Postnatal care

Birth to 2 hours

During this time you will be on Delivery Suite having your well-earned tea and toast and bath while your midwife finishes all of your labour and birth notes.

Following the birth of your baby the midwife will conduct an initial top to toe examination of your baby to assess for wellbeing and to identify anything unusual. The check will be performed next to you to provide information and reassurance. 

4 hours to 24 hours

At this point you will transferred on to Maternity Ward and handover of care will be given from your birth midwife to your maternity ward midwife. When you first go to the toilet to pass urine the midwife will ask to measure the volume as this gives the midwife an idea if your bladder is emptying adequately after birth. There is lots of information about our Maternity Ward in the Maternity Ward section.

Between 4 to 8 hours after birth we will offer to carry out a pulse oximetry reading on your baby to assess the amount of oxygen saturation in the blood. This non-invasive test involves a small probe being placed against your baby’s skin on the foot and hand. The test can be an indicator of congenital heart defects affecting 3500 babies a year equivalent to 0.5%/1:200 a year. This early test allows for escalation to the senior paediatric team if anything is detected.

6 Hours to 72 hours

A detailed examination of you baby is offered and conducted by a skilled Newborn Examiner. The purpose is to screen for up to four conditions. Congenital Heart Disease, Developmental Dysplasia of the Hips, Congenital Cataracts and Undescended Testes. On identification of these conditions referral to the senior paediatric team will be made and any relevant follow up appointments will be arranged. 

Hearing screening is offered to detect babies with permanent hearing loss during your stay on the ward. A small soft probe is carefully positioned in your baby’s ear. Babies who do not illicit a clear response to the test will be invited back to an outpatient’s clinic for a repeat screen within the first 5 weeks following birth to confirm whether further investigations are required. In the hospital Newborn Hearing Screening Coordinators are present on Maternity Ward in the mornings 7 days a week. If you are on Maternity Ward both the NIPE and Hearing Screen will be conducted before you leave. If you returned home, birthed at home or birthed in another Trust, you will be invited to attend our Maternity Ward to have combined NIPE examination and Hearing Screen or may be given an outpatients appointment for hearing screen. 

When you go home

If you have had an uncomplicated birth and your baby doesn’t need any additional observations then it is possible to have an early discharge from hospital. Each woman will have different needs and will therefore be discharged over different time periods. On discharge from the hospital your midwife will discuss what happens once you’re home and who to contact if you have any concerns. At every visit your midwife will check your physical and emotional wellbeing, discuss your birth experience, discuss how feeding is going and check baby over. Below is a list of the standard visits you will receive but please do ask your midwife if you feel like you need additional support. If these visits fall on a weekend, you may be asked to come into our postnatal clinic in the hospital. 

We are proud to be in collaboration with Worcester Royal Hospital in producing additional guidance for the postnatal period for all women accessing maternity care in Herefordshire.

Day 1 – Day 2

Whether at home or in hospital routine obstetric checks will be offered and undertaken by midwives either on a daily or alternate daily basis. Whether at home or in hospital, or maternity support workers can provide practical support and advice on breastfeeding to support you during your baby’s transition and routine frequent feeding phases in the early days. 

Day 3

We offer to weigh your baby, an initial weight loss is an expected physiological response following birth and may have no significance to overall wellbeing. For babies who may have lost a little too much weight this early intervention allows for review of baby’s general wellbeing and feeding. Small adjustments at this stage can help to support baby to thrive over the coming weeks. 

Day 5

On the 5th day day and before the 8th day, we offer a screening test (Blood Spot Screening) that will look at congenital hypothyroidism, sickle cell and thalassaemia, cystic fibrosis and an array of metabolic disorders. If left undetected all conditions could have a detrimental effect to a baby’s morbidity and mortality with the most common effect being developmental delay. The test involves taking a small sample of blood from your baby’s heal, the technique is straightforward, however, the standards for collecting the four blood spots is very exacting. We will offer advice on how to prepare your baby before the test to maximise on obtaining a good sample and avoiding the need to repeat the test.  Screeing blood spot test. 

Following the Day 5 visit, it will be decided between yourself and the midwifery team when your next visit will be. This is a good time to consider registering baby’s birth and registering baby with the GP. 

Day 6 – Day 10

Wellbeing Visits may be arranged during this period to; support with breastfeeding, reweigh babies on a feeding plan, provide emotional support or continue to provide observational monitoring related to obstetric/medical conditions. If visits are required these will be agreed on an individualised basis. 

Day 10-14

During this period the expectation will be that the midwife will discharge your care to the Health Visiting Team. Final wellbeing checks will be made by the midwife, further appointments can be made if required. The midwife will contact the Health Visitor who will then make contact with you within the next week and should plan to visit you at home by 3 weeks following birth. 

Your Health Visitor will arrange to come and see you at home when baby is 10-14 days old and then again at 6-8 weeks.  Here is more information on the health visiting team.

3 weeks

During weeks 2 to 3 the Health Visitor will make an initial visit to your home.  Where practicable this will be the same Health Visitor you have seen in the antenatal period. The Health Visitor will offer advice on health matters related to yourself and baby and discuss your feelings at being a new parent and the impact on family life. We suggest you make a 3 week GP appointment to discuss contraception as certain methods can now be prescribed and you must arrange a 6 week GP ‘double’ appointment for you and baby. 

6 weeks

Initial GP Check - this appointment provides an opportunity to discuss; how you are feeling, contraception choices and your baby’s wellbeing will also be reassessed. The appointment also provides an opportunity to plan for any gynaecological checks, missed vaccinations or health improvements you may want to consider before planning a future pregnancy. 

Hypertension (high blood pressure)

If you have suffered with hypertension during pregnancy you will need to monitor your blood pressure regularly and continue to take your anti-hypertensive medication if needed. Your midwife will suggest that you make an appointment with your GP two weeks after birth. Your GP will also check your blood pressure at your postnatal check when you are 6 to 8 weeks postnatal. 

Gestational diabetes

You can stop taking any glucose controlling medication once you have had your baby. We will test your blood glucose levels postnatally before you go home to ensure there isn’t any persisting hyperglycaemia and your GP will take a blood test at your 6-8 week postnatal check as well.