PostPartum discharge teaching
Maternal Discharge Criteria
Pain in her chest
Obstructed breathing or SOB
Seizures
Thoughts of hurting herself or baby
Bleeding
Incision that is not healing
Red or swollen leg, painful or warm
Temperature > 100.4*F
Headache that does not improve
- Demonstrates readiness and ability to care for herself and her infant.
- Family members and support people are available for the first few days after discharge.
- Mother is aware of what to do in case of an infant emergency.
- Blood type and Rh status are known and treatment has been provided, if necessary.
- Secondary to blood typing and treatment, mother should receive any necessary vaccinations such as:
- MMR & Varicella
- Hepatitis A/B
Post Discharge Risk Factors:
- History of severe PPD
- Current medical illness
- Domestic abuse
- Substance abuse
- Adolescent mothers with limited support
- No identifiable home
- History of child abuse or neglect
These may indicate a need for assistance, referrals or clinical follow up.
Discharge Teaching
Maternal Discharge Criteria
- Vital signs are stable
- Amount and color of lochia are appropriate for the duration of recovery
- Uterine fundus is firm
- Urinary output is adequate
- Surgical wound healing is adequate
- Able to ambulate with minimal discomfort
- Pain control is adequate
- Discharge education begins at admission!
- Identify any learning barriers prior and make plans to overcome those barriers.
- Make sure that mom is comfortable.
- Time teaching appropriately and don't teach too much at one time.
- Include the support person when appropriate.
- Ask about pressing needs and determine learning needs of experienced mothers.
Many postpartum complications do not develop until after discharge. It is important that women are aware of signs and complications and know when to report their symptoms.
- Inability to care for self or infant
- Persistent or severe mood swings
- Thoughts of harming herself or others
- Irritability may progress to violent outbursts
GAPS In Discharge Teaching
- The majority of educational messages are focused on the baby.
- Women are receiving inconsistent or inaccurate information about maternal post-birth warning signs.
- Education does not focus on warning signs.
- Warning signs are taught to women believed to be at increased risk rather than every postpartum woman.
- Postpartum depression occurs in 10-20 percent of all postpartum patients and even as high as 60 percent for adolescent mothers.
- Women at the highest risk are those with a personal history of depression, or a prior history of prenatal or postpartum depression.
- Most women with PPD present within the first three months postpartum but can occur during the first 12 months.
- Women typically experience intense fear, anger, and anxiety and may become despondent.