Going home from hospital can be very exciting, but you may feel nervous too without the hospital staff on call to help you. The more you handle your baby, the more your confidence will increase. Of course, the community midwife and then the health visitor and your own GP are there to advise you should you have any worries or problems. Ask your midwife or health visitor for a copy of the book which follows on from this one - Birth to Five.

 

Coping

Involving your partner

The more you can share your baby's care, the more you will both enjoy your baby. Your partner may not be able to breastfeed but he can help with bathing, changing and dressing as well as cuddling and playing. He may feel quite nervous of handling the baby and need encouragement. Be patient if he seems awkward at first.

Help at home

You'll probably need a lot of full-time help at first, not just with the chores, but also to give you emotional support. You're bound to feel up and down and to get easily tired in the early days. Many women want to have their partners with them so that they will have a chance to get to know the baby properly, as well as helping with the work. It also gives you some time to start adjusting to the changes in your life. If you're on your own, or your partner is unable to be with you, perhaps your mother or a close friend can be there. Even with help you will probably feel tired. Cut corners where you can.

• Cut down on cleaning. A bit of dust won't hurt.
• Keep meals simple. You need to eat well but this needn't involve a great deal of preparation and cooking.
• Try to space visitors out. Too many in a short time will be very tiring. If visitors do come, don't feel you have to tidy up or lay on a meal. Let them do things for you.
• If you need extra help, ask. Friends or neighbours will probably be very willing to do some shopping, for example.

Rest

During the weeks or months that you are feeding your baby at night and your body is recovering from childbirth, finding time to catch up on rest is essential. It's tempting to use your baby's sleep times to catch up on chores, but try to have a sleep or a proper rest at least once a day.

Physical activity

Continue with any postnatal exercises you were shown in hospital. You can also do this deep stomach exercise when you feel well enough.

• lie on your side with your knees slightly bent;
• let your tummy sag and breathe in gently;
• as you breathe out, gently draw in the lower part of your stomach like a corset, narrowing your waistline;
• squeeze your pelvic floor also;
• hold for the count of 10 then gently release;
• repeat 10 times.

You should not move your back at any time. After 6 weeks progress to the box position.

Besides these exercises, try to fit in a walk with your baby. A short walk in the fresh air will make you feel good.

If a gap or bulge line appears vertically down the centre of your stomach you should ask your physiotherapist for special exercises.

Food

It's very important to continue to eat properly. If you want to lose weight, don't rush it. A varied diet without too many fatty foods will help you lose weight gradually. Try to make time to sit down, relax, enjoy your food and digest it properly. It doesn't have to be complicated. Try food like baked potatoes with baked beans and cheese, salads, pasta, French bread pizza, scrambled eggs or sardines on toast, for example, followed by fruit mixed with yoghurt or fromage frais.

A healthy diet is especially important if you're breastfeeding. Breastfeeding uses up a lot of energy. Some of the fat you put on in pregnancy will be used to help produce milk, but the rest of the nutrients will come from your diet. This means that you may be hungrier than usual. If you do need a snack, try having cheese or beans on toast, sandwiches, bowls of cereal or fruit. (See Your diet when breastfeeding).

Your relationships

When you bring your new baby home all the relationships around you will start to shift and change. Your mother, for example, may find the change alarming and feel quite unsure of how much to get involved. You may find that she is trying to take you over or that she is so anxious to avoid bothering you that she doesn't help at all. Try to let the people close to you know clearly just how much you do want from them.

Your relationship with your partner will also change. It's very easy in those exhausting early weeks to just leave things to sort themselves out. Take care. You may wake up six months later to find that you haven't spent an hour alone together and have lost the easy knack of talking your problems through. You both need time alone, without the baby, to recharge your own batteries, and time together to keep in touch with each other.

Your relationship with the baby may not be easy either, particularly if you're not getting much sleep. Don't feel guilty if you sometimes feel resentful at the demands your baby makes, or if your feelings are not what you expected them to be. Talk to your midwife or health visitor if you're upset, but remember, many mothers do not feel instant love for their baby. They come to love them gradually over the weeks.

