POSTPARTUM CARE- after the baby comes

Postpartum care is just as important as prenatal care. The midwife will follow you closely through the first six weeks after the birth of your baby.

Immediately after your baby is born the midwife stays with you until both mom and baby are stable and everyone is settled in. This usually requires the midwife to monitor you and baby for the first two to four hours.

The midwife will help you establish breastfeeding and monitor your blood pressure, the amount you are bleeding, the size and shape of your uterus (to make sure it is contracting to normal postpartum size) and your general wellbeing.

She observes the baby to make sure he/she is making a smooth transition, looking for good color, temperature, heart rate, breathing rate, etc.

An assistant will help to clean up the house, do laundry and prepare food.

Once she leaves you, the midwife will call you within 24 hours of the birth. You can call her for advice or to request a visit at any time should the need arise.

She will come to your home again within the first 48 hours after the birth. At that time she does a brief exam and vital signs. She will review your birth experience with you, discuss breastfeeding, inquire how you are feeling and offer remedies for any discomforts. This is often a time to celebrate your birthing and oooh & aaah with the baby.

The midwife will do the heel stick for the metabolic screening (aka PKU, in lay language, but consists of other screening tests as well) on the baby at this 48 hour visit.

Your newborn will need to see a pediatrician within the first 48 hours after birth. The midwife can recommend local pediatricians who are friendly to homebirth and supportive of breastfeeding. You contact him/her during your pregnancy to make plans for the newborn check-up.

Other visits by the midwife depend on your needs. If you required stitches after the birth a one week visit to check on the healing process is important. Should you have any unusual symptoms - fever, pain, discomfort - the midwife would come out to see you. Breastfeeding challenges also warrant a visit. In short, the midwife is available to you as you need her, just as she was during your prenatal care.

A six-week visit with physical exam and lab work usually completes your care. At this time, the midwife can refer you to a woman-friendly local physician for family planning needs.