Nursing 209

N209: Reproductive Health Study Guide • It is normal to have an increase in bleeding at day 7-14 PP due to sloughing of eschar at the placental site; this is the most common time for delayed postpartum hemorrhage • Lochia amount o Scant: 1 inch stain on peri pad (approximately 10ml) o Light or small: 1-4 inch stain (approximately 10-25ml) o Moderate: 4-6 inch stain (approximately 25-50ml) o Heavy/large: Saturate pad within one hour Cervix • Closes to about 1cm by one week PP • The return to pre-pregnancy firmness may take months Pelvic Floor Support • May not revert to pre-pregnant state • Childbirth can be attributed to urinary and rectal issues • Depends upon size of baby and trauma at delivery • Kegel’s (pelvic floor exercises) may be prescribed • Muscle tone is regained by six weeks • Complete restoration of connective tissue support usually returns by six months PP Vagina • Will regress, but not return to pre-pregnancy size • Vulvar swelling resolves in 1-2 weeks • Rugae reappear by week three in non-breastfeeding women (breastfeeding mothers have decreased estrogen levels) Abdomen • Soft with decreased tone • Can return to pre-pregnant state depending upon exercise level Ovaries • Non-breastfeeding women may ovulate as early as 27 days after delivery • May be longer if breastfeeding due to an increase in prolactin, which suppresses ovulation Menses • Most women have return of menses by 12 weeks

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