After the baby is born: what to expect in the first hours
First minutes after baby is born
The moment your baby is born can be both magical and stressful. What happens straight after birth will depend on your labour, how your baby is born, and how quickly your baby adapts to life outside the womb.
Uncomplicated vaginal birth
Most babies breathe and cry within a few seconds of being born.
If it’s clear that your baby is breathing well he’ll be placed naked, skin-to-skin, on your chest or belly straight after birth. Skin-to-skin contact keeps your baby warm, helps to steady your baby’s breathing and heart rate, and lets you and baby bond physically straight away. It’s also a trigger for breastfeeding.
The midwife will dry your baby while your baby is on you, and cover you both with a warm blanket or towels.
Forceps or vacuum birth
Most babies born with the help of forceps or a vacuum will breathe and cry at birth. But some babies might be a little stunned or slow to breathe, especially if they’re distressed during labour. If this happens, the midwife, obstetrician or paediatrician will take your baby to a special warming station. They’ll dry your baby and make sure she’s breathing well.
Once your baby is breathing properly, he’ll be dried, wrapped in warm towels or blankets, and given back to you. Then you can hold him and have skin-to-skin contact for bonding, warmth and breastfeeding.
Elective caesarean section
Most babies born via elective caesarean section breathe and cry vigorously at birth. After your baby is born, the midwife or paediatrician will take your baby to a special warming station to dry her, assess her and check that she’s breathing properly.
The midwife or obstetrician will wrap your baby in warm blankets or towels and give him to you to hold while you’re on the operating table (unless you’ve had a general anaesthetic). Some hospitals provide for skin-to-skin contact when you’re in theatre, and you can ask whether this is an option at your baby’s birth.
Unplanned (emergency) caesarean section
Babies born via unplanned caesarean section are more likely to need help to breathe at birth. The midwife or paediatrician will take your baby to a special warming station to dry her and assess what type of help your baby needs.
When your baby is breathing well and your health is stable, the midwife or obstetrician will wrap your baby in warm blankets or towels and give him to you to hold while you’re on the operating table (unless you’ve had a general anaesthetic).
Cutting the cord
After the birth of your baby, the umbilical cord needs to be clamped and cut. The cord is quite tough to cut, but cutting it isn’t painful for you or your baby.
If your baby needs a lot of help to breathe at birth, or looks unwell your baby might need to go straight to the neonatal intensive care unit (NICU). Your first cuddle might have to wait until your baby is well.
How your baby will look and behave after birth
Some important changes happen in your baby’s body as he moves from the protected, quiet and warm environment of your womb to the outside world.
It’s normal for your baby to look somewhat blue or purple in the initial few minutes after birth. If your baby is breathing well, her skin colour will gradually become pink within 5-7 minutes after birth. Your baby’s hands and feet might stay blue for up to 24 hours. This is because the blood vessels in your baby’s hands and feet are very small, and it takes time for blood to circulate properly there and turn them pink.
If all is well, most babies cry immediately after birth. Most then quietly gaze with large open eyes at their surroundings before falling asleep. It’s normal for babies to fall asleep, but some might stay awake and want to feed.
If your baby seems ready, you can breastfeed him within a few minutes of birth. The midwife will help you attach baby to your breast.
The Apgar score
The Apgar score is a rating of your baby’s heart rate, breathing, muscle tone, response to stimuli and skin colour. A score of 0, 1 or 2 is given for each of these five criteria, and the total is the Apgar score. It is performed on a baby at 1 and 5 minutes after birth.
Your baby’s Apgar score measures how well your baby has made the transition from life inside the womb to life outside. Apgar scores are recorded in your baby’s child health and development book.
Checks and medications in the first 24 hours
Within the first hour of birth, the midwife will put two name tags on your baby.
Your baby will also be weighed at some time in the first few hours, and will have a physical check.
Your baby is supposed to have one or two injections into her thigh muscles soon after birth. The injections are:
- vitamin K – this can help prevent a bleeding disorder caused by a vitamin K deficiency
- hepatitis B immunisation
Within the first 48-72 hours of your baby’s life, she will have a newborn screening, which tests your baby for signs of rare conditions. Your baby will also be checked for developmental dysplasia of the hip (DDH) and in some countries also screened for hearing impairment.
