Post-partum

Post-partum refers to the first 6 weeks after a delivery. In the US, women who have had normal vaginal deliveries stay 1-2 days but usually stay longer if they have any complication (high blood pressure, complicated delivery, etc). New mommas get their own private room with a crib and plenty of room for family and friends to spend time greeting the new baby. In the hospital that I work in the DR, post-partum is, in a shocking twist of events, run a bit differently than the US.

In my experience here in the DR, normal healthy patients get a maximum of FOUR hrs for post-partum time. The post-partum room is even more crowded than the labor room- patients often lay on the bed up to three women and three babies at a time. During this time, every patient gets treated with ampicillin and gentamicin prophylactically to reduce the likelihood of an infection. I asked why everyone here got such broad-spectrum strong antibiotics here and the answer I got was honest- they recognized that things were not even close to being sterile and that patients won’t have access to a health care provider once they leave the hospital, so they use big-gun antibiotics to give their patients a chance at staying healthy. Part of the reason they limit the post-partum time is because of lack of physical space for women to stay longer after they delivered but another part is sanitary- get the women out of the hospital as soon as possible.

Adolescents and complicated patients are required to stay in the hospital for longer. This week I worked in the post-partum floor and spent a lot of time getting to know these patients and their clinical history. A 13 year old new mother with no supplies or clothes ready for her new baby. A 15 year old mother who had high blood pressure during her delivery, was sent home, but never filled her antibiotics or blood pressure medicine and came back to the hospital with uncontrolled seizure s, heart failure, and sepsis. An 18 year old woman who developed a pelvic abscess after a Cesarean procedure and had to have her uterus removed later in the week to control the infection. A woman in her 20s whose baby was delivered via an emergency delivery for fetal distress after mom’s pancreatitis made her health so unstable she was in septic shock. A young woman who was staying in the hospital for her third week because of continued abdominal wall infections and healing problems after a routine Cesarean delivery.