After your baby has arrived

In the Bay of Plenty you have the choice to have your postnatal care following birth at home, in a primary birthing centre or at Hospital.

Your postnatal stay at a hospital or primary birthing centre is usually for 48 hours following birth. You will receive help and support on how to care for and feed your baby during this time, and can expect a daily visit from your midwife. 

Your midwife will then visit you within 24 hours of your discharge from hospital or a primary birthing centre, and continue caring for you with 7-10 home visits (more if needed) during the six weeks following birth.

Here is some more information about your postnatal stay choices.

Home birth

If you birth at home, whether planned or unplanned, you can choose to remain at home – unless your midwife assesses that you or your baby should be transferred to Hospital postnatal ward for a clinical reason.

If you birth at home you can also choose to have a postnatal stay at one of the Bay of Plenty's primary birthing centres. You will need to transfer there within 2-12 hours once your labour and birth care is complete.

Birth at a primary birthing centre

If you birth at a primary birthing centre you may want to return straight home following birth. If you and your baby are ready to leave, and your midwife has assessed you as clinically able, you can leave within 2-12 hours once your labour and birth care is complete. 

You can also choose to continue to stay at your primary birthing centre. The usual period of time for a postnatal stay is 48 hours following labour and birth care (or 48 hours from arrival at the birth centre). You can leave before the end of the 48 hour period if you want to. You can also talk to your midwife and the primary birthing centre about extending your stay if you have a clinical need or require further help and support.

Following birth at a primary birthing centre you can also choose to move to another primary birthing centre for your postnatal stay. You will need to leave the primary birthing centre you birthed in once your labour and birth care is complete (within 2-12 hours) and move to your chosen primary birthing centre for postnatal care.

All Waikato primary birthing centres have double postnatal rooms available so your partner or support person can stay overnight with you during your postnatal stay. Extended family can visit during the day – contact each individual birth centre about their visiting policies.

Primary maternity facilities

Primary birthing centres are a safe choice for many women, they may suit you if you have no complications during pregnancy and want to have home comforts in a relaxed atmosphere.

In the Bay of Plenty you have the option to birth at any of the following birthing centres. You can arrange to visit any of these places during your pregnancy, to see what they are like and get more information.

Bethlehem Birthing Centre

Ph 07 570 6106
Alt: 07 570 6115

1 Te Paeroa Road
Bethlehem
Tauranga 3110
Get directions 

Features:

• 12 rooms
• 11 have birthing pools, all rooms are designed to be labour and postnatal stay
• All rooms have queen sized beds
• All rooms are acoustically designed for maximum sound proofing for your comfort and equipped with smart TVs
• On site chef.

Murupara Community Health Centre and Birthing Centre

Ph 07 366 5734

51 Oregon Drive
Murupara
Whakatane
Get directions 

Please call for available facilities.

Opotiki Community Health Centre

Ph 07 315 8500

32A King St
Opotiki
Get directions 

Features:

• Two birthing rooms with bath
• Two postnatal rooms
• Located within community hospital

Birth at Hospital

If you birth at Hospital you may want to return straight home following birth. If you and your baby are ready to leave, and your midwife has assessed you as clinically able, you can leave within 2-12 hours after your labour and birth care is complete.

Many women who have their baby at Hospital choose to have their postnatal stay at one of primary birthing centres near their home. If you have a vaginal birth and you and your baby are well enough you can transfer to the primary birthing centre of your choice for a postnatal stay, within 2-12 hours after your labour and birth care is complete, this will be based on availability.

If you have a caesarean section and after 48 hours both you and your baby are medically able, you can go home or you can transfer to the primary birthing centre of your choice for a postnatal stay (if the end of the 48 hour period falls after 9pm you can transfer to the primary birthing centre at 9am the next day).  

Having your postnatal stay at Hospital

If you have complications or you or your baby have a clinical issue that needs monitoring and/or medical care, you will have your postnatal stay at Hospital maternity ward. The ward is a clinical environment for women and babies who need medical care.

