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What Happens to Baby After Birth?

Are you wondering what happens to your baby right after birth? In this blog post you’ll learn about common newborn procedures and practices so that can decide now what you want and don’t want for your baby.

newborn umbilical cord being clamped

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Birth is one of the most unique, most life-altering experiences a woman will ever experience. Many women spend months preparing for it and then preserve it in photographs and birth stories for years to come. 

But what happens AFTER birth? Specifically, what happens to a baby right after birth?

That is the question I’m answering in this blog post.

Getting Informed and Being Intentional

Depending on where you give birth, it’s likely that the first few minutes of your baby’s life will be spent being whisked about getting cleaned and measured and receiving shots, tests, and other procedures.

The thing is, that makes for a pretty un-gentle beginning to life.

Each of the tests and procedures that providers do for a newborn baby has pros and cons. And each has the potential to affect your baby for more than the few seconds it’s being done.

That’s why I want to help you get informed about all the things your doctor, nurses, or midwives may want to do with your baby after birth – so that you can be intentional about choosing what you do and don’t want done.

Your baby can’t speak for him- or herself; you have to do it for them. So remember, a baby is a person, too. Everything they experience affects them, even what happens right after birth. You have the power to make sure their first few moments of life are happy ones.

Newborn Procedures After Birth

With that said, let’s go over each thing a newborn might experience right after birth. I’ll explain why each thing is done and what you need to know about it so you can make a truly informed choice.

Let’s get to it.

The Apgar Test

As soon as your baby is born, your doctor or midwife 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 mini tests help care providers know within seconds if a baby is doing well.

Your doctor or midwife 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

Clearing Airways

In the womb, a baby is surrounded by amniotic fluid. Because of this, a baby’s airways need to be cleared of fluids as soon as they are born so that they can start to breathe air.

Unsurprisingly, the design of the birth process takes this into account.

A baby who is born vaginally will typically have most, if not all, fluid expelled from their airways simply by the pressure of being squeezed out of their mother’s vaginal opening.

A baby born by c-section will need their airways suctioned out. 

In the hospital, doctors may suction every baby’s mouth and nose, even if he or she was born vaginally (even though studies and official recommendations clearly state it is unnecessary).

Resuscitation

Sometimes, a baby struggles to breathe after being born. This may be because of fluid in the airways or other causes. About 1 in 10 newborns will need some degree of help breathing or resuscitation.

Most of the time, a baby who is struggling will be able to breathe on their own after just 5 breaths given using a ventilation mask (like two awesome midwives explain in their blog post here).

If that isn’t enough to help the baby get going, there are practiced processes to follow until the baby begins to breathe. It is rare for a baby to need intensive resuscitation.

Even if your baby needs a little help breathing, most of the time it could be done while your baby is on or near you. In the hospital, they may not allow for this. But midwives out of the hospital will likely perform the needed resuscitation without taking your baby away from you.

Cord Clamping

Your baby is attached to you by an umbilical cord, which is attached to the placenta. After birth, the cord will be cut. Most doctors will cut the cord within a few minutes – if not seconds – of birth.

But have you heard about “delayed cord clamping”?

In more holistic care (with midwives, especially outside of the hospital), delayed cord clamping is the norm. Delaying clamping of the umbilical cord for several minutes, or even hours, allows plenty of time for the blood in the cord to finish flowing into your baby’s system.

It’s common for midwives to wait for the placenta to be born – and long after that, often – to cut the cord. The placenta may take just a few minutes or up to 30-60 minutes to be born.

Interestingly, one benefit of delayed cord clamping is that more oxygenated blood is flowing into your baby’s body. That extra blood and oxygen helps them make the transition to breathing outside of the womb and lowers the likelihood of needing resuscitation.

Other benefits of delayed cord clamping include:

  • 30% more blood volume in baby’s body to support life apart from mom,
  • less iron deficiency in infancy,
  • improved myelination (which improves brain function),
  • better motor and social development,
  • higher chance of survival for preterm babies,

And more. Plus, not cutting the cord means baby has to stay with mom (the cord is only so long!), which helps everyone remember where baby really should be.

