If a community midwife has not contacted you by 3pm the day after your discharge, please phone Ward F11 on 01284 713216.
Routine postnatal care consists of:
First day after discharged home – A midwife will visit you at home. Full postnatal check including observations and full assessment of baby including feeding assessment with support if needed.
Day 3 – Midwife visit at home. Postnatal check. Baby will be weighed, and plan put in place. Feeding assessment with support if required. Jaundice review.
Day 5 – might visit at home or attend a clinic Midwifery support worker visit/clinic appt. Newborn blood spot test performed with consent. Feeding assessment, with support of required. Jaundice review.
Day 10 - 14 – Midwife visit/clinic appt. Weight and discharge to health visitor.
There may be additional visits from either a midwife or an MSW to support feeding, weight management plans, monitoring of jaundice, emotional support.
We can legally care for women and birthing people for 28 days postnatally, should they require it under a plan of care.
Common problems for mums and babies
If you've had stitches after tearing or an episiotomy (cut), bathe them every day and change your sanitary pad regularly to help prevent infection. Have a short bath or shower with plain warm water then carefully pat yourself dry.
If your stitches are sore or uncomfortable, tell your midwife. Stitches should absorb by the time the cut or tear has healed. If they have not absorbed, please contact your GP. If you notice any signs of infection such as an offensive odour, feeling generally unwell, fever, changes in discharge, increasing pain or swelling, then please contact your GP within working hours or maternity triage on 01284 713755 out of hours.
Spinal and epidural anaesthesia is generally a very safe procedure and it is very unusual to experience severe side effects. However, should you experience any of the following, it is important that you speak to the anaesthetic team as soon as possible, explaining you have recently had a spinal or epidural.
Headache
There is a small chance you may experience a headache after an epidural or spinal anaesthetic. Most of them improve with rest, fluids, and simple pain relief including paracetamol. Report to the hospital of any headache if it: • Does not go away after rest, taken fluids or simple pain relief including paracetamol • Associated with other symptoms such as visual changes, hearing changes, neck stiffness or fever/chills • Does not improve after a few days or is getting worse
Changes in sensation in your lower body
After birth, a small area of numbness in your legs or buttocks is not uncommon. This can be caused by direct pressure of the baby on the nerves in the pelvis during labour and delivery, or rarely as a side effect of the spinal or epidural anaesthesia. These numb patches should recover within weeks.
Please report immediately to the hospital if you experience: •
Worsening weakness
Any weakness in your legs
Any loss of bowel or bladder control
Inability to pass urine
Backache
You may feel a bit tender or bruised where the spinal or epidural was inserted. This should recover after a few days and should not affect normal activity, and should not cause new long-term backache. Simple pain relief such as paracetamol may be helpful.
Please report immediately to the hospital if you experience:
Worsening back pain (for example, if the patient travels up the spine or down into the buttocks and legs)
Severe back pain that starts suddenly
The site of insertion of the spinal or epidural becoming red or having discharge (oozy or weepy) with fever/chills
For urgent advice
Please contact Ward F11 on 01284 713755 and ask them to inform the obstetric anaesthetist on call.
More information
More detailed information on epidural and spinal anaesthesia can be found on the labour pains website.
You’ll bleed from your vagina after the birth. It will be quite heavy at first, and you will need absorbent sanitary towels. Change them regularly, washing your hands before and afterwards. Do not use tampons as this can increase your chance of an infection. You may notice the bleeding is redder and heavier when you breastfeed.
This happens because breastfeeding makes your womb contract. You may also feel cramps similar to period pains. The bleeding may carry on for a few weeks. It will gradually turn a brownish colour and decrease until it finally stops. If you're losing blood in large clots (bigger than a 50 pence piece) or you are soaking a thick maternity pad within an hour, tell your midwife, or call the triage line as you may need some treatment.
Following the birth of your baby, you may wish to consider contraception. It may seem early to start thinking about contraception, but pregnancy can occur from as little as three weeks after birth, even before your first period. Becoming pregnant less than a year after childbirth increases the risks of complications for you and your baby, so it is recommended that a method of contraception is started soon after birth. On F11 we can offer the progesterone only pill, the contraceptive injection, and the implant.
Anaemia (low iron levels in your blood) is common after giving birth because of blood lost during the delivery. It is important to eat a balanced and varied diet to help you recover.
Good sources of iron include:
liver and other red meat
beans, nuts and dried fruit – such as dried apricots
wholegrains – such as brown rice
fortified breakfast cereals
most dark-green leafy vegetables – such as watercress and curly kale.
If your blood test shows a low haemoglobin level, you will be prescribed iron tablets. The prescribed tablets are stronger than the supplements you can buy in pharmacies and supermarkets. It is important to take them as directed and you may be advised to have a follow up blood test in two weeks to check your iron levels are improving.
