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This guideline covers the routine postnatal care that women and their babies should receive in the first 8 weeks after the birth. It includes the organisation and delivery of postnatal care, identifying and managing common and serious health problems in women and their babies, how to help parents form strong relationships with their babies, and baby feeding. The recommendations on emotional attachment and baby feeding also cover the antenatal period.

The guideline uses the terms 'woman' or 'mother' throughout. These should be taken to include people who do not identify as women but are pregnant or have given birth. Similarly, where the term 'parents' is used, this should be taken to include anyone who has main responsibility for caring for a baby.

The Royal College of Obstetricians and Gynaecologists has produced guidance on COVID-19 and postnatal care for all midwifery and obstetric services.

Recommendations

This guideline includes recommendations on:

Who is it for?

Healthcare professionals

Commissioners and providers

Women having routine postnatal care, and their families

Guideline development process
How we develop NICE guidelines
This guideline was commissioned by NICE and developed in partnership with the Royal College of Obstetricians and Gynaecologists (RCOG).

This guideline updates and replaces NICE guideline CG37 (published July 2006).

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

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This guideline covers the routine postnatal care that women and their babies should receive in the first 8 weeks after the birth. It includes the organisation and delivery of postnatal care, identifying and managing common and serious health problems in women and their babies, how to help parents form strong relationships with their babies, and baby feeding.

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Click the link below for resources about mental health and wellbeing

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Where to get support for postnatal depression

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Where to get support for postnatal depression

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If you think you may be experiencing postnatal depression make sure that you seek support and help.

Speak to your partner, a family member or friend and seek support from your midwife, health visitor or GP.

Here are some organisations that can offer additional information and support.

NCT

MIND

NHS

PANDA

This is a great quick reference image regarding common signs of post natal depression. Remember that PND can affect both men and women and an awareness of the signs can lead to quick recognition and treatment.

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This information and videos are available in verified by experts in our Editorial Board including representatives from Royal College of Midwives, Royal College of Paediatrics and Child Health and Royal College of Psychiatrists as well as other key health organisations in the UK. To download Baby Buddy, visit the relevant app store of your choice:

Introduction

Mental health doctor Alain explains how you are the best person to know whether what you're feeling is normal for you - and why it's so important to talk to someone if you feel something's not right.

Feelings in pregnancy

New mum Nicola talks about some of her feelings when she was pregnant, including being very emotional at her first ultrasound scan.

Feelings after birth

New mum Rebecca talks about feeling low and emotional after her baby was born. Talking to friends and family can help - but if you need more support, talk to your midwife or health visitor

Mental Health problems

Mental health doctor Alain explains what postnatal depression is, and what to do if you have it.

Coping and support

New mum Katie, who has depression, talks about some simple, practical steps she took took to help avoid stress and keep her relationship strong.

If you're feeling low, talk to your midwife, health visitor or doctor.

You can get information and support from PANDAS ( www.pandasfoundation.org.uk, helpline 0843 2898401) or APNI ( www.apni.org.uk, helpline 020 7386 0868).

Getting help and treatment

Women's mental health doctor Trudi talks about when to ask for help if you're not feeling right or you're worried about your mental health. Talk to your midwife, health visitor or doctor about how you feel.

Mental health long films

Four mothers talk about their experiences of having depression and anxiety, and health professionals describe the options for support and treatment. This video is a clip from the longer film.

You can get information and support for depression and anxiety at MIND ( www.mind.org.ukhelpline 0300 123 3393 or text 86463), PANDAS ( www.pandasfoundation.org.ukhelpline 0843 2898401), APNI ( www.apni.org, helpline 0207 386 0868) or Anxiety UK ( www.anxietyuk.org.uk, helpline 08444 775 774).

Latest

The Impact Lead will focus on developing Best Beginnings' frameworks for monitoring and evaluating our national and international work ensuring that learning continues to be captured in ways that can be shared and used for effective advocacy and influencing. The successful candidate will also play a pivotal role influencing policy and its implementation within the maternity, early years, digital health and public health context.

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Our Out of the Blue videos support parents' and soon-to-be parents' wellbeing during pregnancy and beyond.

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Health Vistors provide support and advice from the antenatal period until your child is 5. They may visit you at home, in a baby clinic or children's centre. You may meet your health visitor during pregnancy. They will then arrange to meet you and your baby at 10-14 days where they take over care from the midwifery team.

