OBSTETRICS/MATERNITY:
Involution
Involution is the process by which the uterus contracts and slowly moves down into the pelvis.
Immediately after delivery, the uterus is the size of a cantaloupe and that is why women still look pregnant. Over the next six weeks, the uterus shrinks to its normal size and positions itself in the pelvis.
Fundal Massage and Lochia
The top of the uterus is called the fundus. Massaging the fundus initially after delivery helps aid involution and decreased vaginal flow called lochia. Lochia is the vaginal discharge of the uterine lining where the placenta was attached. The discharge will continue for four to six weeks, until the area is completely healed. Immediately after delivery, it will resemble a heavy period flow, appearing bright red in color and sometimes containing small clots. After a few days, it will turn to a pinkish-brown color and then finally to a yellowish-white color. Use sanitary pads--NOT tampons--during this time because the cervix is still open and tampons could introduce bacteria into the uterus.
Afterbirth Pains
As the uterus contracts downward after delivery, women may feel some cramping sensations called “afterbirth pains.” These generally last a few days. These contractions may be stronger in nursing mothers or mothers who have experienced more than one pregnancy.
For general relief and comfort measures, women should gently massage their abdomen (a Saint John’s nurse will demonstrate fundal massage to new mothers and explain when to use it), urinate frequently, take prescribed medications and use a heating pad.