*3.2.6 Contraception*

Contraceptives are a sure protection against unplanned and unintended pregnancies. And the postpartum period is the best time to make the most of its gains. Exclusive breastfeeding in the absence of menstruation amenorrhoea can guarantee protection from pregnancy.

Nevertheless, most contraceptives are safe and highly effective for use in the immediate postpartum period, the midwife can thus introduce mothers to them. Postpartum intrauterine contraception (PPIUC) can be inserted immediately to

provide long-term protection. The woman enjoys the added benefit of immediate service, cost-saving from not having to return for the service. Where this is not readily available, the woman must be encouraged to return for family planning [63].

Commencing contraceptives in the immediate postpartum period is easier due to the ease and proximity to family planning services at the place of delivery. The woman ovulates 2 weeks before the next menstruation and because menses have not resumed, many women become pregnant within this period and are at risk of unintended, unplanned pregnancy and associated abortion risk. Therefore, encouraging early postpartum contraceptive uptake [64].

#### **3.3 Subsequent care**

Global health authorities recommend up to four postnatal visits: within 24 hours of birth, 3–7 days, 2 weeks, and 6 weeks postpartum. At each, both child and mother should be thoroughly examined, educated, and counseled on measures to cope with the phase of growth. Both the child and mother are examined, and results are recorded. Counseling on nutrition, exclusive breastfeeding, urination, lochia, and the uterus is assessed noting uterine height, involution, perineal and hand hygiene and how they are coping with childcare. The neonate is equally assessed for any deviation from normal. He is weighed and details are documented on the growth chart [45, 65].