The Cheshire health visiting team is run by Starting Well.

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Advice about stitches, piles, bleeding and other physical changes after birth, plus tips to help you make a healthy recovery.

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Home-Start is one of the leading family support charities in the UK.

Home-Start volunteers help families with young children deal with the challenges they face. We support parents as they learn to cope, improve their confidence and build better lives for their children.

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Home-Start is a local community network of trained volunteers and expert support helping families with young children through their challenging times. We are there for parents when they need us the most because childhood can’t wait.

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Columns are titled for ease of search
- click on the website link (if present) or photograph to open the link/webpage/document /video
- scroll right to see all topics
- scroll down each column to find additional links/information

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At KidsBank Chester, we distribute resources from where they are abundant to where they are lacking, reducing parental stress, anxiety and depression, in turn helping children and instilling in them a sense of value and confidence.

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We continue to follow government guidelines, meaning we are still unable to do home visits. We are however open for referrals to all of our services, just call us on 0151 608 8288 or email admin@koalanw.co.uk. Groups and Parenting Courses are running again, with a booking system in place for all groups/courses.

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Find out about the postnatal check that happens around 6 weeks after the birth, where you can discuss any health issues you may have, including contraception.

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Advice and Exercises Following Childbirth 

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Advice and Exercises Following Childbirth 

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Squeezy helps women to remember to do their pelvic floor muscle (kegel) exercises and to do them in the right way.

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Multi-award winning app supporting people with pelvic floor muscle exercise programmes. Recommended by pelvic health specialists worldwide.

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How and when to do pelvic floor exercises

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How and when should I do pelvic floor exercises? | NHS

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Resources for partners and non gestational parents

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Click the link below to access all our resources about support for partners

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Click the link below to return to the welcome page

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Scroll right to access the following columns

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Scroll right to access the following columns

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-Postnatal care

-Maternal health following vaginal birth

-Maternal health following caesarean section

- Postpartum complications

- Anticoagulation injections

- Pelvic health advice

-Mental well being support

-General postnatal support

-Support for partners

-Health Visiting services

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Information regarding third or fourth degree tears

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Information regarding third or fourth degree tears

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Information to help you reduce the risk of perineal tears.

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Information to help you reduce the risk of perineal tears.

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Check out this website for lots of information regarding pelvic health issues. If you scroll to the bottom of the website there are some very helpful videos to watch.

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Welcome to the Cheshire and Merseyside Women’s and Children’s Services Partnership - Improving Me Programme Website. We are a partnership of 27 NHS organisations across Cheshire and Merseyside aiming to improve the experience of women and children. The Partnership is one of the Vanguard’s New Care model initiatives, and one of seven maternity pioneers in the country.

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Need advice? Please email Birth Injury Support at info@masic.org.uk or call 0808 1640 8333

We are advocates for women and aim to change the lives of those injured during childbirth.

Find out more

Who are MASIC?

MASIC exists to support women, challenge stigma and drive change.

The MASIC Foundation is the only multi-disciplinary UK charity to support women who have suffered severe injuries during childbirth known as OASI (Obstetric Anal Sphincter Injuries).

The charity is run by injured women and healthcare professionals who are committed to better detection and prevention of injury during childbirth.

Find out more

Women's stories

Breaking the silence. Read stories from MASIC advocates who have suffered injuries during childbirth.

Telling women's stories is the most important thing we can do as a charity. When women are brave enough to speak out, change happens. This page is dedicated to telling those stories, and to the women who have been honest and incredibly brave in sharing their experience.

If you have a story to tell we are dedicated to supporting you and making your voice heard.

Please email socialmedia@masic.org.uk and we will help you to tell your story.

Read more stories

Looking for support?

There is support available if you need it, don't suffer in silence and don't be afraid to ask for help and advice.

MASIC can help you over come the physical and emotional trauma you may have experienced during and after child birth. We can support you and guide you to helpful resources, all you need to do is get in touch.

Get Support

Not sure where to start?

