Taking care of yourself as a parent

The healthcare team that provide care after the birth of your baby includes midwives, student midwives, midwifery support workers, health visitors, doctors/specialists, physiotherapists and your GP (family doctor). The midwifery team will offer support/advice and work with you to develop a personalised care plan including your choices/decisions about your care. They may visit you at home or arrange for you o attend a community hub/clinic. At each postnatal assessment, your midwife will check to see if you have any problems or symptoms which may affect you after the birth. Please discuss any worries/questions with your midwife/GP/obstetrician/specialist or health visitor.

Infection

The midwife will check your temperature, pulse, blood pressure and breathing rate as required, depending on the type of birth you have had. A high temperature, rapid pulse and increased breathing rate may be a sign of infection. Contact your midwife/GP immediately if you are unwell and are experiencing any of the following symptoms:

• pain on passing urine
• sore throat or respiratory infection
• diarrhoea and sickness
• rash on your body
• a painful perineum (see below) or abdominal wound
• abdominal tenderness

You may need treatment with antibiotics. It is important that you try to reduce the risk of infection by maintaining good personal hygiene, washing your hands properly before and after preparing food, using the toilet, sneezing or blowing your nose. Wherever possible keep away from people with an infection e.g., diarrhoea and sickness, cold/flu or any rash illness.

Blood pressure (hypertension)

Pregnancy induced hypertension or pre=eclampsia is usually considered a disease of the second half of pregnancy, but it can occur for the first time after birth. It usually disappears after the baby is born, but in some women, it can take longer for the blood pressure to return to normal. High blood pressure may cause severe headaches, blurred vision/spots before your eyes, nausea and vomiting. This is rare, but if any of these symptoms occur you need to contact your midwife/GP immediately. Your blood pressure will be checked after the birth and may need to be monitored closely if required. If your blood pressure is raised after birth, you may need to stay in hospital longer for your healthcare team to monitor you closely. Some women need treatment/medication to lower their blood pressure.

Breasts

All new mothers produce milk in their breasts whether they choose to breast or formula feed. After two to three days the breasts may become full and tender, but this generally resolves spontaneously. However, if it worsens or you develop flu-like symptoms and the breasts are hard and have a red mottled appearance, this is breast engorgement and you should contact your midwife/breastfeeding specialist for advice. If you are breastfeeding, you will need to feed your baby more often to relieve the breasts. Whether you are breast or formula feeding, your midwife will advise you on how to relieve the discomfort.

Uterus (womb)

After the birth, your uterus should gradually return to its non-pregnant size, this can take about 10 days. Your midwife may check this recovery process by gently feeling your abdomen. Sometimes it may take longer, which in most cases is normal. Occasionally this may be a sign of retained blood or fragments of the placenta or membranes. Often this problem resolves spontaneously, however if you have any heavy bleeding, abdominal pain or a high temperature contact your midwife/GP immediately. You may need treatment with antibiotics/medication.

Blood loss (lochia)

Some vaginal bleeding straight after birth is normal. Your midwife will measure this and record it in your notes. Vaginal discharge after childbirth is called lochia – a mix of blood and other products from inside the uterus. At first it is bright red, and then becomes a pinkish/brown, turning to cream. It can be quite heavy at first, requiring several changes of sanitary pads a day. After the first week, it slows down, but you may find it lasts three or four weeks before finally disappearing. If you start to lose fresh red blood or clots, have abdominal pain or notice an offensive smell, or develop a high temperature contact your midwife/GP immediately. You may need to be treated with medications/antibiotics. However, some fresh red blood loss is normal after a breastfeed. The use of tampons is not recommended until you have had your six week postnatal check-up at your GP surgery. Inserting a tampon can increase the chance of you developing an infection.

Legs (thrombosis)

All pregnant women are at a slightly increased risk of developing blood clots (thrombosis) during pregnancy and in the first weeks after birth. This risk increases if you are over 35, overweight (BMI>30), a smoker or have a family history of thrombosis. You are advised to contact your midwife/GP immediately if you have any pain, redness or swelling in your legs. This may be a sign of DVT (deep vain thrombosis). If you have pain in your chest, with shortness of breath or coughing up blood, this may be a sign of pulmonary embolism (blood clot in the lung) and you should contact your GP/midwife immediately. You will need an urgent medical assessment.