Your stay at our hospital's maternity ward will be based on your clinical need, and you will not be able to move to a primary birthing centre for further postnatal care at the end of your hospital stay.

The maternity ward has few single rooms that are prioritised for women with high clinical need (they cannot be requested). If you are not staying in a single room, you will be staying on a ward with other mothers and babies.

Support people and visitors

There are no facilities to enable male partners to stay on the ward overnight (there are no bathrooms or shower facilities for males). Male partners can stay overnight in some circumstances if you are in a single room.

If needed a female support person can stay with you overnight, but please note there are no beds available for your female support person to sleep in, only bedside chairs for rest.

Male partners can stay during the day and relatives can visit during visiting hours.

If you have travelled from out of town

If you have travelled from out of town and your male support person or partner wants to stay near Waikato Hospital he will need to arrange his own accommodation. This is something to think about ahead of time if you live a long way from Waikato Hospital, even if you’re not planning to birth there, as things don’t always go to plan.

Even if you are planning a home birth, birth at a primary birthing centre, or to transfer to a primary birthing centre following birth at Waikato Hospital, you or your baby could have a complication and you may need to be transferred to or stay at the Waikato Hospital postnatal ward.

What you and your baby will need for your postnatal stay

• Nightwear and day time clothing for yourself.
• Toothpaste, toothbrush, shampoo, shower gel/soap, deodorant and other items for your personal needs.
• Clothing for your baby.
• Car seat and blanket for your baby when you leave the hospital.

Breastfeeding helps give your baby the best start for a healthy life, and has health benefits for you too.

Your breastmilk is specifically designed for your baby’s brain development and has everything in just the right amounts to be absorbed and digested easily. Your breastmilk changes from feed to feed, adapting to the needs of your baby as your baby grows. No other substance can do this.

Breastfeeding is natural but it doesn’t always come naturally. During pregnancy is the best time to learn about breastfeeding, so you have an idea of what to expect when your baby is born.

Breastfeeding apps and websites

There is a lot of helpful information about breastfeeding available online, and it’s well worth reading these apps and websites to find out more. 

• Breastfed App – you can download this app created by local health professionals for New Zealand women. The app includes comprehensive information and stories, information about how to breastfeed and sections with help and advice.
• Māmā Maia Breastfeeding Service – Bay of Plenty breastfeeding support.
• Breastfeeding (Ministry of Health) – breastfeeding information for mothers and supporters.
• La Leche League NZ – information and support from experienced mothers.
• Plunket – practical breastfeeding advice.
• Women's Health Action – information on women's health, including breastfeeding.
• Breastfeeding Friendly Workplaces – information for employers and employees.

Breastfeeding your baby in the first few days

If you are having a postnatal stay at Hospital or any of the Bay of Plenty primary birth facilities you will have support to help you breastfeed your baby in the first few days.

For women who have birthed at home, their midwife will be their main support at this time.  

Community breastfeeding support services

Breastfeeding can be challenging. Once you are home, take some time to read the apps and websites above to help you avoid or problem solve any breastfeeding issues you are experiencing.

If you think you have an infection or mastitis, continue to breastfeed and contact your midwife, GP, or Well Child Tamariki Ora nurse who will be able to help or refer you to the services outlined below.

The Ministry of Health, NZ College of Midwives, World Health Organization, NZ Paediatric Society and many more agencies interested in child health all recommend exclusive breastfeeding (nothing except breastmilk) from birth until your baby is about six months old, and then continued breastfeeding, with family foods too, for at least one year, or as long as you and your and baby want to keep going.

We acknowledges that a small number of women are unable to breastfeed their baby. Some women may choose to both breastfeed and formula feed their baby. Some women may choose not to breastfeed. However you choose to feed your baby, the staff at Hospital and the primary birth centres are here to help and support you. 

The information below will give you some general information about formula feeding, as well as other resources to lower any health risks for your baby. 

