5.1.2  Check if her uterus is contracting normally

Palpate (feel) her abdomen to check contraction of the uterus to make sure it is firm. Immediately after the birth, you should be able to feel it contracting near the mother’s umbilicus (belly button), and it gradually moves lower in her pelvis over the next two weeks. Check her uterus every 15 minutes for the first two hours after birth and every 30 minutes for the third hour. If possible, check every hour for the following three hours. If the uterus is hard, leave it alone between checks. If it feels soft, rub the abdomen at the top of the uterus to help it to contract. Teach the mother to do this for herself (Figure 5.1).

A health worker examines a woman’s uterus to check that she is contracting correctly. The woman is sitting up in bed.
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Figure 5.1  The uterus can be encouraged to contract after the birth by rubbing the abdomen.

The drugs you gave the mother to help expel the placenta and prevent bleeding (e.g. misoprostol or oxytocin) will also help the uterus to contract. So will breastfeeding her baby. The mother may also need to urinate if her bladder is full, because this can prevent the uterus from contracting properly. Check the contraction of her uterus at every postnatal visit.

5.1.1  Check the mother’s vital signs

5.1.3  Clean the mother’s belly, genitals and legs