Hesperian Health Guides

Care After the Birth

In this chapter:

Just after the birth

Encourage the parent to breastfeed the baby. This will help stop any bleeding sooner. Also:

  • Feel the top of the womb. It should be hard and rounded, at about the level of the navel. If the womb feels soft, ask the person to pass urine, then rub the womb until it gets hard. Keep checking the womb to see if it gets soft again. Check for bleeding. Teach the person how to feel their womb and rub it if it gets soft.
  • Look at the vagina. If there is a long, deep tear or a tear that will not stop bleeding, it should be stitched by someone who knows how.
  • Give plenty to drink and eat as soon as the person feels hungry.

Baby Care

Keep the baby and parent together so the baby can stay warm and breastfeed as often as it wants. Encourage the family to keep the baby warm and clean and to let it suckle as often as it likes.

Babies often have a little yellowish mucus coming from their eyes in the first weeks after birth. You can wash out the eyes with breast milk or cool, boiled water and a clean cloth. If the baby’s eyes get red, swollen, and have a lot of pus in them, see a health worker.

If the birth parent has HIV, giving HIV medicines to the baby after birth can protect the baby from becoming infected.

Care of the cord

Keep the cord stump on the baby clean and dry. If possible, clean it with alcohol and a clean cloth with every diaper (nappy) change. It will turn black and fall off during the first week. You do not need to cover it with anything unless there are flies or dust. Then you can use a very clean piece of gauze or cloth to cover it loosely.

If you notice redness or pus around the cord, the baby may have an infection. The baby should be seen by a health worker and be given antibiotics right away.

Tetanus of the newborn

What to do:


Take the baby to a health center or hospital right away.

If the hospital is more than 2 hours away and you know how, first inject the baby with 100,000 Units of benzathine benzylpenicillin in the thigh muscle.

In the first weeks after birth

Someone who has just given birth needs care afterward. This is often forgotten because people are so busy looking after the new baby.

  • To prevent infection, they should not have sex or put anything in their vagina until their bleeding stops.
a woman lying in bed next to a baby
  • They should get a lot of rest for at least 6 weeks.
  • They should try to stay clean—to wash well and keep their genitals clean. While bathing, do not sit in water until a full week passes after the birth.
  • Someone who just gave birth needs to eat more food than usual. Any kind of food—fish, meat, beans, grains, vegetables, and fruit—will all help someone heal from the birth and have energy to be a good parent.
  • They should drink plenty of fluids.
  • If they are breastfeeding and giving no other liquids to the baby, breastfeeding can protect against getting pregnant again too soon. For best protection, see the instructions in Behavioral Methods of Family Planning.
a woman breastfeeding a baby while sitting in a wheelchair
  • If there is a tear at the opening of their vagina, it should be kept clean. They can apply a hot, damp cloth and honey to the tear to help it feel better and to heal more quickly. If the tear is painful, pouring water over their genitals while passing urine may help.

Any plant medicines used to help the genitals heal should be clean (boiled is best). Do not put plant medicines inside the vagina.

  • Help the parents start a family planning method, especially if the baby is fed anything in addition to breast milk Using a family planning method will protect against another pregnancy happening too soon. See the benefits of spacing children with family planning.

If the birth parent says they do not feel well, watch carefully for signs of infection

Danger Signs in the First Few Days After Birth


Bleeding that starts more than a day after the birth is most often caused by pieces of placenta left in the womb or womb infection.

What to do:
  1. If the womb feels large and soft, firmly rub or squeeze it until it gets very hard and the bleeding stops. Have the baby suckle, or have someone roll the parent’s nipples.

  3. Give medicines to stop the bleeding.
  4. Get medical help. Continue to squeeze the womb as you go
  5. If there are signs of infection, give antibiotics for womb infection.

Womb infection

Infection of the womb is very dangerous. It must be treated or it can cause infertility or death.

Danger signs of womb infection:
a woman holding her belly in pain next to a bed where a baby sleeps
  • fever and chills
  • pain and tenderness in the belly
  • bad-smelling fluid from the vagina

Medicines to treat womb infection
Medicine: How much to give: When and how to give:
ampicillin 2 g (2000 mg) first time only inject in the muscle, then reduce dose to 1 g (1000 mg) 4 times a day
80 mg inject in muscle, 2 times a day
500 mg by mouth3 times a day
Stop giving these antibiotics after 48 hours with no fever. Then give the antibiotics below.
When fever has been gone for 48 hours, give:
100 mg by mouth, 2 times a day for 10 days
500 mg by mouth 3 times a day for 10 days
amoxicillin/clavulanic acid
500 mg amoxicillin + 125 mg clavulanic acid by mouth 3 times a day for 10 days

This page was updated:22 Jan 2024