Your body

Happy in hospital

A HOSPITAL WILL never be as comfy and cosy as your own home, yet most moms prefer to welcome their babies there for peace of mind and safety’s sake. Despite the often clinical environment, the first meeting with your little one remains very special. But after those first ecstatic moments, it’s easy to feel a little overwhelmed by the foreign environment and routine. If you know what to expect in hospital, you can use this time to prepare yourself so that you can take care of baby at home with less pressure. Here’s what you should know.

AFTER THE BIRTH

Procedures around the first few hours after baby’s birth vary dramatically from hospital to hospital. At some hospitals it’s standard procedure to separate mom and baby directly after birth, so that the little one can be examined (dad usually tags along), and mom can get a breather and recuperate. During the examination baby gets a bracelet to identify him. In other facilities, baby will be

put to mom’s breast for a little while straight after birth in order to stimulate breastfeeding, before being taken to the nursery until it’s time for the first feed. The rising trend at private hospitals is for babies to be examined and weighed there and then in the maternity ward under mom’s watchful eye, and straight afterwards, if baby is healthy, he’ll be passed to mom for the first nursing session. Skin-to-skin contact is always recommended. So mom, dad and baby can be together and are given some alone time to bond with baby. Then the family officially moves to the postnatal ward. Mom is usually encouraged to take a bath or shower while baby’s in the maternity unit’s nursery or with dad. Mom gets something to eat or drink, depending on the time of day. With caesarean sections things go a little differently, as baby might need to spend some time in the incubator or be monitored. Because you’re not as mobile following a c-section, some hospitals will allow dad to do skin-to-skin in the nursery (you can ask) while you recover or get cleaned up in your room. In other hospitals baby is just taken to the nursery, and you only get to see him after 45 minutes or longer. It’s ideal for baby to breastfeed as quickly as possible, preferably within the first golden hour following the birth. Ask the hospital before your admission what their procedure is so that you know what to expect. If you’d like to do things differently – if you’d like skin-to-skin contact first and try to feed before baby gets taken away – ask if it’s a possibility, otherwise the nursing staff will stick to their normal procedures. Sister Anna Duarte, unit manager of the maternity division at Panorama Mediclinic in Cape Town, says antenatal classes at the hospital where you’ll be giving birth prepare you for the routines and procedures of that specific institution. “Some people who run antenatal classes have never worked in a hospital before and sell fairy tales to expectant parents, who then have unrealistic expectations,” says Sr Anne. NURSERY OR FAMILY ROOM? More and more hospitals have the option to room in, where you have baby with you in the room the whole time, rather than in the nursery and only with you for feeds. You accept full responsibility for your baby’s care – from changing nappies to feeds – although you can call in the help of the nursing staff at any time. If you go and shower or have to leave the room for any reason, you have to take your baby to the nursery. You may be too tired for this after birth. Anna says they give new moms the choice on the first night if they want to keep the baby with them for the whole night or send them off to the nursery so that they can get some rest after the birth and only see baby for feeds. Some women prefer having their babies in the nursery so that they can get as much rest as possible before going home, but Anna recommends that the baby spend at least the last night in the room with mom to prepare for when they’re home all by themselves. “Many moms feel they pay us to look after their baby. But it’s important for them to bond with their babies in hospitals already and practise handling them while there’s help around.” WHO’S BOSS? If you’re a little unsure, you might easily feel you have no say over your baby and that the nurses are actually in control. Remember, it’s your baby. Accept responsibility for him; don’t feel intimidated by the nurses. They’re there to help you. If you have specific preferences, ask. It’s your right. If you don’t ask, the nurses will follow their normal procedures. But accept that safety always comes first. Tell the nurses if you feel uncomfortable with anything. Although the nursing staff is there to help, they’re busy. You’ll get the best results if you treat them with respect and make requests in a friendly but firm way rather than stamping your foot. If you feel sensitive, ask your husband to communicate your needs to them. MORE ABOUT… Visitors It’s often a sensitive matter, especially when there’s a gaggle of anxious grandparents clambering to get to see as much as possible of the newbie. Most hospitals have set visiting hours. Dads are usually given freedom to come and go as they wish until about 8pm in the evening, while morning visits are usually reserved for siblings and grandparents, and other visitors are allowed in the afternoon. Most hospitals only allow moms and dads into the nursery, and some also insist that babies must be in the nursery during visiting hours, so that grandparents can only catch a glimpse through the window. Anna recommends limiting visitors so that the family can bond first. Pain One of mom’s biggest concerns during those first three days is pain, especially after a c-section. Many moms prefer not to take painkillers, but Anna recommends taking them. They’re safe for breastfeeding. Your emotions You can expect to feel tired and shaky after birth, but ecstatic at the same time because of the endorphins that are released. You may struggle to settle down and get some rest. It’s also normal to feel a little weepy by the third day. “Many new moms are too strict with themselves, especially if they have trouble breastfeeding. But it’s like riding a bicycle: you have to fall off a couple of times before you understand how to stay on. Don’t expect yourself to be perfect. There is no perfect mom,” Anna advises. If you feel like you’re battling on an emotional level, ask for help. Many hospitals have a psychologist on call. The hospital routine It can be exhausting: Starting as early as five in the morning with a nurse taking your blood pressure and temperature, followed by medicine rounds, doctors’ rounds, your breakfast or the cleaner coming to empty the bins. Later in the day you need to fit in a visit from the lactation consultant, administration staff might bring in forms, menu choices are offered, it’s tea, coffee and meals, bath demonstrations and visitors… You’re busy all day long until ten at night. Regular observation of

