Neighbourhood Midwives


So, you have had your lovely baby and now what? Maybe you have a lot of friends and family eager to meet the new arrival or maybe you have decided to have a babymoon.

During the first few weeks as you and your baby get to know each other, you will go through some pretty major changes. You will still be under the care of your Neighbourhood midwife for those first few weeks and she will be there to answer all your questions and concerns.

So, you have had your lovely baby and now what? Maybe you have a lot of friends and family eager to meet the new arrival or maybe you have decided to have a babymoon. During the first few weeks as you and your baby get to know each other, you will go through some pretty major changes. You will still be under the care of your Neighbourhood midwife for those first few weeks and she will be there to answer all your questions and concerns. During the postnatal period, you can help yourself by getting family and friends to chip in with practical support.

During the first few days after birth, you will be recovering from the labour and birth as well as getting to know your baby. It’s totally OK - and we think a really good idea - for you to stay in your PJ’s for the first few days. Relax, your baby has been used to being held in your womb and s/he will also have to get used to the outside world which can take some time. You can help your baby make this transition by understanding that you are not spoiling them in the newborn period by having them in your arms, cuddling them, talking to them and reassuring them that you are there to love and care for them.
Remind yourself to eat and drink regularly. It’s a hard one for many mums but sleeping in the day while your baby sleeps will help you to get enough of that crucial ingredient that can be in very short supply during busy nights of feeding and settling.
During pregnancy, get into the habit of doing your shopping online, especially if it’s something you are not used to doing. Not having to traipse out to the supermarket can help you in the early weeks whilst you are getting to know your baby.
Organise friends and family and most importantly your partner, to carry out all the household tasks including preparing your meals, so that you can just concentrate on you and the baby.

It is a little known fact that your newborn has a routine from the moment they are born. Their routine is to be fed, cuddled, to sleep, be loved and to have their nappy changed, although maybe not in that order! All newborns have a routine; it’s just that it might not fit in with your schedule and it may vary from day to day. You might be surprised by just how much a small bundle can take over your life and you can help yourself by not sweating the small stuff like being worried about keeping the house clean and tidy. Your baby is born with a strong survival instinct and that drives him/her to seek attention, food and love. Just go with it for a while and before you know it the baby will be settling down. This really is your one chance to truly indulge in your newborn so make the most of this special time.

Some women find that they feel sore after birth, especially if you have had stitches (or sutures as they are known). If this applies to you, listen to your body and adjust how you sit, spend more time lying down to take the weight off your perineum. You can take some pain relief like paracetamol. If this is not enough, ask your GP for something stronger. You may find a relaxing bath with a few drops of lavender oil in the water can help. Mix the oil with some milk to make an emulsion and pour it under a running tap to disperse. If you feel uncomfortable when passing urine, try pouring some water over yourself as you pee to help dilute your urine and make it more comfortable and remember to drink lots of clear fluids. If the pain intensifies contact your midwife or GP.

After birth, your body will start working on getting you back to pre-pregnancy health. All the excess fluid that you gained for pregnancy will now be released and your body gets rid of this excess fluid by converting it to urine. Equally, all of the extra tissue you have made needs to be broken down and excreted the same way so drink plenty. If you are breastfeeding, staying well hydrated is crucial to ensure your milk supply is maintained.

Yes there is, although it is a little different to a period. After birth your womb will be healing from where the placenta was attached during pregnancy and for a number of weeks after birth you will continue to have bleeding and discharge as your uterus gradually loses its pregnancy lining. The bleeding after birth is called lochia. It looks like a heavy period for couple of days, then gradually becomes much less but you will continue to bleed for some weeks after birth. Gradually, you may notice that the bleeding will change and look like a heavy darkish discharge and for most women the lochia will have stopped by six weeks.

Most new mothers have heightened emotions after birth and, particularly during the first week - often around day three - you can be surprised by suddenly feeling tearful and rather ‘wobbly’ even if you are feeling happy. There are many hormonal changes that happen after birth, linked to your milk ‘coming in’ and these are usually the cause of this sense of instability, especially when combined with the tiredness that sets in as you come down from the ‘high’ of the birth. It is not unusual to start feeling anxious and overwhelmed by everything. Try to rest and be kind to yourself. This will help you to weather this period. At Neighbourhood Midwives we encourage women to rest completely for at least a week to ensure the transition into motherhood is as easy and stress-free as possible.
For most women the baby blues will last only for a day or two, although for a few mothers it can go on longer. In most cases, having a supportive partner and family is all that is needed to help you through this time. Having your same Neighbourhood midwife caring for you can be a great source of reassurance and support - a trusted, familiar face and someone to confide your doubts and anxieties to.