Bladder (passing urine)

Soreness after the birth can make passing urine painful initially, but it should resolve quickly. Drinking plenty of fluids to keep the urine diluted helps. If you have problems passing urine after the birth then a warm bath or shower might also help, but if it persists your midwife will refer you for medical advice. Sometimes leakage of urine may occur on coughing or sneezing, this is known as stress incontinence. It is advisable for you to perform pelvic floor exercises to strengthen your pelvic floor muscles. If you are experiencing this, speak to your midwife/GP who can refer you to a specialist, once other underlying causes such as infection have been excluded.

Bowels (passing faeces/motions)

Constipation is very common after childbirth. This can be made worse by haemorrhoids (piles). Piles can be treated using good hygiene, haemorrhoid cream, Lactulose and pain relief. A high fibre diet including fresh fruit and vegetables and drinking plenty of fluids can help to prevent constipation. It may feel more comfortable if a clean sanitary pad is held against the perineum when having your bowels open. Occasionally women may have urgency, both of wind and motions or have difficulty getting to the toilet in time. This is not normal, and you can get help. Your midwife/GP can refer you to a specialist if any of these problems occur.

Perineum (area between vagina and anus)

Your midwife may check your perineum to see it is healing especially if you have had a tear or stitches. The stitches usually rake about two weeks to dissolve and throughout that time your perineum should continue to heal. Regular pain relief will help with any discomfort, try to avoid constipation. It may be easier to lie on your side rather than on your back, especially when you are breastfeeding. The perineum is a common area for infection and should be kept clean and as dry as possible.

Pain

It is not unusual to have some pain following the birth. This can be because of the type of birth you have had. It can vary from minor discomfort, which is eased by bathing and pain relief e.g., paracetamol, to post-operative pain requiring prescribed pain relief by your doctor. If you develop any type of pain, always tell your midwife and she will advise you on what to do to ease the pain.

Sleep

As your nights will be disturbed caring for your, it is important to catch up on sleep when you can as your body is still recovering from the birth. Try and rest when your baby is asleep. It may be tempting to use this time to catch up with housework, but rest is very important. Ask friends/family to help with housework/shopping or looking after your baby whilst you have a nap/rest.

Keeping healthy

If you think you need to lose weight, talk to your GP, Midwife, Health Visitor or practice nurse. The best way to lose weight healthily is by eating a well-balanced diet and taking regular moderate exercise e.g. a brisk walk for 30 minutes five times a week. Being overweight (i.e. BMI over 30) has a risk for long term health. Risks include developing diabetes, high blood pressure and heart disease.

Quitting smoking for you and your family: The best thing you can do for you and your family’s health is to stop smoking and now is a very good time. Tobacco smoke contains over 4000 harmful chemicals. Babies and children breathe faster than adults, and these chemicals can easily pass into their lungs. Their immune systems are less developed than adults and this makes them more likely to develop a serios illness e.g. asthma, glue ear, or chest infections. Babies are at an increased risk of Sudden Infant Death Syndrome (SIDS/cot death) if they are exposed to cigarette smoke. Your midwife or health visitor will be able to tell you about local ‘stop smoking’ groups, or you can access information via www.nhs.uk/smokefree. Even if you do not smoke but other adults do in your household, ask them to smoke outside. Never smoke in the car with your baby or children. Smokers increase the risk of housefire by 40%. Smoke detectors and fire safety checks are provided for free from your local fire station.

Alcohol, street or illegal drugs: Drinking too much alcohol can cause a variety of health problems including high blood pressure, cancer and liver problems. Its recommended that women do not drink more than 14 units a week on a regular basis and avoid binge drinking. For further information including examples of what one unit of alcohol is, visit www.drinkaware.co.uk. If you or your partner use street or illegal drugs, there is support and help available to you. Speak to your midwife, health visitor or GP who will be able to refer you for specialist support services.

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