The 'Baby Blues' and Post Natal Depression

Up to 80% of mothers go through a patch of what is known as the 'baby blues', often about three or four days after birth. You might feel anxious about small things. for example, or mildly depressed or just keep bursting into tears, for no apparent reason

Baby blues may be caused by hormone changes, tiredness, discomfort from sore stitches, or sore breasts, or even a feeling of anticlimax after all the excitement. Whatever the cause, you will usually find it only lasts a day or so. Have a good cry if you feel like it, and try to sleep if you can. The best help your partner or someone else is probably just to listen, give you a reassuring hug and look after the baby whilst you rest. If these feelings do not go away, it may be that you are not treating yourself very well. Take time out for treats, however small - a long lazy bath, your favourite food or visit a friend.

Around 10% of mothers slide into a depression which may be quite deep. They are taken over by a feeling hopelessness. They may feel angry, but more often feel too exhausted to be angry or cope with the simplest tasks. If you feel like this you must get help. You should contact your GP or health visitor and explain how you are feeling. A partner or friend might contact them after talking to your about it. You can also contact the Association for Post-Natal Illness for more information.

Sex and contraception

There are no rules about when to start making love again. If you haven't had stitches you may be eager to share the extra love you feel with your partner. On the other hand, if you're tired and sore, sex may be the last thing you have in mind. Don't rush into it. If it hurts, it will be no pleasure. You may want to use a lubricating jelly the first time because hormone changes may make your vagina feel drier than usual.

It can take some time for the old feelings to come back but they will and, until they do, you may both feel happier finding other ways of being loving and close. If you have any worries, discuss them with your GP or health visitor.

It's possible for a woman to conceive even if she has not started her periods again or even if she is breastfeeding. Contraception should be discussed before you leave hospital and again when you go for your six-week postnatal check. In the meantime, you could talk to your midwife or health visitor when they visit you at home or you could go to your GP or family planning clinic.

The Family Planning Association publishes free leaflets about all methods of contraception.

 

The Post Natal Check

You should have your postnatal check about six weeks after your baby's birth to make sure that you feel well and are recovering as you should from the birth. You may go to your own GP or may be asked to return to the hospital. It's a good opportunity to ask any questions and sort out any problems that are troubling you. You may like to make a list of questions to take along with you so that you don't forget what you want to ask.

If you have had a Caesarean section you may like to ask if another one will be needed if you have another baby. Routines do vary a little but the list below is probably what will be done.

• You may be weighed. You may be on the way to getting back to your normal weight again by now. Breastfeeding mothers tend to lose weight more quickly than those who are bottle feeding.
• Your urine may be tested to make sure your kidneys are working properly and that there is no infection.
• Your blood pressure may be checked.
• You may be offered an examination to see whether your stitches (if you had any) have healed, whether your womb is back to its normal size, and whether all the muscles used during labour and delivery are returning to normal. Tell the doctor if the examination is uncomfortable.
• Your breasts are unlikely to be examined unless you have a particular concern.
• The cervical smear test may be discussed if you haven't had one in the past three years. This is usually delayed until three months after delivery.
• If you are not immune to rubella (German measles) and were not given an immunisation before you left hospital, you will be offered one now. You should not become pregnant for one month after this immunisation.
• The doctor will ask if you still have any vaginal discharge and whether you have had a period yet.
• There will be an opportunity to talk about contraception. If you have any worries over contraception or, indeed, any aspect of sex, now is a good time to discuss them. Tell your doctor if intercourse is painful.
• If you're feeling very tired, low or depressed make sure you tell the doctor about this.
• If you are having trouble holding your urine, or wind or are soiling yourself tell your doctor.
• Your GP's surgery or health clinic will probably arrange for your baby's six-week check to be done at your postnatal check. If you go to the hospital, the baby's check will usually need to be arranged separately