0
Skip to Content
Melanie V. Chevarie B.Sc (Midwifery), MEHP, CPM, LM
Women’s Health
About
Melanie V. Chevarie B.Sc (Midwifery), MEHP, CPM, LM
Women’s Health
About
Women’s Health
About

END OF PREGNANCY · 37 WEEKS TO BIRTH

The Waiting Weeks: 37 Weeks and Beyond

Signs that labour is near, when to call your midwife, what “due date” really means, and how to rest into the waiting instead of pushing against it.

  • Your baby. Full term from 37 weeks. Baby may drop into your pelvis, and fat and immune protection keep building. Movements change in quality, not in frequency.

    Your body. Your cervix ripens. You may lose your mucus plug and feel pelvic pressure, loose stools and a burst of nesting energy, with readiness and impatience taking turns.

    Focus on. Only about 4% of babies arrive on the due date; 40 weeks is the middle of a normal window from 37 to 42. Know when to call: regular contractions, waters breaking, bleeding, or fewer movements.

  • Pelvic pressure

    • Nourish & daily life: Rest on hands and knees or on your side; a warm bath.

    • Herbal & natural: A belly band, circles on a birth ball.

    • Call your midwife if: Pressure comes with regular tightening before 37 weeks.

    Prodromal (false) labour

    • Nourish & daily life: Alternate rest and walking. Eat, drink, and sleep while you can.

    • Herbal & natural: A warm bath, massage, the Miles circuit for positioning.

    • Conventional care: Talk with your midwife about rest options if it is exhausting.

    • Call your midwife if: Contractions reach 5-1-1 (every 5 minutes, lasting 1 minute, for 1 hour), or sooner if you've had a fast birth before.

    Insomnia and restlessness

    • Nourish & daily life: Daytime naps, pillows, a calm evening routine.

    • Herbal & natural: Lemon balm, chamomile, magnesium.

    • Call your midwife if: Anxiety is affecting your daily life.

    Impatience and pressure from others

    • Nourish & daily life: Think of a due month, limit updates, plan pleasant things.

    • Herbal & natural: Rest, nature, connection.

    • Call your midwife if: You feel low or afraid of birth. Ask for support.

    Back pain in early labour

    • Nourish & daily life: Upright, forward-leaning positions.

    • Herbal & natural: Counter-pressure, hip squeezes, warm compresses, TENS, water.

    • Call your midwife if: The pain is constant, with no breaks.

    • Blood pressure, urine, fetal heart, baby's position — Weekly. Pre-eclampsia; confirm head-down.

    • GBS result review — 37 weeks. Your labour plan.

    • CBC — 36 to 37 weeks. Haemoglobin ready for birth.

    • Cervical assessment — Optional, from 39 to 40 weeks. Bishop score, if discussing a sweep or induction.

    • Post-dates monitoring: CTG/NST and fluid scan — From 41 weeks, every 2 to 3 days. Placental function.

  • Each of these is yours to decide. We’ll talk through the benefits, risks and alternatives together at your visits.

    • Waiting or induction: Spontaneous labour, or induction at 39, 41 or 42 weeks: what the evidence (ARRIVE, SWEPIS) shows, and what you value.

    • Membrane sweep: When, how often, and what to expect.

    • Natural ripening: Dates (6 a day from 36 weeks), evening primrose oil, raspberry leaf tea, nipple stimulation, sex, acupuncture. We'll look at the evidence for each.

    • If your waters break first: Waiting (up to 24 hours or longer) or induction, and keeping vaginal exams to a minimum.

    • When to call and when to transfer: And who comes: your midwife, the second attendant, your doula.

    • Vaginal exams in labour: Routine, on request, or none.

    • Pain relief: Water, movement, TENS, hypnobirthing, nitrous oxide, or an epidural (which means a transfer).

POSTPARTUM MOTHER · BIRTH TO 6 WEEKS AND BEYOND

The Fourth Trimester: Caring for the Mother

Healing, bleeding, rest and nourishment, your emotions, and when to ask for help. You're being born as a mother, and you deserve care too.

  • Your uterus. Shrinks from about 1 kg to 60 g over 6 weeks. Bleeding (lochia) moves from red, to pink-brown, to cream over 4 to 6 weeks.

