After you have your baby, your midwifery team will want to make sure you are recovering from the birth, and that your baby is healthy and feeding well.
When thinking about postnatal care, bear in mind that day one is the day after your baby’s date of birth, day two is the day after that and so on.
You will have at least three appointments with a midwife after the birth. Ideally this will be with your named midwife or a familiar member of the team. This is not always possible, because it is important for you to be seen at certain specific points and your midwife may not be working that day. Your named midwife will make sure to see you where it is possible.
A basic postnatal check will be carried out for both you and your baby each time you see a midwife from the birth until you are discharged from maternity care. Most women will be discharged after a week and a half to two weeks. Some women and babies will be supported by midwives a little longer, up to one month after birth.
At each postnatal check, you will be asked questions about yourself and your baby. All the questions are important ways of picking up any problems. Don’t be surprised to be talking about all sorts of body fluids!
First visit after the birth
You will be seen by a midwife face to face at home the day after having your baby, or the first full day that you are home, if you have been cared for in hospital or birth centre for one or more nights. If there are any concerns, a plan will be made to see you or speak to you within the next day or two depending on what is needed.
Extra support if needed in the first days
Additional support with feeding your baby may be provided by a midwife or a maternity support worker. You may be offered a phone call to check in with how things are going. There may be other reasons that additional visits in the first days are recommended. This might be for yourself or your baby.
The hormonal changes women undergo in the first few days are enormous, and it is quite normal to feel low perhaps for several days. This is known as the baby blues. Contact your midwife for extra support if you or your partner are not sure what is normal baby blues and what is a more serious mental health concern.
Day five visit
You will have a visit or appointment on day five. Scheduling for this visit is important to offer you postnatal blood screening for your baby. This newborn blood spot test, also known as the heel prick test, is explained below. Day five is the ideal day for these. Any earlier and the tests are less reliable. If it’s later this provides less time to put the right care in place for babies with certain rare conditions before problems develop.
On the day five visit, your midwife will ask to weigh your baby (without clothes or nappy). You will already have been asked about your baby’s wees and poos. This is how to make sure your baby is feeding effectively. The weight provides another important check.
It is normal for babies to lose weight for two or three days after the birth, before weight gain starts. When babies are first weighed, they have some extra fluid in their system from being in the womb. Just as mothers will pee more often in the days after the birth to get rid of extra fluid, so will babies.
If your baby has lost more than ten percent of the birth weight on day five, a careful feeding plan or further health checks for your baby will be recommended. There may be other signs that feeding is not going well, for example if your baby has a yellow tinge to their skin or eyes known as jaundice.
Discharge from maternity service
Between 10 and 28 days after the birth, you will be discharged from the midwifery team. This may be your third postnatal appointment, or your may have had more. At this point, the midwife will check your baby is well and back to birth weight or will be soon. Your midwife will check that you are well and on track with your recovery from the birth.
Your care passes to the health visiting team, who will support your family and your baby up until your baby is 5 years old. Your GP will also play an important role, carrying out a 6–8-week postnatal check for you and your baby, and being on hand for general health concerns.
Your baby’s cord stump will normally have dropped off by now, allowing you to see your baby’s belly button!