Problem
Tess has delivered twins via Cesarean section! Baby A, a girl named Sofia, has been admitted to the NICU. Her husband, Luis, follows Sofia to the NICU with his cell phone, taking pictures of the unexpected event. Baby B, a boy named Marco, is admitted to the postpartum unit with his mother, Tess. Tess is tired but very talkative about her delivery experience, which included an episiotomy. She complains of having afterpains that seem to be worse during breastfeeding. She is also concerned about why she is having vaginal bleeding, because she thought her menstrual period would not return so quickly.
Task
a) Explain (according to Rubin's theory of psychological adaptation during the puerperium) why Tess is so talkative after delivery and state how these stages influence when parent teaching would be most effective.
b) What are afterpains, and why do they often worsen during breastfeeding?
c) What should the nurse teach Tess about what she can expect in the next few days and weeks concerning her vaginal discharge.