Some people get side effects including constipation, stomach pain, nausea, and vomiting. It is also common for stools (poo) to become darker in colour. Try taking the tablets with, or soon after, food or with orange juice to reduce the chance of side effects. Keep iron supplement tablets out of the reach of children. An overdose of iron in a young child can be fatal.
Deep vein thrombosis (DVT) is a serious condition where a blood clot forms in a deep vein in the body, usually in the leg. If the clot breaks off into the bloodstream, it can block one of the blood vessels in the lungs. This is called a pulmonary embolism (PE) and needs emergency treatment.
Women and those who have had a baby in the past six weeks are at risk of DVT. If you have other factors that put you at risk (smoking, obesity, birth by caesarean, family history etc.) you may be prescribed a blood thinning injection called Tinzaparin and be given TED stockings (flight socks) to wear after the birth of your baby to reduce your risk of DVT.
Wound dressings provide the optimum conditions for wound healing, whilst protecting the wound from infection with microorganisms and further trauma. At West Suffolk Hospital you will have one of two wound dressings applied post caesarean
Between 5 and 15 days after your baby is born, the umbilical stump will dry out, turn black and drop off. After the stump comes off, it usually takes about 7 to 10 days for the belly button to heal completely. Until the stump drops off and the belly button is completely healed, it's important to keep the area clean and dry, to prevent infection. If you notice any bleeding or discharge from your baby's belly button, ask your midwife, health visitor or GP for advice.
Spots and rashes are very common in newborn babies. They may come and go, but if you also notice a change in your baby's behaviour – for example, if your baby isn't feeding well, or is very sleepy or very irritable – tell your midwife or GP immediately.
Jaundice is a common condition in newborn babies that causes yellowing of the skin and the whites of the eyes. Although it is usually harmless, it can be a sign that a baby is not well.
When you're at home with your baby, look out for yellowing of their skin or the whites of their eyes, stool (poo) passed may also be pale in colour. Gently pressing your fingers on the tip of their nose or on their forehead can make it easier for you to spot any yellowing.
In babies of Black or Asian ethnicity, jaundice may not present as yellowing of the skin, therefore if you notice any changes in colour in the whites of the eyes, pale gums or mucous membranes or changes in behaviour such as being very sleepy, difficult to wake or feed and any changes in wet or dirty nappies then it is important to contact a health professional for advice. Speak to your midwife, health visitor or GP as soon as possible if you think your baby may have jaundice. Tests will need to be carried out to see whether treatment is needed.
It can be difficult to tell when a baby is seriously ill, but the main thing is to trust your instincts. You know your baby better than anyone else, so if you feel worried about their appearance or behaviour do not hesitate to act. You can always call 111 for advice if you are in doubt.
See a doctor urgently, attend the emergency department or call 999 if your baby:
Becomes unresponsive, limp, drowsy or floppy
Has severe difficulty with breathing, makes a squeaking or grunting sound with every breath
Has pauses in their breathing (apnoeas), has an irregular breathing pattern
Has a blue / grey skin tone at any time – this includes any ‘mottled’ appearance to the skin
Has blue lips or is blue around the mouth
Has a fit
Is excessively jittering or shaking, even if they seem well
Feeds less than usual and is drowsy or doesn’t seem well
Has a rash that does not fade when pressed with a glass
Has blood in their poo
Has a high temperature
Feels cold, even when dressed warmly
Has got visible jaundice in the first 24 hours of life and is drowsy or not feeding well.
Contact the maternity helpline, GP or 111 service today, if your baby:
Is not feeding well
Is constipated, or is bottle feeding and has diarrhoea
Has got redness around the umbilical cord
Crying inconsolably
Has got visible jaundice (yellow skin and whites of the eyes) and is not feeding well.
Call the community midwives hub or book a non-urgent appointment with your GP if you notice these symptoms or have any questions or worries:
Nappy rash
Thrush in the mouth (white spots, or a white coated tongue)
Colic, problems with winding or seems uncomfortable after feeding.
Following the arrival of your baby, the birth needs to be registered within six weeks/42 days at your local registry office. It is through this process that you will obtain a birth certificate. The registration should be done in the borough you gave birth in. You may register the birth in a different area if this is more convenient, however your details will need to be sent to the borough in which you gave birth in order for them to generate a valid birth certificate.
Screening tests
When your baby is between five to eight days old, your community midwife will offer the ‘newborn blood spot’ test. The test involves collecting four small samples of blood from your baby’s foot on a card. The test screens for 10 rare but serious conditions, such as sickle cell disease, cystic fibrosis and congenital hypothyroidism.
For those babies identified with any of the conditions screened for, we know that early treatment can improve their health and prevent further serious or life threatening complications. If your baby was born early (before 37 weeks gestation) the test may be done in hospital by the neonatal team.
