Recovery from vaginal or assisted birth
Recovery after vaginal or assisted birth
Recovery from vaginal or assisted birth
Recovery from vaginal or assisted birth
Once you are admitted to the postnatal ward or discharged home from hospital to the care of the community midwife, you can expect that your body will need some time to recover from the birth. Midwives, maternity support workers or nurses may be involved in your care and will carry out routine checks to ensure that you are well. This will include a regular top to toe physical check, including inspection of sutures (stitches).
If you have had a vaginal birth you will be offered pain relief. Read “Commonly used medicines” to find out what painkillers are routinely offered. Read “After pains” and “Perineal after-care” which explains how you can help yourself if you are experiencing after pains or if you have had an episiotomy (cut) or a perineal tear. If you have had an assisted delivery you may need to have a urinary catheter for a few hours. Read “Passing urine” for more information.
It is important to eat well and drink plenty of fluids to promote health and wellbeing after any type of birth.
Antibiotics for newborn baby
Antibiotics for newborn baby
Known risk of an infection
If you received antibiotics in labour only because of the known risk of GBS infection, this will be stopped at the time of the birth. For 12-24 hours after the birth, your team will monitor you and the baby for anything concerning, including signs of infection. The monitoring aims to identify early warning symptoms and signs. For the baby, this will include overall assessment and regular measurement of heart rate, respiratory rate, colour, temperature and feeding. The baby will stay with their mothers on the postnatal ward.Signs of a possible infection
At birth, a baby doctor will review your baby’s risk of infection based on factors including your own signs infection, the course of your labour and an assessment of your baby. Your baby will be observed closely and have regular measurement of heart rate, respiratory rate, colour, temperature and feeding for at least 12 hours. Depending on the risk of infection, your baby may need to have some blood tests to look for infection and be started on antibiotics. In this case, the neonatal doctors will put a tiny cannula in your baby’s hand or foot so that they can take some blood to test and give the antibiotics directly into a vein (intravenous). If antibiotics are required, your baby will receive these twice a day through the cannula and the ward staff will continue to monitor your baby closely as before. Your baby can stay with you on the postnatal ward during this time. Should there be further concerns your baby may need to be admitted to the neonatal unit to enable close monitoring, further tests and necessary treatment. You’ll be able to visit your baby in the neonatal unit.Why does my baby need antibiotics?
Antibiotics are started in babies assessed as being at significantly increased risk of infection. This is because infection in babies can be very serious if left untreated and even if your baby looks very well, they can become sick very quickly. The good news is that antibiotics can help keep your baby well. The antibiotics must be given directly into their blood stream as babies are not able to absorb sufficient amount of antibiotics from their gut. You will be able to breastfeed your baby and the ward staff will support your feeding choices. We want you to know that there are normally no side effects or allergic reactions with use of antibiotics in newborn babies. If you are unsure why your baby needs antibiotics, please ask the medical team to explain this to you. Whilst you will have to be careful with the cannula when holding your baby, you will be able to do skin-to-skin and breast feed your baby.What tests will my baby have?
If your baby requires investigation for infection, a number of blood tests will be performed, including:- 1) CRP (C-reactive protein), which is produced by our bodies in response to an infection or inflammation. A high CRP can indicate the presence of an infection in the body.
- 2) Blood cultures to identify if any bacteria are growing in the blood. This result may be available within 36-48 hours of the test.
How long will my baby need antibiotics?
The length of time your baby needs antibiotics will depend on how your baby is doing and what the results show. If your baby remains well, the CRP is not high and the blood cultures do not grow any bacteria, the antibiotics can usually be stopped after 36-48 hours. A longer course of antibiotics may be indicated should there be any concerns.When can we go home?
At the time of birth, it is difficult to know when you and your baby will be able to go home. After 36-48 hours, the doctors will have a better idea of the duration of treatment required. Your team will continue to review you and your baby on the ward daily until they feel sure that you are both well enough to go home. On discharge from the hospital, you will receive written information about the medical treatment delivered on the ward. You can share this with your community midwife and health visitor. Your GP will be sent this information.Guidance for next pregnancy if you or your baby was identified as having GBS
If you become pregnant again, please inform the maternity care team looking after you that about the positive GBS result, so that they can offer antibiotics in labour to reduce the risk of early onset GBS infection in the baby.What should I do if I have worries?
Ongoing maternity care is provided by community midwife, who are local to where you will be based after discharge from the hospital. The community midwife will make contact with you within 24-48 hours of being at home. They will support you and your baby’s care. Should you have any urgent concerns regarding the health of you or your baby, please seek medical advice from your GP, NHS 111, 999 or attend your local Accident and Emergency department. For baby, these concerns may include baby showing abnormal behavior (for example, inconsolable crying or listlessness), being unusually floppy, has an abnormal temperature unexplained by environmental factors (lower than 36 or higher than 38 Degree centigrade), abnormal breathing (rapid breathing, difficulty in breathing or grunting) or change in skin colour (for example baby becomes very pale, blue/grey or dark yellow) or has developed new difficulties with feeding.Loneliness: Emma’s Diary
Loneliness: Emma’s Diary
Feeling lonely and isolated after the birth of a baby is not uncommon for new parents, particularly for those who may not have close family nearby for companionship and support.
