3 percent required hospital readmission within 8 weeks (Glazener, 1995; hompson, 2002). Milder health problems during the first 8 weeks were reported by 87 percent (Table 36-5). Moreover, almost three fourths continued to have various problems for up to 18 months. Practitioners should be aware of these potential issues in their convalescing patients.
By discharge, women who had an uncomplicated vaginal delivery can resume most activities, including bathing, driving, and household functions. Jimenez and Newton (1979) tabulated cross-cultural information on 202 societies from various international geographical regions. Following childbirth, most societies did not restrict work activity, and approximately half expected a return to full duties within 2 weeks. Wallace and coworkers (20 l3) reported that 80 percent of women who worked during pregnancy resume work by 1 year ater delivery. Despite this, Tulman and Fawcett (1988) reported that only half of mothers regained their usual level of energy by 6 weeks. Women who delivered vaginally were twice as likely to have normal energy levels at this time compared with those with a cesarean delivery. Ideally, the care and nurturing of the infant should be provided by the mother with ample help from the father.
The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists (2017) recommend a postpartum visit between 4 and 6 weeks. his has proven quite satisfactory to identiy abnormalities beyond the immediate puerperium and to initiate contraceptive practices.
Ahdoot 0, Van Nostrand M, Nguyen NJ, et al: he efect of route of deliv ery on regression of abnormal cervical cytologic indings in the postpartum period. Am J Obstet Gynecol 178: 1116, 1998 Almeida 00 Jr, Kitay DZ: Lactation suppression and puerperal fever. m J
Obstet Gynecol 154:940, 1986 Alonso-Burgos A, Royo P, Diaz L, et al: Labor-related sacral and pubic frac tures. J Bone Joint Surg 89:396, 2007
TABLE 36-5. Puerperal Morbidity Reported by 8 Weeks Morbidity PercentQ
American Academy of Pediatrics: Breastfeeding and the use of human milk. Pediatrics 129(3):e827, 2012
American Academy of Pediatrics, American College of Obstetricians and Gynecologists: Guidelines for Perinatal Care, 8th ed. Elk Grove Village, AAP, 2017
American College of Obstetricians and Gynecologists: Breastfeeding in underserved women: increasing initiation and continuation of breastfeeding. Committee Opinion No. 570, August 2013, Reairmed 2016a
American College of Obstetricians and Gynecologists: Screening for perinatal depression. Committee Opinion No. 630, May 2015, Reairmed 2016b American College of Obstetricians and Gynecologists: Marijuana use during pregnancy and lactation. Committee Opinion No. 722, October 2017a
American College of Obstetricians and Gynecologists: Optimizing support for breastfeeding as part of obstetric practice. Committee Opinion No. 658, February 2016, Reairmed 2017b
American College of Obstetricians and Gynecologists: Update on immunizationand pregnancy: tetanus, diphtheria, and pertussis vaccination. Committee Opinion No. 718, September 2017c