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Immediate Care of the Mother Following Birth

The first few hours following the successful birth of the baby and afterbirth is sometimes known as the 4th stage of birth or labour .

Immediately after its delivery, the placenta should be examined carefully to detect abnormalities (infarcts, haematomas, abnormal insertion of the umbilical cord), but above all to ensure that it is complete. If there is a suspicion that part of the placenta is missing, the uterine cavity needs to be explored.

The mother should be also observed carefully during the first hour postpartum. The most important observations include the amount of blood lost, and uterine contraction, since if the uterus contracts insufficiently, blood may accumulate in the uterine cavity. If the blood loss is abnormal and the uterus is contracting poorly, gentle abdominal massage of the uterus can be helpful. It is essential to ensure that uterine contraction is not inhibited by the presence of a full bladder. Postpartum haemorrage , defined by the WHO [ 1 ] as abnormal blood loss more than 500 ml, should be treated with oxytocics . The mother's blood pressure, pulse and temperature, and general well-being should be assessed.

At this stage, any tears in the cervix or vagina and the episiotomy incision (if performed) are stitched. The mother, baby and partner are now moved to the recovery room and for the next few hours are closely monitored, as many complications may arise in this period.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. Care in Normal Birth: A Practical Guide. Report of a Technical Working Group, World Health Organisation, Department of Reproductive Health and Research, 1999.

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