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What Happens After a Home Birth (The First 24 Hours)

Are you wondering what happens after a home birth? Do you want to know what to expect in those first 24 hours? This blog post has all the answers you need.

brand new baby getting measured

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For many women, giving birth at home is a beautiful, happy – even sacred – experience. If you’re planning a home birth, you’ve likely learned a lot about what to expect during labor and birth. But what about after your baby is born?

What happens after a home birth?

One of the great things about having a home birth is that the answer to that question is it’s largely up to you!

That said, for most women, the first 24 hours after a home birth will look pretty similar. So let’s walk through those hours and help you know what to expect after your baby is born at home.

Note: While it’s common to meet with only one midwife for prenatal care (if you hired an independent midwife) she likely has a midwife partner that comes with her to births. For that reason, in this blog post I talk about “your midwives” not “your midwife.”

What happens right after birth at home?

As soon as your baby is born – which is one of the most magical experiences in the world – your midwives will help you put your baby on your chest. (Or your abdomen, if the umbilical cord is short.)

Some women catch their own babies. So if that’s you, you can pull your baby up to your chest on your own. No one will take the baby from you.

The Apgar Test

Right away, your midwives will perform the first of two visual checks called an Apgar test. 

Your baby’s Apgar score is determined by a test in each of five areas: appearance, pulse, grimace, activity, and respiration. (Notice the first letters of each: APGAR.) These five areas help care providers (at home or in the hospital) know if a baby is doing well. 

Your midwives will note your baby’s Apgar score at 1 minute after birth and then again at 5 minutes.

A score of 7 or higher indicates a healthy baby.

See the chart below for more information.

chart showing how apgar tests are scored

Taking Care of Mom

If you gave birth in the water, you will be helped to your bed. I moved to the bed within just a few minutes of birth – right after my placenta came out. Some women choose to stay in the water for longer, either because they simply want to or because they are waiting for their placenta to come.

If you gave birth on your bed, your midwives will help clean the area up and then help you get resituated in a clean bed.

Next, it’s important that you eat and drink something. Birth depletes your energy and nutrient stores so it’s a good idea to have something to give you a quick boost – like juice – and then something more.

My husband made me a smoothie right after my daughter was born. Some women eat a hamburger. Leftovers work great, too.

If your perineum tore, your midwife will stitch you up at this point. All certified midwives are trained on how to do stitches. (Though only licensed midwives can carry numbing shots, so I recommend you have at least once licensed midwife at your birth.)

Note: It is rare that a woman will tear severely if she didn’t receive an episiotomy. But if you do, you will be transferred to the hospital so a surgeon with more experience and a better medical setup can repair the tear.

Bonding and Breastfeeding

From the moment your baby is placed on your chest, you begin an important time of skin-to-skin bonding. You can choose to have a diaper put on your baby or just let him or her stay naked.

One of the most significant benefits of skin-to-skin time immediately after birth is its effect on breastfeeding. Mother and baby pairs who have at least an hour of skin-to-skin time right after birth are more likely to exclusively breastfeed and continue breastfeeding for longer.

Skin-to-skin time also has lots of other benefits, including: 

  • Promoting bonding between mother and baby
  • Providing for earlier initiation of breastfeeding
  • Reducing crying
  • Helping baby maintain their body temperature better than a warmer (your body will adjust your own temperature to warm or cool the baby – how neat is that?!)
  • Helping regulate baby’s breathing and heart rate
  • Helping keep baby’s blood sugar level stable
  • Helping baby regulate after a difficult or surgical birth
  • Decreasing pain for baby from any procedures done while skin-to-skin
  • Reducing postpartum hemorrhage in mother (because it promotes release of oxytocin)
  • Reducing maternal stress and postpartum depression (for some women)

In addition to skin-to-skin time, breastfeeding starts in those first few moments. If your baby is placed on your chest, he or she will naturally find their way to your breast when they are ready. Babies are born knowing how to suck (though they do need help learning to latch properly).

Delivering the Placenta

Finally, at some point in the midst of all these things, your placenta will be pushed out by your uterus. It may be minutes after your baby is born or may take up to an hour. You likely won’t even notice the contractions because you’ll be holding your little one.

Letting the placenta come out on its own, without pulling on the cord or injecting Pitocin, is generally the best practice if everything seems normal.

You can choose to dispose of the placenta as waste. Or you can bury it. Or you can freeze the placenta and then encapsulate it for use throughout the postpartum period.

(Some women say that taking capsules made from their own placenta helps them regulate their hormones quicker, avoid postpartum depression, and even boost milk supply. Studies haven’t proven these benefits, but that’s not to say they don’t exist.)

Cord Clamping

After your placenta has been delivered, at some point the umbilical cord will be clamped and cut. You get to choose how long this is delayed. It is common to wait until bonding and breastfeeding have happened for about an hour. Some women choose to have it clamped and cut sooner.

What happens in the first few hours after birth?

After you’ve had time to bond with and breastfeed your baby, you may choose to shower. Or you may choose to wait to shower for a day or two. I waited, at the suggestion of my midwife (to give myself time to heal a bit and avoid fainting).

