Your care after giving birth to a premature baby
You and your new baby
After your baby is born, the healthcare team will immediately assess your baby's health and start treating them if necessary.
The healthcare team will tell you how your baby is doing and what they’re doing to care for them. They will also make sure that you are okay. This means that you may need to wait until the healthcare team have checked your baby before you can hold them. If possible, they will pass your baby to you for a cuddle as soon as possible.
After this time, your baby will move to the baby unit (also called the neonatal or special care baby unit). This is where they will receive the care they need. It may be necessary for your baby to be transferred to a more specialised unit depending on how early they are born.
Your body after the birth
After you give birth, the maternity staff will check you are recovering well. They will take your temperature, pulse and blood pressure. They’ll also feel your stomach to make sure your womb is shrinking back to its normal size. They can also give you pain relief if you are experiencing bad cramps, also known as afterpains, which are common.
“It’s important for new mums to keep up their own strength. If your baby is in the unit, it is easy to forget to go back to the postnatal ward eat because you want to be with your baby the whole time.”
Debbie
If you gave birth vaginally
If you gave birth vaginally, staff will also need to check your genital area to see if it has torn and whether you need stitches. This may include a rectal examination, where the midwife or doctor uses their finger to check for any problems inside your bottom (rectum).
Your midwife or doctor should explain to you what they are going to do. They will ask you to move or help you get into a comfortable position so they can see the area clearly. They may ask to assist you to put your legs into stirrups on the bed.
This gives them a clearer view and is the correct position if they need to give you some stitches. You may be offered some gas and air while they do an internal examination to check for vaginal tearing.
Up to 9 in 10 first-time mums who have a vaginal birth will have some sort of tear, graze or episiotomy. The Royal College of Obstetricians & Gynaecologists says that, for most women, these tears are minor and heal quickly.
If you need any stitches, your midwife or doctor will try to do these straight away. This will reduce any chance of infection or blood loss. Find out more about perineal tears.
After a c-section
In the recovery area and on the postnatal ward, you will have:
- regular checks to make sure the anaesthetic is wearing off – your midwife will also check your breathing, heart rate, blood pressure, wound dressing and pain relief for the first few hours
- regular checks on the amount of vaginal bleeding you have – the midwife will also make sure you’re changing your maternity pads regularly (or change them for you if you are having difficulties
- a catheter to drain wee from your bladder – your midwife will check that you have passed enough urine within 6 hours and will take the catheter out about 12 hours after the operation, once you are up and moving around
- compression stockings to reduce your risk of blood clots
- a needle in your arm (drip) to give you fluids until you’re eating and drinking again – you can usually eat and drink as soon as you feel ready.
Once the anaesthetic has worn off, you’ll be able to stand up and go for a short walk. You are likely to feel wobbly the first time you get up and you will still have your catheter, so you will need the midwife to help you. Your abdomen (tummy area) may feel tender and heavy. Your midwife can give you some pain relief beforehand to make you more comfortable.
A caesarean section is a major operation. You will usually stay in hospital for between 2 and 4 days after the surgery and may need to take things easy for several weeks.
Before you leave hospital, your midwife may give you a supply of a blood-thinning drug to reduce your risk of blood clots. You may have had injections of this drug each day since your c-section.
Find out more about what happens after a c-section.
Going to the toilet
You may find it difficult to wee after giving birth. If you haven’t been able to wee within 6 hours, you may need a catheter. Weeing may sting slightly or feel a little sore at first.
If you had an epidural, you may not be able to feel when your bladder is full. This is because the epidural affects the surrounding nerves. Again, you may need a catheter until you are able to control your bladder again when the epidural wears off.
You are not alone if you are feeling a bit anxious about your first poo after birth. Lots of people feel anxious about this, especially if they had stitches or a tear. You probably won’t have a poo for a few days after birth. If you had stiches, it’s very unlikely that you’ll break them, open the cut or tear again.
