Health after childbirth
After birth - to doctors
What is the need for medical examination or recovery after childbirth?
Hearing the voice of a beloved child, a young mother, forgetting about everything, rushes to the baby. So pass days after days. Many women are mistaken, thinking that having given birth to a child you can forget about your own health. After all, right now the young mother needs to carefully monitor her condition in order to feed and grow a healthy baby, and in the future - to rejoice in her offspring. With the birth of a child in the body of a woman there are various changes affecting all systems and organs. These changes require, deserve serious attention both of the woman herself and of the medical personnel. What kind of doctors need to visit a young mother and at what time is it better to do it?
Marina Pilnevskaya Obstetrician-gynecologist, g. Moscow
The sooner after you leave the maternity hospital you go to a women's consultation, the better and calmer it is for you. It is advisable to visit a gynecologist within a week after leaving the hospital. It is necessary to bring him an exchange card from the maternity home with information about the past births and be under his supervision for the timely detection of various gynecological diseases of the late postpartum period, such as endometritis (inflammation of the uterine mucosa), subinvolution of the uterus (insufficient uterine contraction after childbirth).
Breast after childbirth: a gynecologist will carefully examine the mammary glands, give advice on breastfeeding and eliminate the inconveniences associated with it (nipple cracks, breast compressions, flat nipple, etc.).
Mastitis is an infectious and inflammatory disease of the mammary glands - one of the cases when an appeal to a gynecologist is mandatory. Usually mastitis develops in the second or third week after childbirth.
It is also necessary to visit a gynecologist 6-8 weeks after birth: it is during this time that almost all the organs and systems of the young mother return to their prenatal state. During this visit, an examination is performed on the armchair, the restoration of the genital organs, the healing of the sutures are assessed; the doctor takes swabs from the vagina to eliminate inflammatory diseases of the genital tract. After 6-8 weeks after childbirth, it is possible to resume sexual activity. The doctor will advise you on the possibility of using contraceptives, because even if you feed the baby on demand and only breast milk, this does not preclude the onset of pregnancy, since ovulation (the ovum outlet) can begin even during breastfeeding, menstruation. After this visit, the doctor may recommend that you do an ultrasound. It will allow to judge the condition of internal genital organs, the course of diseases, if any (myoma of the uterus is a benign tumor of the uterus, endometriosis - proliferation of the inner membrane of the uterus in the uterine wall, pelvic organs, and other diseases). So, a visit to a gynecologist will help you to understand how the postpartum period has passed, whether you have had gynecological diseases or conditions requiring medical or surgical correction, as the "old" diseases have changed for pregnancy and childbirth. The doctor will help you choose contraceptives.
A visit to the therapist is necessary for all young mothers, without exception. Schedule it within the first month after childbirth. This doctor
will control your blood pressure, heart and lung function. Women in particular who before the birth or during pregnancy have been diagnosed with chronic diseases of the cardiovascular, digestive, genitourinary systems, as well as the circulatory system and the respiratory system. I must say that gestosis - the complication of pregnancy, manifested by increased blood pressure, the appearance of protein in the urine, edema - is an indirect indicator that a woman has a predisposition to hypertension. Therefore, in the presence of this complication during pregnancy after childbirth, it is necessary to strictly follow the blood pressure indicators and report the results to the therapist.
The abdomen after childbirth - during pregnancy the uterus exerts pressure on the digestive organs. As a result, there is a feeling of discomfort, heaviness, nausea, heartburn after eating. All these troubles must pass after childbirth. If they have not disappeared, then this is the reason for contacting the gastroenterologist. Constipation after childbirth is also a common problem that a therapist or gastroenterologist will be able to cope with.
Therapist обязательно назначит вам анализ крови и мочи. Анализ крови необходим для того, чтобы выявить, нет ли у молодой мамы анемии — снижения количества гемоглобина. Это состояние особенно часто встречается, если во время родов и в послеродовом периоде имели место кровотечения. Анализ крови поможет предположить наличие воспаления, если таковое имеется; доктор может почерпнуть из этого анализа и другую информацию. Анализ мочи позволит исключить воспаление и другие изменения в почках и мочевыводящей системе. При необходимости врач назначит соответствующее лечение.
Passing postnatal dispensary, you need to look to the surgeon. The fact is that many women during pregnancy and childbirth have symptoms of varicose veins of the lower extremities, as well as of the rectum (hemorrhoids after childbirth). These conditions can be successfully corrected after birth. Consultation of the surgeon is also necessary if you have been stitched or had a cesarean section in labor, as there is no possibility for the gynecologist to show up.
Be sure to consult a surgeon in case of development of thrombophlebitis of the veins of the lower extremities - inflammation of the vein wall with closure of the lumen of the vessel. The most frequent predisposing factors to the development of postpartum thrombophlebitis are complicated delivery, especially operative, massive blood loss, traumas of soft birth canals with hematoma formation, prolonged labor, pathology of the placenta. In some cases, thrombophlebitis can develop in healthy women, so the early detection, prevention and treatment of this disease is so important.
