Control group
lochia, bleeding, voice, pain
BLEEDING
(1) In the prenatal period, routine prenatal examinations included blood pressure, body weight, uterine height, and abdominal monitoring. Fetal heart rate was monitored every 2 weeks after 32 weeks of gestation and every week after 36 weeks of gestation. The participants regularly received B-mode ultrasound and related laboratory examinations. Obstetric physicians provided prompt responses to the issues of individual women, while midwives launched collective health education to women during pregnancy check-ups (gestational week 28 and thereafter) at the pregnancy school.(2) During the intrapartum period, due to policies for personnel management during the COVID-19, the hospital did not allow childbirth companions in labor room, women were required to enter the delivery room alone once they reached the first stage of labor. Therefore, in the first stage, the midwife mainly encouraged the family to provide support for women through voice and video calls, affirmed their independent decision regarding delivery mode and pain relief method, guided their family to prepare energy supplements such as functional drinks and chocolates, and promoted adequate nutrition intake to ensure sufficient energy during labor. In the second stage, the midwife encouraged them to actively apply breathing and pain relief techniques, and instruct them to correctly use abdominal pressure. In the third stage, wounds were examined and sutured, and the early skin-to-skin contact and early sucking were implemented.(3) In the postpartum period, mother and baby were accommodated in the same room with close monitoring of maternal bleeding and urination within two hours after birth. Mothers were treated promptly and symptomatically if abnormalities were noted, or then they were sent back to the ward if no abnormalities were observed. Postpartum uterine involution and lochia discharge were monitored, and the mothers’ perineum were disinfected. Before discharge from the hospital, the midwife provided mothers with health education on breastfeeding and neonatal care and informed them to visit for a follow-up at 42 days postpartum.