Please call the MASIC 24h freephone Birth Injury Support Helpline 0808 1640 8333

My name is Luce. I'm a writer. A partner. A mum. And I had a difficult birth which left me thunderstruck, confused, sad, broken, and well, pretty angry. My reaction to birth trauma was unconventional. I wrote a book - a gory, funny, moving book - about the truth of it for me, what I saw and heard and felt as I gave birth and then coped with injuries, continence issues, depression, and trauma. I needed to speak out because traumatic births are often undiscussed. Recognition is important - we don't talk enough about births that aren't picture-perfect, as if they should be hidden in shame. Like MASIC, I'm here to say it isn't shameful. And don't worry - you have found your people. Like my book this website is a place for all of you - the entertainers, the shell-shocked, new mums and old hands - to share, process, or even just start to think about what is happening, and why googling 'birth trauma' or 'MASIC' late at night is a good thing. You are not alone.

85%

of women with severe birth injury said it impacted on their relationship with their child

78%

were affected by traumatic memories of the birth

52%

stated they were embarrassed by the symptoms of their injury

49%

of women affected said they doubted their ability to mother

45%

suffered postnatal depression as a result of their injury

24%

of women affected regretted having a child because of the injuries sustained

Meet the MASIC team

We are a collection of healthcare professionals & MASIC advocates, existing to give a voice to women's childbirth stories.

The Executive Board

We are led by a small and very experienced Executive team who are dedicated to improving outcomes for women with birth injuries.

Products that will help improve your life

Products that can help make everyday life a bit easier.

After sustaining a birth injury it is so important to know that there are products and services out there that can help make everyday life a little bit easier, and help you to feel a little bit more like YOU again.

We recommend the products here that have been tried and tested by our MASIC advocates - women who understand what it's like to cope with symptoms on a daily basis, and who know what has helped them.

Discover More

MASIC News

Keep up to date with all our latest news and stories

If you would like to be kept informed of MASIC's work and our most recent projects please click on our news items in this section and sign up to our MASIC mailing list.

We would love to hear from you if you are an injured woman or a health professional interested in working with us.

Read more stories

Cookie Policy

We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. By clicking "Accept", you consent to the use of ALL the cookies.

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Home - Aiming to change the lives of women injured during childbirth.

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MASIC supports women who have suffered injuries during childbirth; OASI, Obstetric Anal Sphincter Injuries, or 3rd degree & 4th degree tears.

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Bleeding after birth and postpartum haemorrhage (PPH) | NCT

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How much bleeding is normal after birth and how long should it last? Learn about bleeding after having a baby and how to recognise if too much blood is being lost.

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Your vagina and pelvic floor after giving birth | NCT

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There’s a lot going on in your nether regions post-birth. Here’s the information you need to make a good recovery…

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What to expect

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You'll probably be in hospital for 1 or 2 days after a caesarean section, and may need to take things easy for several weeks.

Recovering in hospital

Most women can leave hospital 1 or 2 days after having a caesarean section.

While in hospital:

you'll be given painkillers to reduce any discomfort

you'll have regular close contact with your baby and can start breastfeeding

you'll be encouraged to get out of bed and move around as soon as possible

you can eat and drink as soon as you feel hungry or thirsty

a thin, flexible tube called a catheter will remain in your bladder for at least 12 hours

your wound will be covered with a dressing for at least 24 hours

When you're well enough to go home, you'll need to arrange for someone to give you a lift as you will not be able to drive for a few weeks.

Looking after your wound

Your midwife should also advise you on how to look after your wound.

You'll usually be advised to:

gently clean and dry the wound every day

wear loose, comfortable clothes and cotton underwear

take a painkiller if the wound is sore - for most women, it's better to take paracetamol or ibuprofen (but not aspirin) while you're breastfeeding

watch out for signs of infection

Non-dissolvable stitches or staples will usually be taken out by your midwife after 5 to 7 days.

Your scar

The wound in your tummy will eventually form a scar.

This will usually be a horizontal scar about 10 to 20cm long, just below your bikini line.

In rare cases, you may have a vertical scar just below your bellybutton.

The scar will probably be red and obvious at first, but should fade with time and will often be hidden by your pubic hair.

On darker skin, the scar tissue may fade to leave a brown or white mark.

Controlling pain and bleeding

Most women experience some discomfort for the first few days after a caesarean, and for some women the pain can last several weeks.

You should make sure you have regular painkillers to take at home for as long as you need them, such as paracetamol or ibuprofen.

Aspirin and the stronger painkiller codeine present in co-codamol is not usually recommended if you're breastfeeding.

Your doctor will be able to advise you on the most suitable painkiller for you to take.

You may also have some vaginal bleeding.

Use sanitary pads rather than tampons to reduce the risk of spreading infection into the vagina, and get medical advice if the bleeding is heavy.