Preparing formula feeds

It’s important to make up formula feeds correctly and clean the bottles and teats carefully to avoid your baby getting sick. Formula does not have the same immune protection as breastmilk. Incorrectly made up formula can be too strong or too weak, meaning your baby could get too much salt (which can be harmful to their kidneys) or not enough food to grow well.

Formula is all your baby needs until they are around six months old. At around six months your baby will probably start eating some solid foods but will continue to need formula until 12 months of age.

It is not safe to use ordinary cow’s milk for babies under one year as their main food or drink.

Visit the Ministry of Health website for information about safe formula feeding.

Visit the HealthEd website for step by step information about feeding your baby infant formula, including how to clean and sterilise feeding equipment.  

Changing to formula feeding

If you have started breastfeeding and want to change to formula feeding only, talk to your midwife, Plunket or Well Child Tamariki Ora nurse, GP or paediatrician first for help and advice on making the change.

If you are making this decision because you are having difficulty breastfeeding, there is a lot of advice available to help you overcome any breastfeeding issues you are experiencing. 

• Take a look at the apps and websites listed under "Breastfeeding your baby".
• Talk to your midwife, GP or Well Child Tamariki Ora nurse for advice, they may be able to help you work through any difficulties you’re having or refer you to a lactation support service in your area for extra support.
• Call PlunketLine on 0800 933 922, a free parent helpline and advice service available 24 hours a day, seven days a week. Calls are free from mobile phones too.

Once you’ve stopped breastfeeding and changed to formula feeding it can be hard to change back again, because your milk supply will start reducing as soon as you stop breastfeeding. 

Changing to mixed feeding: formula feeding and breast feeding

If you have started breastfeeding but also want to formula feed (mixed feeding), talk to your midwife, Plunket or Well Child Tamariki Ora nurse, GP or paediatrician first for help and advice on making the change.

Giving formula to a breastfed baby (mixed feeding) will reduce your milk supply and may make returning to full-time breastfeeding difficult if you change your mind, however a lactation consultant can help you to build your supply up again.

Some mothers successfully mix feed their baby (both breastfeed and bottle feed). Their baby may be bottle fed in the day and breastfed in the evening and night, or another combination that suits the individual and her family.

Any amount of breastfeeding is good for your baby. Some babies want the comfort of breastfeeding, even if they are getting most of their milk from a bottle. Some mothers really enjoy this time and the convenience of being able to comfort their baby at the breast, or breastfeed their baby to sleep after a bottle feed.

Whichever way you choose to feed your baby, the important thing is that you both enjoy it and baby is growing well.

If you have any concerns about your baby’s health or growth then contact your midwife, nurse, doctor, or Healthline. 

During childbirth there can be trauma to your vagina and perineum (the area between your vagina and anus), including bruising, swelling, superficial grazes, minor or major lacerations (tears), or episiotomies.

Here are some tips on how to cope with and recover from a painful perineum.

Types of tears

There are four degrees of tears.

• First degree - perineal laceration extending through the vaginal wall and perineal skin.
• Second degree - extending into the perineal muscles.
• Third degree - involving the external anal sphincter.
• Fourth degree - involving the anal sphincter and anal wall.

Some tears and all episiotomies require stitches.

If you have had a third or fourth degree tear, you will have a six to eight week follow-up appointment with your obstetrician and physiotherapist. 

Coping with a painful perineum

• Get plenty of rest. Elevating your perineum by lying down will help reduce swelling.
• Begin pelvic floor muscle exercises within 24 hours to increase blood flow and reduce swelling.
• Apply ice to the affected area for 10 minutes and repeat regularly for the first one or two days.
• Wash your perineum with a squeegee bottle of warm water or a shower attachment. Pat dry with tissues or soft toilet paper. Keep clean and dry.
• When going to the toilet, always wipe from front to back to avoid infection.
• Change your sanitary pads frequently for comfort and to avoid infection. Firm fitting underpants that hold the sanitary pad in place without movement will help prevent rubbing on the wound. Never use tampons for postpartum blood loss.
• Calendula Mother Tincture can be applied to the wound on a warm, sterile natural sponge to reduce pain and swelling. Dilute calendula tincture in a jug of warm water can be poured over the perineum during urination (while you wee) to reduce stinging.
• Avoid constipation by drinking plenty of water and eating a high fibre diet.

