Caring for the Mother and Baby After Bir th 97
Danger signs in the first few days after birth
Bleeding
Bleeding that starts more than a day after the birth is usually caused
by pieces of the placenta that have been left in the womb.
Danger signs of too much bleeding:
• soaks more than 2 pads or thick rags an hour in the first day after birth
• soaks more than 1 pad or thick rag an hour after the first day
• has a continuous small flow of blood
What to do:
1. Firmly rub the top of her womb until it gets very hard and
the bleeding stops. Have the baby suck on her breasts, or
have someone roll her nipples.
2. Give medicines to stop the bleeding (see box on page 93).
3. If the bleeding will not stop, get medical help. Continue to
rub her womb as you take her to the hospital.
4. If she has signs of infection, give the same antibiotics as for
womb infection described below.
Womb infection
Infection of the womb is very dangerous. It must be treated
or the woman can become infertile or die.
➤ If the mother
complains that she
does not feel well,
watch her carefully for
signs of infection.
TRANSPORT!
Danger signs of womb infection:
• fever and chills
• pain and tenderness in the belly
• bad-smelling fluid from the vagina
Treatment:
1. Give one of these combinations of medicines:
ampicillin. . . . . . . . . . . . . . . . . . . . . . . 2 g (2000 mg) IV or IM the first time only,
.then 1 g (1000 mg) IV or IM each other time. . . . 4 times a day
and gentamicin . . . . . . . . . . . . . . 80 mg the first time only, IV or IM,
.then 60 mg each other time 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . times a day
and metronidazole. . . . . . . . . . 400 to 500 mg by mouth or by IV 3. . . . . . . . . . . . . . . . . . . . times a day
OR
cefixime. . . . . . . . . . . . . . . . . . . . . . . 400 mg by mouth 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . times a day
and doxycycline. . . . . . . . . . . . . 100 mg by mouth 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . times a day
(avoid using doxycycline if you are breastfeeding)
and metronidazole. . . . . . . . . 400 to 500 mg by mouth 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . times a day
For either choice, all of the medicines you use should be continued for 2 more days
(48 hours) after the fever is gone.
2. If she does not start to feel better within 24 hours, take her to the nearest hospital.
Encourage her to drink a lot of fluids if she is taking medicines by mouth.
Where Women Have No Doctor 2012