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Human breast milk is the primary source of nutrition for the newborn, which can solely fulfill the nutrient requirements up to six months of age. When a woman conceives, several physiological changes occur in her body under the influence of hormones. One of them is the development of breasts and the production of milk. Several hormones play a role in this process. The hypothalamus secretes stimulatory or inhibitory factor, the pituitary gland secretes prolactin and oxytocin, while the placenta keeps a regulated level of estrogen and progesterone in the blood by producing these hormones. Other hormones, as mentioned in the text, are also essential for the production of milk as they are required for the provision of the basic nutrient components of the milk.

Developmental Milestones in Newborns: Apgar Score and Low Birth Weight

APGAR score is a standard tool for the assessment of newborn babies. APGAR is an acronym for Appearance, Pulse, Grimace, Activity, Respiration. It is a short test performed at 1 and 5 minutes after the baby’s birth that is done to determine the need for breathing aid and any heart trouble the newborn might be experiencing.

Postpartum Contraception — Resumption of Ovulation and Methods of Birth Control

The selection of contraceptives is a personal choice, but the physician should provide information to the patient regarding the optimal contraception. The postpartum period is an ideal time to initiate contraception as women are continuing to follow up with their healthcare providers, and are likely to be more motivated to avoid the next pregnancy soon.

Psychiatric Disorders in Pregnancy: Baby Blues, Postpartum Depression and Postpartum Psychosis

Pregnancy is a time of emotional upheaval for every woman. Besides environmental stressors, there are significant hormonal changes during and after pregnancy that put a woman at risk for several psychiatric disorders. Up to 80% of women will have the baby blues after giving birth. 20% of women will have postpartum depression and one in a thousand will have postpartum psychosis. In this course, we will discuss the baby blues, postpartum depression and postpartum psychosis.

Postpartum Care: Postpartum Contraception

The selection of contraceptives is a personal choice, but the physician should provide information to the patient regarding the optimal contraception. The postpartum period is an ideal time to initiate contraception as women are continuing to follow up with their healthcare providers and are likely to be more motivated to avoid the next pregnancy soon. Postpartum contraception should consider factors like a resumption of ovulation, its effects on lactation, and the woman’s health. Ideally, all women requesting postpartum contraception should be advised not to wait until the resumption of their menstrual cycle but instead start their contraceptive use before resuming sexual activity. Physicians should also provide emergency contraception, if requested, to all women.

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Postpartum Care

Get ready for your USMLE Step 2 exams!

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Content

Your Educators of course Postpartum Care

Veronica Gillispie, MD, FACOG

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