Postnatal information for patients

See GP or Midwife today if mum has:

• a fever, shivering, abdominal pain or offensive vaginal loss
• calf pain (one-sided), any redness or swelling
• headaches alongside any nausea, vomiting or visual disturbances within the first few days
• faintness, dizziness or palpitations
• puerperal psychosis

 Call 999 if mum has:

• shortness of breath or chest pain
• sudden or extreme blood loss
• a sudden collapse
• severe headache

If you are unable to contact your GP or Midwife for a priority appointment the same day, use your out of hours GP service or attend the Urgent and Emergency Care Centre at Rotherham Hospital.

If you are unable to be seen within the next 4 hours contact Wharncliffe ward for advice.

This can continue for a number of weeks following childbirth.

• Expect a bright red, heavy flow for the first few days. This then tapers off and becomes dark red, brown, watery pink, yellow then white/
• Gently increase activity

Contact your GP or midwife if:

• you have heavy vaginal bleeding
• your discharge has a foul odour
• you have a a temperature over 38 degrees celsius (100.4F)
• you have shivering or flu like symptoms

It can be normal to pass small clots. Clots should be no bigger than a 50 pence coin. If the clots are larger than this contact your midwife as soon as possible. 

If any clots are passed:

• check your loss is normal
• if normal, carry on as usual
• if heavy blood loss, rest and if bleeding continues contact your GP or midwife

Hygiene is really important.

• Wash your hands before and after changing pads
• Change sanitary pads frequently
• Bathe or shower daily

Additional information

• Maternity pads are best for first few days then change to lighter pads
• Avoid the use of tampons as these can cause infection
• Use plain water for washing around your vaginal/ perineal area for the first few days as scented products may cause irritation
• Avoid using salt

Vaginal soreness is normal. What can help:

• Use of cold compress for no more than 30 minutes with a break of at least an hour in first couple of days.
• Lavender oil can be used in the bath to help with healing. Use by dissolving 3 drops in the bathwater before bathing. If you find the oil sits on the surface of the bath water, adding the 3 drops to a small amount (approx. an eggcup full) of full fat milk prior to putting it in the bath helps it to dissolve evenly.
• Use analgesia/painkillers e.g. paracetamol. Speak with you midwife or GP if you are unsure of the correct dose.
• Remember to do pelvic floor exercises regularly.

Rotherham Hospital Perineal Clinic:

• open alternate Tuesdays, 9am to 5pm
• your GP or midwife can refer you
• ring Greenoaks for an appointment

Contact your GP or midwife if:

• your perineum becomes extremely painful
• you have any wound break down or wound discharge

Avoid the use of ‘donut’ rings.

Try to wear loose clothing (no tight jeans or thongs).

Rest lying down when able (this can relieve the pressure from your perineum).

Expose your perineum to air after drying following a bath or shower.

See pelvic floor exercises below. 

• keep your wound clean and dry
• bathe or shower daily
• use a separate cloth/wash puff for your wound
• dry well and lift tummy up and air if need be
• wash hands before and after changing pads

Note and report any signs of infection to your GP or midwife. Signs of infection include: 

• redness around the wound
• skin around the wound being warm to touch
• swelling around the wound
• weeping around the wound
• gaping around the wound
• any fever, shivering or temperature

If you have any fever, shivering or a high temperature (more than 38 degrees celsius) contact your GP or midwife urgently as you may need treatment. Maternity Triage or NHS 111 should be contacted through the night.

Most women buy over the counter analgesia such as paracetamol and ibuprofen if further analgesia is needed after hospital prescription medicines run out. If you need stronger analgesia contact your GP or midwife.

Pelvic floor exercises strengthen the muscles around your bladder, vagina and back passage. This can help to stop incontinence, treat prolapse and make sex better too.

You can do this exercise lying down, sitting or standing. With practice, it can be done anywhere and at any time - even while you’re watching TV.

• Squeeze and draw in your back passage as if you’re holding in wind
• Squeeze around your vagina and bladder tube (urethra) as if you’re stopping the flow of urine
• Now relax. This is a short squeeze. Rest for a second, then repeat these squeezes until you feel the muscles get tired.
• After a short rest, squeeze again as above. This time hold the squeeze for as long as you can (but not for more than 10 seconds) then relax.
• It’s important to keep breathing normally while you do these exercises.
• Make sure you don’t pull in your stomach or squeeze your buttocks when you squeeze.
• Aim to build up to 10 repeats of each exercise, four to six times a day.

In the past, women were taught to practice these squeezes while urinating (having a wee). This isn’t the best way to do these exercises because you may not empty your bladder completely. 

Have contraception in place before you need it.

• Contraception is free on the NHS.
• Contraception can be arranged by contacting your GP or the Sexual Health team at Rotherham Hospital (C Level, opposite the Chape)l. For an appointment at the Sexual Health Department, please telephone 01709 427777.
• There are 13 different methods. Some can start 3 weeks after birth.
• Choose a method that suits you.
• Breastfeeding is NOT a form of contraception.
• Resume sexual relations when you feel comfortable.

Take time to enjoy your new baby. They need your love and attention.

