Postnatal

The First Hour

The end of a pregnancy… the beginning of a new life! The first hours!

Your baby arrives!! “At last!” you think, “Its all over!” image

You may be exhausted after a long labour, you may feel relieved that your “bump” with all its kicks and uncomfortable side effects has finally left your body. In fact the next phase of your and your baby’s life has only just begun and it is every bit as exciting and new as the pregnancy was.

As your baby is born into the outside world her nice, warm, wet body hits the air and she takes a gasp. This starts a chain of events that prepares her for life unattached and outside of her mother.

With that first gasp her lungs fill with air giving her oxygen. The whole way her body has been functioning using 2nd hand oxygen via her mother is about to undergo an amazing transformation. The maternal blood used to flow from the umbilicus (tummy button) to the heart which had a hole between the right and left sides to allow blood to bypass the not yet functioning lungs. With that first breath of life all that changes! The air fills her lungs and the hole between the left and right side of her heart closes allowing the freshly oxygenated blood to continue to flow through her body from her own lungs and heart.

This usually takes a few moments and you will see your lovely baby change colour from quite purple at birth to pink as she spontaneously breathes. Babies are usually placed immediately onto their mother’s chest and they do not have to cry, as long as we can see she has lovely pink lips we know she is getting oxygen. Of course some babies do object to the cooler different environment and cry loudly!!!

The umbilical cord has become defunct as a fuel/oxygen channel now that your baby is breathing and separate from her mother. It is sealed with a cord clamp and cut, often by her father.

We let your baby lie on your skin where she can get warmth from you. She can smell your familiar smell and hear your heart beating. Because it is also colder outside of your body we cover the top half of her with a warmed towel including her head.

Sometimes babies need a little stimulation to get breathing and we will rub them with a towel. Occasionally they will need a little oxygen to help get established with their breathing and so we take them to a warmed table in the birthing room where we can help them.

Obviously whilst lying on her mother’s chest your baby is close to her new food supply. Within the first hour they often sniff, lick and explore with their mouth to find this food source. This is helped by the “rooting” reflex whereby your baby is encouraged, when touched on the cheek (by a nipple), to seek it further. There is no hurry for your baby to actually latch, she and you have had a bit of an adventure and you now all have time to rest a little, she will suckle when she is ready!

Whether or not you have noticed the presence of colostrum, your breasts will be primed now to provide what your baby requires. Colostrum being the first food your baby needs it is rich in healthy substances to provide for the first few days of life. Being so rich in goodness your baby will only need a small amount of this colostrum but by suckling the breasts they will be stimulated to provide more and more nourishment to provide for your baby’s needs as she grows.

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Usually within a few minutes after the birth of your baby your placenta will have been delivered, most parents at this time are focussed on their newborn baby, but the doctor or midwife will examine the placenta and weigh it before either returning it to you or disposing it according to your wishes that you have indicated previously.

The uterus now contracts strongly to stem the blood flow which previously nourished your baby. This can cause uncomfortable “afterpains”, especially in women who have given birth before. We give paracetamol for these pains. Bleeding continues for the next several days and up to a few weeks but does diminish in amount.

If you require suturing you will have pain relief for this and you or your partner can usually continue to hold your baby at this time.

Your paediatrician, obstetrician or midwife will fully check your baby during the first couple of hours and your well being will be assessed visually and with a blood pressure, pulse and a temperature check.

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Your midwife will offer you a drink of Milo (or tea or coffee) and some toast or sandwiches.

When you are ready you will want to have a refreshing shower.

Enjoy your time as a family before you and your baby will transfer to a post natal ward.

Because your newborn baby is now adapting to the “outside” world she needs to conserve her energy. She is adapting to a new oxygenation source, new food source and a different temperature environment. While you are showering it is a good idea to warm her clothes so when she is dressed for transfer she is kept warm. She also needs to keep her head covered and warm, ask anyone with a no.1 haircut how cold their head gets! We advise mothers to ensure their babies have a woollen hat and warm cuddly blanket for transfer to the postnatal wards but these can be removed when back in a warm room.

Thus starts another life!

By Jayne Clark.

Our goal at Birthright is to provide you the best gynaecological care in a friendly and relaxed atmosphere, where you can talk to us about your needs.