Even after you are settled, your midwives still have work to do.

How long do midwives stay after a home birth?

Your midwives will likely stay for a few hours after your baby is born. Some may only stay for about one hour. Others may choose to stay much longer. Generally, you can expect your midwives to be with you for about two hours after birth.

They’ll wait for your placenta to be delivered, check your baby’s Apgar score, and stitch you up if needed. Then it’s their job to clean up

They’ll empty the birth pool and pack it away, if you used one. They’ll replace any mats or plastic coverings that got blood on them (like those on your bed or carpet). 

They will get rid of any garbage and put away their supplies.

They’ll also need to fill out a bit of paperwork – notes about labor and birth, mostly.

What about newborn tests and procedures?

In the hospital, your baby’s airways will be suctioned out as soon as they are born. Then he or she will likely be whisked to the other side of the room for bathing, measuring, and other procedures. Your baby will be returned to you with a diaper, hat, and blanket on.

Midwives usually take things a little slower and gentler.

Apgar Test, Measuring and Weighing, Bathing

There are some things that are important to do after birth – the Apgar test and measuring and weighing, for example. But the Apgar test can be done while your baby is on your chest. And measuring and weighing can wait a few hours; your baby won’t change much in that time.

Bathing is unnecessary for newborns. Birth fluids are sanitary and babies don’t need regular baths like adults do. Instead of a bath, just rub the vernix – that creamy white stuff – into your baby’s skin like lotion.

Eye Ointment

In the hospital, your baby will be given medicated eye drops unless you say otherwise. The ointment is given to help your baby avoid “conjunctivitis” – or pink eye – in their first month of life.

The most dangerous cause of this newborn pink eye is the sexually transmitted infection (STI) gonorrhea. But gonorrhea is no longer common in developed countries like America. And for those who do not have this STI, it is impossible for their babies to get pink eye through birth.

Beyond that, most pregnant women are screened for STIs (so you’d know if you had gonorrhea). And all forms of pink eye can be treated with antibiotics.

(For more information, go here.)

For these and other reasons, most home birth midwives do not usually administer eye ointment at birth.

Vitamin K

Vitamin K is important for newborns. New babies do not produce enough of their own vitamin K for about 6 months. And if vitamin K levels get low enough, internal bleeding can occur spontaneously and be dangerous or even fatal.

BUT. A shot of vitamin K is not the only option.

If you prefer to avoid shots for any reason, you can choose to give your baby vitamin K drops instead of the shot. Vitamin K drops – in the right amounts, over the correct amount of time – can be just as effective at protecting your baby from vitamin K deficiency bleeding as the shot.

To learn more, go to my blog post The Vitamin K Shot vs Vitamin K Drops: Pros and Cons.

Blood, Heart, and Hearing Tests and Footprinting

A few other procedures are typically done right after birth, whether in the hospital or at home: blood, heart, and hearing testing and footprinting. Footprinting helps to identify your baby and is a fun keepsake. It may not be super important but it is still normal procedure, even at home.

Blood testing is mandatory in the US and can only be refused on a religious basis. These tests can detect serious diseases and conditions that otherwise would not be known and, therefore, can be lifesaving.

The blood is collected by pricking your baby’s heel and collecting drops of blood on a special paper. Most care providers, including many home birth midwives, will do the blood testing 24-48 hours after birth.

Your midwives will also test your baby’s ears and heart to make sure hearing is normal and no heart defects are apparent.

Once your midwives are sure you and your baby are doing well, they will leave to let you rest.

What happens after the midwives leave?

Once the midwives leave, it’s time to rest. You’ve just done a hard thing and your body needs a break. Get some sleep, cuddle and breastfeed your baby, and just enjoy this time.

Obviously, you’ll need to pick a name at some point. You may have one in mind that your midwives can put on a birth certificate right away. Or you may want to take a few days to decide.

If you have older kids, you can have them come home (or come to your room) right away or you can wait a day or so. You make that call.

Most midwives will come back 24 hours after your baby is born to check on you both. This is when some midwives will do the blood testing.

About Visitors

Everyone is going to want to come see you and your baby. But don’t feel a need to rush into that. Of course, it is up to you how soon to let people come. But I recommend you protect those first few days and delay having anyone over.

Your newborn needs time to get used to life outside the womb. The fewer new faces there are, the less challenging that adjustment will be right off the bat.

Plus, newborns have weak immune systems and more people means more germs. (Breastfeeding babies have a leg up here – they can get antibodies from mom.)

And really, you’re not going to want to have lots of people over either. You need to rest physically, yes. But it can also be really overwhelming in those first few days – especially if this was your first birth – to socialize. 

You choose how to manage visitors. Just be mindful about it and set boundaries where you want and need them.

Conclusion: Prepared for What Happens After

To begin as we started, home birth has the potential to be an incredible experience for you. And now you are prepared not only for the birth, but for what happens after. Those first 24 hours after a home birth (and really any birth) can be a blur, but try to cherish them as much as you can.

Until next time,

Allison

P.S. Want to make sure you’re ready for postpartum? Check out How to Prepare for Postpartum: The Ultimate Guide.

Still wondering if a home birth is the right choice?

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