Physiological Changes during the Postpartum Period

The Urinary System

 Increased urine output from 1500mL to as much as 3000mL due to
increased urine production
 Transient loss if tone in bladder
 Urine contains more nitrogen than normal
 Diaphoresis (excessive sweating)
*Hydronephoresis (increased size of uterus)
still present until 4 weeks after delivery
The Circulatory System
 Added blood volume accumulated during pregnancy is reduced
 1 gram decrease in hemoglobin value with each 250ml of blood lost
 Four-point decrease in hematocrit
 Same high level of plasma fibrogen during first postpartal weeks
 Any varicosities present will recede
The Gastrointestinal System
 Active digestion and absorption
 Hemorrhoids that have been pushed out of the rectum due to the effort of pelvic
stage pushing often are present
 Bowel sounds are active but passage of stool through the bowel may be slow
The Integumentary System
 Stretchmarks on the abdomen still appear reddened and may be even more
prominent than during pregnancy
 Excessive pigment on the face and neck and on the abdomen will become barely
detectable in 6 weeks
 If diastasis recti (overstretching and separation of the abdominal musculature) is
present, the area will appear slightly intended. Appear as a bluish area in the
abdominal midline if separation is large.
 Abdominal Wall and ligaments will require full 6 weeks to return to former state
from stretching
Exhaustion
 Women experiences total exhaustion after birth
Weight Loss
 Weight loss of 2 to 4 kg (5lb) during second to fifth day after birth in addition to
the approximately 5.8kg (12lb) lost at birth.
 *The weight a woman reaches at 6 weeks after birth becomes her baseline
postpartal weight.

VITAL SIGNS
 Slight increase in temperature during the first 24 hours after birth
 Pulse rate is slightly slower than normal
 Decrease in blood pressure can indicate bleeding. An elevation above 10 mmhg
systolic or 90mmhg diastolic may indicate the development of postpartal
pregnancy induced hypertension
PROGRESSIVE CHANGES
 Formation of breast milk begins
 Primary engorgement on third or fourth day after delivery
 The production of placental estrogen and progesterone ends resulting in
decrease in hormone concentrations which causes rise in FSH production
leading to the return of ovulation