We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Below we will list the departments and units that form part of Vall d’Hebron Hospital and the main diseases that we treat. We will also make recommendations based on advice backed up by scientific evidence that has been shown to be effective in guaranteeing well-being and quality of life.
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On a physical level, postpartum is characterised by an involuntary and regression process of the body areas and organs that have undergone changes, with the exception of the mammary gland, which at this time is of greater importance for feeding the baby. In addition to physiological changes, there are also changes in mothers on a psychological level, in the family structure and in their social role.
A period in which so many changes appear can translate into a complex or difficult adaptation, so it is important that the care provided by health professionals is carried out from a biopsychosocial and holistic approach and it is recommended that they be coordinated by a midwife.
From a clinical point of view, three stages can be distinguished.
The immediate postpartum period includes the first 24 hours, of which the first two represent a period of close surveillance, due to the increased risk of postpartum haemorrhage.
Regular monitoring of vital signs, such as temperature, blood pressure, and heart rate, will be carried out in the delivery room. Vaginal bleeding and the size of the uterus will be assessed, which after delivery must gradually recover to its size before pregnancy.
It must be verified that there is no wound or laceration in the vagina that is actively bleeding and, in the event that the woman has requested anaesthesia, the recovery of mobility of her legs must be checked.
Immediate skin-to-skin contact of the baby with the mother will be initiated, under the appropriate supervision of health professionals, as well as the early start of breastfeeding if the mother wishes. The pertinent care of the newborn will also be carried out without altering the mother-child relationship, whenever circumstances allow.
During the hospital stay, checks and care must be aimed at promoting the bond between mother and baby, together with the establishment of breastfeeding. During this process, it is important to instruct the mother and her family with regards identifying the warning signs to detect possible complications early.
It is necessary to offer the mother truthful and simple information so that at the time of discharge she has maximum autonomy regarding the care of her baby. During the hospital stay, active participation of the couple in parenting will also be encouraged.
The "early", "mediate" or "clinical" postpartum covers from 24 hours to the tenth day of postpartum and is considered the most important involuntary period. During this period, attention should be paid to the following possible complications: Infection of the endometrium, the surgical wound, the episiotomy, urine or the breasts; circulatory problems such as varicose veins, haemorrhoids and difficulties related to breastfeeding: pain, cracks, inflammation and problems with the baby's latch.
The hospital stay can be extended by 2 to 3 days depending on the type of delivery and as long as the evolution of the mother and baby is within normal limits. Once hospital discharge occurs, the midwife of the primary care centre will be in charge of the continuity of care for both the woman and her baby.
Finally, the third phase, which corresponds to the late postpartum period, is between the 11th and the 42nd day after delivery (6 weeks). In this period, the physical changes that occurred during pregnancy in the mother have disappeared, breastfeeding is usually in place and the first menstruation appears in mothers who are not breastfeeding.
In this period, the physical changes that occurred during pregnancy in the mother have disappeared, breastfeeding is usually in place and the first menstruation appears in mothers who are not breastfeeding. We should also provide information on postpartum support groups and breastfeeding groups.
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