Following the birth of your baby, you will both have health checks performed to ensure that you are recovering well from the birth and your baby is adjusting well to being a newborn.
Your temperature, pulse and blood pressure will be checked at least once during your stay and possibly more depending on the type of birth you have had, and how long you are required to stay.
The midwife will talk to you during the postnatal check to ensure you are happy with feeding your baby. Please ask your midwife about anything you may not be sure of.
The midwife will feel your abdomen daily to ensure your uterus (womb) is contracted and is returning back to the normal position. The blood loss you experience following delivery is often described as a very heavy period. During the first 24 hours you may have to use two maternity pads at a time. If you have sudden profuse blood loss, feel faint, dizzy or have palpitations please tell a member of staff immediately. If you pass any blood clots please save these and inform your midwife.
Once you go home you will notice that your blood loss reduces over time and goes a darker colour. If this loss changes and becomes heavy or bright red in colour or develops an offensive smell please inform your midwife, as this could be a sign of an infection.
During the birth you may have needed a cut (episiotomy) or sustained a tear which required stitches. Even if you have not had stitches, pain and discomfort around your birth canal is common, (this is due to the bruising and swelling).
There are things that you can do to help the discomfort. Firstly you must tell your midwife or doctor, so that they can check that everything is alright and you do not have an infection or a haematoma “an abnormal collection of blood outside a blood vessel” (this is rare).
You must try to keep this area as clean and dry as possible; you can do this by changing your maternity pads regularly and after going to the toilet pat your stitches dry with a clean piece of soft tissue paper. Do not use powder or ointments on your stitches.
The midwife will give you regular pain relief; paracetamol is a good form of pain relief in the post natal period. However remember not to take more than eight tablets in 24 hours. Do not worry if you are breastfeeding as this will not affect your baby or your milk supply.
To avoid constipation try to make sure that you drink plenty of water (at least eight glasses) and fruit juice. Also try to eat a normal diet that includes fresh fruit, vegetables, salads, wholegrain bread and cereals and food with plenty of fibre.).
You may find that you have piles (haemorrhoids). These often occur during the second stage of labour; pushing stage of labour. You need to avoid straining when you go to the toilet as they will become worse. Should these occur ask your midwife for advice. The first time you pass urine, you may find this difficult or it stings. This is normal and you should not worry. Drink plenty of fluids, this will make the urine less concentrated and easier to pass.
If you had a caesarean section, your postnatal check is the same. In addition, your wound is checked daily. However, the plastic 'opsite’ dressing is left on to prevent infection and ensure that your wound heals. Also if you had a caesarean section you will be seen the next day by the anaesthetist to discuss your anaesthetic, and check you have no problems.
If your recovery is straight forward you may not see a doctor during your stay in hospital. However, if the midwife has any concerns about you, a doctor will be asked to see you. If you would like to discuss anything with a doctor please tell the midwife who will arrange this for you.
Transitional care is an integral part of the postnatal area. Midwives, neonatal nurses and nursery nurses work collaboratively to provide care for mothers and babies who need extra support before transfer to community care.
If you had a caesarean section your bed will usually be in one of the four bedded bays. This allows the staff to observe you and your baby closely during the initial recovery period. You will have a catheter (a tube into your bladder) which allows urine to drain into a bag. This is usually removed 12 hours after your operation. This can be slightly uncomfortable.
You should try to drink plenty of water. This should be still water as fizzy drinks are not advisable after your operation due to the gases; which can make your tummy more uncomfortable.
Your wound will be covered with a dressing which will be checked to ensure that there are no signs of bleeding, if you have any discomfort please tell your midwife.
The large dressing will be removed after 24 hours and the small dressing will stay in place to ensure the proper healing of your wound.
You will need to wear compression (anti-embolism stockings) following your operation. These help to prevent a deep vein thrombosis (blood clot) developing in your legs. Once you are fully up and about the staff will take these off. Whilst you are in bed try to move your ankles and feet frequently. This will help with the circulation and also help prevent the formation of blood clots in your legs. If at any time you experience pain in your calves or they become red or swollen, or you experience shortness of breath or chest pain, you must tell a member of staff immediately.
If you had an emergency caesarean section a doctor will discuss the reasons for this with you before you go home. Please inform staff if you have any concerns.
Staff will check your baby at least daily whilst you are in hospital to ensure your baby is well. 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 become jaundiced around day three or four, but providing your baby is waking for feeds and appears alert this is quite normal. This is referred to as physiological jaundice. However if your baby is very sleepy, not waking for feeds and not feeding well please inform a midwife or doctor.
The midwife will check your baby’s mouth for signs of thrush which is a coating of white different from milk because it is not easily removed. They will check your baby’s eyes to ensure they are not infected. Many babies suffer with sticky eyes but most resolve without antibiotic 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 and there are no signs of infection. If you notice any redness developing around the skin close to your baby’s abdomen close to the cord or if the cord becomes sticky or smelly it is important to tell the midwife as it may be a sign of infection.
You will be shown how to look after the cord, which should be kept clean and dry. When changing your baby try to fold the nappy down and expose the cord and plastic cord clip. This will help the cord dry and fall off quicker. The clip is left on and will come off when the cord falls off. Some women prefer to hold the plastic clip when cleaning the cord.
The baby will be thoroughly examined by a paediatrician or midwife or neonatal nurse skilled in examination of the newborn infants, to ensure that there are no unexpected problems and your baby has adapted to life well. This usually happens before you leave the hospital and is done in the baby clinic on the ward. If you choose to go home before your baby is examined you will be given a time to return to the hospital to have your baby examined, this should normally occur within 72 hours of birth.
If you need advice about your baby when you are transferred home please contact any of the following:
- Your community midwife (the telephone number will be given to you on transfer, as you may not live in the UCLH catchment area, in this case the number of your local maternity unit will be given to you as they will be the midwives who visit you at home).
- Your GP
- Ring 111
Babies who are unwell might appear overly sleepy and lethargic, pale and may not be feeding well.
If for any reason you suspect your baby is unwell, please call your GP or ring 999
Some newborns require additional support and they may require admission to the Neonatal Unit. If this becomes necessary, you will be consulted at length about the reasons for the admission and other details of the unit such as visiting times. Whilst your baby is in the unit you will still be able to breast feed your baby and staff are available to support you to do this.
On your first visit you will be given information about the Neonatal Unit, including visiting arrangements, and why your baby has been admitted and the opportunity to ask questions.
You should make an appointment with your GP for six weeks after having your baby.
Some doctors have different arrangements, check with your surgery. At this appointment your doctor will check:
- Your weight
- Your urine
- Your blood pressure
- Your stitches have healed (if you had any)
- Your breasts
- Your rubella immunity
- Your GP will also ask if you have a vaginal discharge and whether you have had a period since the birth of your baby
- Offer you a cervical smear if you have not had one in the last 3-5 years
- Discuss contraception
- Ask how you are feeling – be honest
If you are having your period, telephone the doctor and change your appointment as you will not be able to have a cervical smear.
The GP will examine your baby when he or she is 6-8 weeks old. This examination will include checking your baby’s hips and spine. The first of the routine courses of immunisation may be offered at this time. It is also useful to discuss the immunisation programme with your health advisor.