RU2734909C1 - Method for postnatal recovery of women - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to health-improving medicine, and can be used in postnatal rehabilitation. During postnatal recovery, the woman is shown a bed rest for two days after the birth and a careful attitude to the physical condition of the woman. Tummy tuck is performed depending on woman's figure, method of delivery and needs. Women's body heat is continuously maintained. Method of eating includes warm food and haemostatic beverages. Performing physical assistance in housekeeping. It is followed by a specialist who controls maternal recovery and child's health. Visceral packet is formed, namely performing abdominal massage technique, by means of which all organs become anatomically correct places occupy the least volume. Restorative gymnastics and complex restorative procedures under the control of a specialist are performed; psychological and information support is provided.

EFFECT: method provides higher effectiveness of female body recovery after delivery and reduced postpartum complications by creating conditions for recovery of body physical and psychophysical state.

1 cl, 3 ex

Description

The invention relates to the field of health-improving medicine and can be used in postpartum rehabilitation, namely to restore the psychophysical state of women and improve the functions of the body of women.

From the prior art there is known a method for improving the human body, in which the healing is carried out in three stages. At the first stage, manual therapy of the spine is carried out on the first, third and fifth days, in parallel, daily for 10-15 days, multichannel electrical stimulation is carried out, for example, with the device "Mioritm-040" of the gastrointestinal tract, and for the complete removal of toxins and toxins during 15 days from the beginning of the instrumental effect on the intestines, cleansing enemas are done .. At the second stage, 3-4 sessions of liver cleansing are performed once a week. At the third stage, under the guidance of a doctor, psychoemotional therapy is carried out daily 3 times a day for 10 minutes for 15 days, influencing the structures of the brain that are responsible for regulating the processes of the nervous system and internal organs, and after a set of basic exercises, the patient switches to formulas of intentions, which wants to convince himself that every day the state of health will improve, that the body is getting younger, that the brain is well supplied with blood and that it controls the entire body well. The method makes it possible to increase the efficiency of improving the human body (patent RU 2201737, 10.04.2003).

There is a known method of postpartum rehabilitation, which consists in influencing a woman's body, in which an external thermal effect on the woman's body is applied without overheating the woman's body, with myofascial release, visceral massage of the abdomen. After the heat exposure, the woman is wrapped for sweating without overheating, then the head, shoulders, chest, ilium, the middle of the femur, the middle of the calves, the metatarsus, the area of the hip joints are sequentially pulled. In addition, before the internal heat exposure, the intestines are cleansed, and lymphatic drainage massage and connective tissue massage are performed (patent RU 2408355, 27.08.2010). The method allows to have a complex effect on the woman's body.

However, these methods do not provide complete physical recovery of the female body after childbirth, as well as the psychophysical state of the woman.

The objective of the invention is to create an effective method of postpartum rehabilitation, which would eliminate the above disadvantages.

The technical result of the proposed invention is to increase the efficiency of the recovery process of the female body after childbirth and reduce postpartum complications by taking into account the adherence to female postpartum physiology and creating conditions for the most complete implementation of the process of physical recovery of the body, restoration of the psychophysical state and, as a result, improvement of body functions in in general, using the deep reserves of the body and the help of natural influences.

The specified technical result is achieved using the following method of postpartum recovery of women, called "10 steps to successful recovery after childbirth", in which bed rest is used after childbirth for two days and respect for the physical condition of a woman, tying is carried out, depending on the figure of the woman, method of childbirth and needs, preserve the woman's body heat, observe a diet that includes special warm food and blood-replenishing drinks, provide physical assistance in housekeeping, monitor the recovery of the mother and the child's health, form a visceral package with a special technique of work with a stomach, through which all organs are placed in anatomically correct places, occupy the smallest volume, carry out restorative gymnastics and complex restorative procedures under the guidance of a specialist, carry out psychological and information communication support.

The method of postpartum recovery of women "10 steps of successful recovery after childbirth" is as follows.

Step 1. Compliance with bed rest after childbirth for two days, respect for the physical condition of a woman.

