What's Next?

Once the birth canal has stretched far enough to allow the head and neck to slide out, the midwife will help you push out your baby’s head completely.  This takes a lot of teamwork and a very close working relationship, where you alternately push a little and rest a little. Finally, his head will be completely born.  At this point you might be so deep in concentration that you barely notice that the head has been born.

The baby will then turn its head to the side and with the support of the midwife, at the next contraction, the shoulders and rest of the body will be born.   Some women like to help pull the baby out.

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This is an overview of what happens in the minutes and hours immediately after your baby is born.

The baby begins to breathe.

Immediately once the baby is born, it will breathe.  The baby will take its first breath and the lungs will fill with air. The circulatory system, the baby’s own heart and lungs, will immediately support itself.  The blood is already oxygenated before birth via the placenta through the umbilical cord. The other transition from life in the womb to life outside is gradual.

Everything the baby experiences from here on is new, such as smell, taste, temperature, along with everything that can be seen and heard.   Even sound is new.  Hearing via the air instead of through water can be a very scary new experience.

All of a sudden there is a tiny new human being lying there.  Most parents dream of and anticipate this exact moment.  Many parents wonder if they will experience that rush of love that other new parents talk about from the first time they glance at their brand new baby.  However, it’s not unusual to not feel this immediately.  Some women are so overwhelmed that they need a little time to themselves before they can really take it all in.  If your baby is in a bassinet when you feel ready, you can pick your baby up yourself or ask the midwife to help.   It’s a brand new big world and there is so much to learn… The baby will need to feel your skin against his own and hear the familiar sound of your heart beat to feel safe.  The baby will also need to feel your hands and arms close securely around him.  It is important that the baby is kept warm as regulating his own temperature can take a few days.

Navel

The umbilical cord will need to be cut after the baby is born.  A clamp or bit of elastic will be placed a few centimetres from the skin.  The umbilical cord thickness varies from baby to baby.  The stump left will dry and then fall off during the first week after birth.

In many countries, at birth, it is not unusual for them to take blood samples from the umbilical cord.  From this they can determine your baby’s blood type.   It is also important to know the baby’s blood type for example, if the mother is rhesus negative.  A rhesus negative mother with a rhesus positive baby should have an injection of gamma globulin within the first days after birth. This injection prevents the mother from forming antibodies against a rhesus negative baby in subsequent pregnancies.   Through the cord blood it can also be determined whether the baby has had enough oxygen during birth.

The placenta is born

Shortly after the birth of your baby, you will experience some further uterine contractions.  This causes the placenta to loosen and then pass. If you bleed too much then the midwife may give you a small injection to lessen the bleeding.  Another injection can also be given to speed things along if the contractions don’t restart.

Once the placenta is completely detached from the uterus, it can be pushed out in the same way as the baby was.  This is relatively painless and the placenta will slip easily through the vagina.  Many say it feels like a big, soft, warm lump.  If you would like, the midwife is able to show you the placenta -the membranes, umbilical cord and the hollow area that the baby had lived in for nine months.

Bleeding and possible supply

Bleeding during a normal birth is usually minimal.   Any bleeding which does occur tends to come from the place in the uterus where the placenta has been.  If there has been a rupture, or a cut in the perineum, the midwife will sew it right after the placenta is born.  Quite small ruptures and bleeds will not be stitched but left to heal naturally.  Tears in the vagina and the perineum heal quickly.   Repairs are usually made with some thread that dissolves by itself, while the tissue heals.   It might take some weeks before the thread is completely gone.  A local anaesthetic will be given prior to any repairs being done.

Hands and feet are blue

It is perfectly normal for new babies to have cold and blue hands and feet for a while.  This can continue for as long as a few weeks after birth.  It is normal and is partly due to the fact that the baby’s blood circulation has changed from foetal life where oxygen is supplied to the foetus via the placenta, to baby life which is dependent on its own flow of oxygen from the lungs.

Covered in vernix

Vernix (foetal fat) is white. It varies from baby to baby, how much foetal fat they have on the skin when they are born.  Some babys may not have much.  In most cases vernix is absorbed by the skin and rubs off on the clothes during the first day.  It’s not uncommon for girls to have it between genital lips. It is designed to protect the skin while in the amniotic fluid.

Strong ties forged between parents and baby

Many babies have a period just after birth, when they are very alert.  This can last up to a few hours.  The baby will look at everything around him with an intense gaze. Eye contact with the infant at this stage may be intense and close in a very special way.  This is a perfect time to nurse your baby for the first time.

This alert time is probably nature’s way of ensuring that a strong emotional attachment is formed between parents and baby immediately.  The baby and parents examine each other and form a bond which will last a lifetime.  After this alert time, the baby will fall asleep.  This long awake period will not be seen again for a while.  At this time, no matter how tired the mother was during birth, she too will be very awake often feeling almost euphoric.

The baby takes the breast

After birth, during that awake phase the baby may start searching for the breast.

In many cultures, immediately after birth, a baby will be placed, unwashed, on its mother’s chest and left to crawl to the breast itself.  It can take anything from a few minutes, to an hour for the baby to find the nipple, however when baby attaches to the breast in this way, it is usually a perfect latch without the need for any help at all.

A washed baby may find it harder.  The baby will use the search reflex to find the nipple.  A mother will gently touch the baby’s cheek or lips with the nipple, baby responds by opening its mouth to allow the nipple in.  The baby begins to suck when nipple touches the rear of the palate (sucking reflex).  Baby will swallow when it gets milk in the mouth (swallowing reflex).  It is important to remember that this is a learning process and it can be a little difficult at first.  Help should be readily available from the midwife or other personnel in the delivery room at this time.

Examination of the newborn

In the first hour after birth, most parents and baby will be left alone to get to know each other.   It’s usual to wait to weigh, measure and examine the baby.  The examination of the baby will include the midwife  examining  baby’s mouth to see whether the palate is full, so the baby can feed well.  The baby’s head, back, arms, legs and stomach will be checked along with the baby’s eyes and ears.  They will then count fingers and toes.   The midwife will also be able to tell if the testes are in the scrotum in boys, and she will see if there is an anus.

Vitamin K

Vitamin K affects blood clotting. Vitamin K is produced in the gut, but the newborn may not be able to produce enough to prevent problems as a result of the birth.   Therefore, shortly after birth, the baby will be given vitamin K by injection.  If the baby does not have enough vitamin K in the blood they may be at risk for haemorrhaging.  When the baby is three months old, it can form enough vitamin K itself.

After contractions

Uterine contractions continue after birth. In most women who have given birth contractions are strongest when the baby is breastfeeding.  Many women say that these contractions feel like period pains. First time mothers may not experience much pain, however mothers who have given birth before often say they get more painful with each pregnancy.

These post partum contractions cause the uterus to contract again to its pre-pregnancy size and at the same time, the post partum bleeding reduces.   The first few hours after birth a mother will notice heavy vaginal bleeding which will reduce over time.  An empty bladder can help this to happen faster, so if you can, go to the toilet as often as possible.

What is your experience? Did your birth go smoothly?