If you have booked Neighbourhood Midwives’ care, your midwife will visit every day after birth for the first five days or so and then regularly for six weeks in the comfort of your home. If you are being looked after by an NHS midwife, it can vary from one area to another but generally she or her colleagues will see you the day after discharge from hospital at home and will then either do 1/2 more home visits or may invite you to see them at a postnatal clinic instead. At the 10 day appointment, if all is well, you and your baby will be discharged from midwifery care.
Your Neighbourhood Midwife is there to ensure that you and your baby are both well and that you are recovering from the birth. She will check that feeding is going well and that your baby is putting on weight and generally thriving. Visits in the postnatal period are tailored to the needs of the new mother and baby and so are always flexible and adaptable to whatever circumstances arise.

Your partner can help by nurturing you, being focused on your needs and by ensuring that you eat and drink regularly while you rest and recuperate after the birth. It is worth filling the freezer with plenty of nutritious meals, during the last few weeks of your pregnancy, which can be taken out and used as required during these early days and weeks. It will be their job to manage visitors through this period, making sure you aren’t swamped with too many and that you are still able to sleep and rest during the day.

Your partner can help with sorting out all the practical jobs needed in the home and the magical part is that they can spend quality time getting to know their baby boy or girl by doing lots of skin to skin, cuddling, changing them in between their feeds and sleeps!

Between day five and eight after birth, your baby will be offered a newborn blood spot screening. This involves the midwife pricking your baby’s heel and taking a blood sample. This will then be sent off to be tested for sickle cell disease, cystic fibrosis, congenital hypothyroidism, phenylketonuria and MCADD. At the screening test, your midwife will also let you know the other four other inherited metabolic diseases conditions that have been recently introduced.

Jaundice is a condition that causes the skin to turn yellow. When babies are inside us, they need more red blood cells to provide oxygen as they do not breathe. Once the baby is born s/he no longer needs so many red blood cells and starts to break them down. The by product of this is bilirubin which can cause the yellow/gold appearance on the baby’s skin. In most cases, jaundice in a new-born is quite normal and usually occurs when your baby is around four days old. You may notice that your baby’s body, face, or the whites of their eyes might look a little yellow. Frequent effective feeding is a key method of clearing jaundice. In most cases, when baby is fed regularly, this type of jaundice disappears by the end of the first week and in some cases the second week. From the moment your baby is born your midwife will monitor your baby’s skin and their colouring. If your baby develops jaundice your midwife will continue to monitor your baby to ensure that it does not cause a problem. Some babies will be born with early onset jaundice or will need help to clear their jaundice; in those cases the baby will have phototherapy which involves exposing their skin to light which helps them to break down the bilirubin. Your baby will have a blood test after treatment to make sure their bilirubin levels have come down to safe levels.

Did you know that the hormones that help your body to make breast milk are highest at night? So, your baby being awake at night in those first few weeks means that your baby instinctively knows that. It means that your baby is doing the right thing in the early weeks by asking to be fed during the night. We know this can be challenging and many mums find that trying to have a nap during the afternoon or early evening can help them to cope with the challenging times. Feeding during the night is essential for your baby’s growth and development and will help your baby to grow. If you are bottle feeding your baby it is also important that you feed your baby responsively and regularly which will mean that your baby will still need to be fed during the night. S/he has a very tiny tummy and needs frequent feeding to thrive and stay hydrated.

The great news is that you can now go back to eating normally after you have had your baby. You no longer need to worry avoiding all the foods you had to whilst you were pregnant. Some mums report finding that starting their day with a nice warm bowl of porridge oats helps them with their milk supply if they are choosing to breastfeed. Taking your pregnancy vitamins or supplements will still be beneficial after you have had your baby and will help you improve your micronutrient health. Growing a baby through breastfeeding takes a lot of work so it is important to eat well at all meals.

After a caesarean birth it’s important to rest and you are recommended not to lift anything heavier than your baby for the first six weeks and most insurers don’t allow you to drive during this time. In most cases, you will be sent home with a medicine that thins your blood as after surgery you are at risk of developing deep vein thrombosis. After you have a caesarean, you will be given pain relief medications to make sure that you feel comfortable. Most mothers find that they will need the pain relief medications for a week or so after birth but it’s important to know that if you still feel uncomfortable after this time, speak to your midwife and continue to take your pain relief. Within 24 hours after birth, the wound dressing will be removed and you will be advised on how you can take care of the wound. You will find walking up and down stairs a little uncomfortable so try to avoid that during the first couple of weeks. Try to keep the things you need to one level in your home in the first couple of weeks to aid your healing. Most mothers feel back to normal around six weeks after birth and can start driving again.

