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Post natal checks in primary care. Dr Lois Jacques. Overview. Why? What should we cover? What is normal? How to manage common problems. 6 week post natal check. Abdomen Bladder and bowels Vaginal symptoms Feeding/breast problems Mood Contraception Specific problems Legs BP.
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Post natal checks in primary care Dr Lois Jacques
Overview • Why? • What should we cover? • What is normal? • How to manage common problems
6 week post natal check • Abdomen • Bladder and bowels • Vaginal symptoms • Feeding/breast problems • Mood • Contraception • Specific problems • Legs • BP
Breast problems • Engorgement • Sore/cracked nipples • Skin infection • Blocked duct • Mastitis • Breast abscess
Persistent lochia • Resumption of menstruation • Infection • Retained products • Unhealed tears • Side effects contraception • Other cervical/uterine pathologies
Fatigue • Normal • Anaemia • Post natal depression • Thyroid disease
Contraception • Need from day 21 • If later exclude pregnancy and additional precautions • Lactational amenorrhoea method • Avoid COCP if breastfeeding • Irregular bleeding if start Depot/Implanon within 6 weeks • IUCD increased risk of perforation and expulsion in first 6 weeks • Can use Levonelle if breastfeeding