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The puerperium (also called the postpartum period) is the time after childbirth during which a woman's body undergoes physiological and anatomical changes to return to its pre-pregnancy state. It is a critical period for both the mother and the newborn.
Duration
Traditionally divided into:
Immediate puerperium: First 24 hours after delivery
Early puerperium: First week (up to 7 days)
Remote (or late) puerperium: From day 8 up to 6 weeks (42 days)
Full recovery of most systems (especially the reproductive organs) is usually complete by 6 weeks postpartum, though some changes (e.g., abdominal wall tone, breastfeeding-related hormonal effects) may take longer.
Major Physiological Changes During Puerperium
Uterus (Involution)
The uterus rapidly reduces in size.
Immediately after delivery: Fundus at or near the umbilicus (~1000 g)
By 2 weeks: Becomes a pelvic organ (100–150 g)
By 6 weeks: Returns almost to non-pregnant size (~50–70 g)
Process involves autolysis and ischemia of excess tissue.
Lochia (Vaginal Discharge)
Lochia rubra: Bright red, lasts 1–4 days
Lochia serosa: Pinkish-brown, days 5–10
Lochia alba: Yellowish-white, up to 4–6 weeks
Total duration: 4–6 weeks (average 3–4 weeks)
Cervix and Vagina
Cervix closes gradually; external os admits only a finger by 1 week.
Vagina regains tone slowly; rugae reappear by 3–4 weeks.
Perineum
Swelling and bruising subside in a few days.
Episiotomy or tear wounds usually heal within 7–10 days