Read the article in Emma’s diary to find out what you can do if you feel lonely.
Helping your premature baby to develop
Helping your premature baby to develop
Having a premature baby is the beginning of a long and emotional journey towards going home. It can be a very stressful time for your whole family. A premature baby’s development happens in the same order as it would have happened in your womb. When your baby reaches certain health, growth and development milestones, you’ll be able to take them.
All babies are different, and their behaviour and development are different too. In premature babies, the differences have to do with how premature they were when they were born.
Below are some changes that you can expect and watch out for in your premature baby and what you can do to help their development.
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23 to 27 weeks gestation |
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| Weeks of gestation/Cues | What you can do to help |
|---|---|
| 23 weeks: Eyes are closed. Little movement. | Ask your baby’s nurse to show you how you can touch your baby. Familiarise yourself with the BLISS family handbook. |
| 24 weeks: Your baby’s skin is very thin and transparent. | Talk quietly to your baby as they can hear you. |
| 25 weeks: Your baby’s body is lean with no fat. His/hers arms and legs are limp. Your baby doesn’t yet have good muscle tone. | Ask your baby’s nurse about how to hold and position your baby. Leave a small piece of cloth that smells of you with your baby. |
| 26 weeks: Your baby’s eyes will start to open but they can’t focus yet. Your baby will sleep a lot. The breath triggering part of your baby’s brain hasn’t fully developed yet, so pauses between breaths are common. | Keep the lights as dim as possible. Shield your baby’s eyes from bright light to enable your baby to try and open their eyes. |
| 27 weeks: Your baby may startle at loud noises. | Avoid sudden noises. Remember positioning. |
|
28 to 32 weeks gestation |
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| Weeks of gestation/Cues | What you can do to help |
|---|---|
| 28 weeks: Your baby’s movements may be jerky and jittery. Their hand grasp and sucking reflexes appear but these will be weak. | Ask the nurse about skin to skin contact (kangaroo mother care). Let your baby gently hold your finger. Your baby may take a non-nutritive tool. |
| 29 weeks: The ability to hear and smell will allow your baby to recognise you. | Talk softly to your baby when you visit. You may like to read short stories, nursery rhymes or sing to your baby. |
| 30 weeks: Your baby has periods of alertness and sleep Your baby may recognise your face now. | Try to observe the periods of alertness in your baby, to allow them to look at you and interact |
| 31 weeks: Your baby may be able to keep his/hers eyes open wide for a time. | Move your face back and forth slowly and your baby may follow you and your eyes. |
| 32 weeks: Your baby will be more interested in sucking and may appear to suck the feeding tube. | Offer a non-nutritive feed with tube feeds. Speak to your baby’s nurse about cup feeds if appropriate. |
|
33 to 37 weeks gestation |
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| Weeks of gestation/Cues | What you can do to help |
|---|---|
| 33 weeks: There are clear sleep and awake cycles. Your baby will be moving around in the cot and incubator a lot. | Provide a calm environment around feeding time to enable your baby to focus on sucking, swallowing and breathing. |
| 34 weeks: Your baby may be sucking on hands and non-nutritive tools. | Offer the breast, or start using your own bottles and teats. Hold your baby still rather than rocking them to enable them to gradually become accustomed to position changes. |
| 35 weeks: Your baby may wake up when hungry, may cry with a wet or dirty nappy. | Allow your baby to gaze at your face. Talk or sing in a soft voice whilst your baby is in light sleep. |
| 36 weeks: Your baby may have a more consistent sleep/wake cycle. Your baby may want to be held and cuddled more. | Parents’ voices, smells and faces are very important. |
| 37 weeks: Your baby should be gaining more weight and has fuller cheeks. | Spend as much time as you can with your baby. If you haven’t talked about or arranged an overnight stay, this is a good time to book it. Ask the team about resuscitation training. |
37 weeks onwards
As long as your baby is well, now is the time to start building on what you and your baby have been doing from 35 weeks. Your baby should be gaining weight well, maintaining their temperature in an open cot and breast or bottle feeding.- Take short walks with your baby and try short periods of time with your baby in a bouncy chair.
- Use more interactive and visually stimulating toys.
- Talk to the neonatal team about structuring your baby’s day i.e. day/night/bath time/playtime.
- Make sure your home is ready for discharge.
- Make sure the baby’s Red Book (Personal Child Health Record Book) is completed before discharge from hospital.
