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自然產產後護理指導
Instructions for Vaginal Delivery Postnatal Care
在平安的自然生產後，以下為可能遇到的情形供您參考：
After a safe virginal delivery, the following are circumstances which you may encounter:
1.子宮：
(1)產後24小時內，一旦發現子宮鬆弛或柔軟情形，就應予以按摩直至子宮收縮變硬為止（按摩的原則是軟的按摩成硬的，不是硬的按摩成軟的）。
但突然發現有大量血液流出，請立刻與護理人員聯絡，才能為您做妥善處理。
(2)生產後第一天子宮底維持在肚臍的高度，爾後每日下降一指幅，直至產後10天～二週之內子宮底已下降至骨盆腔內，腹部則幾乎摸不到。
(3)子宮恢復初期，由於強烈收縮所以會有「產後痛」，持續3-4週後即消失。
1.Uterine:
(1)In 24 hours after the delivery, once you discover the uterine to be loose or soft, give massage until the uterine contracts to a hard state (the massage principle is to massage soft uterine into hard uterine rather than hard uterine into soft state).
However in case of discovering sudden surge of blood, please contact with the nurse for proper treatment.
(2) The bottom of uterine in the first day after delivery will be maintained at the height of belly button and will then descend by the distance of one finger every day until the 10th day to 2 weeks after the delivery, where the uterine declines to the pelvis cavity and could not be felt when touching the abdomen.
(3) Uterine recovery will have postnatal pain due to the strong contraction at the early stage, which will disappear in 3~4 weeks.
2.惡露變化：產後胎盤剝離後，子宮內分泌物經由陰道排出，前二、三天量較多，顏色鮮紅，腥味重；五、六天後至產後十天量較少，顏色逐漸呈紅褐色，此種情形有時可能維持至二～三星期，完全乾淨需四～六星期。
【若含大量血塊或鮮血湧出，請立即告知護理人員或返診檢查】。
2. Changes in lochia: After the placenta has elevated, the uterine secretion is discharged through the virginal. More amount will be discharged for the first 2~3 days with red color and strong smell.
The secretion will become less in 5~6 days to 10 days after delivery, where the color gradually turns dark color.
This circumstance could last for 2~3 weeks and will become completely clean in 4~6 weeks(in the event of large blood chunks or surging blood, please immediately notify the nurses or return for revisit).
3.會陰沖洗：產後第一天由護理人員每天為您沖洗並檢查傷口及子宮收縮狀況，其餘時間請儘量保持清潔及乾爽，至少3-4小時更換產墊，大小便後以沖洗器裝開水自行洗，預防傷口感染。
3. Perineal Douche: The nurses will rinse and check your wound as well as uterine contraction on the first day after delivery. Please keep the perineal clean and dry at all other times. Change the pad in every 3~4 hours. Rinse with the flusher filled with drinking water after urination and bowel movement to prevent wound infection.
4.飲食：產後一般沒有禁忌，而以下食品食用時，請您稍加注意：
4. Food: There is no taboo after general delivery. Please pay attention to the following food:
※酒類食品：
產後一週暫勿食用，若需進食酒類品請酌量，以免影響傷口癒合及子宮收縮。
※Alcohol food: Avoid eating such food in one week after the delivery.
Please take moderate amount of alcohol based food to avoid affecting wound healing and contraction.
※生化湯：產後3天內暫勿食用，因生化湯是一種子宮收縮劑，若子宮收縮疼痛厲害，請暫時停止食用等待疼痛緩解後才食用。
※Shenghua Soup:
Do not take this medicine in 3 days after delivery.
Shenghua soup is a type of contracting agent and severe contraction will cause extreme pain. Please suspend taking the medicine after the pain is alleviated.
5.安全問題：
產後身體比較虛弱，第一次下床時需有家屬陪伴，以免暈厥而發生意外傷害。
5. Safety issues:
The body is weak after giving birth and requires the company of family when getting off the bed for the first time to avoid injury due to passing out.
6.排尿：6-8小時內應自然解小便，若無法自行解小便請通知護理人員。
6. Urination: You should be able to urinate naturally in 6~8 hours.
If not, please notify the nurses.
7.疼痛：當子宮收縮或傷口疼痛厲害時，應暫時停止按摩，休息後若仍疼痛不舒服，請告知護理人員，將依醫師囑咐給予止痛藥。
7. Pain: When the uterine contracts or the wound hurts a lot, stop giving massage temporarily. If pain continues after some rest, please inform the nurses and receive painkiller according to physician instruction.
8.束腹帶使用：產後即可使用。
8. Use of binder: Use after delivery.
9.產後性生活：一般只要產後夫妻雙方做好溝通，心理建設完全，且傷口已沒有任何不舒服的感覺即可開始。
9.Postnatal sex life: In general as both couple communicates after delivery with mental readiness, while the wound no longer feels discomfort, then the couple may begin the sex life.
◎產婦出院須知
Instructions for Maternal Women Discharged from the Hospital
返家後傷口自我照顧方法：
大小便後，以煮過的溫開水由前往後沖洗(陰道口→肛門口)，保持乾爽即可。
Self-care method of wound for maternal woman returning home: After urination and bowel movement, use lukewarm drinking water to rinse from front to back (virginal→anus) in addition to keeping it dry.
