How many postnatal home visits does the NFZ cover?
Your primary care midwife (POZ, podstawowa opieka zdrowotna) makes no fewer than 4 home visits after the birth, known as wizyty patronażowe. Under the regulations on guaranteed services they fall in weeks 1-6 of your baby's life, and the NFZ (Poland's public health fund) and pacjent.gov.pl describe them as 4-6 visits. The visits are free and take place at home, with the parents or carers present.
Four visits is a minimum, not a limit. The midwife plans your care individually, adapting it to your health and your baby's and to the situation at home. If something needs checking more often, such as weight gain or wound healing, ask for an extra visit.
Different rules apply when the baby stays in hospital longer than the mother. In that case the midwife makes at least 2 more visits once the baby is home, and if the baby leaves hospital without the mother, at least 4 visits wherever the baby is staying. For premature babies, home care follows a plan adjusted to the baby's age and health.
When does the POZ midwife come for the first visit after the birth?
The first home visit takes place no later than 48 hours after the POZ midwife receives notice of the baby's birth or information that the mother has been discharged from hospital. Saturdays, Sundays and public holidays do not count towards this deadline, so after a Friday discharge the visit may not happen until early the following week.
The hospital sends the birth notification to the POZ midwife or clinic on the day of discharge. It includes, among other things, the address where you will be staying with the baby and your phone number, so make sure these details are up to date when you are discharged. If the hospital cannot identify your midwife, it tells you how to choose one.
It is also a good idea to call the midwife yourself once you are home. It is the simplest way to book the first visit straight away rather than wait for information that may have got stuck along the way.
How do I choose a POZ midwife and tell her about the birth?
For a POZ midwife to take you on, you need to submit a deklaracja wyboru, a form declaring your choice of midwife. It is best to do this while still pregnant, because then you can use free antenatal education, and after the birth you already know who to call. You can submit the declaration:
- at the clinic where your chosen midwife works,
- directly with a midwife who has a contract with the NFZ,
- through the Internetowe Konto Pacjenta (IKP, the online patient account), in the POZ section, by choosing the clinic and the midwife,
- electronically, with a qualified signature, a trusted signature (podpis zaufany) or a personal signature (podpis osobisty).
Choosing a midwife is free, and you can change her at no cost twice per calendar year. Each further change in the same year has to be paid for. You can check your midwife's details on your IKP.
After the birth, call the midwife and tell her the baby has arrived, even if the hospital has already sent the notification. While you are at it, ask the clinic which declarations are worth submitting for the baby.
What does the midwife check during an NFZ home visit?
The scope of the visits is set out in the organisational standard of perinatal care and is wider than many people assume. During the visits the POZ midwife in particular:
- assesses your health and your baby's, the newborn's physical development, weight gain and how yellow the skin is,
- gives breastfeeding advice: assesses feeding technique, the baby's sucking and how effective it is, and helps solve breastfeeding problems,
- teaches you how to bathe the newborn and care for the skin and the umbilical cord stump,
- removes stitches from a perineal or abdominal wound if needed,
- advises on the pelvic floor, the return of fertility, family planning and coping with stress,
- reminds you about your baby's vaccinations and screening tests, a dentist visit within 6 weeks of the birth and a visit to the obstetrician once the postpartum period is over.
When a problem goes beyond her competence, the midwife tells you that you need to see a doctor or a psychologist. Once the home visits are over, the baby's care passes to the POZ nurse, while the midwife continues to support you, including with breastfeeding.
How is an NFZ home visit different from a private midwife visit?
NFZ home visits have a set minimum and an organisational framework. The POZ midwife is available Monday to Friday, 8:00-18:00, except public holidays, and you agree on visit dates together. The regulations do not set the length of a single visit, so it depends on the midwife and on what is happening with you. Privately, you agree these things directly with the midwife you choose.
| Criterion | NFZ visit (POZ midwife) | Private midwife visit |
|---|---|---|
| Cost | free | paid, according to the midwife's price list |
| Number of visits | at least 4 in weeks 1-6 of the baby's life, more if health requires it | as many as you agree, including a single visit |
| Choice of midwife | the midwife named in your declaration, from POZ midwives with an NFZ contract | any midwife you choose yourself |
| Timing | working days 8:00-18:00, first visit within 48 hours of the notification | according to the midwife's schedule, sometimes also evenings or weekends |
| Length of visit | not set in the regulations, depends on needs and the midwife's schedule | agreed when booking |
| Scope | mother's and baby's health, breastfeeding advice, baby care, education | depends on the offer, for example a longer breastfeeding consultation or scar therapy |
When is it worth paying for a private midwife after the birth?
A private visit makes sense when you need something the NFZ framework does not provide, or does not provide straight away. Most often this means:
- a specific person, for example a midwife you know from pregnancy or from szkoła rodzenia (antenatal classes) who is not your POZ midwife,
- an evening or weekend slot, when your partner is at home and also wants to learn everything,
- a longer, unhurried visit with time for all your questions,
- a midwife with additional breastfeeding qualifications, when feeding hurts or the baby is gaining weight slowly,
- an extra visit outside the POZ midwife's plan, for example right after you get home.
Prices of private visits depend on the city, the length and scope of the visit and travel. On MyMidwife you will find midwives who come to your home, and you can check their prices and services on their profiles before booking.
Can I use an NFZ midwife and a private one at the same time?
Yes. A private visit does not take away your right to free home visits, and the POZ midwife still makes her visits. The most sensible approach is to treat the NFZ visits as the foundation and a private midwife as an extra where you need more time, a different slot or specific skills.
To avoid duplicating care, tell each midwife about the other and about her recommendations. Keep your hospital discharge summary, your baby's health record book and weighing notes in one place, because different scales can give slightly different results. If the recommendations differ, for example about top-up feeding, ask for an explanation and do not change feeding on your own.
Whoever is visiting you, do not wait for the next visit if there is a fever, heavy bleeding, shortness of breath, worsening jaundice or a listless baby. Contact a doctor, and in an emergency call 112.
