The first ten days

Postnatal care in the UK is a sequence of contacts, not a single appointment, and it is split between two professionals. Midwives look after you and your baby first; a health visitor takes over at around two weeks and stays with you until your child is about two and a half.

Before you leave hospital or in the hours after a home birth, maternity staff check your temperature, pulse and blood pressure, your breathing, how much you are bleeding, whether you can pass urine and open your bowels, and they feel your abdomen to confirm the womb is contracting down. You are also asked how you are feeling, which is a clinical question and not small talk.

Your midwife then agrees a plan of visits at home or at a children's centre until your baby is around 10 days old. The number is not fixed; it depends on how you and the baby are doing. In those visits the midwife checks your baby for jaundice, infection of the umbilical cord or eyes and thrush in the mouth, and records temperature, weight and reflexes. Most babies lose some weight in the first days and regain their birthweight within about three weeks.

The health visitor takes over

A health visitor carries out a new baby review when your baby is around 10 to 14 days old, at home, at a GP surgery, clinic or children's centre. It covers safe sleeping, vaccinations, feeding, your baby's development and how you are adjusting. It is worth both parents being there if you can.

From this point your baby's growth, vaccinations and development are recorded in the personal child health record, the red book you were given shortly before or after the birth. Take it to every clinic and GP appointment, and add your own notes about illnesses, accidents and medicines.

Your 6 to 8 week postnatal check

This is yours, not the baby's, and it is a separate appointment even when it is scheduled back to back with your baby's. Your GP surgery should offer it, and you can request it yourself — do, if nobody has been in touch, particularly if something is worrying you.

What is usually offered, though it varies by area:

A general discussion of your mental health and wellbeing, including how you are actually feeling.
Whether you still have vaginal discharge and whether your periods have returned.
Blood pressure, if you had problems during pregnancy or immediately after the birth.
An examination of healing if you had an episiotomy or a caesarean.
Rescheduling cervical screening to 12 weeks after the birth if it fell due while you were pregnant.
Contraception.
Vitamin D advice if you are breastfeeding.
Weight and healthy-eating advice if your BMI is 30 or more.

Raise it at this appointment if you are leaking urine or faeces, struggling with wind, finding sex painful, or feeling sad or anxious. None of those is something to wait out, and postnatal depression is treatable. It is also the moment to check you are up to date with adult vaccines such as MMR.

Your baby's 6 to 8 week check

Usually done by a GP, this repeats the newborn physical examination your baby had within 72 hours of birth: eyes, heart, hips and, for boys, testicles. Some of what it looks for takes weeks to become detectable, which is why it is done twice rather than once.

Your baby is also weighed and measured, with length and head circumference recorded alongside weight. The GP or health visitor discusses the immunisation schedule, which starts at 8 weeks and continues at 12 weeks, 16 weeks, 12 months and before school. You will be asked again how you have been feeling emotionally and physically.

Tell your midwife, health visitor or GP if you have not been offered a physical examination for your baby before 3 days old, or between 6 and 8 weeks. Both are meant to happen.

Reviews after the first two months

Regular health and development reviews continue until your child is around two, usually with a health visitor or a member of their team.

9 to 12 months: language and learning, safety, diet and behaviour.
2 to 2 and a half years: movement, speech, social skills and behaviour, hearing and vision. It may take place at nursery or with a childminder if your child attends one.

Before the 9 to 12 month and 2-year reviews your health visiting team sends you an Ages and Stages Questionnaire (ASQ-3) to complete at home, where your child is relaxed. You do not have to finish it alone; the health visitor will help. If your baby was born prematurely, their developmental age is calculated from your original due date rather than the birth date until they are 2.

What to do if a contact does not happen

Postnatal care is the part of the maternity pathway most likely to fall through in practice, because it depends on handovers between three separate services: hospital maternity, community midwifery and health visiting. Missed contacts usually come from a records problem rather than a clinical decision.

Three checks are worth making. First, confirm your baby is registered with a GP — this does not happen automatically at birth, and without it the 6 to 8 week baby check and the immunisation invitations may never be issued. Second, if no health visitor has been in touch by about two weeks, phone your local health visiting team directly rather than waiting; the number is usually in the front of the red book. Third, book your own 6 to 8 week check with the GP surgery rather than waiting to be called, and say when you book that it is a postnatal check so the appointment is long enough.

None of this waits for a milestone. If you are bleeding heavily, feverish, in severe pain, or having thoughts of harming yourself or your baby, that is an urgent contact today, not something for the next scheduled review.

Where to get help

The NHS is the governing authority for postnatal care in the UK, and NICE guideline NG194 sets out what services should provide. Between scheduled contacts, your health visitor, GP or local baby clinic will see you without waiting for the next review. Postnatal bleeding normally stops after 6 to 8 weeks — speak to a professional sooner if it is heavy, smells offensive, or comes with a temperature above 38C.

Postnatal checks in the UK