Your postnatal check: focusing on Mum
We hope that you had a straightforward pregnancy and are enjoying your new baby, but we know things do not always go smoothly. Your postnatal check is an opportunity to discuss any concerns you have.
This article lets you know the things we will be discussing so you can come prepared. You will also receive a questionnaire to complete. It is really helpful for us to see your answers in advance, so that we can spend time talking about the things that are most important to you and your wellbeing. Thank you in advance for completing the questionnaire.
Firstly, how are you? How are you recovering from pregnancy and what are you feeling? Mental health problems are common in the postnatal period, and we can support you, don’t be afraid to tell us how you are.
Mental health support:
Butterflies – mental health group for parents and parents to be | Havering Directory
Perinatal Treatment – Free evidence-based mental health treatments for new parents (wordpress.com)
Feeding:
However you feed your baby, we want to know how it is going. If you are breastfeeding, are your breasts comfortable? Is your baby satisfied after a feed? If you are not breastfeeding, have your breasts gone back to normal? Is the formula feeding going well?
A reminder that breastfeeding Mums should take a daily vitamin D supplement of 10mcg.
Your health visitor can help with most feeding issues.
La Leche League GB – Friendly breastfeeding support from pregnancy onwards
The Breastfeeding Network | Independent Breastfeeding Support
National breastfeeding helpline open 9.30-21.30 daily 0300 100 0212
Physical recovery:
How are things ‘down there’? If you have a wound – from a Caesarean or vaginal birth – is it healed or healing? We are happy to check any wounds at your appointment if you have any concerns.
It is also really important that we talk about your pelvic floor, the questionnaire we send you will ask quite a lot of questions about this. Are you having any problems with your bladder, bowels, vagina or resuming sex?
Your bleeding should have stopped or be stopping around the time of your appointment. If you are still having significant bleeding, we may need to examine you.
What are pelvic floor exercises? – NHS (www.nhs.uk)
Pelvic Floor Exercises – Finding Your Pelvic Floor – YouTube
Medical conditions:
If you already had a medical condition, or developed one during pregnancy it is important that we review this. We may not have time to do this thoroughly during your postnatal appointment and may require a further appointment to be booked.
Some conditions resolve after pregnancy, but we may need to examine you or arrange blood tests to confirm this. Just in case your discharge letter didn’t mention it, please let us know if you had any temporary medical problems during pregnancy such as high blood pressure, diabetes or anaemia.
Contraception and family planning:
If you require contraception before your postnatal appointment, please book an appointment or send us an econsult: Contact us about your request (accurx.com)
Some women know what they want to do about contraception, but many are unsure. If you think your family is complete, or you don’t want another pregnancy for some time, a long-acting method may be right for you, such as a coil, the implant or the depo injection. Being a Mum is busy and it is not surprising that many forget their pill on occasion, this makes the long action contraceptives the preferred option for many.
Contraceptive choices after you’ve had a baby – Contraception – Sexwise
Keeping you and your baby safe and well:
Smoking:
If you are a smoker and need help to quit, there is help available.
Second hand smoke is also dangerous for your baby and 60% of sudden infant deaths are linked to smoking in the home. Therefore, if someone you live with smokes, it is really important to encourage them to quit too.
Weight:
It is common to gain weight during pregnancy and most women are able to lose weight with healthy diet and regular physical activity. However, taking into account how busy you are with your new baby, this is not always easy. If you need further support, you can reach it here:
Exercise:
We would encourage new Mums to return to physical activity and if you need any advice, please discuss this with your health visitor or GP. It is important to be active to restore your pelvic floor muscles.
Keeping fit and healthy with a baby – NHS (www.nhs.uk)
Safety at home:
We wish everyone has a safe and supportive home environment. Sadly, incidents of domestic abuse increase in pregnancy and the postnatal period. If you have any concerns, we can help. Please speak to us, our staff are trained and ready to support you. If you are worried about the safety of your baby, or if you think they are at risk of female genital mutation, it is vital you disclose this. We will not put you at risk; we will support and help you.
Smear tests:
Can you remember when your last smear test was? If not, we can check for you, just ask at your appointment. If it was due during your pregnancy, you can have it from 12weeks after delivery. We advise that when you book your baby’s 12-week injections, you book a second appointment for your smear test to be done with the same nurse (Marie or Lin).
Vaccinations:
Some women find out during pregnancy that they are not immune to rubella. If your midwife told you this, you need 2 doses of MMR. It is important that you do not get pregnant for at least 6 months after your second dose of MMR so please ensure you have decided on your contraception first! If you think you have missed any other vaccines, please speak with our nurse.
And that is about it! Once we have discussed all these things about you, we will conduct your baby’s check. The baby check is just like when they were first born, and they will need to be fully undressed. They will also be weighed at the appointment and have their vaccines with the nurse before you go. Your baby may get a fever after their immunisations and the nurse will discuss with you how to use liquid paracetamol to manage this; please make sure you have purchased some before your appointment and keep it safe at home. If you have any concerns or questions about the immunisations these can be discussed on the day, or if you need time to think please book a telephone appointment with the nurse in advance so you can get the information you need to make an informed choice. Please remember to bring your red book to the appointment.