Puerperium

The first 6 weeks postpartum (after birth) are called the puerperium41 (PYU-er-PEER-ee-um), a period in which the mother's anatomy and physiology stabilize and the reproductive organs return nearly to the pregravid state (their condition prior to pregnancy). The shrinkage of the uterus during this period is called involution. In a lactating woman, it loses about 50% of its weight in the first week and is nearly at its pregravid weight in 4 weeks. Involution is achieved through the autolysis (self-digestion) of uterine

Saladin: Anatomy & I 28. The Female I Text I I © The McGraw-Hill

Physiology: The Unity of Reproductive System Companies, 2003 Form and Function, Third Edition

1076 Part Five Reproduction and Development

1076 Part Five Reproduction and Development

Crowning Vulva

Figure 28.21 Childbirth. (a) Crowning. The baby's head, between the attendant's fingers, has begun to dilate the vulva. (b) Emergence of the head. (c) The placenta and fetal membranes (afterbirth).

Figure 28.21 Childbirth. (a) Crowning. The baby's head, between the attendant's fingers, has begun to dilate the vulva. (b) Emergence of the head. (c) The placenta and fetal membranes (afterbirth).

cells by their own lysosomal enzymes. For about 10 days, this produces a vaginal discharge called lochia, which is bloody at first and then turns clear and serous. Breastfeeding promotes involution because (1) it suppresses estrogen secretion, which would otherwise cause the uterus to remain more flaccid; and (2) it stimulates oxy-tocin secretion, which causes the myometrium to contract and firm up the uterus sooner. It is important for the puer-perium to be undisturbed, as emotional upset can suppress lactation in some women.

Before You Go On

Answer the following questions to test your understanding of the preceding section:

17. List the roles of HCG, estrogen, progesterone, and HCS in pregnancy.

18. What is the role of the corpus luteum in pregnancy? What eventually takes over this role?

19. List and briefly explain the special nutritional requirements of pregnancy.

20. How much weight does the average woman gain in pregnancy? What contributes to this weight gain other than the fetus?

21. Describe the positive feedback theory of labor.

22. What major events define the three stages of labor?

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