It might feel better if you hold a pad of clean tissue over the stitches when pooing. Try not to strain. It’s important to try not to get constipated, which can be quite common after giving birth. Try to drink plenty of water and eat food with plenty of fibre, such as fresh fruit and vegetables, and wholemeal or wholegrain breads and cereals. If you still struggle, your midwife may give you laxatives.
Tell your midwife if you feel pain or stinging in or around your vagina or surrounding area, or if you notice an unpleasant smell as this may be a sign of infection.
Bleeding
You’ll bleed from your vagina after giving birth vaginally or by c-section, which will be quite heavy at first. This will carry on for a few weeks and will gradually turn a brownish colour and decrease until it finally stops.
Find out more about your body after a birth.
Feeding your premature baby
Health professionals generally advise you to breastfeed if they can. Breast milk has many health benefits for premature babies, and is recommended by neonatologists (doctors specialising in new-born babies) wherever possible. Even just a few drops at a time will do them good.
Expressing milk for your premature baby
If your baby is very tiny or unwell, they may not be able to breastfeed straight away. But you can express your milk to give to your baby through a tube or in a cup or bottle.
“Don’t be afraid to ask for support with this – the staff have seen it all before!”
Debbie
When should I start expressing?
It’s best to start expressing as soon as possible after the birth and to express regularly to build up your milk supply. If you can, try to express at least 8 times in a 24 hour period
Find out more about feeding your premature baby in hospital.
What to expect from your postnatal care
Your healthcare professional should work with you to develop a written postnatal care plan tailored to your needs.
This plan should describe how you will progress through the next 6–8 weeks and should include relevant factors from your care before, during and immediately after the birth.
Your postnatal plan should provide a record of the care you and your baby receive and will be filled in during every contact you have with a member of your healthcare team. The names, roles and contact details of all the healthcare professionals involved in your care should be included. One of these healthcare professionals should be responsible for coordinating your care and should be clearly identified.
If you had a difficult birth
Sometimes things don’t go according to plan during pregnancy or labour. This may be the case if you’ve had a premature birth. This can make the experience difficult to process for you or your partner (if you have one). Some parents may feel traumatised by what they’ve been through. There is support available if you are struggling with your feelings about the birth.
Find out more about recovering from a difficult birth.
Wyllie J, Ainsworth S, Tinnion R (2015) Resuscitation Council Guideline: Resuscitation and support of transition of babies at birth. www.resus.org.uk/resuscitation-guidelines/resuscitation-and-support-of-transition-of-babies-at-birth/
British Association of Perinatal Medicine (2019) Perinatal Management of Extreme Preterm Birth Before 27 weeks of Gestation. www.bapm.org/resources/80-perinatal-management-of-extreme-preterm-birth-before-27-weeks-of-gestation-2019
NICE (2006). Postnatal care up to 8 weeks after birth. National Institute for health and care excellence. https://www.nice.org.uk/guidance/cg37/ifp/chapter/First-24-hours-after-birth
NICE (2014). Intrapartum care for healthy women and babies. NICE clinical guideline CG190. National Institute for health and care excellence. https://www.nice.org.uk/guidance/cg190
Royal College of Obstetricians & Gynaecologists (2020) Perineal tears and episiotomies in childbirth. https://www.rcog.org.uk/en/patients/tears
NHS. Side effects of an epidural. https://www.nhs.uk/conditions/epidural/side-effects/ (Page last reviewed: 11/03/2020. Next review due: 11/03/2023)
NHS. Your body just after the birth. https://www.nhs.uk/conditions/pregnancy-and-baby/you-after-birth/ (Page last reviewed: 08/03/2018. Next review due: 08/03/2021)
NHS. Breastfeeding your premature baby. https://www.nhs.uk/conditions/pregnancy-and-baby/breastfeeding-premature-baby/ (Page last reviewed: 10/10/2019. Next review due: 10/10/2022.)