The first six weeks of the post partum period is referred to as
the puerperium. The first two to three days are spent bonding
with the baby and waiting for the true milk to come in. Milk
usually comes in at about 72 hours after the birth. Multiparous
women will have significantly more intense after pains or
uterine contraction to facilitate involution of the uterus to
its pre-pregnant state. Early in the puerperium there is loss of
blood and later discharge from the vagina. Fever and foul
discharge is indicative of uterine infection. Generally if a
woman does not nurse, she will menstruate 6 to 8 weeks following
birth. Nursing women menstruate anywhere from 6 weeks after
birth to 2 years after birth, however nursing is not an adequate
method of birth control as most women ovulate before they
menstruate, and a woman can become pregnant before her period
returns. If the woman is lactating she will secrete prolactin,
which is actually stimulated by the sensation received by the
nipple when a baby nurses. Prolact