    Your hormones. Oestrogen and progesterone drop sharply while prolactin and oxytocin rise. Milk comes in on days 2 to 5, and the baby blues peak on days 3 to 5.

    Focus on. The 40-day rest (lying-in), warm and nourishing food, help at home, and asking for support without guilt.

  • Perineal pain and stitches

    • Nourish & daily life: Rest lying down, use a peri bottle when you pee, keep stools soft.

    • Herbal & natural: Ice pads for the first 24 to 48 hours, then herbal sitz baths (calendula, comfrey, lavender) and witch hazel pads.

    • Conventional care: Paracetamol, ibuprofen.

    • Call your midwife if: Pain is increasing, or you notice a bad smell, fever, or the wound opening.

    Afterpains

    • Nourish & daily life: Empty your bladder; breathe through feeds.

    • Herbal & natural: A warm compress; motherwort or cramp bark tincture.

    • Conventional care: Ibuprofen.

    • Call your midwife if: Pain comes with fever or foul-smelling bleeding.

    Heavy bleeding

    • Nourish & daily life: Rest, uterine massage, skin-to-skin, breastfeeding.

    • Herbal & natural: Shepherd's purse as support only, never instead of care.

    • Conventional care: Medications that contract the uterus; tranexamic acid.

    • Call your midwife if: You soak a pad in an hour, pass clots bigger than an egg, or feel dizzy.

    Engorgement

    • Nourish & daily life: Feed often (8 to 12 times in 24 hours); hand-express to soften the areola.

    • Herbal & natural: Cold cabbage leaves, cold compresses after feeds, warmth before.

    • Conventional care: Ibuprofen.

    • Call your midwife if: A red, hot, wedge-shaped area comes with fever (possible mastitis).

    Sore or cracked nipples

    • Nourish & daily life: Have your latch checked; vary feeding positions.

    • Herbal & natural: Expressed colostrum or milk, nipple balm, air drying.

    • Conventional care: Lanolin, hydrogel pads; tongue-tie assessment.

    • Call your midwife if: Nipples bleed, or pain lasts the whole feed.

    Constipation and haemorrhoids

    • Nourish & daily life: Fluids, fibre, warm porridge, prunes. Support your perineum when you pass a stool.

    • Herbal & natural: Psyllium, witch hazel, sitz baths.

    • Conventional care: Lactulose, docusate.

    • Call your midwife if: No bowel movement by day 4, or severe pain.

    Night sweats and hair loss

    • Nourish & daily life: Hydration and cotton bedding. Hair loss peaks around 3 to 4 months and is normal.

    • Herbal & natural: Nettle, iron-rich foods.

    • Conventional care: Check ferritin and thyroid if excessive.

    • Call your midwife if: You have a fever, or palpitations with weight loss.

    Baby blues and mood changes

    • Nourish & daily life: Sleep in shifts, eat regularly, get daylight, talk it through.

    • Herbal & natural: Rest, connection, lemon balm.

    • Conventional care: Mood screening (EPDS), therapy, medication if needed.

    • Call your midwife if: Low mood lasts beyond 2 weeks, or you have anxiety, intrusive thoughts, can't sleep when baby sleeps, or have thoughts of harm (urgent).

    Leaking urine, pelvic heaviness

    • Nourish & daily life: Pelvic floor exercises; avoid heavy lifting.

    • Herbal & natural: Gentle core rehabilitation.

    • Conventional care: Pelvic floor physiotherapy.

    • Call your midwife if: You feel heaviness or a bulge, or leaking continues past 6 weeks.

    • Blood pressure, uterus, bleeding, perineum, bladder — Every visit: 24 h, day 3 to 5, day 7, 2, 4 and 6 weeks. Haemorrhage, infection, postpartum pre-eclampsia.

    • Haemoglobin / CBC — 24 to 48 h, if blood loss was over 500 mL or you have symptoms. Postpartum anaemia.

    • Anti-D — Within 72 h, if you are Rh negative and baby is Rh positive. Prevents sensitisation.

    • Rubella (MMR) vaccine — Before discharge, if not immune. Protects future pregnancies.

