Caring for you and your baby
Once you are at home with your newborn baby, your local community midwifery team will look after you for up to 10 days (with a maximum of 28 days) after the birth of your baby; the length of time depends on your needs.
Midwifery care after your baby is born
A midwife will come to see you and your baby at home the day after you have had your baby (if you had a home birth) or the day after your discharge from hospital (if you gave birth in hospital).
After the first visit, the frequency of your appointments will depend on your needs, and you may be seen by either a midwife or by a maternity support worker (a trained healthcare assistant). Depending on your needs and your preference, your appointments can take place either at your home or in our postnatal drop-ins at local children’s centres and other community locations. Your midwife will advise you and give you details of your local postnatal drop-in (see details right).
We will contact your local hospital when you are discharged from Homerton to ensure they will visit you and your baby.
After you are discharged by your midwife, care of your baby will be handed over to your local health visitor. When your baby is 6 weeks old, you will have an appointment with either your GP or your hospital consultant to check your wellbeing following the birth of your baby.
If you haven't had a visit from a midwife
If a midwife has not visited you within 24 hours of your discharge from hospital, please contact us so that a visit can be arranged for you as a priority:
Weekdays, please telephone Homerton community midwifery secretary on 020 8510 5761 (9am - 4pm)
Weekends and outside of 9am - 4pm, please telephone Templar Ward at Homerton on 020 8510 7561 / 7541.
Blood spot screening
This is a blood test carried out when your baby is about 5 days old. Four spots of blood are collected from a heel prick and tested for nine serious but rare conditions which can be treated more effectively if detected early.
The conditions tested for are:
• Phenylketonuria: an inherited condition where the baby’s digestive system cannot break down certain foods, which therefore build up in the body and cause damage
• Hypothyroidism: a condition in which the thyroid gland does not work, seriously affecting the baby’s development if untreated
• Sickle cell disease: inherited unusual types of blood leading to anaemia and likely serious infections
• Cystic fibrosis: an inherited condition which can affect the digestion and lungs leading to the baby not gaining weight and having frequent chest infections
• Congenital hypothyroidism: this causes babies to not have enough of the hormone thyroxine, which, without treatment, could cause them not to grow properly and to develop learning disabilities.
• Inherited metabolic diseases: Babies are screened for 6 inherited metabolic diseases: phenylketonuria (PKU), medium-chain acyl-CoA dehydrogenase deficiency (MCADD), maple syrup urine disease (MSUD), isovaleric acidaemia (IVA), glutaric aciduria type 1 (GA1) and homocystinuria (pyridoxine unresponsive) (HCU). Without treatment, babies with inherited metabolic diseases can become suddenly and seriously ill, but they can all be treated with a carefully managed diet and in some cases, medication as well.
Your health visitor will inform you of the result of this test, usually when your baby is 6–8 weeks old. If the blood test requires further action, you will be contacted within 21 days of the blood test being undertaken.
After screening, blood spots are stored for five years and may be used anonymously for public health monitoring. In the future there is a small chance researchers may want to invite you to take part in research linked to the blood spot programme.
Please tell your midwife if you do not wish to receive invitations to take part in research, so that she can mark the blood collection card accordingly. Further information about this test can be obtained from the Screening Tests for You and Your Baby booklet sent to you before your first appointment.
Just as your body goes through many physical changes during pregnancy so does your mind, thoughts and emotions. It is very normal to experience mixed emotions, such as joy, excitement, and crying, feeling sad or worried while you are pregnant. Pregnancy hormones such as oestrogen and progesterone contribute these mixed emotional highs and lows, that you may experience, particularly in the first three months following confirmation of your pregnancy. It is important to look after your emotional well-being during pregnancy.
If you suspect there is a problem with the way you think or feel, or if you have had mental health problems in the past, there are many ways you can be helped by health professionals. Talking to your midwife, GP, obstetrician or health visitor about your emotional wellbeing is important and can help you towards getting the support that you want and need.
Normal emotional changes and when to seek help
It is very normal to have concerns about yourself and your developing baby while you are pregnant, particularly if this is your first baby or you have experienced complications in a previous pregnancy. After giving birth you my experience the ‘baby blues’ which are symptoms of feeling tearful, irritable, sad or anxious.
The ‘baby blues’ are very common and happen as a result of the rapid changes in your body chemistry and hormone levels during the first week after giving birth. During this time your body will go through many adjustments to promote the start of breast milk production and in most cases the baby blues will ease away naturally with 7 – 10 days after having your baby.
However, if during pregnancy you are feeling sad, anxious or if after the first week of having your baby you continue to feel sad, low in mood, worried or anxious it is important that you seek support and help from your GP, Midwife and or Health Visitor.
What is a Perinatal Mental Health problem?
Perinatal is the period of timearound your pregnancy and up to the first year after having your baby. During the perinatal period around 1 in 10 women will experience common mental health concerns such as depression, anxiety and or other mental health concerns.
Why do they happen?
There is no concrete research evidence to answer this, as mental health concerns can happen to anyone, at any time. Research has suggested that women who experience a difficult birth, stressful life events or lack of support, relationship difficulties, financial worries or those who may have experienced a mental health concern in the past before pregnancy, in a previous pregnancy or after having their baby may be at a greater risk of experiencing a perinatal mental problem.
However, some women may have none of these factors but still go on to experience a perinatal mental health problem. What we do know is that you can get better by receiving support and help.
What symptoms might I have if I am experiencing a Perinatal Mental Health problem?