藥物：出院時醫師會依照您的復原狀況而開藥，依照藥袋上指示服用即可。
Medicine: The physician will prescribe medicine according to your recovery condition at discharge from the hospital. Follow the instructions on the medicine bag for administration.
出院後如有下列情形，請立即返院檢查：
1.陰道大量出血或有惡臭的分泌物。
2.持續發燒及腹瀉。持續性腹部疼痛或陰部疼痛。
3.乳房發生紅腫疼痛的硬塊。
In the event of the following conditions after discharge from the hospital, please return to the hospital for examination:
1. Massive vaginal bleeding or odorous secretion.
2. Continuous fever and diarrhea. Continuous abdominal pain or vaginal pain.
3. Rash, swollen and painful blocks on the breast.
返院檢查：依醫師約定時間返院作產後檢查，並做子宮頸抹片檢查，關於節育方法可與醫師商討。
Return to hospital for examination: Return to the hospital for postnatal examination according to the time scheduled by the physician in addition to taking Papanicolaou test. Discuss with the physicians for birth control measures.
◎產後運動：
1.產後腹肌鬆弛，做合宜運動可助肌肉收緊，保持身材促進產後子宮復舊。
2.依個人情形，選擇適宜的運動，尤其是手術生產者，應請教醫師。
3.最好在早晨或晚上按時施行，需每天做至產後兩個月為止。
4.做時先解小便，躺在硬板床上，起初切忌勉強或太累，次數應漸漸式增加做完運動應適當休息。其方法如下：
◎Postnatal Exercises:
1. Postnatal loose abdominal muscles. Do proper exercises to tighten the
muscles, maintain body shape and promote postnatal uterine restoration.
2. Choose proper exercise depending on individual situation.
Consult with a physician for surgical delivery.
3. Exercise in the morning or at night every day until two months after the
delivery.
4. Urinate first before exercise.
Lie down on the hardboard bed. Do not exercise excessively or too tired.
The number of exercises should be gradually added with proper rest, as
shown in the following method:
乳部運動：產後第三天開始
(1)仰臥床上，雙臂向左右伸展至與肩部對齊，伸直平放。
(2)將兩手慢慢上舉合攏，再慢慢回復原位。
(3)共做五次。
Breast exercise: starting from the third day after delivery
(1) Lie on the bed, stretch the arms out and align with the shoulder, straighten and place flat.
(2) Put the two hands upward and close, then slowly put the hands back to the original position.
(3) Follow the diagram and do 5 laps.
頸部運動：產後第七天開始
(1)仰臥床上，全身放平，手腳伸直，手掌貼身邊。
(2)將頭仰起，盡量向前彎，使下巴貼近胸部，再復原共做10次。
(3)做此動作時，不可牽動身體其他部份。
Neck exercise: Starting from the seventh day after delivery.
(1) Lie on the bed and flatten the body. Straighten the arms and legs with palm stay close to the body.
(2) Lift the head and try to bed forward so the chin stays close to the chest, and then restore. Do 10 laps.
(3) This motion should be pull any other parts of the body.
腿部運動：產後第十天可開始。(會陰縫補者須延至二週後開始)
(1)平躺仰臥，手腳伸直。
(2)先將左右腳輪流向上舉起，膝部須挺直，腳尖伸直各做五次。
(3)然後同時將雙腳舉起。
(4)注意用腹肌操作，不要利用手力。
Legs exercise: Starting from the tenth day after delivery (however persons with sewn perineal may not start until after 2 weeks).
(1) Lie flat and straighten the arms and legs.
(2) Lift both legs in turn. Straighten the knees;
the tip of toe straight and do 5 laps.
(3) Lift both legs up.
(4) Use abdominal muscles for operation and do not use the force of hands.
臀部運動：與腿部運動同
(1)仰臥床上，手腳伸直，手掌貼身邊。
(2)將一腿舉起，使足部貼近臀部，大腿靠近腹部，再伸直放回床面，另一腿作同樣動作，左右兩腿各做五次。
Hip exercise: The same as leg exercise.
(1) Lie on the bed, straighten the arms and legs with palm place close to the body.
(2) Lift one leg so the foot stays close to the hip.
The thigh stays close to the abdomen, then stretch and place back
on the bed.
Do the same motion with the other leg. 5 laps per each leg.
收縮陰道運動：產後半個月開始
(1)仰臥床上，雙手伸直平貼床面，兩腳彎曲分散與肩同寬，腳跟後縮，將臀部抬離床面。
(2)兩膝合併同時收縮臀部肌肉，保持此姿勢1-2分鐘。
Virginal contracting exercise: starting from half month after delivery
(1) Lie on the bed, straighten the arms and flatten to the bed.
Bed the two legs separately to the same width as the shoulder.
Pull up the heels and lift the hip off the bed.
(2) Put the two knees together while pull up the hip muscles.
Keep this position for 1~2 minutes.
腹部運動：產後半個月開始
(1)仰臥床上，雙手交叉放在腦後，腹部或平放身側，
用腰腹力量使身體坐起，反覆數次。
(2)注意不可移動腳部，膝不可彎曲。
Abdominal exercise: starting from half month after delivery
(1) Lie on the bed, cross the hands behind the head, use the abdomen or flatten the body to sit up with the waist and abdominal force. Repeat a few times.
(2) Do not shift the feet or bend the knees.
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