The First Few Hours After

Table of Contents

Your baby is born, the birth is nearly over. Now you can meet your new baby - that wonderful little person you have been carrying around with you everywhere you go. So what can you expect in the next few hours? 

Emotions

The first emotion a mother often has after the delivery of their baby, particularly a vaginal delivery, is relief that it is over and the pain has stopped. This is often accompanied with amazement to yourself about what you have just managed to go through. Especially for first-time mums, you may be bewildered at what you have just experienced with your body, and amazed at what you have done. Childbirth is unlike anything else you will ever do.

This is often followed up with awe over your new baby, that you are now seeing for the first time. Some mothers feel overwhelmed after the birth experience, needing a bit of self-time before holding their new baby. However you will feel following the birth, it will be an emotional and memorable time.

APGAR rating

Babies are given a rating out of 10 one-minute after birth, and again five-minutes after birth. The term APGAR stands for Activity (muscles), Pulse, Grimace (reflex irritability), Appearance (skin colour), and Respiration. A rating of 7-10 is considered normal, while 4-7 may need some assistance. A rating below 3 means baby requires immediate help.

Your baby's initial breathing may sound noisy, like having a cold, due to extra fluid they have in their airway. While it was common practice to use suction in the past, this is usually avoided now unless deemed necessary. Left alone, most babies airways will clear completely after a few minutes and the noisy breathing will ease.

Skin-to-skin Contact

Your LMC will check baby over initially as soon as they are born, and once they are happy that baby does not need further attention, baby is usually placed on your tummy. As you are the only home your baby has ever known, it is natural for newborns to want to stay as close to their mum as possible. Skin-to-skin contact can be very settling and comforting for newborns. This is also a special time for you, being the first time you hold your new little miracle. Newborns who do need attention may have the umbilical cord cut at this stage and placed under heat lights while they receive the help they need.

What Baby Looks Like

Needless to say, in real life babies do not come out looking as clean and pink as they do on television. During the birthing process the bones in baby’s head are like shifting plates, and will cross over each other to help baby fit through the birth canal. This is called moulding. This can mean their head shape, though nice and round, can look a little bubbly or lumpy, it may even appear elongated. This will ease away as the bones move back in to place. Babies delivered with assistance from suction, or forceps, can have a cone-shaped head, which will also disappear gradually in the first week.

In the womb your baby will have a light coloured coating called Vernix, which protects their skin. This substance starts to diminish as full-term gestation approaches, but there can be a bit left after baby is born, particularly around skin folds and on tummies. Overdue babies will usually have none or very little of this on their skin, and may have more wrinkled skin and longer nails. Babies skin colour is usually dark and purple immediately following the delivery, and soon turns pinky-red. This does not usually last beyond the first day.

Whether a boy or a girl, your baby’s genitals may look swollen at birth. Premature baby girls will have a prominent inner labia and clitoris, while a full term baby girl will have a prominent outer labia. A premature baby boy may have a flat scrotum with undescended testes. Baby boys born around full term will have ridges on their scrotum, with descended testes. Swollen breasts can also occur on baby girls and baby boys, up to 3 days after birth.

Cord Cutting

When you discuss your birth plan with your LMC, one of the questions will be on who should cut the umbilical cord. The umbilical cord is attached to your baby and your placenta, and has been the pathway for baby’s nutrition from you, while baby is in the womb. Many mothers choose the baby’s father for the role of cutting so they have some involvement in the birth process. Some mothers prefer to do this themselves, or leave it to the LMC. A birth plan is just a plan though, and if you change your mind at the time, let your LMC know. Very shortly after the birth the umbilical cord will be clamped and cut.

Breast Feeding

If left on their mother’s tummy, many newborns will begin crawling up the tummy towards their mother’s breast. This is a natural reflex. Breastfeeding after birth is common practice as it helps settle baby down, begin the bonding process, and encourages milk production. Once baby has latched on to your breast, they will usually stay there to ‘feed’ for a long time.

If baby has had an assisted delivery, or a long, difficult birth, they may not settle at the breast straight after birth. This can leave mothers feeling distressed that they cannot calm their baby, or latch them on the breast. Mothers can feel added pressure by having others in the room trying to help them. It is okay to ask to be left alone to try to comfort baby yourself. On the other hand, you may feel you want more help, in which case you can ask your LMC or support person to assist you. Some babies will eventually go to sleep, having not fed at the breast. In this case, you can try again next time they wake. 


Stage 3: Delivery of the Placenta

The delivery of the placenta can be managed, or natural. Managing the process is widely recommended, and preferred by many mothers and childbirth practitioners as it speeds up the end of the birth. This involves injecting the mother in the thigh immediately following the delivery of the baby. The placenta will usually detach from the uterus and be pushed out through the birth canal by you, with assistance from your LMC, within 10 minutes. Unmanaged delivery of the placenta may take up to an hour. Your LMC can give you information to help you decide how you would like the delivery of the placenta to proceed.

Whichever method you choose, breastfeeding can help the placenta come away from the uterus quicker, as breastfeeding causes the uterus to contract.

Weighing and Measuring

One of the first things everyone seems to want to know about babies is how much they weighed at birth. Baby will be weighed and measured after the birth and this will be recorded in their notes.

Meconium

This can be a bit of a surprise if no one tells you to expect it – newborns have been practicing their swallowing in the womb, and will have swallowed some of the fluid around them. After the birth this will result in their first ‘poo’ called meconium. This is a dark, sticky substance, which can happen within minutes, or hours after birth. Your baby may only pass one motion of meconium, or may pass several motions over the course of the few days.  It is quite sticky and a good tip is to use a natural barrier balm on baby’s bottom. This makes the meconium much easier to clean as the balm stops it from sticking to their skin.

Time to sleep!