Enf.ª Edna Costa

Specialist Nurse
in Obstetrics and Maternal Health

Companion in the puerperium

HPA Magazine 17

The puerperium is the 6-week period after childbirth, where a regression of anatomical and physiological changes inherent to pregnancy occurs. It can be divided into three periods:
• Immediate puerperium: the first 24 hours;
• Early puerperium: until the end of the 1st week;
• Late puerperium: until the end of the 6th week.. 

The woman’s body changes over the weeks at home, with food and love. However, childbirth takes place and the body changes once again, she is no longer the focus of attention and has a new-born infant (NB) to care for and feed. All changes cause great psychological, emotional and physical strain, in addition to what is involved in caring for a NB.
In order for the woman to overcome these changes more smoothly, the HPA has provided the option of having a companion, during the entire hospital stay. It can be anyone the woman trusts. The most common choice is the NB's father, so that a bond with the newest member of the family can be established immediately.
Often the companions are not aware of how important they are in the recovery of postpartum women and in the care of the NB in these first days after delivery.
This article serves to make them aware of what they can do to help the mother and the NB.

SUPPORT THE PUERPERA
Support the woman emotionally and physically. Depending on how you feel, you may need help to take care of the NB and support in daily living activities.
Inform the family and friends on the birth, the status of the new-born and the mother, so that she can focus on caring for the baby and on recovering. Celebrate achievements, and successes.
TALK TO HER
Childbirth is a remarkable, difficult process in a woman's life, it can be traumatic, so it is necessary to let her talk about how she felt and feels about this subject. If it is suspected that there may be some emotional trauma from birth, or if it is simply not a comfortable topic to talk about, multidisciplinary team can be asked to assess the situation.
Dialogue is important to understand how she feels in the role of mother, whether she needs more support, what she feels uncomfortable with, what she feels more confident in doing, so that care of the baby can be shared. 
Praise is also important, making her realize that she is playing her role to the best of her ability and that if she has any questions or difficulties, she can count on you to support her or call for help.
BE PROACTIVE
When it comes to taking care of a NB, the companion needs to practice as much as possible: changing diapers, giving a bath, comforting the NB, helping with breastfeeding. As difficult as you think it will be, always try as hard as you can to improve and be the mother's two extra hands.
Remind her that you want to be useful in this process, that she doesn't need to do everything alone, that she needs to take advantage of the fact that she is not alone and should take a little time just for herself and rest.
SUPPORT DURING BREASTFEEDING
Breast milk is the most complete food for new-born infants. Breastfeeding is a time when everyone learns, mother, baby and companion.
Breastfeeding can last for hours. While the woman is feeding the NB, the companion can give her water, food, provide comfort, warn her against bad posture, help take care of her breasts, help when expressing milk and feed the NB.
Although, at first glance, breastfeeding is exclusive to women, it can be for both when supporting each other.
If the couple chooses to feed the NB formula, it is an opportunity to take shifts feeding the NB, however all the tasks above remain valid.

KEEP WORK AWAY
It may seem difficult for those who are self-employed, but it is possible. Enjoy these first days of the RN's life, they are unique moments that you will definitely not want to miss.
CAESAREAN
A caesarean delivery is a surgery, which means that the woman has to remain in bed for a few hours until she can progressively get up from bed.  The woman will be depending on some help with daily living activities and especially in caring for the baby. The role of the companion is to help with whatever the mother and the NB need.
Skin-to-skin contact is more than recommended and should take place as soon as possible after birth, as it calms the baby, stimulates its reflexes, warms them and regulates them. If it is not possible for the woman to do so, immediately after birth, then it should be the companion. Ask the team for help, remove your shirt and place the NB naked next to your chest covered warm sheets and blankets and enjoy the moment.

AT HOME
When at home, be everything described above and more.
It may be rash to talk about visits in times of pandemic, but the truth is, it will happen. Manage visits by clarifying rules, ask visitors to help by taking care of the NB and the mother, as well as the house, helping with meals, among other household chores. Parents must save their energy to take care of the NB.
Remind the mother of upcoming appointments, or if the need arises to go to an emergency service or of other appointments that may have been forgotten.  Baby brain is a reality.
Lastly and most importantly take care of yourself and be eternally grateful and happy.