- Low mood
- Persistent sadness
- Anger or increased irritability
- Extreme changes in appetite
- Feeling worthless or hopeless
- Feeling anxious and or often nervous that ‘something will happen’ or ‘go wrong’
- Sleep difficulties (which are not related to complication or discomfort of pregnancy)
- Difficulty bonding with the baby
- Social withdrawal from partner, friends and or family
- Obsessive thoughts and or behaviours
- Suicidal thoughts – Do seek urgent support from your local Accident and Emergency service if you experience such thoughts or you feel that your mental health is worsening
How can I get help?
- Speak to your GP, Midwife, Obstetrician or Health Visitor
- Talk to your partner, family or friends about how you are feeling
- Be aware that talking about how you feel and seeking help is always better than dealing with difficult situations alone in silence
What help will I be offered?
Our midwives, doctors and health visitors are trained in perinatal mental health and are aware of the physical and emotional changes that occur during pregnancy and following childbirth. It is important that you do not feel embarrassed or afraid to talk about how you are feeling as they are there to help you.
After talking about your mental health concerns the healthcare professional will assist you to identify your needs and offer a referral to supportive services such as self-help strategy’s, 1-to-1 counselling, psychology, or specialist perinatal mental health supportive services. The level of support that you are offered will be based on your own personal mental health needs.
I would like to get further information, where can I find this?
A number of useful resources and are provided here:
- Join a group meeting expectant or new mothers in your local area (speak to your midwife or health visitor about these services offered within your local children centre)
- Follow the 5 Steps to Emotional wellbeing in Pregnancy above
- Take a look at helpful websites and resources listed below:
City and Hackney Mind - Part of the City and Hackney community since 1980, they offer advice, counselling and support people with experience of mental ill health
Bikur Cholim - support for people with an experience of mental ill health within the Orthodox Jewish community living in North London
Derman - support for people with an experience of mental ill health within the Kurdish and Turkish, Turkish Cypriot, eastern European living in Hackney
Two in Mind - offer resources and fact sheets about emotional wellbeing and promoting healthy parent-child relationships during pregnancy and beyond
Unicef - offers information about preparing for baby and bonding with baby during pregnancy and following childbirth
http://www.pandasfoundation.org.uk/ - offer a helpline, support groups, online support and advise for any parent who is experiencing a perinatal mental illness
https://www.tommys.org/pregnancy-information/im-pregnant - offers information about, pregnancy and offers practical advice about staying well
Work and Benefits
Maternity Action - provide expert advice and support to empower parents about their rights at work or benefit entitlement
https://www.gov.uk/working-when-pregnant-your-rights - offers expert advice around statutory maternity rights and shared parental leave entitlement
Gingerbread - provide expert advice, practical support and for single parents
What do I do if I have an urgent mental health concern and need to see or speak to someone now?
- Please attend your local Accident and Emergency service if you feel that you mental health is deteriorating and you need immediate support/help
Homerton debrief services
Women and their birth partners may need the opportunity to reflect and discuss their birth experience. At Homerton we run a number of clinics which give the opportunity for this.
Birth Trauma/ Reflections/ Debrief services
We offer a number of clinics for you to talk about your experiences if you feel this would be helpful at any point – even years into the future. You can ask your Midwife to refer you if you are still under our care or contact the Maternity helpline on 020 8510 5955 (10am-6pm daily).A friend, partner or relative is able to attend as well.
- Listening clinic with a Professional Midwifery Advocate
Who is it for? Women and families who want to reflect and debrief over their birth with hospital notes. It is not a complaints procedure. The focus is Midwifery care but the clinic will see women who have had obstetric input. It offers the opportunity to answer questions, fill in the blank spaces and take feedback back into the service.
2. Birth Reflections with a Consultant Obstetrician
Who is it for? Women who have had complex care in the intrapartum or postnatal period who would benefit from discussion with a consultant obstetrician about the event.
3. Reframing Birth Clinic with a Specialist Midwife and Perinatal Mental Health Nurse
Women/partners who are traumatised by a previous birth to the level that their daily living or future birth choices are affected. The focus is on the woman/partner’s feelings about and experience of the events, rather than explaining or questioning the clinical care. Further referrals to Mental Health Services and signposting to other organisations is considered.
Talking Therapies/ IAPT services
Women can self-refer at https://talkchanges.org.uk
24 Hour Mental Health Crisis lines
City and Hackney 0800 073 0006
Newham 0800 073 0066
Tower Hamlets 0800 073 0003
Waltham Forest 0300 555 1000
Postnatal exercise classes
Tuesday 1.30pm - 2.30pm
Homerton Hospital Physiotherapy Department
Homerton Row E9 6SR
020 8510 7835
The postnatal exercise class is suitable for women who have delivered their baby and continue to suffer with pregnancy-related pain. You will need to be referred by your physiotherapist to book onto the post natal exercise class.
If you have had a vaginal delivery you will need to wait for 6 weeks to start the class and if you have had a caesarean section you will need to wait 12 weeks.
The class includes pelvic stability exercises, pelvic floor exercises, back care, posture and advice. The class is run by a women’s health physiotherapist who will tailor the exercises to your specific needs. Babies under 6 months are welcome.
Contraception after having a baby
Studies have shown that fertility can return as soon as three weeks after having a baby - even before periods start again. It is good to start thinking about contraception even before you have had your baby.
The below summarises which contraception can be used in the first few months after having a baby:
Contraception is available from all of our sexual health clinics
To book an appointment
call 020 7683 4103