🔊 Pagina beluisteren After the postpartum period

After the post-partum week, the maternity nurse leaves and the midwife no longer makes home visits. The youth nurse and the GP will now take over the care again. Around six weeks after giving birth, you will have a follow-up appointment with the midwife or gynaecologist.

For the baby

Youth nurse

Between the first and second week after the birth, the youth nurse will contact you by telephone to make an appointment for a home visit. During this home visit, you will meet the youth nurse, receive information about the JGZ and be given information about the first period with your baby. The JGZ keeps a file on your child and there is of course room for all your questions.

When should you visit the GP?

If your child has physical complaints, contact your own GP. The youth physician will always refer you to your own GP in the event of abnormalities or physical problems. If necessary, the youth physician will refer you directly to a paediatrician.

What do you do if things are not going so well?

Sometimes situations may arise in which things are not going so well with your child or with the rest of your family. Even then, you can always turn to the GGD Youth Care. There are experts from several disciplines who can help and there is a network from which help and guidance can be offered if necessary.

For the mother

Recovery

Your body’s initial recovery after childbirth takes six to eight weeks. Full recovery takes up to several months. Changes in the body and in the new situation -your new family- require a great deal of energy.

• Changes in blood circulation. You may have to urinate more often or perspire more because of this.
• After six weeks, the uterus is back in the small pelvis and weighs only 60 grams. Until then, you may still have blood loss.
• After about three days, the pregnancy hormones have left the body and other hormones are produced. The hormone prolactin stimulates breastmilk production and oxytocin triggers the breastmilk letdown reflex. Breast engorgement often occurs.
• The hormone oxytocin also causes the after-effects and restores the uterus to its original size.
• Recovery of the pelvic floor, vagina and abdominal wall takes five to eight weeks. Recovery of the abdominal wall muscles can take a few months. It is wise to resume exercise soon (read more under recovery). Listen to your own body’s signals when doing so.

Sutures

If you have sutures, they may bother you for the first few weeks. If the wound is inflamed, notify the midwife. If the sutures continue to cause problems after a few months, you should discuss this with your GP.

Nutrition

Eat a varied, high-fibre, nutritious and regular diet. It is also important to drink enough, at least two litres a day.

Rest and exercise

It is important to get plenty of rest during and after the postpartum period. Distribute maternity visits well and also make time for yourself, the baby and your partner. Besides taking rest, it is also important to exercise. This promotes your body’s recovery. There are a few leaflets with advice on recovery after childbirth. Here you will find some advice and exercises from physiotherapists:

• In the first six weeks after childbirth, get out of/into bed via the side position.
• Start pelvic floor muscle exercises soon after childbirth. Gently tighten the pelvic floor muscles and relax again. This will stimulate your blood circulation, which promotes pelvic floor recovery. Even if you have stitches, you can do the pelvic floor muscle exercises calmly; this promotes healing.
• During the initial period, when posture changes and coughing, tighten the pelvic floor and abdominal muscles and then release. Examples of postural changes include: turning in bed, rising to a sitting position, and standing.
• When standing: stand up straight, with weight distributed on both legs. Keep the knees slightly bent.

The above advice also applies after a Caesarean section. The following also applies:

• When coughing, sneezing and laughing, support the wound with one or two hands and, if necessary, use a bath towel or sheet. Tighten the abdominal and pelvic floor muscles.

Hygiene care

After giving birth, you can shower as normal. While you still have blood loss, you should not take a bath. You should also avoid using tampons. Wash your hands thoroughly after each visit to the toilet. Change your sanitary towels regularly.

To avoid the risk of infection, it is wise to wait until the bleeding has stopped and the wound of the operation has healed completely before having sexual intercourse. Intercourse may still be painful at first. Moreover, it is normal that the need for sexual intercourse is not so great in the first period after childbirth. This can apply to both you and your partner. If intercourse remains painful, contact your GP.

Fertility and contraception

You can have intercourse again a few weeks after giving birth because your uterus has recovered and the bleeding has stopped. You can start menstruating again for the first time from now on and you are therefore fertile again. If you don’t want to run the risk of becoming pregnant again straight away, think about how you want to avoid this.

Fertile without knowing it

Your first period can start again from six weeks. It can also remain absent for months. This is often the case if you are breastfeeding. Around 2 weeks before your period starts, ovulation takes place. As a result, you can already be fertile without knowing it. Four weeks after giving birth, you can become pregnant again. It is therefore advisable to think about contraception soon after giving birth. Breastfeeding full-time (including night-feeding) can significantly reduce the chance of a new pregnancy, but it does not rule it out.

Who to contact

During pregnancy or the postpartum period, your midwife will provide information on various methods of contraception. During the follow-up visit and six weeks after giving birth, this subject will be discussed again. If you want to know more about the different contraceptives, ask your midwife, GP or gynaecologist for advice.

Or check the following website on contraception (Dutch only) to see which contraceptive method suits you best.