Returning to your normal activities

Try to stay mobile and do gentle activities, such as going for a daily walk, while you're recovering to reduce the risk of blood clots. Be careful not to overexert yourself.

You should be able to hold and carry your baby once you get home.

But you may not be able to do some activities straight away, such as:

driving

exercising

carrying anything heavier than your baby

having sex

Only start to do these things again when you feel able to do so and do not find them uncomfortable. This may not be for 6 weeks or so.

Ask your midwife for advice if you're unsure when it's safe to start returning to your normal activities.

You can also ask a GP at your 6-week postnatal check.

When to get medical advice

Contact your midwife or a GP straight away if you have any of the following symptoms after a caesarean:

severe pain

leaking urine

pain when peeing

heavy vaginal bleeding

your wound becomes more red, painful and swollen

a discharge of pus or foul-smelling fluid from your wound

a cough or shortness of breath

swelling or pain in your lower leg

These symptoms may be the sign of an infection or blood clot, which should be treated as soon as possible.

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Find out about after a caesarean section, including what you can expect and how long you need to avoid activities such as driving.

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Top tips for recovery after a caesarean birth | NCT

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Having a caesarean is a major operation so you’ll need to take it easy afterwards. Here we share some caesarean birth recovery tips to help you heal.

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Perineal tears and episiotomies in childbirth

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Perineal tears and episiotomies in childbirth

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This link aims to inform about the types of tears that can occur during childbirth, how to minimise your risk of deeper tearing, and what can be done to help your recovery if you do tear.

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This hub aims to inform about the types of tears that can occur during childbirth, how to minimise your risk of deeper tearing, and what can be done to help your recovery if you do tear.

We also aim to support you to take prompt action if you have any concerns about your recovery, helping you feel better informed when discussing any topics with a healthcare professional.

This information has been developed by the OASI Care Bundle Project Team, the OASI Care Bundle Clinical Champions and perineal specialists.

It is based on the RCOG Green-top Guideline No.29 The Management of Third and Fourth Degree Tears (June 2015) and expert opinion from the above named developers and key stakeholders in line with RCOG due process.

Please give us your feedback

We would like to understand how people are using this resource to help ensure it is relevant and useful. To give us your feedback, please complete our short survey.If you have any questions, please email womensvoices@rcog.org.uk

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Perineal tears and episiotomies in childbirth

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This hub aims to inform about the types of tears that can occur during childbirth, how to minimise your risk of deeper tearing, and what can be done to help your recovery if you do tear.

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When should I contact a healthcare professional?

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When should I contact a healthcare professional?

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When Should I contact a health care professional?

8:30am - 6pm

Community Midwives - 01244 365166

24hrs

Cestrian ward - 01244 3651778

Maternity Triage - 01244 365806

You can contact the hospital triage, your midwife, health visitor or GP if you have any worries or concerns about your own wellbeing or recovery.

You should always inform a health care professional -

You have a temperature above 38 C

You feel unwell with flu-like symptoms.

You are shaking or have rigors.

You have a headache or blurred vision.

Your breasts feel engorged (full) or are red or painful.

You have worsening abdominal pain.

Your blood loss is heavy or you are passing clots.

Your Cesarean wound look red, feels painful, is leaking fluid or has come open.

Your perinieum is painful, feels swollen or your stiches have come apart.

You are experiencing urinary or faecal incontience.

You have pain or swelling in your calves.

You are worried about how you are feeling emotionally.

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We're here to support you and your unique experience of pregnancy, birth, and early parenthood.

Our vision is that everyone who becomes a parent feels confident, connected, and safe.

We share evidence-based information you can trust

We create opportunities to connect with other parents

We listen to your experiences, amplify all parents' voices and campaign for change

We are strong advocates for improving experiences of pregnancy, birth, infant feeding, and early parenthood, equitably, for all parents.

Access networks of support and build friendships through our courses and community events.

Use our resources to make informed decisions that feel right for you.

Information for parents

If you're pregnant or a new parent, we know that you will have a number of questions and concerns about coronavirus. In our sections below, we've created a range of articles about how coronavirus might affect your pregnancy, birth and early days as a parent.

