Why do we offer postnatal home visits?
Being a midwife from the UK, postnatal home visits are part of the daily role for a community midwife. A community midwife is a midwife who is based out in the community, and holds antenatal clinics (your pregnancy checks), as well as visit you at home, or holds postnatal clinics.
The purpose of the postnatal home visits is to assess both you and baby – in the UK we would do this around day 2-3 when you first arrive home, around day 5-7 to perform a weight check, and do the heel prick test, and then day 7-10 when we would discharge you from care if all is OK.
The things we are assessing at these visits for mum are: Any problems with breastfeeding, or feeding baby, check your uterus is contracting and your bleeding is normal, check to make sure you caesarean or vaginal stitches are healing well, make sure that things like your blood pressure are normal, and there are no signs of clots in your legs. We also assess your mental health – explaining about baby blues and postnatal depression – and give you information such as safe co sleeping, how to make up bottles, remind you of information to reduced the risk of cot death, and answer any questions you have.
The things we are assessing for baby are: The colour of the baby, the tone of the baby, making sure baby is feeding well and is hydrated, asking about what colour stools baby is passing, and how many wet and dirty nappies they have had, and also looking at the cord. We check their weight to make sure that there isn’t more than 10% weight loss, and we also look at them in general.
We can also explain to you about changing nappies, how to swaddle or calm a baby, and how to bath a baby – any baby cares that you aren’t sure about!
In Singapore this system doesn’t exist – after discharge from hospital, you are brought back to see a paediatrician at around 7 days old, and the obstetrician around the same time, and then you don’t see them until around 6 weeks old. There are no home visits.
As we are not licensed midwives in Singapore, we cannot perform any clinical assessments such as looking at stitches or checking your uterus is contracted, or taking observations. However we can offer breastfeeding support, we can reassure you if you are feeling anxious, show you any baby cares with your baby, assess your mental health, and we can ask you the right questions to check that all is OK with both you and your baby.
We like to visit you at home around a day or two after you get home from hospital, as this is when you have been on your own and we can check in with you to make sure baby isn’t losing too much weight before the paediatrician visit (and put you on a feeding plan if they are), as well as reassuring you if you are feeling worried as the nurses are no longer around to help! We often find it is when the hormones kick in and our Ladies like to see a familiar face!
Home visits are so important – the World Health Organisation (WHO) even says that it is recommended that all mothers and babies need AT LEAST 4 postnatal checkups in the first 6 weeks. The time frame for these are within the first 24 hours (you are generally still in hospital then), Day 3 (48-72 hours after birth), Day 7-14 and at 6 weeks.
Both of our Beloved Bumps team members, Natasha and Jessie, are familiar and confident with assessing postnatal ladies at home visits, and are ready to help if you need them!
Reference: https://www.who.int/maternal_child_adolescent/publications/WHO-MCA-PNC-2014-Briefer_A4.pdf