When it comes to risks, people often talk about increased likelihood of jaundice (yellow eyes or skin) or polycythemia (too many red blood cells). But no studies have actually shown that delayed cord clamping increases the risk of either.

Skin-to-Skin and Bonding

The best situation for both baby and mom is immediate skin-to-skin to contact after birth, with no delays. Skin-to-skin time (and breastfeeding, which we’ll talk about next) promotes the release of oxytocin in both baby and mom.

For the mother, oxytocin helps the uterus to contract so that it can push the placenta out and prevent hemorrhaging. It also aids in bonding. Oxytocin helps you develop your maternal instinct and love for your new baby.

Other benefits of immediate skin-to-skin time after birth include:

  • 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 maternal stress and postpartum depression (for some women)
  • Providing for earlier initiation of breastfeeding

Next, let’s talk a little more about that last one on the list.

Initiating Breastfeeding

Breastfeeding is, without question, the best nutrition a baby can receive. A mother’s breast milk is formulated specifically for her baby and provides the perfect amount of nutrients and hydration. 

And that’s only one of the many benefits of breastfeeding!

The time right after birth can make a huge difference in how breastfeeding goes for you and your baby.

The sooner you try to initiate breastfeeding, the sooner your baby will learn how to latch and get the milk they need. And the sooner your body will start the process of meeting the demand!

Rooming in with your baby (rather than letting nurses take your baby to the hospital nursery) is also a great way to help breastfeeding get off to a good start. If you’re in the same room, you’ll be able to respond as soon as your baby starts to cue their hunger.

Plus, if your baby is with you, no one will have the chance to offer your baby a bottle rather than having you feed him or her.

If breastfeeding is important to you, make sure to specify that you don’t want any formula or sugar water given to your baby, no matter what.

If your baby is born prematurely and must be in the NICU, donor milk should be available so your baby can have breastmilk instead of formula even though they are not with you.

Bathing

When a baby is born, they are usually covered in a white, creamy substance called vernix. It is natural and sanitary and does not need to be wiped off. Actually, leaving the vernix on and rubbing it into your baby’s skin has benefits.

While the purpose of vernix isn’t fully understood, researchers have found that leaving the vernix on can provide these benefits after birth:

  • Protection from infection
  • Skin moisturizing, cleansing, and adaptation after birth
  • Temperature regulation
  • Wound healing

If your baby has any blood on them (because of a tear in your perineum, for example) they can be gently wiped off with a towel.

Your nurses in the hospital may offer to bathe your baby but you can tell them no if you don’t want them to.

Whether or not you decline a bath, your baby will likely be dried off and wrapped in a towel before being handed to you. Be sure to specify if you want the vernix left on and if you want your baby to not be wrapped up.

(You can have a blanket placed on top of your baby after they are placed on your chest, rather than the blanket being wrapped around them.)

Measuring

Of course, you and everyone else will want to know how much your baby weighs and how long he or she is. But really, those measurements don’t need to be taken right away. Your baby is not going to grow a significant amount in a few hours.

You have every right to ask that measuring be delayed several hours if you wish to.

Eye Ointment

In the hospital, babies are usually given medicated eye drops. As their mother, you can decline these eye drops if you want to.

Here’s what you need to know:

The ointment (usually erythromycin – pronounced uh-rih-thruh-my-sin) 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, so this isn’t a life or death thing.

It’s also important to note that receiving eye ointment at birth isn’t 100% effective. It sometimes fails to prevent pink eye. Plus, bacteria is becoming more resistant to the ointment making it less effective.

Another risk of these newborn eye drops is that they can cause irritation that looks like pink eye but isn’t actually. That can lead to antibiotics when none are actually needed.

Finally, when a baby receives drops of erythromycin, their vision is clouded for a little while, which may make it harder for you, as their parent, to connect with him or her.

(For more information about erythromycin eye ointment, go here.)

Hepatitis B Shot

Your newborn will likely receive two shots within a few hours of birth (unless you decline them). One is the vitamin K shot, which we’ll talk about next. The other is a vaccination against hepatitis B.

