A woman develops severe perineal pressure and increasing pain several hours after a vaginal birth. The perineum is swollen, but vaginal bleeding is small. Which action is the priority?

Correct answer: C. Notify the provider and assess vital signs

  • A. Apply firm massage to the swollen area
  • B. Encourage the woman to walk around
  • C. Notify the provider and assess vital signs
  • D. Offer oral fluids and reassess later

Explanation

Severe pain, pressure and swelling with little visible bleeding suggest a concealed perineal or vaginal haematoma. Prompt assessment and reporting are required because blood may collect in the tissues without obvious external loss.

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Maternal postnatal care assesses uterine involution, lochia, perineal healing, bladder and bowel function, vital signs, emotional wellbeing and signs of puerperal infection or haemorrhage. Breastfeeding covers colostrum, milk production, positioning and attachment, feeding frequency, common difficulties and the distinction between normal breast changes and mastitis.

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