During pregnancy, the entire body of a woman undergoes changes:

- a shift in the center of gravity leads to an increase in lumbar lordosis, thoracic kyphosis, which is compensated by cervical lordosis;

- due to the forward tilt of the pelvis, the area of contact of the articular surfaces decreases, which is an additional load for the hip joints;

- the thoracic diaphragm rises, the heart takes a horizontal position, the chest excursion decreases;

- the growing uterus presses the stomach, liver and intestines, which makes it difficult for them to work;

- intra-abdominal pressure increases, the outflow from the lower extremities is disturbed, which leads to a strong tension of the vessels of the legs and small pelvis;

- the skin is stretched;

- in the work of muscles, a redistribution of the load occurs, which leads to additional energy costs;

- the stereotype of movement during pregnancy is rebuilt, this process occurs in small doses - every day, so the body is perceived without stress.

During childbirth, in one day, global changes occur throughout the woman's body:

- after childbirth, the center of gravity instantly changes;

- the motor stereotype does not change immediately, it needs time to create a new movement algorithm;

- an open wound appears in the uterus in the size of two palms - the place to which the placenta was attached - the placental site;

- the uterus greatly decreases in volume, its weight on the first day is one kilogram, due to metabolic processes (autophagy, lysis, phagocytosis), which are closely related to blood circulation - in just nine days, the uterus will shrink to 150-200 g;

- while remaining elongated, the fallopian tubes swell greatly and still cannot hold the uterus;

- internal organs (intestines, stomach, liver, pancreas, heart, lungs, etc.) do not immediately take their anatomically correct places, which affects their functions;

- the pelvic floor muscles swell after passing the child's head, and trauma and edema of the soft tissues of the small pelvis occur, which goes away only by the third week;

- excessively elastic ligaments and an injured pelvic floor are not immediately able to hold a heavy uterus, which, when getting up early, causes prolapse;

- the ligamentous apparatus returns to normal only two months after the birth of the child.

Verticalization of the body in the first days after childbirth causes a huge number of microtraumas and traumas that lead to inflammation, and therefore to the adhesion process. Moreover, the pressure on the fragile pelvic floor and the load on the stretched ligaments will lead to prolapse of internal organs and disruption of their functions. Ligaments in childbirth acquire excessive elasticity due to the release of a large amount of the hormone relaxin. All joints in the body reduce their functionality, which leads to: protrusions in the spine, limited joint mobility and compensatory disorders.

Thus, adherence to bed rest for two days after childbirth will allow the ligaments and joints to become stronger, change the dynamic stereotype, restore the pelvic organs without repeated injuries, save the woman's resource for metabolic recovery of the body, and not distract him for movement, because during physical activity, blood flows from the internal organs to the working muscle.

Immediately after the birth of a child, a woman releases a large amount of endorphins, which actually pain relieve her body. Getting up early after childbirth can be compared to "moving on a broken leg under pain relief."

Compliance with bed rest allows you to avoid early verticalization, among the consequences that it has on a woman after childbirth are:

- "sail of pregnancy" (increased lumbar lordosis, compensatory increased thoracic kephosis, deviation of the neck relative to the shoulders anteriorly), which will lead to pain in the back and hip joints, "widow's hump", headaches, saggy belly;

- violations in the work of the reproductive organs;

- disturbances in the work of the urinary system;

- violation of the digestive tract;

- prolapse and prolapse of internal organs.

In the tradition, there was a saying: "After giving birth, a woman should be in bed for a week, a week in bed, a week near the bed, a week near the bed." A respectful attitude towards a woman must be ensured both on the part of the observing doctor and on the part of loved ones. It is also necessary to provide, especially in the first weeks, help in mastering the skills of caring for a child, observing oneself

Step 2. Tying is carried out.

Since the ligaments, skin and muscles of the abdomen cannot recover instantly, it is necessary to tie the abdomen when getting up the first time. This is necessary in order to:

- remove the load from the pelvic floor;

- remove the tension that makes the woman bend in the thoracic region, compensating for the saggy belly;

- maintain intra-abdominal pressure;

- unload the ligamentous apparatus.

