I want to share a story that often gets left out of most birth stories. It’s about the golden hour and newborn procedures that follow. For the purpose of this article we will assume it was vaginal delivery in the hospital, but all that follows is similar after a cesarean, with the exception that the newborn procedures are completed while your procedure is being completed.
Imagine, you just delivered your baby.
You pushed that last big push and out popped the baby. The care team you hired places your baby on your belly or chest depending on the length of the cord. You are exhausted, excited, enthralled, overwhelmed. You’re feeling all the feels. You and your partner kiss and cry and hug and admire your new little person.
While this is happening, it is typical that your provider will still be between your legs, either waiting for the 60 seconds to pass before delayed cord clamping or for the cord to stop pulsing or to turn white depending on what you have requested. Most providers in our area add a bag of Pitocin to the IV line or administer Intramuscular Pitocin to help the uterus start to contract back to its former size. This is optional and worth discussing the pros and cons with your doula and provider.
Someone will check your baby’s APGAR score at one minute and five minutes after birth.
They typically begin examining how well you faired through the experience. They will dab your vagina and labia with a cotton square to assess any tearing. They will also likely apply traction to the umbilical cord to see if the placenta is releasing, unless you tell them you don’t want this to be done. At some point you will either feel the urge or be directed to push again to deliver the placenta. Don’t worry, it’s soft and squishy and not at all like delivering the baby.
Everything is delivered. What’s left?
Next, they will begin any repairs that need to be done to your vagina or perineum. They will spray you with a topical numbing agent before giving you a shot of pain reliever. Stitches usually don’t take too long and while it can feel a bit uncomfortable, you are usually so enamored with your baby, you likely won’t notice too much.
During this time, your baby will likely be skin-to-skin with you and may start rooting around looking for a nipple. This is a great time to explore letting baby latch on if you plan to breastfeed. It can even help your uterus contract and reduce the risk of postpartum bleeding. Don’t worry if your baby isn’t ready right away, they will get hungry at some point.
A nurse or your provider will apply pressure to your uterus a number of times over the course of the next 24 hours to help release any blood clots and help the uterus contract. It’s uncomfortable. Try to stay relaxed and breath through it like you did contractions.
Time for the newborn procedures
For a bit the room will quiet and the majority of your birthing team will leave the room.
After about an hour, a nurse or two will arrive prepared for the newborn exam. During this exam your baby will be weighed, measured around the head and chest, and given any newborn medicines you opt for.
The newborn medical treatments include:
Erythromycin– better known as the eye goop. This is an antibiotic ointment used primarily to prevent the baby from contracting Gonorrhea or Chlamydia.
Vitamin K- a shot administered into the thigh. Vitamin K helps the blood clot. You can use vitamin K drops if you wish to avoid the shot or decline altogether.
Hepatitis B Vaccine- a shot administered to the thigh to prevent your baby from acquiring Hepatitis B, a blood born/ sexually transmitted disease. You will sign a waiver whether you choose to do this or not.
Metabolic Screening– This heal prick allows them to test for PKU among other metabolic disorders.
Within about an hour and a half, you, your partner and your new baby will be left to snuggle and enjoy your time as a brand-new family.
