Postnatal checks in Ireland: the 2-week and 6-week appointments

The schedule, in order

Ireland's postnatal care is unusually clearly defined, because it is written into the Maternity and Infant Care Scheme. If you registered for the scheme, the appointments below are free, with or without a medical card.

The sequence is: examinations in hospital, a newborn clinical examination within 72 hours, a public health nurse home visit in your first days at home, a GP appointment for your baby at 2 weeks, and a GP appointment for both of you at 6 weeks.

In hospital and the first 72 hours

A midwife examines your baby daily during your hospital stay, asking about feeding patterns and wet and dirty nappies, checking for jaundice and looking at the umbilical cord area.

Your baby should also have a full newborn clinical examination within 72 hours of birth, carried out by a doctor or specialist midwife. If your baby was born in hospital this usually happens before you go home; after an HSE home birth, your baby is examined by your GP or at a maternity hospital. It covers:

• eyes — a light is shone into the eyes to detect clouding of the lens
• heart — pulse and oxygen levels are checked
• hips — the legs and hips are gently bent to detect dislocation; further tests may follow if your baby was breech or there is a family history of childhood hip problems
• testicles — checked to confirm they are in the right place, if your baby was born a boy
• hearing — a screening test for echoes in the inner ear using a soft earpiece

You may also be asked about your pregnancy and birth, health problems in your family, and any concerns you have.

The public health nurse visit

You will usually get a home visit from your public health nurse during your first 3 days at home with your baby. If you were on a Domino scheme, your first home visits come from a midwife who then hands over to the public health nurse. After an HSE home birth, your community midwife notifies the nurse, who visits after you are discharged from midwifery care.

Your public health nurse will usually weigh and examine your baby, carry out a neonatal examination, and carry out a maternal health assessment — a check-up for you, not just the baby. They will also give advice on feeding, safe sleep and child safety, and connect you to local resources.

Your public health nurse continues to see you and your baby at intervals over the next 4 years. This is not a one-off visit, and it is worth using.

The heel prick test is also offered during your baby's first week, usually at home, and usually in hospital instead if you are still there more than 72 hours after the birth. Contact your public health nurse if you want to know the result.

The GP checks at 2 and 6 weeks

Under the Maternity and Infant Care Scheme your GP examines your baby at 2 weeks, and both mother and baby at 6 weeks.

The 2-week visit is mainly to re-establish contact with your GP and to check how you and your baby are getting on. It is short, and it is the natural moment to raise anything that has gone wrong in the first fortnight.

At the 6-week visit, your GP or a hospital paediatrician examines your baby to check development, measuring weight, length, head circumference and hips, and discussing feeding patterns and general health. You can have this at your GP or at your maternity hospital.

Your own postnatal check

Your check and your baby's 6-week check can be done by your GP in the same appointment, but they are two different examinations and you should treat them that way.

After an uncomplicated delivery, your postnatal check-up happens after 6 weeks, carried out by your GP or your obstetrician. It may include examining your wound if you had a caesarean section or a tear, checking your blood pressure — particularly if it was raised during or after pregnancy — and weighing you, with advice if your BMI is high.

It is also the right appointment for contraception, which your GP or obstetrician can advise on, and for breastfeeding questions. If you are due cervical screening, they may schedule it for 3 months after the birth.

Your mental health is part of this, not separate from it

Postnatal depression affects 10 to 15% of women within the first year of giving birth. That is not a rare complication; it is a common one, and the six-week appointment is a scheduled opportunity to raise it.

You do not have to wait for that appointment. You can contact your GP, midwife or public health nurse at any point before it if you feel worried about your mental health or that something is not right, and support is available whether your symptoms are mild or severe.

If you have any thoughts of harming yourself or your baby, contact your GP or the GP out-of-hours service immediately, or call 112 or 999. That is an emergency, and it is treated as one.

Where to get help

Your GP and your public health nurse are the two people who carry your postnatal care between them, and either can escalate. Your maternity unit remains available for questions relating to the birth itself. If you did not register for the Maternity and Infant Care Scheme, ask your GP about registering, since it is what makes these visits free.