Acupuncture and the Puerperium

For pain in the perineum, cold compresses and analgesics may be used (NICE 2006). For urinary stress incontinence, the usual treatment is to teach and encourage pelvic floor exercises. For constipation and haemorrhoids, stool softeners may be needed. Making sure all milk is expressed is the first action with mastitis, and cold compresses may be used. If a bacterial infection is suspected, antibiotics are prescribed, while breast abscesses are treated with incision and drainage. Back pain and headache are managed in the same way as in the general population. Persistent fatigue can be the result of anaemia due to excessive blood loss, and may be treated with iron supplements or sometimes a blood transfusion. Women with the ‘baby blues’ need reassurance that it will pass quickly and is a ‘normal’ experience in the first week after giving birth (SIGN 2002). Those with postnatal depression are referred to psychological therapies and possibly given antidepressants (NICE 2007).