Postpartum home visits

When new parents go home with their baby for the first time, there are many things to consider. Now begins the wonderful period when parents get to know their new baby - but at the same time, the mother is recovering from childbirth and parents are figuring out their new roles. There is also a lot to think about when it comes to breastfeeding and caring for your baby - apart from all the questions new parents have. Fortunately, the new family is offered good support during these first days, at a health care institution, at home or at both places. About 90% of women receive home care services from a midwife for the first 10 days after birth. Women who need to stay at the hospital for more than 3 days after giving birth or have a baby who is in the neonatal intensive care unit will receive services first from the health institution and then later from a nurse at their local health care center.

Postnatal care has changed a lot in recent years. Most people have probably heard of “sængurlega” or “lying-in” which was the norm a few decades ago, when women would lay for a few days after birth at a birth center or hospital, where they received care from midwives and help in taking care of the baby after birth. Today, women usually go home a few hours after giving birth, and most women are home with their baby within 24-48 hours of giving birth. Before women go home from the hospital or health institution, the staff contacts the midwife who will provide home care services. Women receive the phone number of their home care midwife, and they can then contact her directly to find a suitable time for the first visit at home.

Continuous care

One of the things that many people find convenient about having a midwife at home is that there is one person - or a team of several midwives working closely together - to take care of the family. The same professional provides you with education and support during these first days – and, in that way, the service will be more personalized and purposeful. Trust develops between the woman and her midwife, and they can ask general questions, discuss sensitive issues and everything in between.

Choosing a home care midwife

The family has a choice as to which midwife takes care of them in home care, and you can find a list of those midwives here. Many of them provide both prenatal care and postpartum care or intrapartum care and postpartum care - so you should ask your midwife in prenatal care, or the midwife who attended your birth or cared for you postpartum, if she could also provide homecare services for you. In this way, you can achieve more continuity in care with a midwife who you know and have formed a relationship with. Midwives of the Reykjavík Birth Center provide home care for families in the capital area, whether they have given birth at Landspítali hospital or elsewhere.

What happens in postpartum homevisits?

When parents bring their baby home after birth, many questions arise. It is therefore a relief for many to know that a midwife will visit almost every day for the first ten days after birth. She can answer these questions, provide you with information about many things related to the baby, but also about the physical and mental well-being of the mother. She is also supportive of a new father/mother who is settling into their new role.

In the first home visit, the main task is usually to help with breastfeeding. Questions are then answered, and the mother is assisted with breastfeeding, such as making sure the baby latches onto the breast correctly. If there are any problems such as sore nipples, she can give advice on the position of the baby or how the baby takes the breast. You will also receive information on how often it is recommended to breastfeed the baby and for how long. The rule of thumb here is that the baby breastfeeds at least 8-12 times a day, but often they breastfeed much more often in the first 2-3 days. They are likely to be at least 15 minutes on each breast each time or longer.

In this first visit, you will also discuss the birth. How you experienced the birth and if you have any unanswered questions. Maybe you want more information about some of the interventions that were done, and maybe there was something that surprised you that can be good to talk about. Maybe the birth was a positive experience, but maybe the birth didn't go as you would have liked. In both cases, your midwife will be there to listen.

From the very first visit, a lot of time is spent helping you with breastfeeding. Sometimes it can go very well without any problems, but it is more common that women have various questions and want help with putting the baby to the breast correctly, especially with their first child.

On the third day, it is recommended to weigh the baby. It is normal for a baby to lose 5-7% weight after birth, but if the baby is losing more weight, the midwife will assess whether the baby is getting enough nutrition. A baby who is generally healthy and has been born after 37-42 weeks of gestation usually does not need anything other than breast milk in the first few days after birth.

On the third day, the midwife will offer to take a blood test for your child, which screens for serious, congenital diseases such as hypothyroidism, phenylketonuria and various hereditary metabolic diseases. The screening is done at this time because early diagnosis leads to more effective treatment. This blood test can be done at home, and most midwives take a blood test from the baby's heel. It is recommended that the baby is breastfed for the duration, this way he/she feels most comfortable and is in the safe embrace of his/her mother during the blood test. The blood sample will be sent to the laboratory at Landspítali Hospital, and the results are available within a week. You will only be contacted if the blood test needs to be repeated or the results indicate further investigations. No news is good news!

If the mother gave birth by caesarean section, the staples are taken on the fifth day after birth. This is also done at home. Removing the staples is completely painless, and most women actually feel some relief after the staples are taken. The midwife will provide information on how to care for the wound and other things that may be helpful to know in the first few weeks after a caesarean section.

The well-being of mother and child is assessed at every visit. A midwife measures blood pressure, evaluates the uterus and bleeding, gives you tips on how to reduce pain and generally increase your well-being. Your midwife also assesses your baby's well-being, both by weighing him but also by observing his behavior and skin color (to assess jaundice).

During these first ten days, the midwife will visit you 5-8 times and she will get to know the family well. The number of visits depends on whether the mother has had her first child or not, the state of health of mother and child, and it is the midwife's assessment of how many visits are suitable for each family. Sometimes fewer visits are needed and sometimes more. There will be time to answer questions about everything, such as about guest visits, diaper changes, parenting, pacifiers, diet, sex after birth and the first outside walk with the baby.

Before the midwife finishes her visits, you are offered assistance with bathing the baby for the first time. This is often done about a week after the birth of the child and is a wonderful moment.

Who pays for the home care?

Iceland's health insurance pays for the services of midwives in the postpartum period, so the service is free of charge.