Postnatal Midwifery Care

During the postpartum visits a midwife monitors the mother's breast and lactation, the uterus becoming small again, the postpartum bleeding, the healing of any birth injuries such as perineal tears or episiotomies and the healing after a caesarean section.

In the case of sutures (after tears, episiotomies, caesarean sections) she can remove knots, stitches and staples as required. 

With the baby, she monitors, among other things, how he or she is drinking and developing, the weight, the healing of the umbilicus (the belly button), the behaviour, temperature, skin and excretions (urine and bowel movements). 

If the baby has an umbilical cord clamp, the midwife can remove it as soon as the umbilical cord has dried. 

It is especially important that a midwife helps ensure that any woman who wants to breastfeed can do so.

Midwives give advice on many different topics. 

Here are some that I have talked about a lot in my life as a midwife: 

• everything about breastfeeding, e.g. also pumping, breast milk storage, breastfeeding and employment, weaning
• baby development
• babies and older siblings
• babywearing / how to use slings and carriers
• baby clothes 
• disposable and cloth nappies
• different styles of parenting, especially attachment parenting
• sleeping, family bed
• prevention of rickets / vitamin D
• return of menstruation and fertility
• family planning 

After home births, birth centre births and early discharge after hospital births, it is advisable to have the first home visit on the same or the following day, depending on the time of the birth.

After hospital births with an inpatient stay, is is advisable to do the first home visit on the same or the following day after the discharge, depending on the time of discharge from hospital.

There are widely different ideas about how many postnatal visits a woman and baby should have.

Personally, I believe it should be individualized, so that every family gets the amount of care they need.

Still, it is useful to have a visiting scheme that one can use as a starting point to individualise care from. This is the schedule I use:

The first 10 days after the birth daily visits, the following week 2-3 visits and then weekly visits until about 6 weeks after the birth. 

The schedule can be flexibly adapted to the family's wishes and needs.  

I have had families who wanted and needed only 2 postpartum visits, others over 30...

The average in my experience as a midwife has probably been around 12 visits.