All offered industrial postpartum bandages are aimed at tightening the abdomen. However, with a weakened pelvic floor, pulling down the stomach, we, as from a tube of toothpaste, begin to squeeze all our internal organs downward, which will lead to a violation of their anatomical position and functions. There are a huge number of traditional tying methods that have evolved in different parts of the planet, depending on the prevailing anatomical type of woman's structure. A woman with a genikoid figure can be tied up using the old Russian method - a wide belt that supports the stomach. A woman with an anthropoid figure who does not have wide hips can be tied with a bek-kung - a 9-meter cloth that is wound around the body in a certain way. Women with a parted pubis can gently tighten their thighs. And you can also use other tying methods. Tying time is individual: subjective - while it is easier with a garter than without it; objectively - depends on age, tissue condition, physiological deficits, the complexity of pregnancy and childbirth. It is necessary to begin to tie up from the moment a woman starts to get up after childbirth, and throughout the entire postpartum period. It is worth tying up even longer if a woman is carrying a child in her arms. I tie up the abdomen with a plastic soft cloth that allows you to support every centimeter of the lower back, hips, abdomen. There are many different tying techniques (see https://www.babyblog.ru/community/post/happypregn/3193377, https: // zen.yandex.ru/media/id/5d9610a54e057700b1181116/podviazyvanie-jivota-posle-rodov- benkung-5d9eca9e04af1f00b1edd1ae, https://mama-poslerodov.ru/blog/ utagivaem-i-podtagivaem-zivot-kogda-eto-nuzno-posle-rodov,) https: // www. youtube.com/watch?v=_-ds0J1S1-c), the woman chooses the one that best suits her.

Step 3. Retains body heat.

The woman is given only warm drinks, warm food. The body heats food in the stomach up to 38 degrees Celsius. So, cold or raw food should be warmed. Otherwise, the digestion of food begins to be disrupted, which causes rumbling, pain, gas in the abdomen and stool disturbance. Poor digestion leads to deficiencies in women and also to abdominal pain in children. This wastes the heat needed for recovery.

It is necessary to maintain body heat - sleep in pajamas, walk in slippers, and not expose your lower back. After giving birth, the body is very vulnerable. Any sickness can weaken it, so it is necessary to conserve the body's energy, which should be directed towards recovery. Cold provokes a spasm of muscles, blood vessels, ducts, etc., which disrupts the circulation of body fluids. This can be the cause of lactostasis, cystitis, pyelonephritis, back pain, uterine contraction disorders, etc. Failure to follow the recommendations after childbirth will affect the subsequent life of various urogenital, gynecological diseases, poor posture, back pain.

Step 4. Observe the regime and diet.

The main recommendations concern the nature of the food. It should be easily digestible, high-calorie, rich in vitamins and microelements, semi-liquid and containing a large amount of soft dietary fiber dishes: blood-restoring drinks, broths, cereals, compotes, fish and meat soufflés and cutlets, baked fruits and vegetables. It is also important that the mother's diet is safe for the baby.

During childbirth and the postpartum period, a woman's body loses up to a liter of blood. In addition, a nursing woman spends a huge amount of resources on the synthesis of milk from the blood and its release from the breast. At such costs for the body, nutrition comes to the fore, since it is one of the main sources of energy and nutrients for recovery.

Step 5. Provide physical assistance to a woman in housekeeping.

Help needs to be organized. It can be both free (help from relatives, friends) and paid (food delivery, cleaning, babysitting services for older children).

If there is no help, a woman, instead of resting, recovering and gaining strength after childbirth, will get up and start doing her everyday life. She will have to clean up, cook food, wash, iron, go to the store, and provide services for older children on her own. This leads not only to exhaustion in the postpartum period, but also to depression, the causes of which are associated with physical weakness and denial of the need to help a woman in the postpartum period. Childbirth is an important and difficult event after which a woman needs recovery. It is important that not only relatives but also the woman herself remember this.

One of the main tasks of the postpartum period, which few people pay attention to, is the acquisition of parenting competencies. A young mother needs to learn to understand the child. This also requires strength, time, which must be freed from household chores. In many countries, for example in the Netherlands, Germany, such assistance is provided by the state free of charge for a woman in childbirth.

6 step. Observation is carried out for forty days.

This is the organization of supervision by a specialist who can monitor the recovery of the mother and the health of the child.

The postpartum period is full of dangers, ranging from a slowdown in uterine contraction, non-healing of the placental site, psychological "blues" or depressive states of the postpartum period, difficulties with breastfeeding, etc. According to the protocol, only a visit to a gynecologist is provided at the end of the postpartum period. However, it is in the forty-day period after the birth of a child that the risk of psychological and physiological complications is high. Therefore, it is necessary to observe during this period not only by doctors - gynecologists, but also by psychologists, therapists, chiropractors, osteopaths, as well as various specialists in helping professions - breastfeeding consultants, postpartum doulas.

