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Eva Paris @paris_eva

Quarantine is the traditional way in which the puerperium postpartum period is known, a stage that lasts between six and eight weeks and that is characterized by the return to normal of all the organic and physiological changes that occurred in pregnancy and childbirth.

Quarantine is defined by the Dictionary of the Royal Academy as "Time of 40 days, months or years". In another of its meanings we have that means "Preventive isolation to which it is subjected during a period of time, for sanitary reasons, to people or animals".

But, as we see, neither the quarantine is reduced to forty days nor the woman has to isolate herself. However, the second meaning we have seen has tinged the postpartum period with certain myths, in which the woman is not a sick person, but she is undergoing changes and needs recovery.

And let's not forget that the changes in the quarantine are not only physical, but also emotional, and in both aspects we are going to focus next, because both aspects have to be taken into account and understood both by the mother herself and by her environment.

Physical changes in the mother during quarantine

Throughout the nine months the uterus has grown considerably, from about 6.5 centimeters to 32-33 centimeters and increasing from about 60 grams to over 1000 at the end of pregnancy. The process of uterine involution after childbirth begins after giving birth and occurs throughout the first weeks, returning to its initial state.

This process is accompanied by postpartum lochia, which are the vaginal secretions in which blood is expelled, vernix caseosa, cervical mucus and placental tissue throughout the first four weeks.

At first, uterine involution and expulsion of the lochia are favored by postpartum contractions. They are intense and frequent contractions during the first 24 to 48 hours after giving birth (although they last about a week with less intensity). They are a normal process that helps to return the uterus to its normal state, in addition to facilitating the sealing of the arterial mouths that remain open after having given birth.

Childbirth traumatizes the bladder and urethra locally, so during the first hours and even days after birth some women can not urinate easily and others suffer from loss of sensitivity to the desire to urinate. These situations spontaneously correct when local inflammation subsides in 48-72 hours.

At the beginning there may also be constipation in the postpartum and difficulties to defecate if an enema has been carried out and if there are hemorrhoids, because in addition the abdominal muscles are relaxed after giving birth.

On the other hand, other changes appear, especially in the breasts, to allow the adequate nutrition of a new baby thanks to breastfeeding. The rise of milk after childbirth occurs between 30 and 72 hours after delivery, causing some discomfort in the mother, little by little, with the proper establishment of breastfeeding, dissipate.

The breasts increase in size, consistency, temperature and superficial veins can be appreciated. As we know, they will initially secrete colostrum, which gives the baby everything he needs during the first days, and from the third or fourth day will begin to be a whiter milk.

The nipples can suck the baby, especially if the grip is not correct, so it is common during the puerperium that the mother suffers cracks (although these can be prevented) or other discomfort. But breastfeeding, although it usually hurts, should not hurt, so in these cases you have to see what produces pain. Remember to ask professionals for advice on how to hold if the pain persists.

Finally, we must talk about the recovery during the quarantine of possible injuries such as episiotomy or cesarean, which need the relevant cures to avoid painful complications such as infection.

And the mother also has to recover from very frequent important discomforts such as numbness of the perineum or postpartum hemorrhoids.

All these physical limitations are going to make us need some help at the beginning of the postpartum to perform such simple tasks as getting out of bed to go to the bathroom or put the baby in the changing room. In addition, all these sequelae of childbirth, together with frequent fatigue and weakness, will mean that until the quarantine period is over, complete sexual relations are not resumed .

Around four or six weeks after having given birth, an appointment is usually made with the gynecologist to check and verify that the recovery is being positive. It is time to raise the doubts we have.

A sensitive period of recovery

Quarantine is a period in which, along with the physical changes that we have just seen, important emotional changes occur . Therefore, recovery must not only be physical but also psychologically we need a time to adapt to the new situation.

We already discussed some keys to "survive" at home with the baby, and it is a sensitive and difficult stage sometimes in which we may need help to take care of the baby, the house and in which we will need time to Get to know our baby and our new body.

It is likely that we are puzzled by the crying of the baby, that we feel like a stranger, that we think we do not have time for anything, that intimacy with the couple is over or that we can not attend to the older children ... and they often forget own needs.

But it is important to remember in this recovery process that the body and mind need their time to be in shape and that we have our needs. Many mothers feel anxiety and sadness that can lead to more severe cases of postpartum depression, so the environment must be alert to the signs and help the mother as much as possible.

The tiredness, the possible disappointment with how the delivery has gone, the difficulties with breastfeeding, feeling relegated to a secondary role, the feeling of incapacity, the rejection of the new body, the mismatches in the relationship ... are just some of the factors that can revolutionize our mind even more, but are within the "normal". If the sadness lasts several weeks and affects the relationship or the care of the baby, the specialist should be consulted.

In short, the work to give birth to our baby has been great and the changes that we began to discover in our lives, even greater. During the quarantine or puerperium the mother needs to recover and adapt to the new situation, knowing the baby, establishing a bond that will last a lifetime.

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