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Lactation is a kind of Natural Contraceptive,Thus mesturation depends on lactation
If a mother is breast feeding Mesturation stops in 70 percent mother.
If mother is not lactating it start after 6 weeks in 40% and 12 week in 60 %

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It is uterine discharge just after postpartum
continues until 3 weeks of postpartum
divided into 3 types according color
1. RUBRA : red in colour due to presen e of RBCS just after delivery.
2. SEROSA: pink in colour contain mucus and wound exudates.
3. ALBA: white pale in colour continues till 15 days.
250ml discharge is normal and can increase in twins delivery having strong odour

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Physiological changes in uterus (group 2)

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Physiological changes in uterus (group 2)

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Uterus become hard and retracted with alternate hardening and softening

weight approx 1000 gram and measures 15×12×8-10 in length, width and thickness respectively.
Increases in roughly 2-3 times size of non-pregnant
approx 500 gram at first postpartal week .
300-350 at second week
100gram at 6th postpartal week.
60 gram by the 8th postpartal week

After delivery, it rises to the level of umbilicus and then descends

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Striae sliver white lines
Flabby abdominal wall
Diastasis rectie
Pandulus abdomen
Back pain

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*streching ,edema and bruising
*gaps open at introitus
*smooth and larger
*increase in size
*perineum muscles tightning
*scar tissue formations called myrtiformes
*laceration of vulva and perineum

( Breast)
*Colostium secretion becomes abundant

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Vital Signs:
-Pulse initially raised but gets normal in second day.
It shouldn't be above 100, it is a sign of an infection.
-Temperature during intrapartum can be raised but it settles within 24 hours, but on third day it could be slightly raised due to breast engorgement.
It should not be increased for more than 1 day.
-Respiration and BP should be stabilized within normal ranges.

Weight Loss:
-2kg weight loses during first post partum week because of fluid loss through diuresis.
-Weight loss is because of expulsion of uterine contents.

Fluid Loss:
-2Litre fluid loses during first week.
-1.5 Liter fluid loses in next 5 weeks. The amount of fluid lost depends on retained fluid during pregnancy.

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.Increase thrust/fluid loss/dehydration/
. Constipation
.weight loss
. excessive hunger
. abdominal striae
.diastasis recti
. extreme back pain
.pendulus abdomin(multiple gestation)
.flappy abdominal wall
.Lack of tone of perineal and abdominal muscle
.reflex pain
Hematological changes:
.blood loss
. decrease cardiac output
. platelets decrease (placenta detached)
.Esr and fibrinogen increase
.Blood volume decrease (postpartum and dehydration) returns to normal in 2nd week.
Cardiac output increase 60%
Leukocytosis imcrease by 30,000 per cubic due to infection.
Platelets decrease and increase by 3-4 days.
Increasr ESR and fibrinogen

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Renal changes
pelvis and ureter ( dilated and stretch 4th week).
urethra is insensitive and sense because of delivery trauma recover within 24 if no UTI occurs.
proteinurea immediate and up to 2 day of delivery
Abdominal changes

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1. Anteriorly it is edematous and bruised.
2. Extremely flabby and soft or floppy
3. Looks congested
4. It contracts slowly (external os is about 2 fingers stretched and then about a tip of a finger stretched)
5. External os never reverts back
6. Contour of cervix takes approximately 6 weeks to regain the structure.
7. Broad and round ligaments are lax (too much stretched due to increased size).