7 step. The abdomen is ruled to form a visceral "package".

Visceral "package" - related to the viscera, the viscera (Great Medical Encyclopedia https: // big_ medicine.academic.ru/3100/%D0%92%D0%98%D0%A1%D0%A6% D0% 95% D0% A0% D0% 90% D0% 9B% D0% AC% D0% 9D% D0% AB% D0% 99).

The huge uterus during pregnancy makes the diaphragm work differently, shifting all internal organs to it. Intra-abdominal pressure is one of the factors that keep the organs in the anatomically correct place. After childbirth, intra-abdominal pressure drops, overly elastic ligaments, after massive release of the hormone relaxin during childbirth, still cannot perform their functions, returning the organs to their places.

The well-coordinated work of organs and systems implies the correct anatomical arrangement of organs, free movement of the organ (visceral rhythm), precise work of the sphincters. The following pathologies disrupt the work of organs: 1) ligament fixations (ligament spasm);

2) muscle fixation (smooth muscle spasms); 3) adhesions (trauma, surgery, inflammation) (https://cyberleninka.ru/ article / n / vistseralnaya-terapiya-pri-rannih-srokah-beremennosti). According to the observations, more than a third of women in the postpartum period have prolapse of internal organs, two-thirds of women have other visceral dysfunctions, and half of women have joint disorders (https://cyberleninka.ru/article/n/kompleksnaya-metodika-vosstanovleniya-zhenschiny- v-poslerodovom-periode).

The formation of the "visceral column of internal organs" solves not only the problems of correct interposition of internal organs, but also the restoration of the correct visceral rhythm of each organ, a good outflow of all digestive secretions, restoration of intestinal motility, relieving pain in the spine, and also contributes to the rapid recovery of a woman after childbirth (https : //cyberleninka.ru/article/n/kompleksnaya-metodika-vosstanovleniya-zhenschiny-v-poslerodovom-periode). The organs fall into place, thanks to the effect on the spasms of the ligaments of the internal organs, muscle spasms, adhesions, as well as the massage effect on the peritoneum.

Techniques of visceral massage are known from the literature (Visceral massage of internal organs. Basics, Ogulov A.T., Series How to become healthy. Modern self-instruction manual, AST Publishing House, 2017) and are applied in practice (see https://dvrzdrav.ru/metodiki/ vistseralnaya-terapiya; https://heaclub.ru/visceralnyj-massazh-sut-tipy-naznachenie-tehnika-protivopokazaniya-kak-vypolnyat-visceralnyj-massazh-samostoyatelno).

Step 8. Restorative gymnastics is performed.

On the first day, breathing exercises are very important. They restore the surge of the diaphragm, which means that they remove congestion in the abdominal cavity, accelerate venous circulation, and increase the flow of venous blood to the heart. Exercises can be started from 2 days, the duration of the sessions is 15-20 minutes. In the future, gymnastics becomes more complicated every day and serves a rapid contraction of the uterus, strengthening the pelvic floor muscles, converging diastasis, increasing metabolism, improving lactation, and regulating the function of the intestines and bladder. The Pilates Polestar technique (http://tenchi.ru/news/stili-pilatesa) can be used as an example of recommended gymnastics. This type of modern Pilates specializes in physical therapy and rehabilitation. It is suitable for people who suffer from various injuries and for those who would like to restore the full functionality of their body. And also the technique of myofascial release (https://stoneforest.ru/look/allabout/health/ miofascialnyj-reliz /, https: //medbanki.ru/omolozhenie/miofastsialnyy-reliz.html), where the approach to the postpartum woman is individual, The technique allows to achieve positive health dynamics in people with problems with posture and musculoskeletal system in general.

Step 9. A comprehensive recovery procedure is carried out under the guidance of a specialist.

The specified complex restorative procedure includes external thermal effect on the woman's body without overheating the woman's body, for example, in a bath, in a sauna, in a bath, after thermal exposure, a woman is wrapped to sweat without overheating, then the head, shoulders, chest, ilium, middle are sequentially pulled. femur, mid-calf, metatarsus, area of the hip joints.

Step 10. Provide psychological and informational support for forty days.

