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Maternity stay: what to expect
The stay in the maternity hospital must first allow the young mother to recover physically. For about 4 days, she will try to rest, while adapting to the rhythm of her newborn baby. Competent staff will help him take care of it. When it comes to the first child, these few days are indeed used to acquire the essential notions to take care of your baby and start breastfeeding well. Caregivers are usually keen to help the young mother feel comfortable in her new role. The medical team does more than just provide physical and emotional follow-up. She assists her in all her administrative procedures, advises her on the modalities of declaration to the civil status. She also works in a network with the nursery nurses of the Maternal and Child Protection (PMI), in case of special needs of the mother. But the main purpose of this stay is to monitor the health of the young woman and her baby. Indeed, even if the vast majority of births go smoothly and everything goes back to normal very quickly, complications can still occur.
Maternities: very different conditions today
Maternity life has changed a lot in recent years, although in some cases it obviously looks like a very classic hospitalization.
After waking up generally early in the morning (6 a.m. or 30 a.m.), the nurse or midwife asks the mother to take her temperature, checks her blood pressure and pulse and then proceeds, if necessary, to care for the scars. The afternoon is reserved for visits. Childcare auxiliaries take care of the baby, whether or not his mother is present. Some maternities leave him in his mother’s room for the night, while others offer to take him. If you are breastfeeding, it is best to keep your baby near you. Medical surveillance is very present. The healthcare team comes twice a day, morning and evening, to take the young mother’s temperature, her blood pressure, monitor the return of the uterus to its normal size, the perineum, the circulatory state (due to the risks of phlebitis within 7 hours of giving birth), breasts, episiotomy scar …
In many settings, there is real progress in relieving postpartum pain. It is a revolution almost as important as childbirth without pain. It was not until the second half of the twentieth century to see the emergence and generalization of the first painless childbirth methods. But as soon as the baby was born, no one cared about their mom’s well-being. Fortunately, this is no longer the case today.
There are support protocols. Very often, a combination of analgesic, paracetamol type, and anti-inflammatory is enough to make the pain after childbirth disappear; this treatment is compatible with breastfeeding. Circulars from the health authorities encourage newborns to benefit from it. Before registering, check with your maternity hospital to find out if they apply them because it will change your life. You will be less tired and more available to your child and those close to you.
Care is increasingly individualized, the new mother often has more freedom in her room. So as soon as the effects of the epidural have worn off, you will have already recovered and you can lead an almost normal life. Know that it is recommended to walk as soon as possible to stimulate the blood circulation slowed down during pregnancy, prevent any risk of phlebitis and facilitate the work of the kidneys.
You can normally take a shower in the morning. Then, if your condition allows it, and almost always is, nothing prevents you from dressing and putting on makeup. To receive visitors, it is more pleasant. If you are tired, prefer to read, watch TV or want to preserve your privacy, when feeding your baby for example, do not hesitate to ask the healthcare team not to allow visitors to enter your room.
A growing number of maternity hospitals seek to involve the dad in the care of the child. These establishments offer her the possibility of sharing the mother’s room as well as her meals. In some cases, you can choose your menus and invite some of your loved ones over for lunch or dinner.
Baby-side care
We monitor his weight curve which, after a perfectly normal fall, starts to rise again on the third day. The newborn also benefits from systematic screening for a certain number of diseases (Guthrie test) which must be treated as early as possible: hypothyroidism, phenylketonuria, cystic fibrosis, etc.
Childcare workers and childcare assistants provide her with the necessary care, which they teach the young mother if she wishes.
If the baby was born by cesarean, the mom is more tired ; as after any surgery, you have to recover gently. We invite the dad to take his place to learn, too, to take care of his child, to change him, to wash him.
Mother’s side medical surveillance
During the first few days after childbirth, uterine contractions cause bleeding, which is called lochia. This bright red discharge is a mixture of small clots of blood and uterine lining. They are always less abundant after a cesarean birth because the placenta is removed manually. In all cases, they regress, last a fortnight and turn from bright red to brown. The return of diapers, that is, the onset of menstruation, occurs 6 to 8 weeks later. Every morning the midwife examines the lochia and, together with the gynecologist, she also seeks to prevent any possible risks.
Immediately after birth, very heavy or prolonged discharge indicates hemorrhage. It is still the leading cause of maternal mortality in France today. Caused by an imperfect detachment of the placenta, ineffective uterine contractions, a tear of the cervix or other, a hemorrhage requires a very great reactivity of the obstetric team.
Venous problems may appear afterwards. From birth, the body produces natural anticoagulants to prevent any risk of bleeding. Sometimes small clots form in the lower limbs and can cause phlebitis which will be treated medically. Report any pain, redness or edema in the lower limbs and remember that getting up and walking very early after childbirth is the best prevention, unless there is a medical contraindication.
A fever may be a sign of a uterine infection, linked to poor involution of the uterus which is slow to regain its pre-pregnancy size. An infection results in a foul odor of lochia. It requires an appropriate prescription.
