of water over the vulva and perineum after voiding or defecation
    Wiping from front to back after voiding or defecation
    Heat therapy

  4. Preventing Excessive Bleeding

  5. Prevent Bladder Distention

  6. Avoid Infection

  7. Providing Pain Relief

    Support the patient with nonpharmacologic and pharmacologic relief of discomfort associated with the episiotomy, lacerations, or breastfeeding

  8. Lactation Measures

    Instituting measures to promote or suppress lactation.

  9. Constipation

These are the most important nursing care plan aspects healthcare professionals observe in the postpartum period. Mothers can rely on nurse’s well-developed assessment skills to recognize the normal progression of labor, to identify potential risks to the patient and fetus, and to identify how and when to intervene and consult with doctors and other health care providers.

3 Sources

Pain Relief Help uses the most up-to-date and reliable sources for our articles, but its content should be used as informational only. All the information provided doesn’t replace a medical consultation, which is always your best choice of action.

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Diego Molina

I’m a Clinical Psychologist with a long personal history of dealing with pain: knee tendinitis, TMJ syndrome, and most recently some shoulder pain that I haven’t had the chance to name yet! A long time yoga student, recently I have been researching the mechanisms of pain relief and habits to a healthier and pain-free life.

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