By Raising Children Network
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Newborn crying at medical check-up

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About 8% of babies are born before 37 weeks of gestation. Most premature babies need special care in a NICU or special care nursery.
 
Finally your baby is here. Knowing what to expect in the first hours after baby is born can make it easier for you to relax and start getting to know your newborn.

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.

Sometimes you might need further medical attention, so that first cuddle with you might have to wait. Your birth partner can stay with your baby and give baby lots of cuddles until you get back to recovery or the maternity ward. 

Some hospitals will let your birth partner provide skin-to-skin contact for your baby in theatre if you can’t.

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).

If your baby needs a lot of help to breathe at birth, 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. 

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.

Your birth partner can usually cut the umbilical cord if that’s what you and your partner want. This is possible after an uncomplicated vaginal birth, but isn’t usually possible after a caesarean section.

If your baby needs to be taken quickly to the warming station after birth, or you have complications like heavy bleeding, the midwife or obstetrician will clamp and cut the cord.

Video Bonding with newborns: parent stories

In this short video, parents share their experiences of bonding with newborns. Some parents describe the joy of bonding at birth. Others say that they didn’t feel an instant attachment to their baby. These parents talk about how they formed that bond later.

 
You can bond with your newborn baby as soon as she arrives. Early skin-to-skin contact is a great way to do this, whether it’s cuddling your baby on your chest or encouraging baby to breastfeed. 

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. As he cries and takes his first breaths, oxygen and blood flow through his lungs as they expand.

It’s normal for your baby to look blue or purple in the initial few minutes after birth. If your baby is breathing well, her skin colour will gradually become pink within 7-10 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. 

One of the keys to making breastfeeding work for you and baby is getting a good attachment at your breast. You can see how in our baby-led attachment video and our illustrated guide to breastfeeding. You can also read more about breastfeeding attachment techniques. 

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.

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. 

When your baby needs medical help after birth

If your baby isn’t breathing properly after birth and needs help to breathe, has a low heart rate (below 100 beats per minute) or is floppy, she’ll be moved to the warming station, where staff will decide whether she needs extra medical help.

The doctor or midwife might clear your baby’s airways and help him breathe by giving him normal air through a special baby mask and breathing device. The breathing device and face mask might stay on until your baby can breathe on his own.

If your baby’s breathing, heart rate and floppiness don’t improve, she might need oxygen through a mask or breathing tube.

If your baby needs a lot of resuscitation at birth, he’ll be taken to the special care nursery (SCN) or NICU for further assessment and close monitoring. 

Most babies start breathing quickly in response to simple actions like drying and stimulation. Very few babies need help to start breathing. And fewer than 3 in 1000 babies need more active resuscitation like chest compressions (CPR) and drugs. 

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. When weighing your baby, the midwife will do a quick physical check.

The midwife will record when your baby first poos and wees. This is usually within the first 24 hours.

You’ll be asked to give your permission for your baby to have one or two injections into her thigh muscles after birth, either immediately or within a few hours. The injections are:

  • vitamin K – this can help prevent a bleeding disorder caused by a vitamin K deficiency (‘haemorrhagic disease of the newborn’)
  • hepatitis B immunisation – this is the only immunisation required at birth, and is given as part of Australia’s universal immunisation program.

You can discuss these procedures with your midwife, GP or obstetrician at one of your appointments towards the end of your pregnancy. 

Within the first 48-72 hours of your baby’s life, you’ll be asked to give your consent for newborn screening, which tests your baby for signs of rare conditions. In the early days, your baby will also be checked for developmental dysplasia of the hip (DDH) and screened for hearing impairment.
 
 
 
  • Last updated or reviewed 04-06-2018
  • Acknowledgements

    This article was written in collaboration with Dr Valerie Sung, paediatrician, Centre for Community Child Health at the Royal Children’s Hospital and Murdoch Children’s Research Institute.