Defaecating (or doing a poo)

• Put your feet on a stool in the toilet when doing a poo.
• Let your tummy fall into your hands.
• Bulge your lower tummy forward.
• Let your waist widen.
• Practice while sitting on a firm chair.
• If your tummy goes in, relax and start again.
• Try holding a soft clean pad firmly against the wound while pooing.

Pelvic floor exercises

How to do a pelvic floor contraction

• Tighten around your back passage (anus) as though holding wind.
• Draw up inside your vagina (birth canal) as if holding a tampon in place.
• Continue to pull up towards the front passage (urethra).
• Hold and keep breathing!
• Hold as long as you can, then slowly lower your hold (like going down in a lift).

How often to do pelvic floor contractions

• Every time you have been to the toilet, while still sitting on the toilet.
• Make this part of your daily routine, not just an exercise to fit in. (Make it a habit like tooth brushing).
• Don’t hold your breath or tighten your thighs or bottom.
• Do half of your maximum number (e.g. if you can do 10 contractions maximum then just do five each time).
• Hold your contraction for half of your maximum hold.
• Follow your hold with three quick flicks.
• Rest for about 10 seconds between each contraction.
• Do the contraction whenever you sneeze, laugh, push, lift, cough or exercise. Remember to tighten your lower tummy muscles as well.
• Be patient – it will be easier the more you practice. If you are not improving, ask for help.
• Remember it is not normal to be wet no matter how old you are.

If you have any concerns or queries you can contact your GP so they can refer you to the right care for treatment.

Although some women don’t want to have sex again for a while after giving birth, it’s ok to have sex once your birth canal or caesarean section wound has healed, the bleeding has stopped and you feel up to it.

Remember, it is never ok to be forced or coerced into having sex, even if you are married or in a long-term relationship. Here’s some information about that. It can take a while to feel ready for sex again – there’s no hurry.

When you are ready to have sex again, remember you need to think about contraception unless you want another baby again really soon.  

Contraception methods

If you are not breastfeeding you could, in theory, release an egg as soon as three weeks after giving birth, with the possibility of becoming pregnant again if you are having sex.

While breastfeeding can delay ovulation (egg release) for many women, you need to follow some rules about relying on breastfeeding as a contraceptive. It’s best to learn how to use this method from an accredited teacher, such as Natural Fertility NZ.  

Many methods of contraception are suitable after having a baby, but some hormonal methods aren’t suitable if you’re breastfeeding or have other health risk factors.

Talk to your midwife about your future plans while you are pregnant, and be sure to get some advice before you feel ready to have sex again. Your midwife can provide a starter pack of the oral contraceptive pill, and/or condoms for you while you are under her care.

Contraception services

Hospital services during postnatal care

Our hospital can prescribe free contraception, available at during your postnatal care:

• condoms and a three month supply of progesterone only pill or Depo Provera injection (continue with your GP or Hamilton Family Planning Clinic after three months)
• long acting reversible contraception (LARC)
  • Jadelle implant is available to women who meet a criteria on the postnatal ward.
  • Intra uterine device (IUD) - Copper or Hormonal (Mirena or Jaydess) is available for women having a planned caesarean section, talk to your doctor at your antenatal visit if this is of interest to you.
  • For all LARC contraception you will need to contact your GP or Hamilton Family Planning Clinic for removal/replacement. Visit the NZ Family Planning website for more information about LARCs.

Your midwife

Your midwife can prescribe the contraceptive pill and condoms for up to six months and emergency contraception for free while you are still in her care (there will be a $5 prescription cost to pick up the pill or condoms at a pharmacy)..

You will then need to see your GP practice or Family Planning Clinic for ongoing contraception.

Our BOP sexual health clinics

Our free and confidential service offers contraception, pregnancy tests, sexual health check-ups, treatments, advice and information.

