Changes in the Postpartum Period

The postpartum period begins with the delivery of the baby and the placenta. The end of the postpartum period is generally considered to be 6-8 weeks after delivery (though some systems do not return to pre-pregnancy states for 12 months).

Summary of immediate postpartum physiologic changes

It can be helpful for the dietitian to have an understanding of some of the changes that occur in the immediate postpartum period. If problems persist past discharge, they may have nutrition implications. At the very least, a basic understanding of the client’s experience can make communication easier.

Skin-to-skin contact (mother and infant) is recommended, as soon after birth as possible. In addition to promoting breastfeeding initiation, this helps the infant maintain body temperature and glucose levels. After the baby is delivered, 25-50% of women experience chills and shivering, which may last up to an hour. Uterine involution begins, and the cervix, vagina, vulva, and abdominal wall begin to return to their pre-pregnancy states. Mean weight loss in this period is about 18-28 pounds (fetus, placenta, amniotic fluid, and other fluid). Rooming-in and on-demand infant feedings are current trends that promote breastfeeding initiation.

Complications that can occur in the immediate postpartum period include hemorrhage, preeclampsia/eclampsia, urinary retention, adverse reactions to medications, thromboembolism, musculoskeletal pain, neuropathy, and persistent vaginal bleeding for longer than 8 weeks. (Berens, 2018)