    • Mood screen (EPDS) — 2 and 6 weeks. Postpartum depression and anxiety.

    • Glucose test (OGTT) — 4 to 12 weeks, if you had gestational diabetes. Type 2 diabetes risk.

    • Pelvic floor check, contraception, Pap if due — 6 weeks. Recovery and planning.

  • Each of these is yours to decide. We’ll talk through the benefits, risks and alternatives together at your visits.

    • Your placenta: Burial, encapsulation, tincture, or disposal.

    • Feeding: Exclusive breastfeeding, combination feeding, pumping, or formula, and when to introduce a bottle.

    • Contraception: The lactational amenorrhoea method (LAM), barrier, progestin-only, IUD, fertility awareness, and timing.

    • Pain and mood support: Natural remedies, medication, therapy; supplements while breastfeeding.

    • Visitors and the 40-day rest: How much help, who comes, and your cultural practices.

    • Returning to exercise and sex: Go by readiness, not the calendar.

    • A birth debrief: Time with your midwife to talk through your birth story.

YOUR NEWBORN · BIRTH TO 6 WEEKS

Your Newborn: The First Six Weeks

Feeding, sleep, cord care, jaundice, and the normal newborn quirks that surprise new parents, plus the signs that mean it's time to call.

  • Transition. Your baby's lungs open, circulation changes, and temperature control is still immature. Skin-to-skin steadies heart rate, blood sugar and temperature.

    Weight. A loss of up to 7 to 10% in the first days is normal. Babies regain birth weight by 10 to 14 days, then gain about 150 to 200 g a week.

    Nappies. Wet nappies match the day of life until day 5 or 6, then 6 or more a day. Stools go from black meconium to green to yellow and seedy by day 5.

    Normal quirks. Hiccups, sneezing, irregular breathing, the startle reflex, milia, swollen breasts or genitals, and a little vaginal discharge in girls.

  • Jaundice

    • Nourish & daily life: Feed often (8 to 12 times in 24 hours) and watch nappy output.

    • Herbal & natural: Indirect daylight is a comfort, not a treatment.

    • Conventional care: Bilirubin check (skin meter or blood test); phototherapy.

    • Call your midwife if: Yellowing appears in the first 24 hours, spreads below the chest, or baby is sleepy, feeding poorly or has pale stools.

    Feeding difficulty, poor latch

    • Nourish & daily life: Skin-to-skin, laid-back nursing, baby-led attachment.

    • Herbal & natural: Breast compression, hand expression.

    • Conventional care: A lactation consultant; tongue-tie assessment.

    • Call your midwife if: Fewer than 6 wet nappies after day 5, or not back to birth weight by 2 weeks.

    Crying and colic

    • Nourish & daily life: Swaddle, sway, shush, babywear, keep things calm, burp. Crying often peaks around 6 weeks.

    • Herbal & natural: A warm bath, clockwise tummy massage, bicycle legs; look at the mother's diet if signs persist.

    • Conventional care: Assessment for reflux or cow's milk protein allergy.

    • Call your midwife if: Baby is inconsolable with fever, vomiting or a high-pitched cry.

    Spit-up and reflux

    • Nourish & daily life: Hold upright for 20 minutes after feeds; smaller, more frequent feeds.

    • Herbal & natural: Paced bottle feeding.

    • Conventional care: Assessment if growth is poor.

    • Call your midwife if: Vomit is green or projectile, contains blood, or weight gain is poor.

    Umbilical cord

    • Nourish & daily life: Keep it clean and dry with the nappy folded below. It falls off at 5 to 15 days.

    • Herbal & natural: Air exposure.

    • Conventional care: Chlorhexidine where recommended (Kenya MoH).

    • Call your midwife if: Redness spreads onto the skin, or there is a bad smell or pus.

    Nappy rash

    • Nourish & daily life: Frequent changes, nappy-free time, gentle cleaning with water.

    • Herbal & natural: Breast milk, coconut oil, zinc cream.

    • Conventional care: Antifungal cream if it's thrush.

    • Call your midwife if: There are blisters, open sores, or a rash with fever.

    Cradle cap and baby acne

    • Nourish & daily life: Gentle washing; both clear on their own.