Please call 0800 7233 5683 (0800 SAFELOVE) to speak with a clinic nurse or to make an appointment.

Please note this is NOT a 24 hour number. In addition, we cannot guarantee that we can answer your call during a clinic session.

If the phone is not answered, please leave your name and contact number and a Clinic Nurse will call you back (our work days are Wednesday, Thursday and Friday). If your matter is urgent, please call Tauranga Sexual Health Clinic on 07 579 8157.

Clinic 1 (Whakatāne) session times

Clinic 2 (Tauranga)

To make an appointment for Clinic 2 Tauranga please call 07 579 8157

Your GP practice

All GP practices can provide prescriptions for condoms, the contraceptive pill, Depo Provera injection and emergency contraception.

Most GP practices also offer long acting reversible contraception (Jadelle implant). Some practices offer intra uterine devices (IUDs). Check with your GP practice.

If you hold a community services card or meet eligibility requirements your appointment at your GP practice for contraception may be free or at a reduced cost. Check with your GP practice.

For all other women (over 25 years or living in Hamilton, or do not meet eligibility requirements) the cost will be the same as a normal appointment at your GP practice.

There will always be a $5 prescription cost to pick up the pill or condoms at a pharmacy.

Tauranga Family Planning Clinic

Tauranga Family Planning Clinic offers a range of contraception including the contraceptive pill, Depo Provera injection, Jadelle implant, condoms, intra uterine devices (IUDs) and emergency contraception.

If you are under 22 years old the appointment and contraception is free (there will be a $5 prescription cost to pick up the pill or condoms at a pharmacy).

If you are a community service card holder your appointment will cost $5 and the contraception is free (there will be a $5 prescription cost to pick up the pill or condoms at the pharmacy). For implant and IUD contraceptive services you may need two appointments. If you have a contraceptive implant (e.g. Jadelle) there will be a $10 dressing fee.

For all other women the appointment cost is $40. If you are having a contraceptive implant (e.g. Jadelle), or an IUD insertion (e.g. copper or Mirena),  you will also need a procedure appointment which costs $50. Those having an implant will have a $10 dressing fee.

In the first few days after birth the ‘baby blues’ are very common – about 60 per cent of women experience feeling a bit sad, crying for no apparent reason or feeling stressed during this time.

Some women have the opposite. They feel buoyant and have the ‘pinks’, feeling full of energy and very happy. These feelings are usually self-limiting and short-lived.

Both the baby blues or pinks are normal and will usually pass. These feelings do not need any treatment other than support.

Sometimes your feelings don’t pass, get worse, or they happen even though you’ve been feeling well. They could be a symptom of postnatal depression or psychosis, and in these situations it’s important to ask for help.

Postnatal depression

Postnatal depression is more common than most people realise. It can be a moderate to severe depression, and occur at any time during your baby’s first year. With treatment and support you can make a full recovery.

Visit the Health Navigator New Zealand website for more information about postnatal depression.

Postnatal psychosis

Postnatal psychosis is rare but is a very serious mental health disorder that needs urgent treatment. This disorder usually develops 2-4 weeks after having a baby, but can also develop earlier or later than this.

Postnatal psychosis may show as mood and behaviour changes and losing touch with what is real. If you are worried about this condition in yourself or a loved one, get help as soon as possible.

Visit the Mental Health Foundation website for more information about postnatal psychosis.

Getting support and treatment

If you are concerned about postnatal depression or psychosis you will need support and treatment. You can access help from the following services.

Your midwife

Talk to your midwife about your concerns. Midwives are recommended to ask all women how they are feeling using a screening tool at least once during pregnancy, and again after the baby is born. This screening tool helps screen for mental health symptoms, just like taking your blood pressure helps to screen for physical issues.

Depending on the outcome of the scoring sheet your midwife will direct you to the service you need.

Your GP

In the Waikato you can ask for an extended GP appointment with your doctor to talk about mental health concerns and symptoms, with more time than a normal appointment.

