puerperio

Puerperium, or the postpartum period, is the interval after childbirth during which the mother's reproductive organs return to the nonpregnant state. It begins with delivery and ends when the body has largely returned to its pre-pregnant condition, typically around six weeks after delivery.

During puerperium, the uterus gradually involutes; it contracts and reduces in size, with the fundus descending in the pelvis over the first days. Lochia is the vaginal discharge reflecting endometrial healing, progressing from red (lochia rubra) to pink-brown (serosa) and finally white or yellowish (alba) over several weeks. The cervix closes progressively; the vaginal mucosa and pelvic floor recover. Hormonal changes include rapid fall of estrogen and progesterone, initiation of lactation, and stabilization of metabolic processes. Breast changes include engorgement and milk production beginning on about day 2-3 postpartum.

Clinical monitoring focuses on maternal well-being, uterine tone, lochia, perineal healing, and bladder function. Early postpartum checks assess for wound infection, fever, heavy bleeding, and signs of thromboembolism. Most routine care is aimed at ensuring adequate rest, nutrition, pain control, wound care, and support for breastfeeding and infant care.

Potential complications include postpartum hemorrhage from uterine atony or retained tissue, infections such as endometritis, urinary tract infection, thromboembolism, wound complications after cesarean, and mood disorders including postpartum depression. Proper hydration, hygiene, and prompt treatment reduce risk.

Follow-up typically includes a postpartum visit at about six weeks, with additional appointments as needed. Contraception planning, physical recovery, and mental health screening are commonly addressed during this period.