The postnatal period is classified as the stage from birth to 6 weeks & may involve the following issues for parents. Emotional (feelings of happiness, anxiety, tearfulness), physical (recovering from a caesarean section, sleep deprivation), social (isolation, difficulties adjusting to not being at work) & psychological (adjusting to parenthood, postnatal depression). Therefore, the health visiting six-week review is crucial to identify any issues & support both parents may require.
The Centre for Parent & Child Support, South London & Maudsley NHS Foundation Trust (2014), have produced a postnatal promotional guide which uses evidence-based methods supporting the adjustment to parenthood. Topics such as labour, birth/recovery, emotional well-being, becoming a mum/parent, my family/friends, plus recent/past experiences are discussed with parents.
Labour, birth/recovery allows you to discuss your labour, birth experiences, being a parent & your recovery. Emotional well-being encourages you to express your feelings of parenthood, any anxieties or depression & coping with a new baby. Becoming a mum/parent allows you to review what parenting means to you individually & as a couple, plus how your relationship may affect caring for their baby. Family/friends assesses how having a baby may affect siblings or other family members & support available. Recent/past experiences reviews any major life events, coping mechanisms, your current situation, your childhood/family life or any concerns.
The review allows open two-way discussion with yourselves & your health visitor, identifies positive aspects of parenting, any concerns & community support. A plan is completed & reviewed regularly. It is essential to include both parents in the review, as fathers can suffer from postnatal depression.
We know that a fulfilling relationship & supportive partner can provide protection against postnatal depression/stress & can enhance recovery from postnatal depression. A baby can also place new demands on your relationship e.g. less time together, sleep deprivation & changes in identity. It is important for parents to regularly discuss their feelings with each other & find ways of coping e.g. emotional or practical support from family/friends can be crucial.
The postnatal promotional guide is not available in all health visiting areas. Ask your health visitor for details.
If you as a parent/s need additional support, there are specialist services available e.g. Early Intervention Health Visitors, the Perinatal Mental Health Team or Counselling Services.
In many cultures during the postnatal period of 40 days, a mother is celebrated & may undergo special postnatal customs, such as a special diet, nurturing, rest, remaining at home & “closing of the bones”; which allows organs, bones & muscles to return to their pre-pregnant positions. She is supported by her mother or women in the community to ensure her physical, emotional & psychological needs are met & her baby is cared for. (Nafsa Project School)
In the UK, once discharged home from hospital, you may be visited once or twice & asked to attend the clinic for your final discharge appointment; around day 10 (although mother & baby can be seen up to 28 days by the midwife). If you have a home birth, you may receive additional visits. You will then receive a new birth visit by your health visitor between days 10-14, asked to visit clinic or an appointment is made for your six week review.
You can seek advice & support from your GP at the six week review or anytime. The review provides the opportunity to discuss your birth, recovery & any health concerns you may have regarding yourself. You may also see the Nurse for contraception or a cervical smear can be booked.
If you require any postnatal support to assist your transition to parenthood, please do not hesitate to contact me via www.ihvol.com.
This article has been written by Jackie Morrison, Independent Health Visitor.
Dr Day, C. The Centre for Parent & Child Support, South London & Maudsley NHS Foundation Trust (2012) Antenatal & Postnatal Promotional Guides, London
Nafsa Project School, Moroccan Postnatal Medicine accessed online via www.laylab.co.uk/nps on 03/04/2019