Mammography — врач, который занимается диагностикой, лечением и профилактикой различных заболеваний, опухолевидных образований (доброкачественных и злокачественных) в молочных железах. К маммологу можно обратиться также по вопросам грудного вскармливания. То есть все проблемы, возникающие в период лактации, среди которых застой молока, лактационные кризы, трещины сосков, может помочь решить и маммолог, хотя с этими проблемами чаще принято обращаться к гинекологу или консультанту по грудному вскармливанию (такой специалист может быть в женской консультации, в родильном доме или специальной коммерческой службе).
Be sure to visit a mammalologist at the end of breastfeeding. This is especially important for those women who had breast diseases even before pregnancy or had symptoms of stagnation of milk or mastitis, as well as for those who had to abruptly stop lactation. Do not postpone the visit to mammologu in the case when a few months after the end of breastfeeding, there are still discharges from the mammary glands. In the presence of secretions from the nipples, smears are taken for a cytological study - the study of cells to exclude oncological diseases. Colostrum - white, slightly unclear - the discharge is permissible within one year after the end of lactation. At other times, such secretions may be associated with an increased level of the prolactin hormone (this hormone stimulates lactation during breastfeeding, its amount should be shortened at the end), or be a manifestation of fibrocystic mastopathy (benign tumor-like formation of the mammary glands), which requires special treatment . Transparent discharge of amber color, as well as bloody discharge are possible with intracapsular papilloma - outgrowths in the ducts of the mammary glands - and with oncological diseases.
If pathological formations in the mammary gland are found to clarify their cellular structure - a cytological examination of the tissue under the microscope - puncture (from the Latin punctio - prick, puncture of pathological formation and taking a tissue sample from it) can be performed.
In general, preventive examinations at a mammologist should become the same regular for every woman, as well as examinations at a gynecologist. The main task of these examinations is the detection of early forms of oncological diseases. In the absence of complaints, a prophylactic examination - ultrasound examination of the mammary glands - is performed in women up to thirty-five years of age once a year. After thirty-five, ultrasound is replaced by mammography (X-ray examination of the mammary glands), but the frequency of examinations remains the same.
Many women get acquainted with this specialist for the first time during pregnancy, since the frequent cause of the threat of interruption of pregnancy in the early stages is the pathology of endocrine glands - thyroid gland, adrenal glands. During pregnancy, there is also a disease, like diabetes mellitus of pregnant women. If all these diseases and conditions are detected during the period of bearing the baby, it is necessary to visit the endocrinologist within the first three months after delivery. The doctor, if necessary, will prescribe a blood test for hormones, the study of endocrine glands with the help of ultrasound diagnostics. If necessary, drugs or surgical treatment will be prescribed. I must say that in the care of an endocrinologist there is also a disease, like obesity. In the period of breastfeeding, many young mothers gain weight or can not get rid of the weight gained during pregnancy. The most logical and competent approach in this case is the consultation of an endocrinologist, then a nutritionist. They will tell you how to cope with this female problem without harming one's health.
A visit to a neurologist is not mandatory for all women - this specialist should be contacted if there are complaints of headaches and dizziness. A neurologist with a surgeon examines the puerperas with various unpleasant sensations in the neck and back with the purpose of revealing the pathologies of the spine. Headache can be a complication of epidural anesthesia, performed during labor or cesarean section. In this case, the neurologist will appoint the appropriate treatment.
If before the birth the woman wore glasses or during her pregnancy vision deteriorated, it is necessary to show the ophthalmologist during the first month, because in childbirth the load on the eyes increases several times. The doctor will check the visual acuity, the fundus. If necessary, you will pick up new glasses, assign other methods of correction.
During pregnancy and breastfeeding, your baby needs a lot of calcium to build his bone system, develop and form teeth. Therefore, after giving birth, a woman should take a vitamin-mineral complex that will help cover the deficiency of calcium, phosphorus and other trace elements. There is an opinion that "with each child, a woman loses her tooth". To prevent this from happening, during pregnancy, you should monitor the condition of the oral cavity, and after childbirth for the first two months, it is necessary for the dentist to show up and continue preventive examinations every six months. In time cured teeth will be a pledge of health and a beautiful smile.
Psychotherapist or psychiatrist
Childbirth is a serious test for the woman's body. At present, great importance is given to various psychological aspects in the provision of obstetric care. Psychological aspects of delivery include the moral satisfaction of the woman giving birth, the formation of the relationship between the mother and the child, the relationship to the next pregnancies, as well as the sexual relationship between the parents.
Immediately after birth, many women begin to feel so strong euphoria that they are ready to love the whole world, but soon other sensations come: unexplained anxiety, irritation and aggression, uncaused tearfulness. As a consequence, there are bad dreams, loss of appetite and libido, helplessness in household chores, loss of positive feelings for your child, addiction to medications or alcohol. These are all symptoms of postpartum depression. In these cases, it is vital to advise a woman from a psychiatrist, and if necessary, then hospitalize in a profile hospital. A psychotherapist or psychologist will help you cope with everyday and family problems that often arise after the arrival of a new person in the family.