ASK THE HOSPITAL BEFORE YOUR ADMISSION WHAT THEIR PROCEDURE IS SO THAT YOU KNOW WHAT TO EXPECT. IF YOU’D LIKE TO DO THINGS DIFFERENTLY, ASK IF IT’S A POSSIBILITY

mom and baby is necessary for patient safety, so it’s non-negotiable, Anna says. The secret is to make the most of every opportunity to take a nap. THE IDEAL LEARNING OPPORTUNITY See your time in hospital as an opportunity to learn new skills while you have very experienced staff right there beside you. Remember, the nurses aren’t there to find fault. They see new moms feeling insecure every single day – they’re used to it. “If you battle in hospital or have a problem, a nurse is just a ring of a bell away,” Anna says. Bath time In some hospitals your baby’s bathed shortly after birth, but at other facilities the policy is not to bath the babies within the first 24 hours to allow the vernix to be absorbed by the skin. The nurses usually bath your baby the first time, while you watch and learn. (Make sure you know when they’ll be bathing your baby so you can be there. Involve your man as well so that he can see how it’s done.) The next day, they’ll expect you to bath baby yourself under their watchful eye. It can be nervewracking, especially if the limp little body is slippery in your arms, but don’t feel intimidated. Nappy changes If you’re unsure about when and how to change your baby’s nappies, ask the nurse to be there while you do it for the first time. She should also show you what to do with the umbilical cord and how to take care of it. She can recommend products to use, and what’s normal in baby’s nappy and what isn’t. Breastfeeding It’s probably the most important skill you can master while you’re in hospital and still have nurses or a lactation consultant nearby. The advice can vary from nurse to nurse – like many things in life, there’s not only one right way – so see what works for you. After the nurses have helped you for the first time, try it without their help to see if you can get it right. Ensure that you know how to let baby latch and release by the time you go home, and also what to do if you have tender nipples at a later stage. Self-care The nursing staff should give you clear advice about how you should handle and take care of a c-section incision, stitches after a natural birth and sore boobs or nipples when you’re home. Make sure you know what kind of bleeding is normal, what the signs of infection are, and that you are able to recognise the symptoms of postnatal depression.