The first hours
Immediately after the birth, the baby will be put on the mother’s chest or tummy. The heart rate and breathing will slow down and become calmer during skin-to-skin-contact. The baby will be dried and wrapped with towels to keep the baby warm. The heart rate, breathing, muscles control, reflexes and the baby’s crying will be monitored which allows the midwife to give an Apgar-score. You will most likely not notice this part. Breastfeeding can start within the first postnatal hour. This can take some practising which we will support you with.
Once the heartbeat cannot be felt in the umbilical cord, this can be cut. After which the placenta can be born. On average this happens within 30 minutes of the baby’s birth. The midwife will assess whether any stitches are necessary (this would happen under local anaesthetics). Rarely this cannot be done by the midwife (for example, when part of the anus or mucosa is ruptured) the gynaecologist will perform the stitching.
We will check your baby from top to bottom, measure its weight, temperature and a variety of reflexes. We will give your baby 1mg of vitamine K orally with your consent. This will cover its vitamin intake for the first week after which you will be advised on a daily dose. Vitamine K intake is recommended for the first 3 months, beyond 3 months the body will make enough of this vitamine. Vitamine K helps the blood to coagulate.
After some private time with the three of you, the kraamzorg (maternity assistant) will help you shower. After home deliveries, the kraamzorg will usually leave after four hours. When you have given birth in the hospital, you are usually discharged after 3 or 4 hours (you will have been able to go to the toilet independently). The kraamzorg will come to help you at home the following moring.
The first 24 hours postnatal the blood loss can be quite vast, often with clots (these can be the size of an orange). As long as you feel good, this is not a problem. When you need to change the pad every half hour, if you loose two or more orange-sized clots, or if you feel like an open tap you are loosing too much blood. In this case call the on-call midwife 020 – 333 04 20
It is normal to change the pad every 3 hours. The first few days after the delivery the flow is heavier than a regular period. After a few days the flow will decrease. This can last 4 to 6 weeks, by which time it will not be red coloured, but it will turn into a brown colour. At the end this can be white or yellow discharge.
After the deliver you can suffer from afterpains, similar to contractions. Paracetamol can help (maximum of 6x500mg every 24 hours). Breastfeeding can increase the afterpains. Afterpains help the uterus to reduce to it’s original size which also should slow down the blood flow in your pad. The afterpains will slowly reduce and are often gone after 48 hours.
Urinating after birth
It is very important to urinate within 6 hours after the delivery. This can be quite sensitive, especially if you have had stitches. It can help to flush with warm water during the urinating. If you have not been to the toilet or nothing will come out, continue drinking water and sit on the toilet every hour. If you are still not able to urinate after 6 hours or you feel like you can’t completely empty the bladder, call the on-call midwife on 020 – 333 04 20.
With an empty bladder, there should be plenty of space for the uterus to retract well. It is likely in the first few days that you do not feel when your bladder is full. Therefore, we would advise to go to the toilet prior to each feed. This ensures you to go to the toilet regularly and will reduce the chance of afterpains during the feed.