Your body needs to recuperate after birth. Sexual intercourse after birth may not be comfortable. If it is painful, stop and try again at a later date. If problems persist contact your GP or the Sexual Health department on telephone 01709 427777.

A Deep Vein Thrombosis (DVT) is a blood clot that commonly forms in the veins of the lower leg or calf. The blood clot may break away and travel to the lungs (Pulmonary Embolus or PE) or the brain and this is very dangerous.

Risk factors include:

• surgery
• previous DVT
• being overweight
• dehydration
• smoking
• immobility
• blood disorders
• contraception
• pregnancy and birth
• increasing age (over 35yrs)

 Help reduce your risk by:

• keeping mobile
• drinking plenty and keep hydrated
• doing ankle exercises when immobile

If you have multiple risk factors further treatment may include:

• blood thinning injections
• anti-embolic (compression) stockings

Signs of a DVT/PE require urgent medical attention:

• calf pain (one-sided), any redness or swelling
• shortness of breath
• pain in chest or upper back 

It is important that any medication prescribed and given to you is taken correctly and the course completed.

The following three medications need to be completed to avoid complications:

1. Antibiotics - these are given to you if you have any infection.
2. Antihypertensives - these are given to you if you have been diagnosed with high blood pressure.
3. Blood thinning injections known as Tinzaparin - these are given to prevent blood clots in your brain, lungs and legs, which can be very dangerous or even fatal.

• You will be shown how to give the injection prior to discharge. Either yourself or a family member can do this.
• You will also be given TED stockings to wear for the same duration as your Tinzaparin. We give you a spare pair to go home with.
• You will go home with a sharps bin and instructions on its collection from Rotherham Borough Council.

In the first few weeks after birth you may find that you think about what happened during labour and birth again and again to try to make sense of it all.

Sometimes remembering things that happened can be distressing and you may experience unusual feelings, flashbacks and nightmares. This is quite normal as your body and mind adjust after childbirth and these feelings usually fade away within 4-6 weeks.

You may find it helpful to talk to family, friends, or your community midwife or health visitor, about your birth. These conversations help to naturally process in your mind what has happened and people often find this is enough to help them make sense of their experience.

If symptoms like flashbacks are not stopping, or you have any unanswered questions or unresolved feelings following your birth experience, please speak with one of our specialist midwives.

You can contact the service directly by emailing rgh-tr.birthinmindservice@nhs.net or by leaving a message on the voicemail service on 01709 427123 and someone from the team will contact you. Or you can speak to your GP or health visitor who can refer you to this service on your behalf.

This can start from day three and can last for up to two weeks.

What does this look like?

• feeling emotional, irrational or irritable
• bursting into tears for no apparent reason
• feeling depressed or anxious

These symptoms can be normal

Things that will help:

• get plenty of rest
• eat well
• limit visitors and trips out
• sleep/nap when your baby does

If baby blues doesn’t seem to be lifting after two weeks, or you are feeling concerned about your mental wellbeing, speak to your midwife, health visitor or GP.

The baby blues is not an illness and should settle without any treatment.

This affects 1 in 10 women; occurs two to eight weeks after birth and lasts longer than two weeks. It is an illness.

Symptoms include:

• anxiety
• feelings of not being able to cope
• panic attacks
• struggling to sleep
• not able to stop crying
• extreme tiredness
• loss of appetite
• aches and pains
• feelings of hopelessness
• feeling generally unwell
• not being able to enjoy things you normally would unable to concentrate
• memory loss
• loss of interest in their baby
• excessive anxiety about their baby

Ask your midwife about local support groups. Speak to your GP about your symptoms as it is easily treated with talking therapies/medicines.

This is an emergency and needs urgent referral to a specialist.

• new feelings and thoughts which you’ve never had before
• new thoughts of violent self harm
• sudden onset or rapidly worsening mental symptoms
• persistent feelings of estrangement from their baby

See your GP or midwife today if your baby:

• has a high pitched continuous cry
• starts to refuse feeds
• seems more sleepy or is not waking for feeds
• has reduced wet nappies
• vomits green bile
• passes blood in stools
• has thrush - sore buttocks / white coating on the tongue which does not clear (usually found in bottle-fed babies or with dummy use)

Call 999 if your baby:

• is floppy, unresponsive or has glazed eyes
• stops breathing
• turns blue, mottled or very pale
• has a fit (febrile convulsion)
• has a high temperature (over 38˚C)
• has difficulty breathing, is breathing fast or is grunting whilst breathing
• has a spotty purple, red rash anywhere on their body 

Babies feed frequently. The first sign of an unwell baby is a baby who will not wake for feeds or refuses to feed.

Rashes in babies are very common and come and go. If the rash persists or a rash is noted and baby is unwell seek medical advice.

Jaundice causes baby’s skin and the whites of their eyes to become yellow. This is due to a breakdown of excess red blood cells that the baby does not need.

