Dr Ayushi Gupta
Pregnancy and it’s related complications is such a huge problem for especially a country like India in which population is increasing likely anything. Pregnancy is the most normal thing which can lead to so many abnormalities and can potentially deteriorate a woman’s health if not managed properly but not only pregnancy, the period after that is also very significant Puerperium is the period after childbirth during which body tissues of the mother go back to their pre-pregnant state. This usually lasts for approximately 6 weeks. Be it anatomical (or structural) changes and physiological (or functional) changes, a female’s body go through a lot in order to carry a child and then all these changes have to revert back. It starts immediately within 24 hrs of childbirth with changes in uterus, weight loss, hormonal changes, vaginally discharge or Lochia, lactation etc. Labour, the process of childbirth, is a very stressful event that a female has to go through. It requires a lot of physical as well as mental and emotional strength. So during the period following labour. She requires good care, nutrition and rest. But unfortunately this is usually not the case. In India there a so many superstitions and regional and cultural practices involved especially related to female’s post delivery which leads to lifelong weakness, anemia, bone pains and what not.
That is the time when she needs care and support as she is so fragile but instead practices like fasting for 5 days, not letting her bathe for a few days, having tea instead of milk and restriction of nutritious food etc are followed and she is sometimes treated as an outcast and nobody is allowed to touch that female. Although the ‘not touching that female’ part still does make sense as this prevents spreading infection to her but others don’t seem to benefit at all rather cause lifelong problems. Adding to that a lot of deliveries especially in rural areas are done in low resource settings or the home of the female itself making these females more prone to develop what is called as Puerperal Sepsis i.e., infection of the genital tract occuring after and mainly as a complication of delivery.
But not every time rural areas are to be blamed, even urban population females with malnutrition, anemia, HIV, diabetes mellitus, preterm labour (delivery occurring before 37 weeks of pregnancy), prolonged or obstructed labour, repeated vaginal examination, bleeding through genital tract either before or after delivery etc. can develop infection after delivery. This infection can remain locally or spread throughout her body which can even result in death of the female. Infection presents itself as local rise of temperature or fever, she may also develop offensive smelling discharge from vagina, rapid pulse rate, pain and tenderness and bulging of lower abdomen and pelvis besides other findings. Whenever a female in puerperium is having fever, it has to be taken seriously and proper examination by a doctor is needed. Some tests of blood, urine, ultrasound etc. are to be done to find out the exact cause and site of infection. Treatment involves intake of antibiotics, adequate rest, fluid and Calorie intake. If pus is formed in the wound, then stitches are removed to drain the pus or if stitches are opened accidently, then cleaning of the wound is done followed by removal of excess tissue and stitches are again applied. So in short, based on severity treatment varies from medical to surgical with antibiotics remaining the mainstay of treatment.
Although it should be diagnosed and treated quickly and efficiently, but it is nothing to be afraid of. Besides all the medical treatment options, maintaining adequate health and taking proper nutrition during pregnancy, following all the measures to avoid exposure to infection and following proper course of antibiotics given by the doctor, use of clean pads after delivery etc. are some of the measures that when taken before and after delivery will ensure less chances of a female getting infected.
One more problem which is actually one of the cause of plethora is other problems(like overpopulation, malnourished newborn. Children and the female predisposing to infections frequently, rickets in children etc.) is Contraception after delivery. It is said that after delivery around 3 years of gap is required by the body to fully recover for another pregnancy but sadly this is also not followed leading to pregnancies as early as 6-8 months of delivery which should be highly discouraged and effective contraceptives methods should be used by the couple post delivery.
A country like India where around 70thousand to 80thousand children are born daily, maintaining clean, safe and hygienic delivery practices are crucial for that female as well as the newborn. People should be aware of all the potential risks and health problems that could happen so that proper timely, measures can be taken to prevent and treat them.
