One of the things we love the most about home birth is the postpartum and newborn care – you may have heard us mention this more than once in our podcasts. The simplicity of crawling into your own bed with your baby after your home birth is everything. For so many reasons.
Of course, there is a bit more to our postpartum care than what happens in the immediate hours after birth, when we fully assess the health and well-being of you and your baby before we leave you to get to know each other on your own terms in those first precious hours. In this post, we want to share with you what your care will look like in the weeks following your home birth.
The first 24-48 Hours
After we leave your home, you and your baby will most likely spend a lot of time alternating between sleeping and establishing breastfeeding (or chestfeeding). Your midwives will check in with you by phone or text sometime during that first day, and we will have left instructions to contact us with concerns, questions or warning signs.
Between 24 and 48 hours, a member of your midwife team will come back to your house to do your first postpartum home visit. At this visit, we will check your vital signs, assess your bleeding, make sure your uterus is firm and involuting (slowing shrinking back to normal size – this takes awhile), and take a look at your sutures, if you had a perineal repair.
This first visit is a big one for your baby. We will do the first newborn metabolic screen, which is collected with a foot poke, and we will screen for Critical Congenital Heart Disease (CCHD), using a pulse oximeter. Your baby will be examined from head to toe, assessed for jaundice, and weighed. It is normal for your baby to have lost a little bit of weight at this visit. Your midwife will also take a look at baby’s latch and help with any breastfeeding questions or concerns you have.
You will typically have a second home visit on day 3 or 4, though this has sometimes shifted due to COVID restrictions. As of the writing of this article, we are on our normal postpartum visit schedule. A member of your midwife team will return to your home to assess all of the same things for your postpartum body, and check in with your emotional wellness.
Your baby will again be weighed and examined, but there is usually not a need for testing at this visit, unless we are concerned about jaundice. In that case, there will be another foot poke to check the bilirubin levels in the blood. Again, we will work on any breastfeeding questions or concerns.
Between one and two weeks, we will schedule a visit for you and your baby in our office. At this visit, we will do a quick physical exam to check vitals and make sure the uterus is involuting normally, and discuss how things are going at home with your new baby.
Your baby will have the second part of the newborn metabolic screen at this visit, and the newborn hearing screening. We will also do another weight check and breastfeeding assessment. At this point, your newborn is probably also getting care established with their pediatrician.
If all has been going well with your other visits, you may choose to do your four week visit virtually. If you have any concerns, we’ll do this visit in office, and check on all the same things. There is not typically any testing needed at this visit.
This is your graduation visit! We’ll do a quick vitals check, and discuss how you are doing settling in to life with your baby, any questions or concerns, family planning, and everything else. If you are due for a Pap smear, we can do one at this visit.
We’ll do another weight check and quick exam for baby, and much cooing and lamenting over this being our last visit together! This visit is always bittersweet – we miss seeing our clients and their adorable babies! But we love knowing that you’ve had good hands-on postpartum support to help you and your baby get off to a good start.