First minutes after your baby is born

The moment your baby is born is very special, but there’s usually a lot going on too. What happens straight after birth will depend on your health and your baby’s health during pregnancy and labour. It will also depend on how your baby is born and how quickly your baby adapts to life outside the womb.

Vaginal birth without forceps or vacuum extraction
Most babies breathe and cry within a few seconds of being born.

If your baby is breathing well, they can be placed naked, skin to skin, on your chest or belly straight after birth. Skin-to-skin contact keeps your baby warm. It also helps to steady your baby’s breathing and heart rate and trigger your first breastfeed. And it helps you to bond with your baby.

The midwife will dry your baby while your baby is on you and then cover you both with a warm blanket or towels.

If you prefer, your baby can be dried and wrapped in warm towels or blankets for you to hold.

Vaginal birth with forceps or vacuum extraction
Most babies born with the help of forceps or vacuum will breathe and cry at birth. But some babies might be a little stunned or slow to breathe, especially if they were distressed during labour. If this happens, the midwife, neonatal nurse, obstetrician or paediatrician will take your baby to a special warming station. They’ll dry your baby and check your baby’s breathing.

You can hold your baby once they’re breathing well. You can hold your baby skin to skin, or your baby can be dried and wrapped in warm towels or blankets for you to hold.

Elective caesarean section
Most babies born via elective caesarean section breathe and cry at birth.

If you’re well and your baby is breathing well, you can have skin-to-skin contact before your baby goes to a special warming station to be dried and checked. Sometimes your baby’s breathing will be checked before you can hold them. You can ask to hold your baby skin to skin, or they can be wrapped in warm blankets or towels for you to hold while you’re on the operating table.

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

Unplanned (emergency) caesarean section
Babies born via unplanned caesarean section are more likely to need help to breathe at birth. The midwife, neonatal nurse or paediatrician will take your baby to a special warming station for drying. They’ll give your baby help to breathe or any other medical care that’s needed.

If you’re well and your baby is breathing well, you can hold your baby. Even if you’re still on the operating table, it’s OK to ask for skin-to-skin contact or cuddles.

If you’ve had a general anaesthetic, you’ll be able to hold your baby after you’ve recovered, so long as your baby is well.

If your baby needs extra medical care like help to breathe at birth, your baby might need to go straight to the special care nursery (SCN) or 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. This usually happens 1-5 minutes after birth if your baby is well. Delayed cord clamping allows you to hold your baby straight after birth. It can also be good for your baby’s health. For example, it can improve your baby’s heart rate and increase the haemoglobin in their blood.

But sometimes the cord might need to be cut straight after birth. This might happen if you or your baby needs medical help.

If you and your baby are well, your birth partner can usually cut the umbilical cord, if that’s what you and your partner want. Your partner won’t be able to cut the umbilical cord if your baby is born by caesarean section or needs to be taken quickly to the warming station after birth, or if you have complications like heavy bleeding. In this situation, the midwife or obstetrician will clamp and cut the cord.

The cord is quite tough to cut, but cutting it isn’t painful for you or your baby.

How your baby will look and behave after birth

It’s normal for your baby to look blue, purple or dark red in the first few minutes after birth. If your baby is breathing well, your baby’s 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 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. But some might stay awake and want to feed.

If your baby seems ready, you can try breastfeeding within a few minutes of birth. The midwife can help you and your baby with attachment if you need it.

One of the keys to making breastfeeding work for you and your baby is getting a good attachment at your breast. You can see how in our baby-led attachment video, mother-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 5 criteria, and the total is the Apgar score. The maximum Apgar score is 10.

Your baby’s Apgar score measures how well your baby has made the transition from life inside the womb to life outside. If your baby’s Apgar score is 7 or above, this is a sign that your baby is in good health and transitioning well to life outside the womb. But if your baby’s Apgar score is 6 or less, this means that your baby might need medical help.

Apgar scores are recorded at 1, 5 and 10 minutes after birth in your baby’s child health and development book.

When your baby needs medical help after birth

If your baby isn’t breathing well after birth and needs help to breathe, has a low heart rate (below 100 beats per minute) or is floppy, your baby will be taken quickly to the warming station. Staff will decide what sort of extra medical help your baby needs.

A doctor, midwife or neonatal nurse might clear your baby’s airways and help your baby to breathe by giving normal air through a special baby mask and breathing device. The breathing device and face mask might stay on until your baby can breathe independently.

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

If your baby needed help to breathe at birth, your baby will be taken to the 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 medicines.

Checks and medicines in the first 24 hours

Within the first hour of birth, the midwife will put 2 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 1 or 2 injections. These injections are given into your baby’s 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 childhood immunisation program.

Skin-to-skin contact or breastfeeding can comfort your baby and reduce their pain during injections. If your baby can’t breastfeed or be held skin to skin, a very small amount of oral sucrose – a special sweet syrup – can also help.

You can discuss newborn baby checks and medicines 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 but serious conditions. In the early days, your baby will also be checked for developmental dysplasia of the hip (DDH) and screened for deafness and hearing loss.