In the postpartum period, mothers need psychological support for 40 days. They have no experience in motherhood yet, and this is the time to acquire parenting competencies. They are anxious because many things are not working out, but no one will tell them that this is normal. A high emotional background drains a woman and can be the cause of a depressive state. In this case, the mother-child dyad is violated and the child receives no response to his signals. This means that his emotional and psychological development will be inhibited.

Information on how to take care of the child, how to feed him, put him to bed, what to eat so that the child does not have stomach aches and allergies, how to dress him, when to walk. In addition, family relationships are changing. The structure of the “big” family is changing. Everyone gets a new role and does not always cope with it. Searching for information and clarifying relations with loved ones takes a large amount of the mother's resource. Provide psychological and informational support through nursing patronage, consultations, online consultations conducted by specialists (gynecologists, psychologists, therapists, pediatricians, and various specialists in helping professions - breastfeeding consultants, postpartum doulas, etc.) test -visits to specialists.

Clinical example 1.

The patient is 28 years old. 5th day after childbirth.

After being discharged from the hospital, the woman called for a patronage. She was confused, as she was left alone, and there was no specialist at hand, to whom, as in the maternity hospital, she could seek advice around the clock. The woman cried and trembled, considering herself a bad mother from the fact that she could not calm the child. They cried together.

After answering all the questions, recommendations on how to bathe, how to feed, how to put the baby to bed and dress, she calmed down. We bathed the child together, put him to bed and finally paid attention to the mother herself. For the whole day, and it was 15.00, she ate one sandwich, because she did not let go of the child. Her back ached and she couldn't take a full breath. After the story about "10 steps of postpartum recovery" she was given recommendations on nutrition, gymnastics, and straightening and tying of the abdomen.

The woman also needed information about the existence of helping professions, advice on choosing a postpartum doula and a food delivery service for mothers who gave birth.

The woman was monitored by telephone for the first week every day. The second week, the telephone consultation was required only 2 times. Then she stopped calling.

After 2 weeks, the woman underwent the Swaddling procedure. She straightened up, her mood improved.

After another 2 weeks, a follow-up call was made to this woman to obtain information about her condition. She complained of fatigue and said that again she did not have enough air. She was advised to simply check her condition by taking a blood test and ferritin. Ferritin was low, and a complete blood count clearly indicated anemia. The woman was referred to a therapist for anemia.

After another 2 weeks, another follow-up call was made. The woman was happy, calm and thanked very much for her help. There were no complaints.

Clinical example 2.

Patient 30 years old. 7 day after giving birth.

A call was received from a woman a week after discharge from the hospital. Request - the child does not sleep well, it is necessary to show how to rock him and what kind of gymnastics to do with him. The child often cried, the woman constantly breastfeed him, complained of back pain.

After a conversation about clothes, it turned out that the woman was used to sleeping exclusively in her underwear. When asked “Does she get up at night to go to the toilet?” She replied that she gets up several times. Recommendations were given to take a urine test, and change the diet, as it turned out that she eats a lot of raw fruits. Also after the story about “10 steps of postpartum recovery” she was given recommendations on clothing, nutrition and gymnastics.

The woman called back 4 days later. She said that the tests were abnormal. A recommendation was made to see a doctor. The woman also noted that the child became calmer after she changed her diet and she herself began to feel better.

After 2 weeks, I called with gratitude, because I felt good and calm, as I knew that I could always call and get advice.

Clinical example 3.

The patient is 36 years old, 10 days after delivery.

A woman from Orenburg listened to all the webinars and recommendations for postpartum recovery. Then she received consultations by phone. She said that she eats warm, dresses well, follows all the 10-step recommendations, but her stool did not get better and the diastasis did not go away. Received advice on self-massage, gymnastics and nutritional adjustments. I called back a week later and thanked: the chair got better, the stomach got stronger.

Claims (1)

The method of postpartum recovery of women, in which bed rest is applied after childbirth for two days, the abdomen is tied depending on the woman's figure, the woman's body is constantly kept warm, a diet is observed that includes warm food containing easily digestible, rich in vitamins and microelements, food fibers and semi-liquid dishes and hemostatic drinks, provide physical assistance in housekeeping, monitor the recovery of the mother and the health of the child, perform visceral massage of the abdomen, perform breathing exercises on the first day after childbirth, and from the second day perform exercises , aimed at strengthening the pelvic floor muscles, correcting diastasis of the rectus abdominis muscles, also provide psychological and informational support.