Birth Wishes: STEP SIX: After Birth

Step One:
http://www.medhelp.org/posts/GroupTrack-We-Want-a-Natural-Birth/Birth-Wishes-STEP-ONE-The-Opening/show/1475184
Step Two:
http://www.medhelp.org/posts/GroupTrack-We-Want-a-Natural-Birth/Birth-Wishes-STEP-TWO-Labor-Options/show/1476757
Step Three:
http://www.medhelp.org/posts/GroupTrack-We-Want-a-Natural-Birth/Birth-Wishes-STEP-THREE-Monitoring/show/1476796
Step Four:
http://www.medhelp.org/posts/GroupTrack-We-Want-a-Natural-Birth/Birth-Wishes-STEP-FOUR-Drugs-and-Pain-Relief/show/1479807
Step Five:
http://www.medhelp.org/posts/GroupTrack-We-Want-a-Natural-Birth/Birth-Wishes-STEP-FIVE-Delivery/show/1481385

Welcome to the Birth Wishes series where we are working together to write our birth plans. In this step I'll be mentioning some things you may want to consider for what happens immediately after birth. Because the main goal of this group is to have a natural birth those things will be emphasized but I will talk about other options you may want to consider in the event of induction or cesarean.

You've made it through labor and you've just pushed your beautiful new baby into the world! Now what? Does baby get whisked away to a warmer for measurements and shots and eye drops? Do you get to hold them right away? Does someone else give them their first bath? Who will cut the cord and when? A LOT happens immediately following the delivery of your baby to both you and to the baby.

Where does baby go?:
First thing first is to decide if you want baby cleaned off before you hold them or if you want to hold them immediately. Most women choose the latter but it's okay if you'd like for baby to be wiped off a little first or bathed (they may be covered in a thick, white substance called vernix and will have blood on them from your vagina). Most women want to hold their baby for an hour or more before weighing them or bathing them. Some women wish to massage the vernix into their babies skin to keep it soft and protected against irritants in fabric. Make your preferences known about when to hold baby, for how long and who will bathe your little one first. Also mention if you want to breastfeed that first hour or two, when baby is most alert (especially if you avoided drugs; if you ended up having something baby might be a little out of it) so that you can have help if you need it.

Cord Clamping and Cutting:
And then immediately after that is the choice to delay cord clamping or to have them cut the cord right away. There are many benefits to delaying cutting the cord. First, it is still providing baby with oxygen and antibodies for up to 5 minutes after birth. If that cord gets cut the moment they are born you're cutting off their oxygen supply before they've gotten used to breathing. Think of a diver coming up from the sea and someone pulling their oxygen before they've reached the surface to catch their breath. This can cause baby to be distressed and cry, still unable to breathe (when you cry hard it is difficult to catch your breath). The cord does not have to be cut immediately; in fact it doesn't have to be cut for several hours though only a few rare people wish to still have their baby connected to the placenta for so long especially when it's turning white and no longer providing anything to baby.

You'll also want to decide who will cut the cord. If you're a single mom you may want to cut it yourself or leave it up to the doc or midwife. If you're married or have a partner they may want to participate in this ritual and cut it themselves.

Placenta:
Baby is born and now in your arms you still have the third stage of delivery where you will deliver the placenta. Here's a point to keep in mind: many doctors may try to give you Pitocin to help you expel the placenta. Pitocin may also be administered if you begin to hemorrhage (this would be considered an emergency and should be a time you allow the administration of Pitocin if you've avoided it thus far). But so long as all is well you shouldn't need to have Pitocin; your body will deliver it. Some women deliver theirs five minutes after their baby is born and others 35 minutes after their baby is born. Don't let anyone pull on the cord, there's no rush. Make sure you let them know your feeling on Pitocin in order to expel the placenta; if you want it that's fine and if you don't they need to know.

Stitching:
Since this is a natural birth forum we'll assume you've just had a natural birth. If you've had any tearing that requires stitching they should give you a local anesthetic (just a little shot, much like what you get at the dentist's office) to numb the area. If they don't numb you up SPEAK UP! If you did end up having the epidural then you most likely won't feel this part unless it is wearing off. Let them know if you can feel it.


The next two posts will cover your preferences in the event of an emergency (cesarean) and the next will provide more information to provide postpartum that deal mostly with the care of your infant.

[hiltonvslohan]

if u choose that you want baby to be in the room at all times and not taken away will they still get a bath? can you or DH give baby first bath at the hospital?

[JoyRenee]

That is a choice you get to make, definitely. Most first-time parents are too nervous to do the first bath so a nurse may do it for them and let Mom and Dad watch. Other nurses may let Mom and Dad do it while they walk them through what to do. And other times parents just want to do it themselves.

The bath is actually a sponge bath and typically happens when you're still waiting to be moved to your recovery room (you may still be in the delivery room unless you have a LDR room; labor, delivery, recovery room). The nurse will carry your swaddled baby to the sink and wash their hair (I should get out pictures of my Zoë's first wash). For their body they usually just unwrap them and wash one body part at a time. Babies LOVE the hair washing. The body washing? Not so much! It's a bit chilly for them.

Newborns don't need to be bathed often at all. Mine only got an initial bath after birth and that was it at the hospital. You may be on an adrenaline kick and want to bathe them (you can always wait to do it later; doesn't have to be done right away whatsoever) or you may be so tired that you let the nurse go ahead and do it while you watch.

[JoyRenee]

P.S. The bath is almost always done in the mom's room, even if baby is not rooming-in all the time. So if you want to be present for it, even if someone else is giving it, you can totally be there!

[hiltonvslohan]

ok thank you :) i just atleast want to be there ya kno

[LACh1]

hi again - more questions sorry - As I have had to c-sections in the past we have not given my babies a first bath (other than initial wipe off) until the next day once I was able to get up and about.  Is this done straight away in a natural birth or whenever you feel ready and chose?

[JoyRenee]

LACh - I think this should always be up to the parents. Some hospitals are more restrictive and may say, "Hospital policy states baby must be bathed and cleaned up by hospital personnel within 2 hours of birth" or whatever. I just made that up but hospitals may have policies in place. BUT what people don't realize is that hospital policy is not law and with anything you have the right of refusal. Obviously no one wants a huge fight on their hands with the hospital so it's important to ask when you're on the hospital tour or to just call up and speak with someone about policies.

Most of the time the nurses don't mind. They have things they need to do, paperwork to fill out, etc. AND it is YOUR baby so you have a choice. So you can choose to do it right away (most natural birthers can get up pretty quick after birth; others need some time and may be shaky on their legs from exhaustion and hormonal rushes). Or you can let them know you'd prefer to bathe baby when you're ready. I don't think this will be a huge issue with most docs or nurses or especially midwives (many midwives do VBAC deliveries as well).