This service is free for a non-urgent appointment, but there may be a fee for an urgent appointment. Please check with your GP practice.

Following your GP appointment your doctor may be able to refer you for counselling with a qualified therapist service (ask your doctor for further information).

Get urgent help

If you feel very down or worried about your own or your partner’s mental health right now, and need urgent help: 

• talk to your midwife straight away, don’t wait
• call your GP practice and ask for an urgent appointment
• go to your nearest emergency department
• call the mental health crisis assessment team 0800 800 508 (Tauranga) or 0800 774 545 (Whakatāne)
• in an emergency call 111.

Helplines

You can also access the following helplines 24 hours a day, seven days a week, to talk to someone straight away for free.

• 1737, Need to Talk? – Text or call 1737 to talk to a trained counsellor.
• Depression Helpline – Call 0800 111 757 or text 4202 to talk to a trained counsellor.
• PlunketLine – Call 0800 933 922 for parenting help and advice.
• Lifeline – Call 0800 543 354 (0800 LIFELINE), text ‘Help’ to 4357.
• Suicide Crisis Helpline – Call 0508 828 865 (0508 TAUTOKO).
• Healthline – Call 0800 611 116.
• Samaritans – Call 0800 726 666.

Helpful websites

• Depression.org – information and resources to help with depression (includes Pasifika)
• Mental Health Foundation – information and resources to help with mental health and suicide prevention.
• Women’s Health Action – information about a range of topics including mental health.

“Look at you – Aroha Atu, Aroha Mai” video has information for you and your whānau to understand your baby’s social and emotional needs in the first three months of life.

The video has been developed by Counties Manukau District Health Board and is available in English, Māori, Samoan, Tongan, Cook Island Māori and Niuean. Open the link of your choice below to view the video:

• Look at you (English Version)
• Aroha Atu Aroha Mai Reo (Maori version)
• Pepe Vaai ia te oe e ese lou Samoa (Samoa version)
• Pepe Sio hifo kia koe Tonga (Tongan version)
• Pepe akara ia ana koe Cook Island (Cook Island version)
• Muke Onoono la kia koe Nuie (Nuie version)

PEPE (Parenting Education Programme) is a series of five courses aimed at supporting parents through the different stages of their child’s early development.

The transition to parenthood is a time of many changes. PEPE groups can play a significant role in helping parents through this process.

PEPE is a national programme developed by Plunket. The courses are designed to support parents in their parenting role, build parent confidence, and connect parents with other parents and local support and resources in their area.

Currently the PEPE programme consists of a series of five courses, free to all participants.

• Your New Baby – Parenting in the first six weeks.
• Your Growing Baby – Parenting from 6 weeks until baby is rolling or crawling.
• Your Moving Baby – Parenting when baby is moving but not yet walking.
• Your Active Toddler – Parenting from around 14 months to around 2.5 years.
• Your Curious Young Child – Parenting from 2.5 years until your child is at school.

Find your local Bay of Plenty Plunket branch for more information or to register.

The Well Child Tamariki Ora programme is a series of health visits and support that is free to all families of children from around six weeks up to five years of age.

Well Child Tamariki Ora nurses are experts in child health and growth. Your nurse will support you to protect and improve your child’s health. The Well Child Tamariki Ora visits cover:

• child growth and development
• family health and wellbeing
• immunisation information
• oral health (teeth and gum) checks
• early childhood education
• vision (sight) and hearing
• health and development checks for learning well at school.

Visit the Ministry of Health website for more information about Well Child Tamariki Ora visits.

Talk to your midwife about which service is right for you and covers your area. Your chosen service will contact you to set up your first visit.  

Bay of Plenty Providers

Plunket (Tauranga)

471 Devonport Road
Tauranga

Ph 07 578 7811
bayofplenty@plunket.org.nz
plunket.org.nz

Tamariki Ora

1 Tebbs Lane,
Gate Pa
Tauranga

Ph 07 578 7811
tamarikiora@temanutoroa.org.nz
temanutoroa.org.nz