The first 48 hours: What happens after birth that no one warned you about

The first 48 hours: What happens after birth that no one warned you about

Everyone prepares for labour. Almost no one prepares for what comes after. You've packed your hospital bag, practiced your breathing, maybe even made a birth plan. But what about the 48 hours between "congratulations, you have a baby" and "off you go home, good luck"?

That gap is where most new parents fall apart.

I'm Lisa, a paediatric nurse and certified lactation consultant IBCLC in Dubai with over 20 years working in with families straight after birth. I've seen thousands of families in those fragile first hours. And I've partnered with Nikki Oliver (The Fit Midwife) to create Birth & Beyond specifically because this gap is where support is needed most.

Here's what actually happens in those first 48 hours - the stuff the hospital discharge papers and most prenatal classes in Dubai don't cover.

Your body immediately after birth

Let's start with you, because the baby gets all the attention and you're sitting there wondering why no one mentioned you'd still look six months pregnant.

The bleeding:It's called lochia and it's heavy. Heavier than your worst period. You'll go through multiple giant maternity pads in the first 24 hours. This is normal. You'll pass clots. Some the size of golf balls. If they're bigger than that, tell your midwife. But otherwise? Normal. The bleeding continues for weeks (2-6 weeks is typical), gradually getting lighter.

The cramps (afterpains):Your uterus is contracting back down to normal size. With your first baby, you might not notice. With subsequent babies, they can be genuinely painful - especially while breastfeeding (because breastfeeding releases oxytocin which causes contractions).

The swelling:Your feet, hands, and face might swell MORE after birth than they did during pregnancy. This is because of all the IV fluids and the hormonal shifts. It resolves within a week or so.

The exhaustion:You just ran a marathon. You're running on adrenaline. You probably haven't slept properly in days. And yet, you're expected to care for a newborn, when you potentially have never even kept a plant alive before.

This is why we talk about postpartum support in Birth & Beyond prenatal classes. Because understanding what's normal helps you know when to ask for help.

The first breastfeed (or not)

Most Dubai hospitals will encourage skin-to-skin immediately after birth. Your baby will probably latch within the first hour. They might just nuzzle and sleep. Both are completely normal.

What colostrum actually is:It's thick, golden, sticky. There's not much of it - maybe a teaspoon per feed. This freaks new parents out because it looks like "not enough." But it IS enough. Your baby is born with reserves. Colostrum is concentrated nutrition and immune protection, like liquid gold. Quality over quantity.

The first latch:Some babies latch perfectly and some need help. Some refuse entirely for the first few hours. If the latch hurts (beyond slight discomfort), something's wrong. Call for support immediately. Bad latches cause nipple damage that makes everything harder.

Cluster feeding starts around day 2:Your baby will suddenly want to feed constantly. Every 45 minutes. For hours. New parents panic. "I don't have enough milk!" "Something's wrong!" "I'm starving my baby!" No. This is normal. This is your baby ordering your milk supply. It's temporary. It's exhausting, but it's not a sign of failure. Breastmilk works on a supply and demand principle. The more a baby feeds and demands milk, the more your body will produce.

Your milk "comes in" around day 3-5:Your breasts will suddenly feel rock hard, hot, and painful- like two giant melons on your chest. This is engorgement. It passes within around 3- 5 days as your body calibrates supply to demand. Some women don't experience dramatic engorgement. That's also normal. The annoying thing about pregnancy and childbirth/postpartum is that the only 'normal' thing is YOUR normal.

If you're bottle feeding:

If you're choosing formula (or need to supplement), you're not failing. You're feeding your baby.

What no one tells you about formula:

• It takes longer to digest than breastmilk, so babies can potentially go longer between feeds, although only by around 15 minutes. it's also not guaranteed.
• Constipation can be an issue (watch for hard, pellet-like poos)
• Different formulas work for different babies - you might need to try a few

We cover bottle feeding support in Birth & Beyond because every feeding journey is valid and deserves proper education. For example (and this blows my mind every time!) formula is NOT produced to be sterile. You cannot just use bottled water straight from the bottle to prepare formula (for most formulas), you must use cooled boiled water.

Your baby in the first 48 hours

They cry. A lot.Newborns cry. It's their only form of communication. They're not "difficult" or "fussy" - they're human. Common reasons: hunger, wet nappy, too hot, too cold, overtired, overstimulated, or just... processing being born.

They sleep (but not when you expect):Newborns sleep 16-18 hours a day. But in 45-minute to 2-hour chunks. Around the clock.There's no "day" or "night" yet. That comes later.

Their poos are weird:First poos (meconium) are black, tarry and sticky. Like crude oil. This is normal. Best tip I can give you is to get as much meconium off of the baby's bum as possible with either the nappy (diaper) or a dry cloth before using a wet wipe or a wet cloth to get the remainder off. If you go straight in with the wet cloth, it's like smearing an egg all over your windscreen.

By day 3-4, poos transition to yellow (if breastfed) or tan (if formula fed). If they're still passing black poos after day 4, mention it to your midwife.

