What to expect from your midwife in the first four weeks after birth - Mums

You may have had a named midwife throughout your pregnancy and have a great relationship and rapport with them that has made talking, getting advice and support a little easier. Or by the time you have given birth, you may well have met several midwives throughout your pregnancy both at your GP practice, children centre as well as at the hospital, antenatal clinic and ward.
What to expect from your midwife in the first four weeks after birth - Mums


The midwifery team are there to support you as new parents. Your midwife has a responsibility for your postpartum care for between 10 – 28 days after your delivery but often if all is well, you and your baby will be discharged to your health visitor/care team around 10-14 days after birth. If there are any concerns around mum’s well-being or baby they may extend the care.

Before being discharged from hospital you and your baby will have many postnatal checks. To put your mind at ease and to prepare ahead, we thought we would provide a list of the checks and also conversations you may have following the birth of your little one.

Before discharge from hospital and at each home visit you can expect your midwife to -

  • Checking  blood loss vaginally  – lochia – this is often red in the first few days after birth and you may change your pad frequently  over the next week. The loss will change to brown and reduce in less volume to spotting– chat to your midwife immediately if you have a sudden gush, feel unwell, dizzy, nauseous.  It is normal for your midwife to chat and check this so don’t feel apprehensive or embarrassed. If you are breastfeeding your loss may be more with the start of a feed as your milk hormone oxytocin also contracts the uterus and may last for a longer period.
     
  • Check the position of your uterus in relation to the pubic bone – over next few days your uterus will contract and return to pre pregnancy size – if this is slow it may indicate an infection or retained placenta products.
     
  • Chat to you about birth control
     
  • Chat to you about your diet and also your toileting – you may not have passed a stool in the first 24-48 hrs after birth but your midwife needs to know when you do and if you have experienced any difficulties. Your body during the birth preparation usually helps to clear the bowels but after birth you may feel apprehensive that it will hurt or be uncomfortable especially if you have had stitches or a caesarean section. Eating small and often fibre rich foods helps such as Weetabix, brown bread and fruits.
     
  • Pelvic floor exercises – whilst these are not a great topic to chat about they are crucial to help you manage for the rest of your life. Many women with stress incontinence often have stretching to the pelvic floor during the birth process and find that they leak when lifting, sneezing, coughing. Be proactive and keep toning the pelvic floor – if you are not sure or are having difficulties you can ask your midwife /GP to refer you to a specialist physiotherapist.
     
  • Pain management – your midwife will talk to you about maintaining good posture, minimising pain, regular medication if you are in pain.
     

From a feeding point of view:

  • If you are breastfeeding or expressing they will chat to you about breast fullness, breast emptying.
     
  • Your milk will come to volume around day 3-5 after birth and engorgement is normal. Frequent effective feeding helps and hand expressing to soften the nipple to get baby to latch easier – your midwife will show you how to hand express.
     
  • Ask how your nipples are – it is common to have a little soreness but if they are very sore and cracked this is usually down to latching difficulties and needs tweaking.
     
  • Your midwife may ask to observe a breastfeed and this is a great way to iron out some difficulties around positioning and attachment. She will provide you with tips to support baby to help get that wide open mouth and a deep latch.
     
  • If you are expressing exclusively because baby is in special care or you don’t want to breastfeed she will chat to you about pumping frequency, check and chat about milk volumes, night sessions and making sure that you have the correct vacuum setting for you and the right breast shield size. Find out more here.

To find out about the health checks your baby will have, pop back on Thursday for our next blog post!

Expect to have 3 postnatal checks at home after being discharged from hospital. Occasionally you may have more and you can get additional support from local breastfeeding groups and the national breastfeeding helpline as well as lactation consultant advice from Medela here or Medela’s Facebook page.