Postnatal Care

By Midwife Louise Clarke

The period following the birth of your baby is referred to as the post-natal period. Midwives can care for you and your baby up until the baby is 28 days old should you need regular help and support, however in most cases the midwife will discharge you and your baby to the care of the health visitor when your baby is between 10 and 14 days old.

Following your birth on Labour Ward you will have chance for yourself and partner to spend time alone with your baby. Approximately 2 hours post delivery you will be taken to the post natal ward (Swan Ward) at Warwick hospital.

Depending on the type of birth you have had will depend on how mobile and able you are to look after your baby. You will be greeted by your named midwife for the shift, she will check you into the ward and assist you in caring for your baby.

The midwives on Swan ward are there to help you get used to the demands of your baby, such as feeding, nappy changing and bathing. Whilst you are in hospital there is help to hand 24 hours a day. It is advised to stay in hospital for as long as you feel comfortable with feeding and changing your baby. Your stay can be anything from as little as 6 hours to 48 hours for a normal birth and between 3 and 4 days for a Caesarean section. Each person is different, you need to inform your named midwife on the morning you wish to go home to enable the staff to carry out the checks of you and your baby.

Post natal checks

The midwife will check baseline observations of temperature, pulse and Blood Pressure at least once a day during your hospital stay depending on the type of birth you have had.

The midwife will talk to you during the post natal check to ensure you are happy with feeding your baby. If you are breast feeding she will ensure you are positioning your baby correctly as to not become sore or cracked.

The midwife will feel your abdomen to ensure your uterus (womb) is contracted and ensure your blood loss is normal. The blood loss you experience following delivery is described as a very heavy period. Often during the first 24 hours you may have to use 2 maternity pads at a time. If you pass any large clots this should be reported to your midwife.

If you required stitches of the perineum, the midwife will check to ensure it is healing well and there are no signs of infection. Perineal hygiene is very important to aid healing and Tea tree and Lavender oil have been described as soothing when added to your bath.

If you had a Caesarean section your wound will be checked to ensure no signs of infection are developing.

The midwife will ensure you are able to pass urine without any problems and that you are opening your bowels. It is quite normal for you not to need to open your bowels for 2 or 3 days after your birth.

Post natal exercises and diet will be discussed with you and you may be seen by the obstetric physiotherapist who will also advise you.

Baby Checks

Following your delivery your baby will have 2 labels placed on it’s ankles with your surname on to enable staff to pair baby to mum.

Your baby’s skin and colour will be observed for signs of jaundice. You will be asked if your baby is having both wet and dirty nappies. Babies often get jaundiced around day 3 or 4 but providing your baby is waking for feeds and appears alert this is quite normal and is referred to as physiological jaundice.

The midwife will check your baby’s mouth for signs of thrush and check your baby’s eyes to ensure they are not infected. Many babies suffer with sticky eyes but most resolve without treatment. Very occasionally if it persists the midwife may take a swab and treatment may be necessary.

The midwife will check your baby’s cord to ensure it is drying up adequately, she will show you how to look after the cord, which should be kept clean and dry.

Feeding will be discussed and assistance given where necessary.

Paediatrician Checks

The baby will be checked by a Paediatrician before you leave the hospital. The Paed checks the baby's heart and also it's hips among other tests. This check cannot be carried out before your baby is 6 hours old, because it takes that long for the baby's circulation to change from fetal circulation to adult circulation and this will affect the way the heart sounds.

If you are having a home birth or need to leave hospital before the paediatrician can check the baby. Your GP can conduct the examination, or you can come back to the hospital to see the paed.

Leaving the Hospital

When you are discharged from the hospital you will be given paperwork to give to your GP and the community midwife, this information is important and should be dropped at your GP surgery as soon as possible.

The staff on swan ward put your information into a folder for the community midwife to collect. Please ensure the staff have your correct address so the midwife can visit. You will be given 2 or 3 telephone numbers to call should you need assistance at home.

The community midwife will visit the day after you leave the hospital including Saturdays and Sundays. She will continue the post natal checks at home.

The midwife can visit everyday if needed however if all is well she may visit alternate days.

If all is well visits are as follows.

3. Day following discharge

4. Visit at home

5. No visit

6. No visit

7. Visit at home Baby weighed and PKU heel prick test carried out

8. No visit

9. No visit

10. Visit at home Baby weighed again hopefully back to birth weight (babies generally loose weight in the first week of life)

If on day 10 your baby has regained or is above it’s birth weight and the cord has dropped off she will probably discharge you to the Health Visitor.

The Health Visitor will visit once a week for 1 or 2 weeks and then you will be asked to take your baby to the child health clinic on a regular basis to be weighed.

The Health Visitor will inform you of immunisations and development checks your baby will need to attend.

I hope this brief outline of post natal care prepares you for the beginning of life with a newborn. You will be tired and it is important to take regular rests and accept as mush help as possible from friends and family.

Life with a newborn can be very demanding and time consuming but believe me a mother of 3, it is worth every minute. - Louise

For excellent information on looking after yourself after having your

baby see the MIDIRS Informed Choice Leaflet on Health and Care after Childbirth