Postnatal Care in Kenya: The Checks You and Your Baby Need, Up to the 6-Week Visit

Short answer: After giving birth, you and your baby need at least four postnatal checks: within the first 24 hours, around day 3, between weeks 1 and 2, and at 6 weeks, following WHO guidance. These visits check healing, bleeding, blood pressure, feeding, your baby's growth and vaccines, and your mood, and they are the right time to choose a family planning method.

The baby is home, visitors are arriving with sugar and unga, and someone has already cooked a pot of uji. In the middle of it all, it's easy for a new mother to put her own health last. But the weeks after birth are when some serious problems first show up, for mother and baby alike. Postnatal checks are how they are caught early.

When are the postnatal visits?

If you gave birth at a facility, try to stay at least 24 hours so the first check happens before you go home. Your Mother & Child Health (MCH) booklet records every visit, so bring it each time.

What is checked for the mother?

• Bleeding. Some bleeding (lochia) is normal for a few weeks and should gradually lighten.
• Your womb shrinking back as expected.
• Blood pressure, because high blood pressure can still develop after birth.
• Temperature and signs of infection, including your stitches, tear or caesarean wound.
• Breasts and nipples, for pain, cracks or a hot, red area.
• Passing urine and stool without difficulty.
• Anaemia, especially if you lost a lot of blood. Your clinician may advise continuing iron supplements.
• Your mood and sleep.
• Follow-up of any antenatal results, such as HIV or syphilis screening, where needed.

What is checked for the baby?

• Weight and growth, plotted in the MCH booklet. Babies often lose a little weight in the first days and regain it by about two weeks.
• Feeding, including latch and how often your baby feeds.
• The cord stump, which should stay clean and dry until it falls off.
• Skin colour, looking for jaundice (yellow skin or eyes).
• Breathing, temperature, eyes and skin.
• Immunisations. BCG and the birth dose of polio vaccine are given at birth, and the next vaccines are due at 6 weeks. See the Kenya immunisation schedule.

Many families find it easiest to plan the mother's 6-week check on the same day as the baby's 6-week vaccines.

Family planning after birth

You can become pregnant again before your first period returns. Giving your body time to recover between pregnancies is healthier for you and your next baby, so it helps to decide on a method early.

• Many methods are safe while breastfeeding, including implants, the copper coil (IUCD), progestin-only pills and the injection. A provider will advise on timing.
• Some methods, such as combined pills, are usually not recommended in the first months of breastfeeding.
• Exclusive breastfeeding can delay pregnancy only if your baby is under 6 months, is fed only breast milk day and night, and your periods have not returned. Once any of these changes, use another method.

Compare options in our guide to family planning methods in Kenya.

Looking after your mood

In the first two weeks, many mothers feel tearful, anxious or irritable. These "baby blues" usually pass on their own. Postnatal depression is different: it lasts longer and can make daily life feel very hard. It is common, it is not a sign of weakness, and it can be treated.

Talk to a health worker if, for more than two weeks, you:

• Feel low, hopeless or empty most of the time
• Have lost interest in things you used to enjoy
• Can't sleep even when the baby is sleeping, or sleep all the time
• Feel unable to cope or unable to bond with your baby

If you have thoughts of harming yourself or your baby, seek help immediately, at any hour. Partners and family: listen without judgement and help her get care.

When to seek care immediately

Don't wait for your next scheduled visit if you notice heavy bleeding, fever, a severe headache or blurred vision, a painful swollen leg, difficulty breathing, or a baby who is not feeding, is very sleepy or has a fever. Read the full list of warning signs after birth. In an emergency, call 999 or 112.

How Primegala can help

Primegala Medical Centre at Maili Sita offers postnatal checks for mother and baby, family planning counselling and child health visits, and we are open 24 hours if something worries you between visits. Learn about maternity care, family planning and child health, or book a postnatal visit.