Postnatal Care and Family Planning

(Content revised 03/2018)(Reprinted 12/2019)

After giving birth, the body system of women will revert to the pre-pregnant state. This period usually lasts for 6 weeks and is called puerperium. Proper care is important during this period. A postnatal check up should be carried out after the puerperium to ensure complete recovery. Moreover, this is now high time for a couple to discuss the method of contraception for family planning in order to achieve a good foundation for the future family life.

What is lochia?

Uterus will revert back to pre-pregnant size after delivery. The wasted tissue passes out from the vagina is called lochia.

  • In the first few days to 1 week, lochia amount is heavy and appears as reddish colour.
  • The colour of lochia will turn to pink colour and last for another week.
  • Finally it will turn to a whitish discharge and gradually subside.
  • Usually it takes 2 to 6 weeks to clear from lochia.
  • Breastfeeding can stimulate the brain to secrete more hormone that helps the uterus to contract and revert back to normal size. The period of lochia passing will be shortened. However, for those who breastfeed their babies just briefly, after they stop breastfeeding, the lochia may change from pink or white back to red colour before it gradually subsides.

When should one consult a doctor?

If the amount of lochia increases and with foul smelling, or there is fever and lower abdominal pain, then a doctor should be consulted for proper examination and management.

When will menses return?

  • It will usually return in 4-6 weeks for mothers not breastfeeding. For mothers who breastfeed their babies, menses will return later.
  • Even when menses has not yet returned, the couple should practise reliable contraception when they resume sexual intercourse.

Why do I have frequent urination and burning pain during urination?

Frequent urination or burning / scalding pain during urination can be symptoms of urinary tract infection, which is not uncommon among postnatal women. Please consult a doctor if you have any of these symptoms.

Why is there excessive hair loss?

  • During pregnancy, much scalp hair is in the growing phase. After delivery, the condition changes and the hair will revert into resting phase. Thus apparently much hair is lost.
  • This condition lasts for 4 to 20 weeks after delivery. It will recover completely within 6 months of delivery without any treatment. Therefore no need to worry.
  • Hair loss will be less marked with successive pregnancies.

What is the dietary advice after delivery?

  • One should keep a balanced diet and choose food from the five basic food groups namely milk and alternatives, meat, fish, eggs and alternatives (including beans), vegetables, fruits and grains (rice, noodles and bread). Adequate portions from these five basic food groups will allow the mothers to recover from delivery and prepare her for lactation.
  • Since the liver function of the newborn babies may be immature, breastfeeding mothers should avoid consuming any medication without doctors' advice.

How to take care of the perineal wound?

  • Clean the wound every time after urination and bowel opening with shower.
  • Frequent change of napkin and maintenance of personal hygiene can speed up the recovery of the wound.
  • If the wound opens up or there are signs of infection, consult the doctor.

How to take care of the abdominal wound?

  • If there is no sign of gaping or infection after the stitches are removed, then one can bathe and shower as usual.
  • If the wound is red, swollen, hot, aches, or has fluid oozing out, one should consult the doctor for proper examination and management without delay.

When can sex life be resumed after delivery?

  • After giving birth, the body needs some time to revert back to pre-pregnancy state. This period, called puerperium, generally lasts for 6 weeks.
  • When puerperium is over, lochia will clear, uterus will return to its natural size, uterine lining will recover, cervix will close, vaginal membrane will return to normal and wound on abdomen or perineum will be healed. At this time, sex life can be resumed if the mother is emotionally and physically ready.

What should be noted in resuming sexual intercourse?

  • When resuming sexual intercourse after delivery, the mother will sometimes experience dryness in her vagina as well as mild pain or strange feeling at the perineum. The reasons are mostly psychological. She can get used to it gradually after a few times of intercourse and these discomforts will fade away naturally.
  • Overly vigorous gestures and deep penetration at the early resumption of sex life should be avoided. Priority should be given to what feels good for the mother.
  • Medical examination should be sought if there is bleeding, pain or difficulties during intercourse.

Will the wound be ripped apart by sexual activities after delivery?

  • Generally speaking, the perineal wound will be healed after the puerperium. Therefore sexual intercourse will not result in wound gaping.

When should contraception be used?

Although ovulation usually will not occur in the first 4 weeks after delivery, in order to avoid pregnancy, couple should use reliable contraception once they resume sexual intercourse. Maternal & Child Health Centres provide professional contraceptive advice to women.