    • Herbal & natural: Oil massage, then a soft brush.

    • Call your midwife if: It spreads or weeps.

    Stuffy nose

    • Nourish & daily life: Saline drops, gentle suction, a humid room.

    • Herbal & natural: Breast milk drops.

    • Call your midwife if: Breathing is laboured or baby isn't feeding well.

    Oral thrush

    • Nourish & daily life: Treat mother and baby together.

    • Herbal & natural: Sterilise dummies and pump parts.

    • Conventional care: Nystatin or miconazole.

    • Call your midwife if: Baby isn't feeding.

    Emergency signs at any age: Temperature of 38 °C or higher (or below 36 °C), fast breathing or grunting, blue or grey colour, floppy or very sleepy, not feeding, or a seizure. Go to hospital now.

    • Apgar score — 1 and 5 minutes (and 10). Transition after birth. (Both)

    • Full newborn exam — Within 24 h, and at 6 weeks. Head-to-toe, hips, heart, eyes. (Both)

    • Vitamin K — At birth. Prevents a rare bleeding disorder (VKDB). (Both; injection or oral doses)

    • Eye prophylaxis — At birth. Newborn conjunctivitis. (Both (tetracycline in Kenya))

    • BCG and OPV0 — At birth or before 2 weeks. Tuberculosis, polio. (Kenya schedule)

    • Hepatitis B birth dose — Within 24 h. Hepatitis B. (Routine in the US; being introduced in Kenya)

    • Pulse oximetry — 24 to 48 h. Congenital heart disease. (Routine in the US; available in Kenya)

    • Heel-prick metabolic screen — 24 to 72 h. PKU, hypothyroidism, sickle cell and more. (Universal in the US; private labs in Nairobi)

    • Hearing screen — Before 1 month. Hearing loss. (Universal in the US; selective in Kenya)

    • Blood group and Coombs test — At birth, if mother is O or Rh negative. Haemolytic disease. (Both)

    • Weight checks — Day 3 to 5, 2 weeks, 6 weeks. Feeding is going well. (Both)

    • 6-week vaccines (Penta, PCV, rotavirus, OPV) — 6 weeks. Immunisation schedule. (Kenya KEPI)

  • Each of these is yours to decide. We’ll talk through the benefits, risks and alternatives together at your visits.

    • Cord clamping: Delayed (at least 1 to 3 minutes), waiting until the cord is white, cord milking, or lotus birth.

    • Vitamin K: Injection, oral doses, or declining, with a clear understanding of the risks.

    • Eye ointment: Routine or declining, depending on the mother's STI results.

    • Vaccines: Birth vaccines (BCG, OPV, hepatitis B) and their timing.

    • Newborn screening: Heel prick, hearing, pulse oximetry.

    • First bath: Delay it 24 hours or more and keep the vernix.

    • Circumcision: Cultural and medical considerations.

    • Sleep: Safe co-sleeping, a bedside crib, or a separate room; always on the back.

    • Feeding rhythm: On demand or scheduled, dummy use, and vitamin D drops (400 IU) for breastfed babies.

Mélanie V. Chevarie, B.Sc. Midwifery, MEHP, LM, CPM

This library is educational and supports, but never replaces, care from your own midwife or doctor. Herbal and supplement suggestions are general starting points; check with your care provider before you begin, especially if you take other medication. In an emergency, go to your nearest hospital.

 

Specialists

  • Reach out for individul or group trainng and certification.

  • Reach out for individul or group trainng and certification.

  • Reach out for individul or group trainng and certification.

  • Reach out for individul or group trainng and certification.

  • IV placement is a foundational skill for a birth worker. IV is the base for many preventative care, and also part of life saving skill during birth.

    Reach out for individual or group training and certification.

    Cost 100USD for certification

    Donation Based for practice

  • Item description

  • Item description

Trauma-Informed &
Person-Centered Care

Melanie V. Chevarie, B.Sc. (midwifery), MEHP, CPM, LM

Newsletter Block
This newsletter signup form needs a storage option. Edit the block and enter a storage location via the Storage tab.

Stay in touch

Sign up for women’s circle, workshops, teachings and more.

We respect your privacy.

Thank you!