Delivered…Now What?

If you’re on the homestretch of your pregnancy, you’re probably anxiously awaiting the moment when you finally get to hold your newborn in your arms. But what should you expect in the whirlwind of minutes and hours following the much-anticipated arrival of your baby?

The first five minutes. During the first minute of life, healthcare providers will conduct an Apgar exam to evaluate your baby. “The Apgar score is a quick assessment of the baby’s well-being immediately after birth. The baby’s skin color, heart rate, reflex irritability, muscle tone, and respiration (breathing) are all assessed at one and five minutes (sometimes longer if the first scores are abnormal) after birth,” says Dr. Terrie Thomas, OB/GYN at Woman’s Hospital.

A normal Apgar score ranges between 7 and 10. A score of 4 to 6 may mean that the baby requires oxygen and additional monitoring. Scores 3 and below demand emergency medical intervention.

Soon after delivery, babies receive Erythromycin eye ointment to prevent rare, but serious eye infections that can be passed from mom to baby during delivery. Newborns also receive Vitamin K, a vitamin that helps with blood clotting. Because they don’t produce enough of the vitamin on their own just yet, lack of the supplement puts infants at risk for anemia, excessive jaundice, or damage to internal organs, including the brain.

Meanwhile, if you’ve had a vaginal delivery, your ob/gyn team will oversee the delivery of the placenta and repair any tears to the perineum.

Many hospitals also try to ensure mom and baby get skin-to-skin bonding time in the first few minutes post delivery, even if only for a few minutes in the operating room following a c-section.

The first hour. If you require a c-section, you’ll spend the first several minutes postpartum in the operating room where the OB team will suture the uterus and the abdominal skin before transferring you to the recovery room.

Your baby will be most alert during the hour following delivery. You may be pleasantly surprised at how your newborn turns toward your voice and instinctively reaches to nurse.

“Newborns may be fed immediately after birth and most will ‘root’ or give signs to indicate hunger,” says Dr. Thomas. 

The first feeding will stimulate breast milk production and help the uterus contract, which can prevent excessive bleeding. Don’t expect you or your baby to get the hang of breastfeeding right away. Instead, be patient, it will take time for mom and baby to get comfortable.

Your breast milk won’t come in right away, but don’t worry. The colostrum that your breasts produce is usually enough for your newborn. Dr. Thomas adds, “Mothers may secrete colostrum until three to five days after birth when full breast milk lets down. Colostrum is the first milk that mothers secrete after giving birth. It is concentrated with nutrients and immune (infection-fighting) chemicals that are essential for a newborn.”

After the first feeding, you and your baby will be tired and ready to sleep. Newborns typically sleep anywhere from 16-20 hours per day and may be need to be woken up for a feeding.

Baby will also pass her first stool called meconium, which will be sticky and dark green or black in color.

First four to 12 hours. These days, most hospitals keep babies with their mothers rather than moving them to a nursery. The time together promotes mother-baby bonding, relaxation, and healing. You’ll begin to learn your baby’s cries and recognize feeding cues like hand sucking.

While some hospitals will bathe the baby soon after delivery, others wait until four to 12 hours after birth. “Newborns may be bathed (with parental consent) within the first couple of hours after birth if the body temperature is at least 98 degrees Fahrenheit,” says Dr. Thomas.

You may also notice your baby sneezing, but that doesn’t mean she’s sick. She’s simply clearing her nasal and respiratory passages of congestion and airborne particles.

You may experience physical pain from the delivery and mixed emotions. “Every mother experiences different levels of pain depending on individual pain tolerance, the type of delivery, and the type of pain relief that she receives during labor and childbirth. Many different forms of pain control are offered including oral pain medication, intravenous pain medication, and epidural anesthesia,” shares Dr. Thomas.

Up to 24 hours. Your pediatrician or family physician will conduct a complete physical assessment of your newborn, including blood type, bilirubin level, screening for rare genetic disorders, and a hearing screen.

Labor and delivery nurses, lactation consultants, and other healthcare providers will continue to provide you with support. A financial counselor, social worker and WIC nutrition consultant may also visit to provide resources that you might need before heading home. Of course, friends and family will be anxious to drop in too.

“At Woman’s Hospital, many mechanisms exist to ‘protect’ a new mother’s privacy. The Labor and Delivery nurse may, at the patient’s request, ask family members and other visitors to wait in the family waiting area until the mother requests their return after birth. Mothers may also request that the new baby’s siblings get a ‘first glimpse’ at the new arrival before all other visitors come into the delivery room. Expectant mothers may also request ‘confidential’ status upon admission. With confidential status, the only way a visitor or family member will know of the mother’s presence in the hospital is it the mother herself notifies the individuals,” says Dr. Thomas.

If you’d prefer to wait to see visitors, ask them to visit after the first 24 hours or ask your nurses to advocate for you.

Guests should refrain from visiting if they are sick since babies don’t have well-developed immune systems and are more susceptible to infection. Be aware that different hospitals have different security measures in place to ensure the privacy and safety of their patients. If possible, advise your friends ahead of time of your hospital’s visitor policies.

The first couple of days are strange yet magical for most mothers. Now you can be more prepared for the experience, though nothing can prepare you for the flood of love you will feel.

Words of wisdom
Be gentle with yourself. Listen to your body and your baby. Also, give yourself grace, you just delivered a baby!
Rest. When the baby sleeps, try to get some sleep for yourself.
Lean on your nurses. They are there to help, answer questions, and provide education that you need before you go home.

A Few Essentials for Your Hospital Stay
Comfortable, loose-fitting clothing (including maternity clothes)
Warm socks
Nursing bra or tank top
Car seat
Stocked diaper bag and going home outfit for baby
Hospital admission forms
Physician contact information
Insurance card, driver’s license, social security card
Paperwork for baby’s birth certificate, social security number and insurance
Phone and phone charger