Principles of postnatal care

The postnatal period can be defined as the first 6-8 weeks after birth. Postnatal care should be a continuation of the care the woman has received through her pregnancy, labour and birth and take into account the woman’s individual needs and preferences. It should aim to create a supportive environment in which families will be guided by professionals in how to care for their baby and themselves and be able to recognise and act upon any deviation from the normal (NICE 2006; updated 2015).

Midwifery care may apply for the whole or part of the postnatal period. In the absence of any physical, emotional, social or psychological risk factors or concern, it is anticipated that women will be discharged to the care of the GP and Health Visitor by day 10-14 following birth. It is important that care is planned according to the woman and her baby’s individual needs and these plans communicated to all relevant professional groups that may be involved in her and her baby’s care.

If everything is well with you and your baby and depending on the type of birth you’ve had, you will normally be discharged home between 6-24 hours after birth to the care of the community midwifery team, who will continue to support you in your own home. The first community postnatal visit will be done by a midwife in your home who will discuss and agree with you further visits. You will be given information of who to contact in the event you have any questions or if there is an emergency involving you or your baby.

If you have any questions which are not answered here, please ask your midwife for further information.

The BCG vaccine will be offered to all babies born at UCLH. This is following recommendations made by Public Health England in response to fluctuating TB rates in London. The service started on the 10 of October 2017 with an unlisenced vaccine, and babies before that date were not offered the vaccine. Since 1st of September 2018 we are using a license vaccine.

Newborns who catch TB are much more likely to experience severe illness such as meningitis TB and pulmonary TB. The BCG vaccine offers protection against this.

All babies born at UCLH will be offered vaccination on the day that you go home or you may be offered an appointment at a weekly catch-up clinic. A midwife will discuss this with you once your baby has been born, you do not need to do anything before the birth.

Babies who have not been given the BCG vaccine by 28 days old will only be offered vaccination if they fall within a high risk category. This will be followed up by the health visitor and not the UCLH team.

The BCG vaccine is recommended by Public Health England but is not compulsory and you can decline if you wish, we would still like to discuss your reasons for declining and the risks of newborn TB.

Vaccines will only be given once your baby is well enough to go home. A doctor will decide the best time to give your baby the vaccine and will discuss this with you.

The vaccine is given in the left arm and your baby will have a small blister to begin with. After a few days this will turn into an ulcer. The ulcer may ooze some clear fluid but this is normal. The ulcer will then dry, form a scab and heal. Leaving only a small scar. The healing process may take up to 3 months.

Very rarely some babies may get a fever, enlarged lymph nodes under the arm. If you are concerned about your baby being unwell following the vaccine, seek medical advice.

You will be given a leaflet and have the opportunity to discuss the healing process with the Immunisation midwife giving the vaccine.

No, vaccination is once only.

You can speak to a midwife at your antenatal appointments or once the baby is born. A member of the immunisation team will visit you in hospital to discuss the BCG vaccine.

If you have any questions or concerns you may contact us on the details below.

Maternity Immunisation Team, University College London Hospital, Maternity Care Unit. 3rd Floor, EGA Wing. Grafton Way. London. NW1 2BU