Microsoft word - skype session 2(nov2013).doc

Skype Training Session for SRI Community
Health Workers
Date : 8th Nov 2013; Friday
Time : 2:30- 3:30 pm
Session Number: 2(11/2013)
Instructor: Dr. Ambreen N Haq
Attendees: Community Health Workers
Location : SRI Office .Saidu Sharif Swat
Facilitators : Mr. Sardar khan, Mr. Irfan Ali


Aim of the visit
Visit outline: Greeting, what to look for?
General and specific advice
Myths and taboos regarding Postnatal period.
Specific : What to look for in history and examination and Episiotomy care, Cord care

“A postpartum period (or postnatal period) is the period beginning immediately after
the birth of a child and extending for about six weeks. Less frequently used is the term
puerperium” Urdu it is chilla , in pukhto it is salwekhti
It is the time after birth, a time in which the mother's body, including hormone levels
and uterus size, returns to a non-pregnant state. Lochia is post-partum vaginal discharge,
containing blood, mucus, and placental tissue.
The postpartum time period, also called the puerperium, lasts from delivery of the
placenta until 6 to 12 weeks after delivery. Most of the physiologic changes in pregnancy
will have returned to pre-pregnancy physiology by 6 weeks. However, many of the
cardiovascular changes and psychological changes may persist for many more months

1. To detect any serious problems which require urgent attention, like fits, severe anemia,
severe depression, wound infection, sepsis etc
2. To inform of Do`s and Dont`s
Greeting: Salam, show kindness, friendliness, and empathy if there is some thing
Ask for current issues or problems.
Look for :

Ask your self by looking at the patient :
Does she look well?
Is she responsive?
Is she looking well and is she happy?
Is she crying and irritable?
Is she coping with additional responsibility?
Is she eating well, what is she eating?
Is she bleeding heavily,
Cleanliness , daily bath
, clean sanitary protection with frequent change.
Cord care
Advice on breast feeding (separate session will be held for training) ,
Eating healthy and balanced diet including fresh vegetables,Milk, cheese, butter, eggs
fruit, meat, chicken and fish if possible , dry fruits ,and not just Halwas and desi ghee.
Remember to inform that nothing is thanda or garm ; nothing will put hawa in the lady`s
Vital signs : Pulse; Blood pressure , Temperature
Breast tenderness
Feeding technique
Uterus involution
Leg pain

Sitz bath
Warm water with salt vs Cold water
Pros and cons :

Both help in healing but cold water with ice helps in pain relief. But may be impractical
in extreme cold weather.

Donot advice Dettol, Pyodine etc as they irritate the sensitive skin.
Ice (Cold sitz bath)
Immerse in room temperature water tub, for ten minutes , add few ice cubes it will
provide pain relief
Hot water with salt:

Warm water with added salt sitz bath three times a day for five to ten days.
• Ponston forte every eight hours • Brufen 400 mg twice daily • Anafortan twice daily
Add Ulsanic syrup if complains of heart burn
Or Cap Nexum 40mg daily if there is severe heartburn.
Advice Myacitracin , Bactroban, Healit, Poly fax ointment for local use thrice daily to
prevent local infection.
Cord care ;
Apply spirit on cord three to four times daily.



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