Pregnancy

When it comes to your pregnancy, we've got it covered. You'll find everything you need to help you feel confident and reassured over the next nine months right here.
Find out more

Labour & birth

Thinking about how, what happens and where to give birth? We're here to help you feel more confident. We've got information and tips on everything you need to know.
Find out more

Baby & toddler

Your baby's arrived and you've probably got 101 things on your mind. Don't worry, you're not on your own. We're here with information and support as your baby develops.
Find out more

Life as a parent

You've just had a baby and everyone is focused on your little one. But how about you? We're with you on your journey with support and tips from other mums and dads.
Find out more

Courses and workshops

Interactive, engaging and social, our antenatal course is a fun and exciting way to grow your knowledge of birth and early parenthood, and make life-long friends.
View all courses & workshops

Local activities and meet-ups

Our local activities and meet-ups can help you build up a supportive social network around you.

Support NCT Charity by becoming a member

Join NCT and there's great member benefits for you - exclusive live talks, money-saving offers & competitions, digital magazine & quick-read newsletters, plus early entry to every NCT Nearly New Sale - whilst you help fund free support for others.

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The UK's leading charity for parents | NCT

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We are the charity that supports people as they become parents. We're here for you through pregnancy, birth, and early parenthood.

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Welcome to the Starting Well website! On here you will find lots of information about your health and wellbeing, guiding you to extra support if you need it.

Starting Well Service 'Outstanding for Care' CQC
Please click this link to read more...

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Welcome to the Starting Well website! On here you will find lots of information about your health and wellbeing, guiding you to extra support if you need it. Starting Well Service 'Outstanding for Care' CQC Please click this link to read more...

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Our Health Visiting teams provide expert advice, support and interventions for families and children across North Wales. Health Visitors support the health and wellbeing of children from the antenatal period up to 5 years old by offering information and advice to their parents. This advice includes antenatal support, physical and emotional wellbeing of children, the childhood immunisation programme, parenting support, health and developmental progress.

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Ferinject information leaflet.

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You may be offered blood thinning injections during your pregnancy and after you have had your baby to prevent you developing blood clots. This guidance from RCOG explains why these injections may be needed.

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Published: August 2015

Please note that this information will be reviewed every 3 years after publication

This information is about reducing the risk of venous thrombosis for women who are thinking about having a baby, who are already pregnant or who have just had a baby.

It may also be useful if you are a partner, relative or friend of someone in this situation.

The information here aims to help you better understand your health and your options for treatment and care. Your healthcare team is there to support you in making decisions that are right for you. They can help by discussing your situation with you and answering your questions.

Thrombosis is a blood clot in a blood vessel (a vein or an artery). Venous thrombosis occurs in a vein. Veins are the blood vessels that take blood towards the heart and lungs whereas arteries take the blood away. A deep vein thrombosis (DVT) is a blood clot that forms in a deep vein of the leg, calf or pelvis.

Pregnancy increases your risk of a DVT, with the highest risk being just after you have had your baby. However, venous thrombosis is still uncommon in pregnancy or in the first 6 weeks after birth, occurring in only 1-2 in 1000 women.

A DVT can occur at any time during your pregnancy, including the first 3 months, so it is important to see your midwife early in pregnancy.

If you need information on the diagnosis and treatment of venous thrombosis during pregnancy or after birth, please see the RCOG patient information Diagnosis and treatment of venous thrombosis in pregnancy and after birth.

This information covers:

Why a DVT is serious

Risk factors for DVT and a pulmonary embolism (PE) before, during and after pregnancy

When your risk will be assessed

How to reduce the risk

Heparin treatment

What you should do when labour starts

What happens after birth

Breastfeeding if you are receiving treatment after birth

Within this information, we may use the terms 'woman' and 'women'. However, it is not only people who identify as women who may want to access this information. Your care should be personalised, inclusive and sensitive to your needs, whatever your gender identity.

A glossary of medical terms is available at A-Z of medical terms.

Sources and acknowledgements

This information has been developed by the RCOG Patient Information Committee. It is based on the RCOG Green-top Guideline Reducing the Risk of Thrombosis and Embolism during Pregnancy and the Puerperium (April 2015). The guideline contains a full list of the sources of evidence we have used.

This leaflet was reviewed before publication by women attending clinics in Glasgow, Coleraine and Sunderland, and by the RCOG Women's Network.

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royal college of obstetricians and gynaecologists

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Reducing the risk of venous thrombosis in pregnancy and after birth

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Reducing the risk of venous thrombosis in pregnancy and after birth patient information leaflet

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We’re here to help you become pain-free.

We offer support and information about pelvic girdle pain (PGP).