Urinary tract infections, especially cystitis, are very common during this period due to relaxation of the sphincters, distension of the bladder and repeated urinary catheters, especially after a cesarean section, but also sometimes during childbirth. If you feel a strong urge to urinate ending in a painful burning sensation, you should notify the healthcare team, who will prescribe treatment.
After the birth of a third child or after a cesarean section, uterine contractions are more painful
This is called trenches, a natural phenomenon accompanying uterine retraction and the expulsion of clots. They start within 24 hours of giving birth naturally, or within 12 hours after a cesarean, and usually last for three or four days. If you are in pain, tell the nurse or midwife who will suggest the appropriate medication. While waiting for them to take effect, there are some very simple methods to give you relief:
– Lie on your stomach or on your side. When you feel the contractions coming, make yourself as comfortable as possible by pressing a pillow against your uterus. It is a little painful at first, but you quickly feel appreciable relief.
– Relax. When the spasm arrives, close your eyes, relax as much as possible, and breathe deeply for the duration of the contraction.
– Massage your uterus with small circular motions. You should feel it contracting under your fingers. Repeat every four hours and preferably before feedings. Lochia usually increases after this type of massage, tell the midwife so that she does not worry for no reason.
After the birth of a third child or after a cesarean section, uterine contractions are more painful
This is called trenches, a natural phenomenon accompanying uterine retraction and the expulsion of clots. They start within 24 hours of giving birth naturally, or within 12 hours after a cesarean, and usually last for three or four days. If you are in pain, tell the nurse or midwife who will suggest the appropriate medication. While waiting for them to take effect, there are some very simple methods to give you relief:
– Lie on your stomach or on your side. When you feel the contractions coming, make yourself as comfortable as possible by pressing a pillow against your uterus. It is a little painful at first, but you quickly feel appreciable relief.
– Relax. When the spasm arrives, close your eyes, relax as much as possible, and breathe deeply for the duration of the contraction.
– Massage your uterus with small circular motions. You should feel it contracting under your fingers. Repeat every four hours and preferably before feedings. Lochia usually increases after this type of massage, tell the midwife so that she does not worry for no reason.
Perineal healing is also carefully monitored.. During a first childbirth, more than half of women suffer from tears of the mucous membrane and even of the perineal muscles. If it is a small tear, stitched up in a few minutes, it heals in 48 hours, the area being very irrigated. An episiotomy scar takes a little longer. If the scar is painful, tell the midwife who will find the right treatment and monitor the progress.
After a cesarean
This intervention concerns 20% of deliveries in France. When the child is born by cesarean section, the consequences are a little different. Depending on the establishment, the mother will stay 4 to 9 days in the maternity ward. Surgical act, the caesarean section can cause some inconvenience, such as difficulty in mobility for 48 hours for the breastfeeding and the care to be given to the baby. Morphine intolerance can cause itching or rashes on the skin. The healthcare team must then be notified, who will immediately administer treatment.
The very first days, the young mother remains bedridden before being able to stand up with the support of the midwife. In the meantime, lying on your back promotes blood circulation and healing. For a few more hours, medical equipment will help him, while his body becomes fully operational again.
– The infusion. It is not possible to resume a normal diet immediately after a cesarean section. This is why we leave the infusion that hydrates the young mother. It can also be used to diffuse sedatives and antibiotics.
– The urinary catheter. It allows urine to be evacuated; it is removed as soon as they are sufficiently abundant and of a normal color, as soon as possible after childbirth.
– The epidural catheter. Sometimes the anesthesiologist leaves it in place for 24 to 48 hours after the procedure to maintain a light anesthesia.
In some maternity hospitals, to prevent the risk of phlebitis after a cesarean section, we systematically inject anticoagulants. This treatment lasts several days. In other establishments, this treatment is reserved for mothers with risk factors.
The nurse or midwife changes the dressing once a day and monitors healing. Usually, the wound heals quickly. In case of infection, always possible but rare, everything quickly returns to order thanks to the taking of antibiotics. If the incision has not been stitched up with absorbable suture, the sutures or staples will be removed 5 to 10 days after the procedure. For the toilet, it is allowed to take a small shower from the second day. On the other hand, for a bath, we recommend to wait a fortnight.
A listening team
The role of the team is not limited to medical surveillance of the young mother and her newborn baby.
His vigilance is also exercised on the psychic level and it facilitates the proper development of the mother-child relationship. Likewise, she does everything to promote the role of the father in the care of the newborn. In case of particular concern or blues, do not hesitate to talk about it, in all confidence. If necessary, you can benefit from the assistance of nursery nurses from PMI, who generally work in a network with maternity hospitals, or meet with a psychologist.
The team provides essential support when feeding the baby. Indeed, the establishment of breastfeeding begins in the hours following birth. Ideally, the newborn baby should be put to the breast as soon as possible after giving birth. When the mother has chosen not to breastfeed her child, the team helps her to stop the milk flow by taking drugs that inhibit lactation. Be aware that they sometimes cause nausea and discomfort. Be careful, these drugs are only effective if you are not breastfeeding at all. Not even a few days, to give your child the benefits of colostrum, this very nourishing milk from the very first days.