Between six weeks and eight weeks after birth, it is recommended that you see your GP to have a health check. This is where you can discuss with your GP how you are recovering after birth, discuss contraception and also check whether your smear test is due. The reason for this check is that traditionally the midwife will discharge you at ten days, well before you have physically recovered. Your Neighbourhood Midwife will not discharge you until your baby is six weeks old.

I am a little worried about getting postnatal depression. What signs should I look out for?
Around 10% of mothers develop postnatal depression. Some women might notice signs of depression between two weeks and two months after birth, while other mothers notice that they do not have signs of depression until a year after birth. It is important to understand that if you feel that your mood is low or you find you do not want to socialise and that you might be depressed, that you seek help and speak to your GP, your midwife or your health visitor.

Signs of depression can be different for everyone.  Signs can include:

  • Feeling anxious
  • Feeling down
  • Feeling unwell
  • Loss of appetite or eating too much
  • Feeling tearful or being unable to stop crying
  • Feeling hopeless
  • Not wanting to socialise.
  • Wanting to sleep or not able to sleep.

You do not have to manage on your own and there are many great support services available to you. In most cases talking therapies can be enough to help mothers cope with postnatal depression. Other women will choose medication to help them cope. Either way, the important thing is to know that there is a solution and you do not have to feel alone.

So, as a new parent or parent to be, you have probably heard stories about parents trying to get their newborn to sleep through the night. You may have been asked by that friend or family member “Does s/he sleep through the night yet?” even though your baby is a newborn. Or perhaps you may be asked the age old question “Is s/he a good baby?”, somehow insinuating that a good baby is one that sleeps through the night and that your baby is somehow bad as they did not get that memo!

Sleeping through the night for a newborn is an old fable
Relax, it’s not you and it’s not your baby. Take the pressure of yourself from thinking that something is wrong with your newborn if they are not “sleeping through”. Your new baby is a newborn for twelve weeks and it is entirely normal for your baby not to be sleeping through the night for some time (not forever, we promise). As your baby gets older their sleep cycles will lengthen which will mean that your nights will be less disturbed. Evidence shows that it is normal for the majority of babies to have wakeful periods even up to the first year. Many mothers find that sleeping during the day helps them to cope with the sleep they miss at night. Some mothers use meditation or relaxation techniques during the day or just before they go to bed to help them feel more rested.

So why does my newborn wake up so much during the night?
When you comfort, feed and cuddle your baby at night, you are giving s/he the reassurance that helps them to feel loved, cared for and nurtured. Your baby is instinctively clever and their sleeping pattern is very different to yours. A newborn baby has a shorter cycle between deep and light sleep which enables them to be more wakeful to ensure that they get the right nutrition for their growing body. Your growing newborn needs regular feeding to also help grow their brain. When baby’s receive attentive night time parenting, they produce much fewer stress hormones which enables them to be more resilient in the future and less likely to suffer from anxiety and depression.

So what about a routine?
Surprisingly, your newborn baby will have a routine and that will be to be loved, cuddled, fed and changed. It’s just that this routine may not fit into your schedule in the early days! Many first time parents can find the lack of sleep in the beginning a shock to the system and there is a suggestion that pregnant women start to have interrupted nights during pregnancy as a way to prepare for this time. The good news is you cannot spoil a newborn by picking him/her up to soothe and settle them, no matter what people tell you. In fact, your newborn can sleep for on average 15 to 18 out of 24 hours.

What can I do to support myself during this time?
In those early weeks, many new parents help themselves get through the newborn period by using the support of their family and friends. Ask them to bring you meals when they come to visit you and your new baby (and to wash up afterwards!). Some parents prepare meals towards the end of pregnancy and stock them up in the freezer. If you haven’t already, try internet grocery shopping to take the pressure out of food shopping. Asking family members to help with laundry or housework can help you get some much needed rest during the day. Sleep when the baby sleeps is an oldie but a goody, if you find it difficult to sleep during the day start practising by trying power naps towards the end of pregnancy. Even if you can’t sleep, relax on the sofa and leave the washing up until later. Make the most of any down time you get!

It is important to remember that after birth, once you have started to ovulate again, you tend to be very fertile which means that you can get pregnant sooner than you might have planned. The reason you may not realise this has happened is because you ovulate before you see your first period but iIf a mother is breastfeeding, her periods may not return for a few months yet. Breastfeeding can work as a contraceptive but at its best, it is only around 95% effective. This requires you to fully breastfeed your baby with no other feeds. This is because the protection occurs through regular feeding keeping your prolactin high and preventing ovulation. If you miss a feed, your levels could fall and allow ovulation. Relying on breastfeeding as your only form of contraceptive is not necessarily advisable if you are definitely not planning any more babies but it is at its optimum when a baby is alert and responsive; is breastfeeding at regular intervals, including at night and is not mixed feeding. To be really safe, barrier methods of contraception are recommended if you are not using any other contraception.