Postnatal care in the community
Our community midwifery teams are based
in the Royal Sussex County Hospital, the
Princess Royal Hospital and the local
Children’s Centres where you may have
been receiving your antenatal care. We
provide care both in the home and at
postnatal clinics which are held either in
a local Children’s Centre or in the antenatal
clinic at the hospital during the weekends.
Our team is made up of midwives and
maternity support workers who are trained
to support families during the postnatal period. They will monitor the health of both mum and baby and can provide advice and support for feeding as well as giving you details of other support services in the community.
During the postnatal period we will provide an individualised package of care and will continue to look after you until your baby is at least 10 days old at which point we will transfer your care to the health visiting team. If either you or your baby have any problems in the postnatal period we will not discharge you until it is appropriate to do so.
If you have had your baby at home our community midwifery team will have been caring for you during your labour and will organise to visit you the next day to ensure all is well. If you have had your baby in hospital the postnatal ward will inform the relevant community midwifery service that you are going home and we will arrange to visit you the day after your discharge.
Routine Appointments
Where all is well you can expect to receive the following visits from the community midwifery team. Some appointments are at your home others may be offered at one of our postnatal clinics to save you waiting in for the midwife as we are unable to give specific times for visits.
At each appointment the midwife or support worker will talk to you about any physical or emotional problems you may have or any concerns you have with your baby. Any problems will be treated accordingly and you may be referred to other members of the multi-professional team if required.
At every appointment we will be considering the following in our assessment:
For You
1. Your Blood loss
2. Perineal care and care of stitches
3. General observations
4. Eating and drinking
5. Bladder and bowel habits
6. Your emotional wellbeing
7. Breast changes
8. Feeding your baby
9. Any medication you are taking
For your baby
1. Jaundice
2. Skin
3. Umbilical cord separation
4. Feeding
5. Wet nappies
6. Colour and number of dirty nappies
7. Weight
When you are ready to be discharged from midwifery care we will ensure you have had contact from your health visitor and will liaise with the health visiting service in respect of any additional needs either you or your baby have. You will be visited at home by your health visitor usually between day 10-14 after your baby has been born. Before you are discharged the community midwife will give you details of the 6 week postnatal appointment that you will need to have with your GP.
Your Postnatal Schedule of Care
When: Day after birth or day after discharge – all parents at home
Reason for appointment: Review health of mum and baby, plan postnatal care,
review feeding, discuss birth experience and make any referrals needed.
With whom: Midwife
When: Day 1 to 4 – as required, at home
Reason for appointment: Support with feeding, review health needs, review
Jaundice of baby.
With whom: Maternity Support Worker or Midwife
When: Day 5 – all parents at home
Reason for appointment: Newborn bloodspot screening, weigh baby, update
feeding plan, review health of mum and baby.
With whom: Maternity Support Worker or Midwife
When: Day 6 to 9 – as required, at home
Reason for appointment: Further feeding support, ongoing review of feeding plan, review of ongoing health needs.
With whom: Maternity Support Worker or Midwife
When: Day 10 – all parents at postnatal clinic or at home
Reason for appointment: Weigh baby, review fitness for discharge, transfer to health visitor, inform of follow on GP care.
With whom: Midwife
Postnatal care in the community
In the first week after birth we will offer
you Newborn Bloodspot Screening
testing for your baby. This screening
test helps identify babies who have some
rare but potentially serious conditions.
The test is taken by pricking the heel of
your baby and putting four spots of blood
onto a specially designed screening card.
The test is carried out at home or, if your baby has not yet been discharged, in the
hospital or special care baby unit. Early treatment of the conditions can improve health and prevent severe disability. If the bloodspot screening test indicates your baby may have one of these conditions they would need further testing to confirm this. Occasionally a test may need to be repeated for a technical reason so not all repeat testing indicates a possible disorder.
What does the test check for?
The test screens for:
Phenylketonuria
About 1 in 10,000 babies will be born with this condition meaning they cannot process a substance in their blood called phenylalanine. Early treatment with a special diet can prevent severe disability meaning they can lead a normal life.
Congenital Hypothyroidism
About 1 in 4,000 babies will be born with this condition meaning they do not produce enough of the hormone thyroxine. Early treatment with thyroxine can prevent serious disability and allow them to develop normally.
Sickle Cell Disease
About 1 in 2,000 babies has a sickle cell disease. This condition causes red blood cells to become sickle shaped and get stuck in the blood vessels. This can cause damage to the body or serious infection. Early treatment and education for parents can help support the baby to lead a healthier life.
Cystic Fibrosis
About 1 in 2,500 babies are born with cystic fibrosis. This condition affects the digestion and lungs. Early treatment can help those affected lead longer healthier lives.
About 1 in 10,000 babies has MCADD. This condition causes problems in breaking down fats to make energy, leading to serious illness. Early diagnosis allows special attention to be paid to the diet helping prevent serious illness and allowing babies with MCADD to develop normally.
Our unit is currently participating in a pilot study for expanded newborn bloodspot screening. This study is for a specific period of time and the health professional who is taking the bloodspot screening will discuss this study and provide you with full details if this is to be offered to your baby.