What will happen to my baby immediately after birth?
Newborn babies don't have good temperature control, so it's very important that they be kept warm and dry. If you have a vaginal delivery and you and your baby are both in good condition, he can be placed directly onto your abdomen and dried off there. He'll be covered with a warm towel or blanket and given a cap to keep him from losing heat through his head.
Skin-to-skin contact will help keep your baby warm and let the two of you start bonding as well. (Don't worry about bonding if you can't hold your baby right away because one of you needs immediate medical care. There'll be plenty of time for bonding later.)
Your practitioner will clamp the umbilical cord in two places and then cut between the two clamps. (Your partner can do the honors if he or she wants to!) Your caregiver will collect a tube of blood from the cord to check your baby's blood type and possibly use for other tests as well.
During your baby's birth, your caregiver may have suctioned your baby's mouth and nose before the delivery of his shoulders. If your baby still seems to have too much fluid in his mouth or nose, she may do further suctioning at this time.
While you and your baby are locking eyes, he'll be closely observed to ensure that he continues to do well. At one and five minutes after birth, an Apgar assessment will be done to evaluate your baby's heart rate, breathing, muscle tone, reflex response, and color. Your caregiver can do these simple assessments while your baby is resting on your belly.
When can I start breastfeeding?
Babies tend to be very alert right after birth, so now's a good time to begin breastfeeding if you're both willing. There's no need to panic if your newborn seems to have trouble finding or staying on your nipple right after birth — he may just lick your nipple at first. Most babies will eventually begin to nurse within the first hour or so, given the opportunity.
Don't be shy about asking your caregiver or nurse to help you get started while you're still in the birth room (or recovery room if you had a c-section). Later, when you get to the postpartum unit, there may be a lactation consultant available for one-on-one coaching or group breastfeeding classes. You should be able to find out ahead of time what resources are available. Be sure to ask for all the help you need. And keep asking questions and asking for help until you are satisfied.
What if my baby has problems at birth?
If your baby has any problems at birth that require extra observation or a full-fledged resuscitation (or anything in between), your practitioner will quickly clamp and cut the cord. Your baby will then be dried off and placed on a radiant warmer in your birthing room. The warmer allows him to be left naked without getting cold so his medical team can do whatever is necessary to help him make the transition to life outside the womb.
An Apgar assessment will be done, as will more suctioning, if needed, and whatever other interventions are necessary. If your baby needs further care after being stabilized, he may be taken to an intensive care nursery. But if he's doing well and needs no more assistance, he'll be swaddled in a warm blanket and brought to you so you can nuzzle, bond, and breastfeed.
What if I have a c-section?
If you have a c-section, your baby will be handed to a nurse or pediatrician as soon as he's delivered and taken to a radiant warmer. He'll be dried off, his mouth and nasal passages will be suctioned, an Apgar assessment will be done, and he'll get any other attention he might need.
In many hospitals, if your baby is doing well, he'll be swaddled in a warm blanket and brought to your partner (who'll be sitting by your head) to hold while you're being stitched up. This way, you can admire and kiss your baby while you're still in the operating room. Afterward, in the recovery room, you can begin to breastfeed if you want.
When do they do the ID bands and footprints?
Whether your baby is lying on your body or on a radiant warmer, a nurse will put ID bands on you, your baby, and your partner minutes after the delivery (and certainly before taking your baby out of the room for any reason).
She'll also footprint your baby. Most hospitals routinely make two copies of the baby's footprint, one for his hospital record and the other as a keepsake for you. (If they don't usually do this and it's something you'd like, be sure to ask for a copy.)
What else will happen in the first hour?
A nurse will put antibiotic ointment or drops in your baby's eyes within an hour after birth. The ointment or eyedrops are required by state law in the United States to help prevent eye infections — some of which can cause blindness — from a variety of bacteria that your baby could have been exposed to just before or during birth, including gonorrhea and chlamydia.
She'll also weigh your baby and give him an injection of vitamin K to help his blood clot. She may measure his length and head circumference, or that may be done later by the pediatrician.
What else will be done for my baby before we leave the hospital?
After your baby's temperature has remained stable for at least a few hours, a nurse will give him a sponge bath and wash his hair if needed. Baths usually take place in the nursery so the baby can be put under radiant heat to warm up afterward, but you can ask for your child to be bathed in your room if you want.
Your baby will get a complete pediatric exam. Like the bath, this is usually done in the nursery but can be done in your room, instead. After the exam, you can ask to have your baby back or have him taken to sleep in the nursery. If you're breastfeeding, it makes sense to keep the baby in your room, as you'll probably need to feed him every few hours.
What tests will be done on my baby?
When your baby is 48 hours old, his heel will be pricked and a small amount of blood taken to test for phenylketonuria (PKU), hypothyroidism, and other disorders. All 50 states require newborn screening tests (sometimes referred to as "the metabolic screen"). But the number and type of genetic and metabolic disorders tested for vary widely from state to state, from as few as four conditions to more than 40.
If you live in a state that does only limited testing you can pay for additional testing, but you may need to make arrangements ahead of time. If you deliver at a birth center or at home, you'll need to bring your baby to the doctor for these tests before he's a week old. And if you give birth in a hospital but are discharged early — within 24 hours after delivery — your baby will need repeat testing one to two weeks later because the screening test done for PKU in the first day of life isn't always accurate.
Many hospitals routinely perform newborn hearing tests before your baby is discharged. In some states it's required by law. (Both the March of Dimes and the American Academy of Pediatrics recommend testing for all babies.)
If your HIV status is unknown, your baby's cord blood may be tested for the virus. (In some states, this is required.)
Will my baby get a hepatitis B shot?
Your baby will probably get his first dose of the hepatitis B vaccine before being discharged from the hospital. If you're a hepatitis B carrier or your status is unknown, your baby should definitely be vaccinated within 12 hours of birth. (If you're sure that you, other family members, and anyone who will be caring for your baby are all negative for hepatitis B, the first dose can be delayed and given when you are ready to do so. I mean think about it. The only way the baby can contract hepatitis B is if you are carrier, if the baby partakes in risky behavior like having sex, doing drugs or getting tattoos... You really think your baby is going to be doing any of that anytime soon? So my theory is to delay this until they come of age to be thinking about doing something of this nature.)
Babies of mothers who are known hepatitis B carriers will also receive an injection of hepatitis B immune globulin (HBIG) within 12 hours of birth. If your hepatitis B status is unknown, your blood will be drawn for testing, and if you're found to be positive, your baby should receive a dose of HBIG as soon as possible.
Keep in mind that you have the ability to make decisions for yourself and your baby regarding accepting vaccines, vitamin K shots, eye drops and even when the chord is cut. I encourage you all to do your homework and find out the pros and cons to each procedure.