Mouth (oral) thrush
Mouth (oral) thrush
Oral thrush is a common fungal infection in the mouth. It can be easily and quickly treated if it doesn’t clear up on its own.
How do I know if my baby has thrush?
- Look out for white spots or patches on your baby’s cheeks, gums and palate. These patches can look like milk spots, but if you rub them there will be a raw area underneath.
- Your baby may fuss when breastfeeding or might even refuse your breast or bottle.
- Sometimes babies get nappy rash when they have oral thrush. It might look red or bright pink with small raised spots and you might find standard nappy rash creams aren’t effective in clearing the rash.
- If you are breastfeeding you may notice that you have thrush on your nipples, making them painful, red and cracked.
What treatment will we receive?
Your GP or Health Visitor may prescribe an antifungal treatment. The type of treatment will depend on the age of your baby. A course of treatment usually takes 7 days. If there is no improvement after a week, ask your GP for further advice.- If you have thrush on your breasts, the GP will prescribe medicine for you too.
How can I prevent thrush?
- Oral thrush will usually become less of a problem as your baby’s immune system develops.
- Take extra care when sterilising bottles, soothers and other feeding equipment.
- If you still have thrush, wash your breasts after feeding. Use plain water, pat dry and applied any prescribed treatment to avoid further contamination.
- To prevent re-infection, make sure you keep separate towels for your hands before and after feeding, and before and after changing your baby’s nappy.
Healthy eating after birth
Healthy eating after birth
Eating healthily after the birth of your baby is as important as it was during pregnancy. Eating a balanced diet with plenty of clear fluids helps your body to recover. Speak to your midwife, health visitor, infant feeding specialist or GP if you have specific concerns relating to weight loss, diabetes or breastfeeding.
Nutrition after pregnancy from Nutribytes
Getting practical help after birth
Getting practical help after birth
Additional resources are available to help you with finances, housing, infant feeding, peer suppport, social activities in your local council area. Go to your council website to discover these and more resources.
Portal: Getting Practical Help in After your baby is born
Paediatrician/Neonatalogist (baby doctor)
Paediatrician/Neonatalogist (baby doctor)
Paediatricians or neonatologists are doctors specialising in the care of newborn babies and children. They will be involved in your care if early (premature) delivery is anticipated or if there are likely to be concerns about the health of your baby during or after the birth. Carpal tunnel syndrome
Carpal tunnel syndrome
What is Carpal tunnel syndrome (CTS)?
There are eight small bones called the carpal bones in the wrist. These bones form a semi-circle, and a tough band of tissue (the carpal ligament) forms a roof over these bones. This tunnel is known as the ‘carpal tunnel’. Passing through this tunnel are the tendons which move the fingers and thumb and the median nerve. When the median nerve gets compressed (squeezed or pinched) in the tunnel, it causes the symptoms of CTS.
During pregnancy, the body naturally retains more fluid, and swelling of the hands is common. If some of this fluid is localised to the carpal tunnel, this leads to pressure on the median nerve causing the symptoms of CTS. Up to 62% of pregnant women develop CTS. These symptoms are also common after the birth.
What are the common symptoms?
Symptoms are commonly felt in the thumb, index and middle fingers. You may have symptoms in one or both hands. Symptoms may include:- pain in your wrist, palm or forearm
- ‘pins and needles’
- numbness
- weakness caused poor grip or clumsiness
- burning sensations in the fingers
- hands may appear swollen
What can you do to help yourself?
Positioning
Keep your wrists straight to avoid putting pressure on the nerve. You may find wearing a wrist splint useful at night and when resting during the day. Do not put splints on too tightly and do not wear them continuously unless advised.Rest
Reduce all non-essential activities, such as shopping, carrying, lifting and repetititve tasks such as typing and writing.Ice
Using an ice pack over the wrist/hand area may help reduce the swelling and pain. Leave for 10 minutes.Contrast bathing
Using alternating heat and cold can also be helpful to reduce pain and swelling. You can do this by either using an ice pack and hot water bottle wrapped in a tea towel or by dipping your hands in cold or warm water. Alternate between warm and cold for 30 seconds each, for 5-6 minutes, always finishing with the cold. You can do this 3-4 times a day. Precaution: always check the water temperature before immersing your hand.Elevation
When possible, place your wrists on pillows above the level of your heart to reduce swelling. This can be very useful at night – remember not to sleep with your hands under your pillow.Movement/Exercise
These exercises done throughout the day between rest periods may help relieve your symptoms. Aim to do the exercises at least three times every day. 1. Bend and straighten your wrists keeping your fingers straight. Hold each position for 5 seconds and repeat x10:
2. Hand squeeze. Make a release a fist (this can be done with your hands elevated). You could also squeeze a stress ball:
3. Fingers bend and straighten. Forearm upright, wrist and fingers straight. Now hook your fingers down, trying to touch the tips of your fingers to the top of your palm. Straighten again. Repeat 10 times:
