Postnatal Care

Emotional wellbeing 

Many mothers will experience the 'baby blues' after childbirth. Baby blues are a normal response to your changing hormones along with lack of sleep and adjusting to new life with your baby. 

Symptoms of the baby blues can include:

• Bursting into tears for no obvious reason 
• Feeling irritable or overly sensitive 
• Feeling low 
• Feeling restless or anxious.

These symptoms are normal and usually last for a few days. 

​​​​​Postnatal depression 

Postnatal depression affects more than one in ten new mothers. It can start at any time during the first year after childbirth. 

Symptoms include:

• A persistent (long-term) feeling of sadness or low mood
• Lack of enjoyment and loss of interest in things that would usually make you happy
• Lack of energy and feeling tired all the time 
• Feeling irritable 
• Loss of appetite or eating too much (comfort eating) 
• Trouble sleeping 
• Difficulty in bonding with your baby or not enjoying your time together
• Withdrawing from your partner, friends, or family
• Finding it difficult to concentrate or make decisions
• Frightening thoughts, for example, about hurting your baby
• Thinking about suicide or self-harm.

A lot of women find it difficult to know that they have postnatal depression because it can develop very slowly. 

How are you, partner? 

It is important to understand that partners can also experience postnatal depression. It isn’t clear why this happens, but it is thought that: 

• First time parents are more likely to experience symptoms 
• Hormonal changes can play a part in causing depression
• Postnatal depression in partners is more likely if the mother is experiencing depression
• Other issues such as money problems, new responsibilities or worrying about your baby can cause postnatal depression.

Postpartum psychosis 

Sometimes new mothers experience severe mental illness called postpartum psychosis. This is an emergency, which requires immediate medical help. 

Symptoms include:

• Confusion or racing thoughts
• Feeling unusually elated, frightened or tearful
• Unable to sleep
• Beliefs that are unusual or concerning to others 
• Seeing, hearing, or sensing things that other people can’t.

How to get help 

There is support available if either you or your partner are worried. We encourage you to make your partner, friends, and family aware of the signs of postnatal depression and postpartum psychosis so they can support you if needed. 

Please speak to your midwife, health visitor or GP as soon as possible if you have any problems with your mood, mental health, or emotional wellbeing. 

For urgent help, please go to your nearest A&E or contact your local CRISIS team immediately: 

Royal Liverpool University Hospital 

Tel: 0151 706 2000

Whiston Hospital      

Tel: 0151 426 1600 

Aintree University Hospital                          

Tel: 0151 525 5980 

Wirral University Teaching hospital          

Tel: 0151 678 5111  

One in four women experience domestic abuse at some point in their lives. Pregnancy can be a trigger for domestic abuse. Also, existing abuse can get worse either during pregnancy or after your baby is born. 

Domestic abuse can be physical, sexual, emotional, psychological, or financial and is often a combination of different types. 

Domestic abuse puts you and your baby in danger and can cause you to experience emotional and mental health problems. 

Getting help 

For immediate danger, dial 999 and ask for the police. 

If you are not in immediate danger, dial 101 to report domestic abuse. 

If you are experiencing domestic abuse, you can also speak to your midwife, health visitor or GP. 

You can also contact the National Domestic Abuse Helpline using their online chat function or by calling their 24-hour helpline on 0808 2000 247.

There is also free, confidential advice on the Refuge, Women's Aid or Liverpool Domestic Abuse Service websites.

Shortly after birth, the midwife will clamp the umbilical cord close to your baby’s navel with a plastic clip. The midwife or your partner then cuts the cord with the clamp attached. The cord takes about a week to dry out and drop off. Keep the navel clean and dry until this happens. If you notice any bleeding or discharge from the navel tell your midwife, health visitor or doctor. 

After your baby is born, your midwife will ask for your permission to give vitamin K to the infant via an injection. This vitamin will prevent a serious bleeding condition called Haemorrhagic Disease of the Newborn which, although rare, can be life-threatening. 

This is a diamond-shaped area on the top of your baby’s head where the skull bones haven’t yet fused together. The fontanelle may take about a year before the bones close over. 

Most babies have little marks and spots, mainly around the head and face. Most common are the little pink ‘stork marks’ on the forehead and upper eyelids or marks on the nape of the neck. Most of them will go away eventually. Strawberry marks, with their dark red and slightly raised appearance, can appear a few days after the birth. They may take a while to disappear but are generally nothing to worry about. Spots and rashes are not unusual but you should tell your midwife or doctor if there is marked change in your baby’s behaviour, such as an unwillingness to feed, sleeplessness or irritability. If you are concerned about a birthmark, please consult your midwife, health visitor or GP. 

It is also quite common for a newborn to have some swelling and bruises on their head, or to have bloodshot eyes. This is usually due to the pushing and squeezing of childbirth and they will disappear in time. If you are worried about any bumps or bruises talk to the midwives looking after you. 

Skin

The top layer of a newborn’s skin is very thin and easily damaged but over the first month, as it matures, it will develop its own natural protective barrier. We would advise against the use of moisturisers or other products initially which can be quite harsh for a newborn’s sensitive skin. 

It is also normal for newborns' skin to peel in the first two weeks after they are born. Your newborn is shedding their top layers of skin as they transition from the uterus into the outside world. Their skin is developing its own natural barrier. 

Jaundice

At three days old, many babies develop mild jaundice with their skin and whites of their eyes taking on a yellow tinge. This usually fades within 10 days, though more serious jaundice may need treatment. If this is the case your midwife will discuss it with you.

Every cigarette harms your baby.  Do not smoke in the house. 

Babies and children exposed to a smoky atmosphere are: 

• Four times increased risk of cot death. 
• Two times more likely to have asthma attacks and chest infections 
• More likely to need hospital care in their first year of life, contributing to more than 9,500 hospital stays. 

We suggest that any smokers, parents or visitors:

• Always smoke outside away from baby 
• Remove any outside clothes on entering your home. 
• Wash your hands before handling baby
• Do not smoke in a car with under 18’s - it is illegal.

Pregnancy is possible as soon as three weeks after having a baby. Every person differs as to when they might feel ready or comfortable to have sex again after having a baby, and you should not feel pressured or worry about this. Nevertheless, many unplanned pregnancies do occur in the months after having a baby. Even if you would like more children, it is recommended to space pregnancies out by at least 12 months to allow yourself to recover and improve the chances of a healthy future pregnancy. Contraception comes in many forms and is a way to prevent or delay pregnancy. 

Which method will be suitable for me? 

This depends on:

• What you and your partner prefer 
• Your medical history 
• Any problems during your pregnancy 
• If you are breastfeeding.

Short-acting options (if you may want to have another baby soon)

• Combined hormonal contraception – pill, patch or vaginal ring. 
• Progestogen only pill 
• Condoms - male or female 
• Diaphragm or cap with spermicide.

These are all effective methods if used correctly. Condoms and the progestogen only pill can be started straight away and can be used if you are breastfeeding. 

Long-acting reversible contraception

• Contraceptive progestogen implant - lasts for three years 
• Progestogen intra-uterine device (hormonal coil) – lasts for six years
• Copper intra-uterine device (copper coil) – lasts for three to ten years
• Contraceptive progestogen injection – lasts for 13 weeks (Depo-Provera).

These methods are all highly effective and can be easily removed. Fertility returns immediately with all these apart from the injection, which can take six to twelve months. The implant and injection can be started straight away. Intrauterine devices can be inserted at the time of caesarean birth, or from four weeks after having a baby. These can all be used if you are breastfeeding. 

Permanent methods of contraception- If you are sure that you never want any more children, you may wish to consider female sterilisation or male sterilisation (vasectomy). 

Lactational amenorrhoea method (LAM) – breastfeeding can be used as a natural contraception, although it is less effective than other methods. 

This is only reliable if: 

• You are exclusively breastfeeding including at night
• You are having no periods
• Your baby is less than six months old.

Two in a hundred women using this method get pregnant in the first six months. 

Remember to use condoms to protect from sexually transmitted diseases, as the other options do not provide protection. 

More information 

At Liverpool Women’s University Hospital: you can speak to your midwife or doctor about your options. 

At your GP practice your six-week postnatal check is a good opportunity to discuss contraception, or you can speak to a practice nurse. 

There are many sexual health clinics in Liverpool and the surrounding areas that can provide contraception: 

Liverpool, Knowsley, Cheshire East, Warrington and Halton - Axess sexual health

Tel: 0300 323 1300 

St Helen’s Sexual Health

Tel: 01744 646473 

Southport, Bootle, Maghull, Netherton - Sefton Sexual Health

Tel: 01695 656550 

Sexual Health Wirral

Tel: 0300 123 5474 

Lancashire and West Lancashire

Tel: 0300 1234 154 

Wigan and Leigh

Tel: 01942 483188