• babies under 24 hours old becoming jaundiced will require urgent medical attention
• jaundice is common in newborn babies over 24 hrs old
• babies over 24 hours old should be reviewed by midwifery staff the same day
• it is important that babies with jaundice feed frequently

Midwifery staff assess babies for jaundice at each visit. Any baby with jaundice over 24 hours old will have their level of jaundice checked with a machine. If the reading is high, baby will need a review in hospital by a paediatrician.

We encourage you to feed your baby frequently. Feed your baby when they wake for feeds. In the first few days some babies may need to be woken for feeds. Feeding flushes out the bilirubin (from the breakdown of red blood cells that baby no longer needs). Bilirubin is passed out of the body in wee and poo. If bilirubin is left to build up, it can cause baby to become sleepy and then baby could become ill.

If you are concerned about your babies colour, poor feeding or a sleepy baby then contact your midwife.

The safest place for your baby to sleep is in their own crib or cot.

• sleep baby in the same room as yourself (both day and night) for 6 months
• always place your baby on their back to sleep
• place baby’s feet at the foot of the crib or cot
• use a firm, flat well-fitting, waterproof mattress
• do NOT use duvets, bumper sets or pillows
• keep baby’s face and head uncovered
• avoid baby overheating
• ensure baby’s environment is smoke free
• never sleep with your baby on a sofa or armchair

At home the midwife or midwifery support worker will undertake a safe sleeping assessment and will ask to be shown where your baby will be sleeping during the day and at night. This is only to offer guidance on the safest way for your baby to sleep.

Follow up assessments may be needed if any risks are identified. These may be carried out by the health visitor or midwife. 

• baby is settled during and after feeds
• they appear healthy and alert when they’re awake
• in the first 48 hours, your baby is likely to have only two or three wet nappies.
• from day five onwards, wet nappies should start to become more frequent, with at least six heavy, wet nappies every 24 hours.
• from the fifth day breast fed babies should have at least two soft yellow poos the size of a £2 coin, every day for the first few weeks
• from the fifth day formula feeding babies should pass soft yellow poos which should remain soft and may vary in frequency
• your baby gains weight steadily after the first two weeks - it’s normal for babies to lose some of their birth weight in the first two weeks

All breastfeeding mothers will have received information and support on how to position and attach baby to the breast, to always offer the second breast, to feed 8-12 times in 24 hours, how to express breast milk and about responsive feeding.

Formula feeding mothers will have received information and support on how to make up feeds, what type of formula to use, how to feed baby and responsive feeding.

All babies are weighed on day 3 and day 5 after birth and again a few days later before discharge from midwifery services. Babies are usually weighed on a monthly basis after they have gained their birth weight (more frequent if a problem is identified). 

Why do babies cry?

• because they are hungry
• because they are tired
• because they feel uncomfortable and need winding
• because they are overstimulated or bored
• because they feel unwell
• because they have a wet or dirty nappy
• because they need a cuddle
• because they are too hot or too cold
• because they are in pain

How to calm baby

• feed your baby
• hold your baby close (skin to skin is best)
• gently sway or dance with your baby
• talk or sing to your baby
• bathe with your baby
• use motion by gently rocking your baby in their pram, go for a walk or drive
• turn the radio on and lights on (during day)
• take turns with your partner to settle your baby
• seek information about infant massage classes

Babies are able to sense a mother's anxiousness, therefore your partner or mum may be able to settle your baby if your are stressed. If settling through the night keep lights and sounds low so baby learns the difference between day and night. Babies are often unsettled in the evenings.

If colic is going to develop, this usually starts within the first few weeks and stops around 4 months. 

By law all children under the age of 12 or 135cms (whichever comes first) must travel in the correct child car seat even for short journeys.

• use a rear facing car seat up until the child reaches 15 months then a forward facing seat can be used
• only use EU approved height based seats
• make sure the seat is fitted properly in the car following the manufacturer’s instruction
• use the back seats for all under fives if you can
• never leave your baby or toddler alone in the car
• the safest place for a baby seat is behind the driver.
• it is dangerous and illegal, to carry a baby in a rear-facing baby seat in a front car seat that has an active airbag

The T.I.C.K.S rules for babywearing, produced by the UK Sling Consortium, advises how to safely carry your baby in a sling. 

To register the birth, make an appointment at Riverside House (Monday to Friday). You can either phone for appointment on 01709 823543 or book online. You need to bring baby's red book as well as other documentation. See the Rotherham Metropolitan Borough Council's website for details. 

Child benefit forms can be found in the Bounty Pack.

Child tax credit office contact details: 0345 300 3900

Healthy Start Vouchers: Complete the form found in the booklet (See leaflet for inclusion criteria)

A Community Midwife will visit the day after your discharge from hospital (9am to 5pm). If they have not attended by 4pm, please call 01709 424348.

A health visitor will see you at home from 10 days after the birth of your baby.

Wharncliffe Ward
24 hours
Telephone: 01709 424348

Labour Ward
24 hours
Telephone: 01709 424491

Midwifery Triage
7am to 7pm
Telephone: 01709 427700

Greenoaks
Monday to Friday, 9am to 5pm
Telephone: 01709 424513

Sexual Health Services
Telephone: 01709 427777

Community Midwifery Office
Monday to Friday, 9am to 4pm
Telephone: 01709 424058