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The fundal massage and 6 other things that happen straight after birth

There is a moment just after you give birth. A moment when time stops and you finally get to hold the baby you’ve been dreaming about seeing for the past nine months. But whilst you’re catching your breath and giving those magic first kisses, your midwife is busy doing a lot of very important postnatal checks. Here are just some of the things that are going on…

What are postnatal checks after birth?

Postnatal checks after birth are really important. They’re sometimes referred to as postpartum assessments or monitoring. They are the examinations that the medical team conducts shortly after birth to make sure you and your baby are recovering properly.

Why are postnatal checks important?

Postnatal checks are important for lots of reasons. The main aim is to identify any potential complications as soon as possible, support recovery, and provide guidance for the fourth trimester and postnatal period. Some of the checks include monitoring blood loss, assessing any vaginal tearing, supporting skin-to-skin contact and wound assessment (for C-Section mamas).

What checks happen after birth?

A lot really does happen after giving birth but you might be so engrossed in your new baby that you won’t really notice what’s going on. However, your midwife will be very busy looking after you and your baby. Here are some of the assessments and monitoring that they’ll be doing:

  • Monitoring your vital signs, such as blood pressure, heart rate, and temperature.
  • Evaluating the size, position, and firmness of the uterus to ensure it is contracting appropriately.
  • Checking for signs of excessive bleeding or other complications related to the uterus.
  • Inspecting the perineal area for any tears, lacerations, or signs of infection.
  • Assessing your emotional well-being and mental health.
  • Monitoring postpartum bleeding (lochia) to ensure it is within normal limits.
  • Examining incisions, such as those from a C-Section or other surgical interventions.
  • Monitoring for any symptoms of blood clots.
  • Assessing postpartum swelling.
  • Monitoring your baby’s health, weight, and overall well-being.

What is the fundal massage?

During pregnancy, the uterus enlarges to accommodate your growing baby. After delivery, the uterus needs to shrink to limit bleeding and return to its pre-pregnancy size. A fundal massage helps stimulate the uterus to contract. Your midwife will ask you to lie on your back whilst she presses on your tummy to find the fundus (top of the uterus). Using gentle but firm pressure, she will then massage the fundus in a circular or kneading motion. This helps the uterus contract and also enables her to monitor for changes in size, firmness, and position.

Does the massage hurt?

The massage can be uncomfortable for some women, but it shouldn’t really be painful. As the purpose of the massage is to stimulate the uterus to shrink, it is likely that you will experience some after-birth pains.If you find the massage particularly painful or have concerns, it’s essential to tell your midwife so they can adjust their approach or offer pain relief options.

6 other postnatal checks to know about

In addition to the fundal massage, here are six other checks that happen after birth to help you recover:

1 .Umbilical cord clamping and cutting

The umbilical cord is what connects your placenta to your baby. It is the lifeline that has helped keep your baby alive whilst growing in your tummy by delivering oxygen and nutrients. After giving birth, the umbilical cord is still working hard and so it is advised not to immediately cut the cord. Instead, it is recommended to delay cutting the cord to allow for the transfer of blood from the placenta to the baby. Typically, the cord will turn from red to white. It can then be clamped and cut by you, your partner or a midwife.

2. Skin-to-skin contact

After delivery, it is common for your midwife to immediately place your baby on your abdomen or chest for skin-to-skin contact. This special time (sometimes referred to as the Golden Hour) has so many positive benefits. Research has shown that skin-to-skin after birth is great for promoting bonding, regulating the baby’s temperature, and encouraging the start of breastfeeding.

3. Perineal care and potential repair

If there are tears or an episiotomy (a surgical cut to the perineum) that occurred during delivery, the midwife may perform perineal care. This might include having the wound repaired with stitches.

4. Apgar Score: Assessment of your newborn

A quick assessment of your baby’s overall well-being is conducted using the Apgar score. This evaluation, usually performed at one and five minutes after birth, assesses the baby’s heart rate, respiratory effort, muscle tone, reflexes, and skin color.

5. Incision care (after a C-section)

Monitoring the incision site (where the surgical cut was made) is essential for assessing healing and preventing infection. The medical team will regularly check for signs of redness, swelling, or discharge and provide guidance on caring for the incision.

6. Monitoring for complications

Things can change quickly after giving birth so it’s really important to check in with your body. Your midwife will also be monitoring you closely for any signs of complications, such as blood clots, swelling or changes in heart rate. Your vital signs, such as heart rate, blood pressure and temperature, will be repeatedly monitored to make sure you’re recovering well.

If you have any concerns about how you’re feeling after giving birth, ask your midwife, health visitor or GP straightaway. Giving birth is a really big deal – emotionally, physically and mentally – so it’s crucial that you ask questions, talk about how you’re feeling and make sure you recover well.

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8924870/#:~:text=Uterine%20massage%20involves%20placing%20a,and%20thus%20to%20reduce%20haemorrhage.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235060/#:~:text=Newborns%20at%20Birth&text=Compared%20with%20newborns%20who%20did,thermal%20regulation%20(Moore%20et%20al.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353264/#:~:text=The%20World%20Health%20Organization%20recommends,least%202%20minutes%20after%20birth.

 

 

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