Study sheet: Postpartum System Changes

📋 Course Outline

1. Postpartum Fluid Balance
2. Gastrointestinal Changes
3. Respiratory Changes

📖 1. Postpartum Fluid Balance

📝 Essential Points

• Rapid diuresis occurs particularly during days 2–5 postpartum because the sodium and water retention of pregnancy is reversed. — Azulay Chertok, 2013

• Fluid and electrolyte balance is generally restored to non-pregnant homeostasis by 21 days postpartum. — Coad and Dunstall, 2011

📌 The midwife should ensure that the woman passes an adequate amount of urine within 6 hours following birth. — NICE, 2006

💡 Memory Hook

Reversed pregnancy sodium and water retention → rapid diuresis and restored fluid balance

📖 2. Gastrointestinal Changes

★ Must-know

• Reduced gastrointestinal muscle tone caused by progesterone and abdominal relaxation increase the likelihood of constipation following birth.

• The first bowel movement usually occurs within 2–3 days postpartum. — Coad and Dunstall, 2011

Further detail

• The first postpartum bowel movement may be complicated by the presence of haemorrhoids. — Coad and Dunstall, 2011

💡 Memory Hook

Reduced tone → constipation → bowel movement in 2–3 days

📖 3. Respiratory Changes

📝 Essential Points

• Birth immediately reduces intra-abdominal pressure, allowing expansion of the diaphragm.

• Respiratory rate returns to normal within 1–3 weeks postpartum. — Coad and Dunstall, 2011

💡 Memory Hook

Birth → reduced intra-abdominal pressure → diaphragm expansion → normalized respiration