Hepatitis B is a viral infection of the liver. It can be short-term or long-term, with differing severities. There is a treatment for it, but most people who require treatment will need it for the rest of their life.

Hepatitis B can be fatal, though survival can be increased with treatment.

Hepatitis B is usually transmitted from an infected mother to her child during birth or through contact with body fluids of an infected person.

I am not a vaccination expert and I know vaccines are a highly controversial topic. For that reason, I have simply given you the facts. With this information and any other research you do, make your own decision as you feel is best for your baby.

Vitamin K

The other shot your baby may get after being born is an injection of vitamin K. Vitamin K is important for newborns because babies do not produce enough of their own vitamin K for about 6 months.

If vitamin K levels are too low, internal bleeding can occur spontaneously and be dangerous or even fatal. This spontaneous bleeding is called “vitamin K deficiency bleeding.”

That said, 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.

Footprinting

No matter where you give birth, your care provider will most likely take your baby’s footprints. Footprinting used to be important for identification reasons. Now, babies (in hospitals) are given ankle bands for ID reasons, but footprinting is still done.

In some states, footprinting is required.

Footprinting is often done with an ink pad that doesn’t leave residue on your baby’s feet. There are no risks to baby other than some mild discomfort in having their ankle grabbed and their foot pressed against the ink pad and then the paper.

Circumcision

If your baby is a boy, you will need to decide whether or not you want him circumcised. Circumcision is when a doctor removes the foreskin from a boy’s penis. Circumcision is a personal choice.

Most parents who decide to circumcise their boys do it for religious or cultural reasons.

Circumcision is generally safe, though it can cause pain and does carry some risk. It will usually be done within 48 hours of birth, if you want it done.

To learn more about circumcision, go here.

Newborn Screening (Heel Prick Blood Test)

In the US, newborn screening is mandatory (though it can be refused on a religious basis). This screening is a blood test done to check for serious diseases and conditions that otherwise would not be known and, therefore, can be lifesaving.

The blood is drawn by pricking a baby’s heel and collecting drops of blood on a special paper that is then sent to a lab for testing.

Most care providers will do this screening 24-48 hours after birth. In some states, your baby will need to be screened a second time when they are 2 weeks old.

Hearing Test

Your baby’s hearing will also be tested. Often this is done with a special machine. Little probes (like earbuds) are placed in your baby’s ears and measure the ear’s response when clicks or tones are played.

It is not painful and is important in ensuring your baby has normal hearing and will be able to interact with you and learn to communicate normally.

Your baby’s hearing will likely be checked at the same time the blood tests are done – 1 to 2 days after birth.

Heart Screening

Finally, your care provider will check your baby’s heart. This is usually done using something called a pulse oximeter. To do the test, the sensors of the pulse oximeter are placed on one of your baby’s feet and one of their hands. The sensors are attached to a monitor that checks the oxygen levels in your baby’s blood (usually over a period of a few minutes).

The main purpose of this test is to make sure your baby does not have a congenital heart defect. (About 1% of babies will have a heart defect.)

The test is safe and non-invasive – it just uses light and doesn’t penetrate your baby’s skin.

(By the way, that little clip that nurses put on your finger when you go to the doctor is also a pulse oximeter.)

Conclusion: Decide Now

There you have it – all the things your baby might experience right after birth. While what happens to your baby right after birth may not be top of mind during pregnancy, it is important to think about.

The more you understand about what usually happens, the more power you have to make intentional choices.

Knowing these things also gives you the chance to decide now, so it isn’t all new news after hours of labor when you don’t want to be making decisions like this.

With what you know now, you can be prepared to communicate exactly what you want – and don’t want – for your baby after birth. 

Whatever you decide, stick to it. This is your birth and your baby. This matters. Stay strong, mama.

Until next time,

Allison

READ MORE:

Medications During Labor: Is It Worth the Risk?

The Cascade of Interventions [Explained]

How to Prepare for Postpartum: The Ultimate Guide

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