They lose weight:All newborns lose 5-10% of their birth weight in the first few days. This is normal. They should regain it by (on average) 2 weeks. Your midwife will track this, or your paediatrician depending on whether you are in a private healthcare system like Dubai, or a public system like the NHS in the UK.

Their behaviour changes around day 2-3:Day 1: sleepy, calm, easy.Day 2-3: AWAKE. Hungry. Cluster feeding. Constantly, which makes parents panic.This is when your milk is coming in. Your baby is doing their job, which is to feed, sleep and poop. You're doing your job, but it just doesn't feel like it.

The emotional crash

Around day 3-5, your hormones plummet. Your progesterone, which has been high throughout pregnancy, drops suddenly, and then your milk comes in (more hormones). You're exhausted, sore and overwhelmed. This is called the "baby blues" and it affects up to 80% of new mothers. You might cry for no reason or feel anxious. Wonder what you've done and question whether you can do this. Spoiler alert, you can.

This is all absolutely NORMAL. It passes within 1-2 weeks usually. If it doesn't pass, if it gets worse, or if you're having intrusive thoughts - that could potentially be postnatal depression and please reach out to someone you trust to talk about it.

We talk about this in Birth & Beyond because maternal mental health matters just as much as physical health.

What no one tells you about partners

Partners are struggling too. They're watching someone they love in pain (and had to watch them in pain throughout labour without being able to do anything about it). They're learning to care for a newborn, and (hopefully) caring for you too. They're probably terrified of "doing it wrong."

They need support and they need education as well as help to understand what the new normal is. That's why we designed Birth & Beyond for BOTH parents. Partners come to every session. We teach them comfort techniques, feeding support, nappy changes, safe sleep, when to worry, and when to just listen. Because you need to be a team.

Why hospitals discharge you so fast

In Dubai, uncomplicated vaginal births often mean discharge within 24 hours. C-sections within 48-72 hours. This feels terrifying. You've just had a baby and you're being sent home. But hospitals need to discharge when you're medically stable - not when you feel ready. This isn't a Dubai-centric policy, it's worldwide. Whether you're in a private or government healthcare system.

This is why postnatal support matters. Why having a (qualified) lactation consultant on call matters. Why understanding what's normal (vs. what needs medical attention) is important. Every Birth & Beyond participant has a month of virtual postnatal midwife & lactation support included, because sometimes all you need is to hear someone tell you that this too shall pass, and that it's going to be ok. And if you need in person support, you receive a preferential rate with professionals who know you and your journey already. Because questions don't stop when you leave the hospital.

What to watch for (when to call for help)

For you:

• Heavy bleeding (soaking a pad in an hour)
• Fever over 38°C
• Severe pain (beyond normal soreness)
• Foul-smelling discharge
• Red, hot, swollen areas on your breasts (mastitis)
• Feeling unable to cope

For baby:

• Fever over 38°C
• Fewer than 6 wet nappies in 24 hours (after day 5)
• Not feeding (refusing multiple feeds)
• Excessively sleepy (difficult to wake)
• Jaundice getting worse (yellowing skin)
• Difficulty breathing

When in doubt, call. Always trust your instincts. A medical professional (like us!) would ALWAYS rather be disturbed for something that turns out to be nothing, rather than have you worrying needlessly.

Why we're telling you all of this

Because the first 48 hours are overwhelming. You're exhausted. Hormonal. In pain. Learning to feed a baby whilst forgetting to feed yourself. Navigating hospital protocols and lack of information/ continuity of care. Fielding visitors whilst trying to nap when you can and make sure the dog is still walked and the cat is fed whilst wondering if you're allowed to change cat litter yet (toxoplasmosis anyone?!) whilst questioning if you should because of your c-section scar. Phew. It's a lot.

And because no one prepared you for this part. Birth & Beyond does.

We don't just teach you about labour. We teach you about:

• Immediate postpartum recovery (the bleeding, the pain, the exhaustion)
• Breastfeeding reality (latch problems, cluster feeding, engorgement)
• Formula feeding support (if that's your choice)
• Newborn behaviour (why they cry, why they cluster feed, what's normal)
• When to worry vs. when to breathe
• Partner support (so you're not doing this alone)
• Maternal mental health (baby blues vs. postnatal depression)

Plus practical baby care stations where you learn:

• Nappy changes (meconium is STICKY)
• Bathing (they're slippery and terrifying)
• Safe sleep (current guidance, Dubai-specific)
• When to call your paediatrician

And 28 days of virtual support after birth, as well as your own baby manual to take away. Because that's when the real questions start, when you're on your own.

If you're pregnant in Dubai and you want to be prepared for what comes AFTER labour - not just during it - this is for you. We deliberately keep our classes small to meet the needs of the parents that join us, and so that you don't just feel like another face in the crowd. Or even worse, an insurance payment number in the Dubai healthcare system.

If you're pregnant in Dubai and want to feel prepared (not petrified), this is for you, our course dates and booking links are available here.

P.S. The couples who come to Birth & Beyond become each other's Dubai village. The WhatsApp group from each course stays active for months (sometimes years). Because you need people who are going through exactly what you're going through, exactly when you're going through it. That support is priceless.

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