This is a very brief overview of some of the things a midwife has to consider when discharging a mother and baby from her care in the post natal period
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1. Ending the partnership
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2. Physical examination
Breasts - ensure adequate lactation; talk about breast
exam.
Abdominal scar (if woman has one) -healed
Fundus - involuted
Lochia - minimal
Perineum -healed;refer if woman is having painful sexual
intercourse
Bladder/bowels returned to normal pattern
BP - normalised
Evidence of post natal depression lack of sleep, poor appetite,
unsettled or depressed state of mind
3.
6 week baby check
Head to toe
Heart and lungs
Length and head circumference
Hip check
Feeding
http://www.flickr.com/photos/spamily/296925400/ 4. Associated
information
Cervical smear at 3 months if required
Sexual intercourse recommence when comfortable
Contraception
?Rubella immunisation if not immune
?Physical check with general practitioner some mothers may
prefer midwife to do it, as opposed to GP
?Referral to other health providers eg mental health, child
health nurse
5. Information given to woman
Child health nurse and clinics
Immunisation
Post natal support groups
Financial help
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6. Ending the partnership
Make sure woman is warned of your last visit
Will you be continuing a relationship?
Debrief about labour and birth
How will you evaluate your care and get the womans
feedback?
Make sure the woman has a copy of her notes
Pass on discharge information to GP/child health nurse